Early Physiotherapy Rehabilitation after Lower Segment Cesarean Section Delivery | Chapter 7 | Medical Science: Trends and Innovations Vol. 12

Lower segment cesarean section (LSCS) is one of the common modes of delivery carried out nowadays to prevent complications during a normal delivery. It is a life-saving surgery for the mother and the child. LSCS is a surgical procedure wherein the abdominal wall and the uterus are incised to deliver the child. The recovery of a patient after LSCS is difficult and slow compared to that of a normal delivery due to mobility restrictions due by the scar and the incision. The functional capacity of the patient also gets limited due to incisional pain. Physiotherapy is a useful tool to hasten and enhance the recovery of such patients. Generalized physiotherapy protocols for patients after LSCS are available in the literature. However, there is a lack of evidence of personalized protocols to date. Hence, this chapter aims to explain how to form a personalized early physiotherapeutic rehabilitation for LSCS patients.

 

Author (s) Details

Tushara Nair
College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, India.

 

Chakshu Mehta
College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, India.

 

G.P. Kumar
College of Physiotherapy, Sumandeep Vidyapeeth Deemed to be University, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v12/4967

Changing Trends in Indication of Cesarean Section: A Case Study of a Tertiary Care Centre of Central India | Chapter 13 | Advancement and New Understanding in Medical Science Vol. 9

Background: Cesarean section is the most common major surgical procedure performed in obstetrics. There is increase in the rate of Cesarean section in both developed and developing countries. This study was carried out to find the rate of Cesarean section (CS) in our institute from 2012 to 2016 and also to find any change in the indications of CS over these five years.

Methods: A retrospective analysis of data was done from the records of the patients who underwent CS and the rate of Cesarean section and the indications were noticed. Year-wise data of cesarean section and vaginal deliveries was recorded and the rate of cesarean section in each year was calculated. Data was collected from labour register and operation register and the results were summarized in percentages and proportions.

Results: The rate of Cesarean section has increased from 43.85% in 2012 to 48.18% in 2016. There is increase in the number of Primary Cesarean cases from 61.8% in 2012 to 68.4% in 2016.The percentage of Elective CS has increased in last five years from 10.2% in 2012 to 23.6% in 2016 which is due to the drastic increase in Elective Repeat CS from 13.3% in 2012 to 43.4% in 2016. The first and second major indication of Primary CS over the years remained the same i.e. fetal distress and CPD. Other major contributing indications were Non-progress of labour, failed induction and Malpresentation. Oligohydraminos and IUGR, Multiple pregnancy and precious pregnancy have emerged as the major indication in last three years. Previous CS and Previous 2 CS contributed as the main indication for Elective CS. The CS rate in 2015-16 was 50.5% which is high due to increase number of cases referred from periphery.

Conclusions: There is increase in the rate of Cesarean section not only in India but globally also. However, the rate of Cesarean section need to be reduced. The overall main indication for CS was Previous CS and thus Primary CS rate should be reduced. Fetal distress being the main indication for Primary CS should be further confirmed by fetal scalp pH findings and Repeat CS cases should be given more trial of labour.

Author(s) Details:

Pooja Patil,
Department of Obstetrics and Gynecology, L. N. Medical College, Bhopal, Madhya Pradesh, India.

Malini Bhardwaj,
Department of Obstetrics and Gynecology, L. N. Medical College, Bhopal, Madhya Pradesh, India.

Priyanka Sharma,
Department of Obstetrics and Gynecology, Sita Devi Hospital, Jaipur, Rajasthan, India.

Garima Chandrakar,
Department of Obstetrics and Gynecology, L. N. Medical College, Bhopal, Madhya Pradesh, India.

Please see the link here: https://stm.bookpi.org/ANUMS-V9/article/view/13638

A Comparative Study on the Effect of Low-Dose Ketamine Versus Dexamethasone Versus Placebo on Intraoperative Nausea and Vomiting During Cesarean Section under Spinal Anesthesia | Chapter 14 | Advanced Concepts in Medicine and Medical Research Vol. 6

