Search published articles


Showing 15 results for Cesarean Section
Intrathecal Fentanyl Lidocaine combination for cesarean section: a randomized clinical trial
Raji B, Taheri F, Osia Sh,
Volume 65, Issue 6 (9-2007)
Abstract

Background: Spinal anesthesia can be associated with hemodynamic changes and some other complications. The aim of this study was to evaluate the effect of adding fentanyl to lidocaine on the spinal anesthesia time and its complications for cesarean section.

Methods: Sixty pregnant women with gestational age of 37- 42 weeks and ASA physical status I and II undergoing elective cesarean section under spinal anesthesia were enrolled in a randomized double blinded clinical trial. They were randomly allocated to receive spinal anesthesia with lidocaine-normal saline (LS: 75 mg lidocaine 5% with 0.3 ml normal saline) lidocaine-fentanyl (LF) group (75 mg lidocaine 5% with 50 μg fentanyl). The duration of initiation of sensory block to achieve T4 level, time to return of sensory level to T12, time to first analgesic request, ephedrine requirement, nausea and vomiting during and after the surgery, pruritus, respirator depression, headache and apgar score of the new born  at 1st and 5th minutes were assessed.

Results: There was no significant difference between time to achieve T4 level, ephedrine dose, post operative nausea and vomiting (PONV), pruritus and headache in study groups. Time to return of sensory level to T12 was significantly longer in LF group (152.6±14.7 vs. 66.2±11.2 min, P=0.0009). Time to first analgesic request was also longer in LF group (164.2±20.8 vs. 68.1±11.3 min, P=0.0009). The incidence of nausea and vomiting during surgery was significantly more in LF group (20% vs. 0%, P=0.023). No case of respiratory depression was observed in groups.The 1st and 5th minute's apgar score were comparable between groups and were between 7 and 10.

Conclusions: Addition of fentanyl to intrathecal lidocaine in patients undergoing elective cesarean section results in increasing of the block duration and time to first analgesic request without significant maternal or neonatal side-effects, without effect on 1st and 5th minutes apgar score  with increasing the incidence of during surgery nausea and vomiting.


Sexual satisfaction after child birth: vaginal versus elective cesarean delivery
Hantoushzadeh S, Shariat M, Rahimi Foroushani A, Ramezanzadeh F, Masoumi M,
Volume 66, Issue 12 (3-2009)
Abstract

Background: The perception of impairment of sexual function after childbirth in vaginal delivery (as a complication) makes pregnant women to request elective cesarean section. But this conception is more related to culture. Therefore we studied women's sexual health after childbirth to assess whether women who underwent cesarean section experienced better sexual health in the postnatal period than women with vaginal births.

Methods: A cohort study was conducted on 303 primiparous women who had delivered vaginaly and 315 primiparous delivered by elective cesarean section in seven private hospitals in Tehran, employing data of demographic characteristics like age, education, BMI, obstetric history (weight gain in pregnancy, history of pelvic pain and vaginal discharge), stress incontinence history (prepregnancy and during pregnancy) and effect of delivery on sexual satisfaction in several follow-ups until 12 months after delivery.

Results: Sexual satisfaction after delivery in vaginal group was significantly more than cesarean group. (76% vs 60%, p<0.0001). There was no relation between pelvic pain & delivery type (in several follow- up).

Conclusions: Instead of social conception of have more sexual satisfaction after cesarean delivery, outcomes from this study provide no basis for advocating cesarean section as a way to protect women's sexual function after childbirth. Therefore Request of cesarean section by mother for having more sexual satisfaction after childbirth is not logic.


Sagittal venous sinus thrombosis after cesarean section: a case report
Farideh Keypour , Ilana Naghi ,
Volume 71, Issue 4 (7-2013)
Abstract
Background: Cerebral venous thrombosis (CVT) is uncommon after cesarean section. Although it can be a leading cause of maternal mortality. CVT may occur during pregnancy because of hypercoagulable states such as preeclampsia, thrombophilias, antiphospholipid antibody syndrome and sepsis.
Case presentation: A 31 years old woman G2 Ab1 at 37 weeks gestational age with  premature rupture of membrane underwent cesarean section because breech presentation and preeclampsia. Spinal anesthesia was done for emergent cesarean section. On the second day after cesarean section, she developed headache, vomiting, focal neurologic deficits, paresthesia, blurred vision. Brain magnetic resonance imaging (MRI) showed thrombosis in anterior half of superior sagittal sinus. Treatment consisted of anticoagulation. 
Conclusion: Thrombophilias, pregnancy-related hypertension and cesarean section are the predisposing factors for thromboembolism. Unfractionated heparin and low molecular weight heparin (LMWs) are effective drugs for thromboprophylaxis. It is vital to prevent venous thrombosis to reduce mortality during both intrapartum and postpartum periods. Consideration of cerebral venous thrombosis in similar cases is recommended.

Outcomes of vaginal delivery and cesarean in Mashhad Ghaem University Hospital
Hassan Boskabadi , Maryam Zakerihamidi , Fatemeh Bagheri ,
Volume 71, Issue 12 (3-2014)
Abstract
Background: Normal vaginal delivery is the best method of delivery. Vaginal delivery is followed by the best pregnancy outcomes. Reducing the rate of cesarean delivery has been a health goal for the United States with economic and social advantages. This study has been conducted with aim of maternal and neonatal outcomes of Normal Vaginal Delivery (NVD) and comparing with cesarean delivery. Methods: This descriptive- analytic study was conducted in Ghaem University Hospital in Mashhad during years 2007 until 2013. Five hundred thirty six full term infants aged 3- 14 day, born either by NVD as control group or cesarean delivery as case group par-ticipated in this study. Sampling was a convenient method. The data in questionnaire containing maternal information (maternal age, mode of delivery, maternal weight, du-ration of delivery, duration of maternal hospitalization, let down reflex, breast feeding status) and neonatal information (age, sex, Apgar score, urination frequency and defe-cation frequency) were collected by a researcher. Results: According to the findings of this study, the infant’s age (P=0.425), admission weight (P=0.278), jaundice access (P=0.162), urination frequency (P=0.165), maternal weight (P=0.869) showed no statistically significant difference between two delivery methods. Time of the first breast feeding after childbirth (P=0.000), defecation fre-quency (P=0.000), maternal age (P=0.000), maternal parity (P=0.003), duration of de-livery (P=0.000), duration of maternal hospitalization (P=0.025), feeding position (P=0.029), let down reflex (P=0.012), mastitis (P=0.025) and breast problems (P=0.027) showed statistically significant difference between the groups. It means defecation frequency, duration of maternal hospitalization, Apgar score, mastitis and breast problems were more in cesarean group, but early breast feeding after delivery, duration of delivery, proper breastfeeding position and let down reflex were more in NVD group. Conclusion: The results of this study showed in comparison with cesarean delivery, normal vaginal delivery provides better outcomes in terms of breast problems, breast feeding status, duration of labor and duration of maternal hospitalization for both mother and infant. So, adopting careful instructions in management and administration of deliveries will help the prevalence of making decisions for normal vaginal delivery and the recovery of delivery outcomes.
Vitamin D deficiency and mode of delivery: a study in Tehran Women General Hospital
Mojgan Asadi , Farzane Saeidifard , Mostafa Qorbani , Khadijeh Adabi ,
Volume 73, Issue 6 (9-2015)
Abstract
Background: Vitamin D deficiency is a widespread problem especially in the developing countries like Iran. The prevalence of vitamin D deficiency differs from moderate to severe among Iranian women, particularly among pregnant women, and it can cause some problems such as preeclampsia, gestational diabetes mellitus (GDM), premature labor and primary cesarean section. The aim of this study was to evaluate whether the mode of delivery is related to serum vitamin D levels or not and if there is any difference in the percentage of cesarean section between vitamin D-deficient and vitamin D-insufficient women. Methods: This cross-sectional study was carried out between the April 2012 and April 2014 in a woman university hospital, Tehran, Iran. One hundred and eighty-six women aged between 17 and 52 years old (Mean age 28.46 and SD5.97) were surveyed in this study. The study group comprised of (N=186) consecutive cases attending Tehran Women General Hospital Clinic for normal vaginal delivery or cesarean section. Women who underwent cesarean section due to previous cesarean delivery were not recruited for the study. The participants were divided into two groups: women with vaginal delivery and women with cesarean section. Serum vitamin D concentration (25(OH) Vitamin D) was measured for each patient. Concentration of serum vitamin D was compared between these 2 groups. Results: One hundred and twenty-eight (68.8%) women had cesarean section and 58 (32.2%) had vaginal delivery. Median and inter-quartile range (IQR) of serum 25(OH) D were 13.64 and 12.47 ng/ml respectively, among women with cesarean section, compared to 11.68 and 12.59 ng/ml in those with vaginal delivery. No statistically significant difference was detected in serum vitamin D between these 2 groups (P=0.72). In addition, no statistically significant difference was detected between women with vitamin D deficiency and women who were vitamin D insufficient (P=0.8). Conclusion: In this study, there was no association between serum vitamin D levels and delivery mode.
Effectiveness of community based intervention on improvement of pregnancy and delivery process in district 4 of Tehran
Mamak Shariat , Farnaz Ehdaeevand , Mahasti Ataie , Zahra Karami , Leila Hadipoor Jahromi Hadipoor Jahromi, Zahra Farahani ,
Volume 73, Issue 7 (10-2015)
Abstract