 Qualification and Objectives: Intraoperative Sickness in stomach and Vomiting (IONV) can be upsetting for patients, obstetricians, and anesthetists, and it can increase the risk of visceral harm during medical procedure due to involuntary unrestrained abdominal motions. This study aimed to equate the antiemetic efficacy of depressed-dose Ketamine versus Dexamethasone in lowering the incidence of IONV all along Cesarean Section (C/S) under sleep-inducer anesthesia.Materials and Patterns: The study included 135 entire-term parturient daughters, aged middle from two points 18 and 40 years, who were applicants for cesarean section under sleep-inducer anesthesia in the room for surgery. The participants were randomly assigned to three groups using a randomized obstructing method. Group I (n = 45) taken 8 mg Dexamethasone with a total syringe book of 5 ml, while group II (n = 45) received 20 mg Ketamine with a total syringe book of 5 ml, and control group III (n = 45) received 5 ml usual saline. An anesthetist, confuse to the drug administered to the patient, written the number of nausea, retching, and disgorging episodes all the while the intraoperative period. Intraoperative hypotension and bradycardia were too recorded. The patients were requested to report any syndromes of nausea, disgorging, and shivering that happen at intervals. Vomiting was trained by administering Metoclopramide 10 mg moderately intravenously. A standardized surgical method was used as a whole cesarean sections. Mathematical analysis was acted using the Mathematical Package for the Social Sciences rendition 21 program (SPSS21).Results: The study included 135 pregnant women detached into three groups, with 45 appendages in each group (the first group received Dexamethasone, the second and third groups taken Ketamine and Placebo, individually). The average age was 30.35 ± 5.94 years in the Dexamethasone group, 29.97 ± 6.18 age in the Ketamine group, and 29.6 ± 6.03 years in the control group (P = 0.840). The study erect a statistically insignificant increase in the rate of successful stop of IONV (P = 0.062) and shivering (P = 0.550) utilizing preoperative Ketamine and Dexamethasone. However, skilled was a statistically significant decrease in the rate of IONV in the Ketamine group compared to the Dexamethasone group (P=0.023). The intentional groups were comparable in agreements of mean arterial blood pressure (Table 7) and courage rate (Table 9), and there was no statistically important difference between the groups all the while the study period. Furthermore, there was no statistically meaningful difference in hypotensive episodes (P = 0.885), the total amount of Ephedrine executed (average amount in those who knowledgeable hypotension and received Ephedrine) (P = 0.623), and bradycardia (P = 0.146) betwixt the studied groups all along the intraoperative period. However, skilled was a statistically significant decrease in the occurrence of bradycardia in the Ketamine group compared to the Dexamethasone group(P=0.049).End: This study demonstrates that skilled was no statistically significant difference 'tween the groups receiving Dexamethasone and reduced-dose Ketamine distinguished to the control group regarding the decrease in the rate of nausea and disgorging(P=0.062), hypotension (P=0.885), and shivering (P=0.550) all the while the operation ending.

Author(s) Details:

Sona Emami,
Ardabil University of Medical Sciences, Iran.

Please see the link here: https://stm.bookpi.org/ACMMR-V6/article/view/12688

Oral Feeding after Cesarean Section | Chapter 23 | New Horizons in Medicine and Medical Research Vol. 4

 The goal of this study was to examine the return of bowel motions in spinally sedated women who had a caesarean section (LSCS) and were given Early Oral Feeding (EF) vs those who were given Late Oral Feeding (LOF) (LF). Maternal satisfaction and gastrointestinal problems were also looked at as secondary outcomes.

Methods: 362 singleton pregnant women undergoing elective LSCS with spinal anaesthesia were randomly assigned to receive either EF or LF in a prospective randomised controlled experiment. Participants began eating normal diet between 6 and 12 hours after surgery, or began sipping water after 12 hours, soft diet after 24 hours, and then regular diet after 48 hours.

The study included 183 women in the EF group and 179 women in the LF group. The participants' ages ranged from 19 to 47, with a median of 35. There was no loss in follow-up, and patient characteristics were not significantly different. Patients who received EF were more likely than those who received LF to have bowel sounds the next morning (EF 93 percent , LF 71 percent , P 0.032). However, there was no change in the time it took to pass flatus and faeces. The EF group had considerably higher maternal satisfaction (EF 5, LF 2.11.1, P 0.026). There was no difference between the groups in terms of gastrointestinal problems (P 0.786).

Conclusion: The results of this study back up the use of EF for women undergoing straightforward LSCS under spinal anaesthesia.

Author(S) Details

Mohammad Othman
Department of Obstetrics and Gynaecology, Fakeeh College of Medical Sciences, Jeddah, Saudi Arabia.

Basil M. Othman
Al-Rayan Medical College, Madinah, Saudi Arabia.


View Book:- https://stm.bookpi.org/NHMMR-V4/article/view/6385