Background: To reduce cesarean section rate, we need complex interventions to modify related behavior. We aimed to identify the effectiveness of a community-based intervention on prenatal care status, delivery and decline of cesarean section rate. Methods: A quasi-experimental study was carried out on mothers residing in Khak Sefid and Javadiyeh in Tehran from January 2011 to September 2014. Study population was 274 mothers attending in health centers for first vaccination of their neonates. Mothers' demographic data were recorded in some questionnaires. One year interventions including consultation, distribution of educational package and training courses (for mothers, fathers and their families, educational programs for midwives, obstetricians and gynecologist, residents, medical students), accomplishment of 10 steps baby-friendly principles and provision adequate personnel in labor-delivery room were implemented in community, hospitals and health centers. After intervention, 250 mothers who were attending in health centers for vaccination of 2 months aged neonates were assessed and their data were recorded in the same questionnaires. The effectiveness of intervention on cesarean section rate and cesarean tendency in before and after intervention groups were compared. P< 0.05 was considered as level of significance. Results: Of 274 mothers in "before intervention" group 193 (70.44%) and of 250 mothers in "after intervention", 169 subjects (67.6%) had cesarean section. Although a significant decline was seen in cesarean tendency in "after intervention" group (P= 0.034), no significant difference was seen between 2 groups' cesarean section rates (P= 0.48). In "after intervention" group episiotomy, induction of labor rate and maternal morbidity were significantly lower than "before intervention" group (P= 0.0001, 0.0001, 0.01). Although no significant difference was seen between two groups neonatal birth weight (P= 0.69), a significant difference was seen between two groups' gestational age (P= 0.007). Conclusion: After intervention, in spite of no decline in cesarean section rate, NVD tendency and morbidity rate were raised and improved respectively. It seems that cesarean section rate was influenced by other important factors.


Surgical staples compared with subcuticular suture for skin closure after cesarean delivery: a randomized controlled trial
Sahar Assadi , Haleh Ayatollahi , Javad Zeynali , Zahra Yekta ,
Volume 73, Issue 12 (3-2016)
Abstract

Background: Cesarean delivery is the most common surgical procedure and this prevalence is on the rise. Given these trends, cesarean wound complications, such as disruption or infection, remain an important cause of post-cesarean morbidity.

Methods: We conducted a single-center randomized controlled trial that included women with viable pregnancies (≥24 weeks) undergoing cesarean delivery at Motahary University Hospital, Urmia, Iran from April to November 2014. All cesarean types were included: scheduled or unscheduled and primary or repeat cesareans. Women were excluded for the following reasons: inability to obtain informed consent, immune compromising disease (e.g. AIDS), chronic steroid use, diabetic mellitus and BMI≥30. Of 266 women, 133 were randomized to staples and 133 women to suture group.

Results: The mean±SD age of the staples group was 27.6±5.4 years and mean±SD age of suture was 28.7±5.9 years. Multiparity is the most frequent in both groups that by using Chi-square test, no significant differences were observed between the two groups (P=0.393). The most frequent indication for cesarean section in both groups was history of cesarean section in staple 40 cases (30.1%) and suture 32 cases (24.1%). The survey was conducted using the Chi-square test was not significant (P=0.381). Pain at 6 weeks postoperatively was significantly less in the staple group (P=0.001). Operative time was longer with suture closure (4.68±0.67 versus 1.03±0.07 minute, P<0.001). The Vancouver scale score was significantly less in suture closure (6.6±0.8 versus 7.5±0.9, P=0.001). Wound disruption was significantly less in suture closure (3.8% versus 11.3%, P=0.017).

Conclusion: The staple group had low pain and operation time but had a significant wound disruption and scar. The patients who have suffered a significant wound disruption were affected by age (P=0.022) and BMI (P=0.001) at compared those who were not affected by factors such as age or high BMI as risk factors for open surgical wound.


The effect of listening to Quran on umbilical cord cortisol level during caesarean section under spinal anesthesia
Shiva Rafati , Hajie Borna , Fateme Hajebrahim Tehrani , Seid Mohammad Bager Akhavi Rad, Zahra Abdolla Poor,
Volume 74, Issue 2 (5-2016)
Abstract

Background: Surgery and pain increases cortisol levels with inducing hormonal responses. By reducing stress, adverse effects of cortisol can be controlled and accelerated the healing process. Religious practices like listening to Quran have important roles in reducing anxiety. Moreover, the level of cortisol hormone of the blood is one of the best indicators of the stress level. The aim of this study was to investigating the effect of listening to Quran on the plasma cortisol level of the umbilical cord in cesarean with spinal anesthesia.

Methods: A clinical trial study was designed and conducted on sixty primigravid mothers who were hospitalized to deliver their first baby by elective caesarian operation, 30 of them were selected as intervention group and 30 of them were selected as control group. For the subjects of the intervention group, the personal information questionnaires were completed and their vital signs were recorded. Also, their blood was sampled for measuring cortisol level. Then they listened to Quran. After spinal anesthesia, vital signs were recorded and the blood of umbilical cord was sampled for measuring the cortisol level. For the subjects of the control group, all the steps were done except listening to Quran. Two groups were statistically homogenous in the variables of age, gestational age, systolic blood pressure and diastolic blood pressure, pulse rate and cortisol levels before the intervention. The mean and SD cortisol in intervention group before and after listening to the Quran were 39.08±10.71 versus 41.10±5.05.

Results: The reduction of cortisol level of the intervention group (who listened to Quran) was significantly greater than of the control group P=0.035. Systolic blood pressure of the intervention group in the operating ward had statistically significant reduction relation to the systolic blood pressure before operation P=0.043. However systolic blood pressure of the control group in the operating ward had not statistically significant reduction relation to the systolic blood pressure before operation P=0.357. Listening to Quran has no effect on diastolic blood pressure and pulse rate.

Conclusion: Listening to Quran before caesarean affects the change of plasma cortisol level and the systolic blood pressure.


The effect of aminophylline on prevention of post-spinal anesthesia headache in patients undergoing elective cesarean section: a randomized clinical trial
Bahman Hasannasab , Nadia Banihashem , Shahram Seyfi , Manizheh Yazdanmehr ,
Volume 76, Issue 6 (9-2018)
Abstract
Background: The post-dural puncture headache (PDPH) is a common complication in spinal anesthesia. Headache may occure seven days after dural puncture. The headache may be worsened in sitting position and be better in supine position. PDPH is common in younger and tall people. The incidence rate of PDPH related to the size of spinal needle and the number of try and decrease with small, cutting needle and less puncture try. PDPH is a well-known iatrogenic complication of spinal anesthesia, which continues to be a major problem. In this study, we assessed the effect of intravenous aminophylline on prevention of post-spinal anesthesia headache in who were elective for cesarean sections.
Methods: This double-blind randomized clinical trial was conducted on 140 women with 18 to 35 years old and American Society of Anesthesiologists Classification (ASA Class) I and II undergoing spinal anesthesia in elective cesarean section. Patients were randomly divided into two groups called case and control. After umbilical cord clamping 1 mg/kg aminophylline dissolved in 100 cc normal saline was infused to the case group but only 100 cc normal saline was infused for the control group. Patient's blood pressure and heart rate were recorded before spinal anesthesia, immediately after spinal anesthesia, after uterine incision and umbilical cord clamping, after drug injection and then every five minutes. The incidence of headache was assessed at 4, 8, 24, 48 and 72 hours after the surgery.
Results: Although severity and duration of headache in case group was more than in control group, no meaningful difference was found between two groups. The mean changes in systolic blood pressure were greater in control group (P<0.001). The mean changes in heart rate was greater in case group than control group (P<0.001).
Conclusion: This study showed that intravenous aminophylline although, caused hemodynamic changes in some case, but it doesn't have any effect on prevention of incidence and severity of post-spinal anesthesia headache in elective cesarean section.

Effective factors to select cesarean-section
Hamideh Pakniat , Razieh Akbari ,
Volume 76, Issue 7 (10-2018)
Abstract
Background:  A significant increase in cesarean section in worldwide is known as one of the health system problems. The WHO has estimated that cesarean section in recent years has been 10% in all countries. Despite the increasing popularity of cesarean section, the literature lacks insights about factors affecting the selection of this delivery method. In this vein, this study investigates the factors affecting the choice of cesarean-section from the perspective of pregnant women.
Methods: The sample of this descriptive and analytical study is 200 pregnant women selected using simple random sampling method in Kosar Hospital in Qazvin Province, Iran. The survey questionnaire was used for data collection from March to September of 2017. In order to evaluate the validity and reliability of the research, expert’s opinion and Cronbach alpha coefficient have been used. The questionnaire included scales designed to measure effective factor. Statistical package for social science software (SPSS) version 22 (SPSS Inc., Chicago, IL, USA) were used to analyses the data. T-test and ANOVA were used to compare groups.
Results: The results of prioritizing the items in terms of psychological factors showed that the statements “I am afraid of the pain of normal labor” and “I feel higher stress and anxiety with natural labor were the first priorities”. There was no significant difference between pregnant women who had previous experience and those who did not have a delivery experience. The results of the mean comparison test showed no significant difference between the attitudes of women with previous delivery experience and women who did not have a delivery experience. There were only differences between socio-cultural factors (P= 0.004), factors related to delivery conditions (P= 0.001), consequences of delivery (P= 0.017) among pregnant women with different levels of training.
Conclusion: The results of this study revealed that there is a difference between the attitudes of pregnant women and different levels of education, so pre-pregnancy training should be provided to pregnant women.

The effect of promethazine on intrathecal morphine-induced pruritus in caesarean section patients
Arman Taheri , Mohammad Hosseini , Hossein Chaychi Nakhjir ,
Volume 76, Issue 9 (12-2018)
Abstract
Background: Adding morphine as adjuvant intrathecal drug for cesarean section is a gold standard for post-operative analgesia according to literature, but because of frequent incidence of nausea, vomiting and pruritus, it has limited popularity. Various mechanisms have been demonstrated for the opioid-induced pruritus, with a variety of medications with different mechanisms of actions for prevention and treatment. The aim of this study was to determine the effect of intramuscular promethazine on intrathecal morphine-induced pruritus after cesarean delivery.
Methods: In a retrospective descriptive-analytical study, recorded data of two thousand American Society of Anesthesiologists (ASA) I or II women undergoing elective cesarean delivery at the Bahman Hospital of Tehran, Iran, during the period of 2008 to 2013 were reviewed. Participants were divided into two groups of one thousand for each theme; the initial group underwent spinal anesthesia by employing intrathecal morphine as part of a standard anaesthetic regimen without prophylactic administration of promethazine, the subsequent group received 25 mg intramuscular promethazine after intrathecal drug administration. The incidence and severity of pruritus (absent, mild, moderate or severe) and intensity of pain using numeric rating scale (NRS) and also the incidence of nausea and vomiting were examined as main variables. All data were analyzed using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and P values of less than 0.05 were considered as statistically significant.
Results: The incidence of nausea (P=0.025) and vomiting (P=0.046) was different in two groups; with statistical significance. The mean score of pain according to numeric rating scale (NRS) was similar in both groups (P=0.46). The frequency of pruritus was statistically similar in both groups, (P=0.302); but the severity of itching showed statistically significant difference between two groups (P<0.001).
Conclusion: The severity of pruritus was significantly reduced by intramuscular administration of 25 mg promethazine, shortly after spinal morphine administration but it was shown to be ineffective to reduce the incidence of pruritus. Also, the incidence of post-operative nausea and vomiting (PONV) was less by intramuscular promethazine application.

Optimizing outcome of cesarean hysterectomy by performing placental imaging: a case report
Soheila Aminimoghaddam , Setare Nassiri , Fatemeh Chegini ,
Volume 77, Issue 7 (10-2019)
Abstract
Background: Abnormal placental invasion in pregnancy is one of the most important dilemmas in gynecology and obstetrics medicine and because of the high potential risk of life-threatening massive bleeding, it has been considered as one of the most important causes of maternal morbidity and even mortality. According to the fact that previous cesarean section is the most highlighted and well-known risk factors for developing these types of abnormal placental invasion, and despite comprehensive recommendations for decreeing of this kind of surgery, the rate of caesarian delivery is raising worldwide, detecting the safer methods of management for optimizing the outcome is mandatory.
Case Presentation: In this report, we are discussing a patient in Firoozgar Hospital, Tehran, Iran, with twin pregnancy accompanying with placenta previa with abnormal invasion, which has got the best possible outcome after performing a multidisciplinary approach without any need to blood transfusion or general anesthesia during cesarean hysterectomy as the standard management of placenta increate. In this case, we have performed magnetic resonance imaging (MRI) before surgery. We found out that we can use the exact site of placental margin and the distance between placental margin and uterovesical junction. So we have done the uterine incision horizontally without damaging to the placenta. Generally, Doppler ultrasonography has enough accuracy for detecting all kinds of placenta creates.
Conclusion: By selecting a safe uterine incision, we can prevent such a sudden and massive bleeding during the operation and also avoid occurring end-organ damage due to hemorrhage for instance, acute tubular necrosis, disseminated intravascular coagulation resulted in maternal morbidity and mortality. In this report, we also discuss the points needed for management and treatment of abnormal placental invasion by reviewing the recent literatures.

Effect of sublingual Misoprostol in combination with oxytocin in reducing blood loss during and after cesarean delivery: a randomized clinical trial
Masoumeh Mirteimouri, , Farideh Akhlaghi, Roya Jalali Bajgiran,
Volume 78, Issue 6 (9-2020)
Abstract
Background: One of the main causes of maternal death in developing countries is postpartum hemorrhage. Cesarean section is one of the most common surgeries all around the world. In comparison with normal vaginal delivery, cesarean section is a greater risk factor for postpartum hemorrhage and need for blood transfusion. The risk of postpartum hemorrhage will increase when other risk factors such as multiple pregnancies, polyhydramnios, severe preeclampsia, peripartum hemorrhage, protracted labor, labor induction, and obesity are present. Oxytocin is conventionally used for the prevention of uterine atony during the cesarean section. The aim of this study was the evaluation of the effect of sublingual misoprostol in combination with oxytocin in reducing blood loss during and after cesarean delivery.
Methods: This randomized clinical trial was performed in Ommolbanin hospital; an academic hospital that is affiliated to Mashhad University of medical sciences from September 2016 to January 2018. The subjects were 90 pregnant women with a term pregnancies who were candidates for emergent cesarean delivery under spinal anesthesia and were at high risk for postpartum hemorrhage. All participants received 40 IU oxytocin in 1 liter of normal saline after delivery, and then they were randomly assigned to the intervention group who received 400 μg sublingual misoprostol in combination with oxytocin infusion, and the control group who received only oxytocin infusion without adding misoprostol.
Results: Sublingual misoprostol in combination with oxytocin infusion during cesarean section led to a significant decrease in postoperative blood loss for six hours after the surgery (P<0.001). The decline in the hemoglobin and hematocrit levels and the amount of intraoperative hemorrhage were the same in both groups. Less additional uterotonic agents were needed in the misoprostol group. The frequency of fever and other side effects were similar in the two groups.
Conclusion: It seems that adding sublingual misoprostol to oxytocin infusion among high-risk women for postpartum hemorrhage is more effective for reducing blood loss during and after cesarean section.

Successful cesarean section in a woman with coronavirus and scleroderma: a case report
Shamsi Zare, Payman Rezagholi,
Volume 80, Issue 7 (10-2022)
Abstract
Background: The incidence of adverse perinatal outcomes including increased risk of miscarriage, preeclampsia, preterm birth and stillbirth is higher in pregnant women with coronavirus. Pregnant women who are infected with the coronavirus have placentas that are abnormal compared to the placentas of healthy women. Examples of these adverse effects have been observed before and include reduced fetal growth, pre-eclampsia, premature birth and stillbirth. Scleroderma is an uncommon connective tissue disease and its most obvious manifestation is skin fibrosis. Patients may also have involvement of visceral organs, as a result, their digestive system, kidney and heart are affected. Scleroderma also exacerbates miscarriage, fetal growth retardation, intrauterine fetal death, and preterm delivery. Pregnant women with these problems need special measures, so this study was performed to report a successful cesarean section in a woman with coronavirus and scleroderma.
Case presentation: The patient was a 31-year-old pregnant woman with a gestational age of 29 weeks who presented to Sanandaj Besat Hospital in November 2021 with symptoms of shortness of breath and dyspnea. HRCT-positive, PCR-positive, bilateral pleural effusion, and pulmonary dilatation corona were diagnosed. Due to 3 liters of vaginal bleeding and diagnosis of Décollement 60% and severe preeclampsia underwent emergency cesarean section. The live baby was born weighing 1300 g with Apgar 7. During surgery, he received 3 units of FFB and 3 units of Cryoprecipitate. Microcalcifications and fibrin thrombi were reported in the pathology of intermittent nodules. The diagnosis and treatment of this patient has significant points that are mentioned below.
Conclusion: Complications of pregnancy and childbirth in pregnant women infected with Corona virus include an increase in premature birth and an increase in the rate of cesarean section. Pregnancy in women with scleroderma at the right time and careful delivery monitoring will increase the probability of successful pregnancy outcome and all patients need counseling.

Assessment of success factors in normal vaginal delivery in late term pregnant women
Sargol Movagharnejad, Maryam Javadian , Hoda Shirafkan, Shahla Yazdani,
Volume 80, Issue 8 (11-2022)
Abstract
Background: The aim of this study was to find the causes of failure of natural childbirth in late-term pregnancy that can be useful for managing childbirth in these pregnant mothers and to design a solution to increase natural childbirth.
Methods: This cross-sectional study was conducted in the community of pregnant women with a late-term pregnancy of more than 41 weeks. The studied sample includes 148 pregnant mothers who were referred to Ayatollah Rouhani Hospital in Babol from March 2018 to February 2020. Mother's age, Body Mass Index, gestational age, number of pregnancies, number of deliveries, length of hospitalization, the state of the cervix and preparation method of the cervix for termination of pregnancy were extracted and recorded from patients' files. Data were compared in two groups of pregnancy termination methods (natural childbirth and cesarean delivery). Statistical analysis was done using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and Chi-square test and Student’s t-test statistical tests and logistic regression model fitting. P-value less than 0.05 was considered significant.
Results: In this study, 167 pregnant women with late-term pregnancy were studied. The age of pregnant women is reported with mean of 26.03 and standard deviation 5.98 of years. The high Bishop variable, with odds ratio of 0.44, is a variable protective factor for cesarean delivery (P=0.001). Higher body mass index with odds ratio of 1.09, is also known as a risk factor for cesarean delivery (P=0.01), so that for each unit of increase in Bishop score, the chance of cesarean delivery decreases by 56% and for each unit of increase in body mass index, the chance of cesarean delivery increases by 9%.
Conclusion: This study showed that nearly half of cases of late pregnancies lead to normal delivery. High body mass index reduces the chance of normal delivery in late term pregnancies. But a higher Bishop score can be effective in the success of natural delivery.

Page 1 from 1     

© 2024 , Tehran University of Medical Sciences, CC BY-NC 4.0

Designed & Developed by : Yektaweb