Markers and the Materno-Foetal Result of Caesarean Section: A Study at the Secondary Health Facility in Obudu, Cross River State, Nigeria | Chapter 1 | Medical Science: Recent Advances and Applications Vol. 3

Background: Caesarean section (CS) refers to the delivery of a foetus, placenta and membranes after the age of viability through an abdominal and uterine incision. Caesarean section is further divided into two subtypes as far as the urgency of the operation is concerned. Elective caesarean section refers to those occasions where the decision to carry out caesarean section is made and planned more than 24 hours before delivery. Caesarean section (CS) is an important tool in obstetric care for the reduction of maternal and foetal morbidities and mortalities. This study was done to determine the CS rate, the indications and the maternal and foetal outcome of emergency and elective caesarean sections at the Sacred Heart Hospital Obudu, Cross River State.

Methods: A retrospective review of clinical records of all patients delivered by CS from September 2011 to August 2016 at the Sacred Heart Hospital, Obudu, Cross River State, Nigeria was conducted. Data for the study were extracted from theatre records, labour ward records and neonatal ward records using a structured questionnaire. The information obtained included socio-demographic variables, obstetric history and outcome of caesarean section. The data collected was checked for its completeness, entered into a computer and analysed using SPSS version 20.0. Frequencies.

Results: There were 2445 deliveries with 453 caesarean sections during the review period, giving a CS rate of 18.1%. Emergency CS accounted for 338(74.6%), while elective CS accounted for 115(25.6%). The main indications for emergency CS were cephalo-pelvic disproportion (CPD) (16.9%) and obstructed labour (16.0%), followed by breech deliveries. Previous CS was the main indication for elective CS (50.4%). Generally, the maternal and foetal outcomes of elective CS were better than emergency CS. There were 4 deaths, all accounted for by emergency CS, giving a CS mortality of 0.9%. Maternal morbidities like post-partum haemorrhage, sepsis, and prolonged hospital stay were worse among the emergency CS patients. Some conditions, like obstetric fistula and ruptured uterus, were found only amongst the emergency CS patients. For foetal outcome, poor Apgar score, sepsis, death, jaundice and need for referral were worse among emergency CS patients.

Conclusion: The incidence of CS is high in this centre, with a higher rate of emergency than elective CS. Also, the maternal and foetal outcomes of emergency CS were worse than those of elective CS. Caesarean section remains an important tool in obstetrics practice for the reduction of maternal and neonatal morbidity and mortality. In this review, the main indications for emergency CS were CPD, obstructed labour and breech presentation, while previous CS was the main indication for elective CS.

 

Author (s) Details

Maanongun MT
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Ornguze AA
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Ojabo AO
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Eka PO
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v3/2630

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

Short Note: Neonatal Emergencies | Book Publisher International

Cyanosis refers to a blue tone visible in the skin and mucous membranes, caused by desaturated or abnormal hemoglobin.

Jaundice in the first 24 hours of life of a term newborn is pathologic.

Cardiac disease presenting in the neonatal period are often congenital but can be acquired. Age at presentation of CHD varies with the underlying lesion, its impact on cardiac performance, and its dependence upon the ductus arteriosus. Neonatal sepsis can be categorized into early onset (occurring in newborns who are less than 72 hours of life) or late onset (occurring between 3 and 7 days of life).

Author(s) Details:

Elsharif Ahmed Bazie,
Elimam Elmahdi University, Sudan.

Mona Isam El-Din Osman,
Sudan International University, Sudan.

Please see the link here: https://stm.bookpi.org/SNNE/article/view/13225

Children with Asthmatic Exacerbation Influences of Different Phenotypes| Chapter 1 | Perspective of Recent Advances in Medical Research Vol. 5

 Asthma exacerbations are outlined as an acute or subacute worsening of syndromes and lung function concerning the usual conditions of the patient. Asthma is a assorted disease and various phenotypes have been identified.Objective: To see the epidemiological and clinical profile of pediatric inmates hospitalized for unable to respire normally exacerbations in a highly complex metropolitan emergency room.Methods: A retrospective explanatory study that included all children old between 4 to 14 age with a diagnosis of intensification or asthmatic crisis sick in one period period was performed. The dispassionate records were reviewed, and mathematical and clinical history particularly directed to identified various phenotypes and comorbidities were analyzed.Results: Fifty unable to respire normally children met the addition criteria. Prior to treatment, 66% had moderate asthma, and 10% had severe asthma. Persistent rhinitis was found in 66%, and 40% had a annals of at least one former hospitalization for asthma attacks, place 20% had been hospitalized accordingly in the last year and 18% had not completely one previous regimen in the ICU or CPU. Only 70% of the patients had a earlier established diagnosis of asthma and 28% had able compliance with two together treatment and attendance at healing controls. On admission, 20% were obese. In 54% of the cases, individual or both persons reported smoking all along the research period. Symptoms duration superior to admission was inferior 24 hours in 40% of the patients, and 34% could be delineated with doubtful asthma. Twenty two percent of the patients were conceded to the ICU or CPU, of which 45% started their symptoms in less than 24 hours and 36% more can be defined as bearing unstable asthma.Conclusions: We raise a group of patients who, in spite of not presenting syndromes and apparent clinical signs of harsh asthma, some of them accompanying a history of premature hospitalizations, suddenly presented an unable to respire normally exacerbation that progressed in a few hours with respiring failure and requiredadmission to hospital ICU or CPU. Further description is necessary for the instruction, management, and personalized situation of this group cause they resemble a different phenotype earlier described as type II labile asthma in men.

Author(s) Details:

Isabel Gárate,

Children´s Hospital Dr. Exequiel González Cortés, Santiago de Chile, Chile.

Guido Girardi,

Department of Pediatrics, School of Medicine University of Chile, Santiago de Chile, Chile.

María Angélica Pérez,

Department of Pediatrics, School of Medicine University of Chile, Santiago de Chile, Chile.

Arnoldo Quezada,

Department of Pediatrics, School of Medicine University of Chile, Santiago de Chile, Chile.

Please see the link here: https://stm.bookpi.org/PRAMR-V5/article/view/9137

Asthma exacerbations are outlined as an acute or subacute worsening of syndromes and lung function concerning the usual conditions of the patient. Asthma is a assorted disease and various phenotypes have been identified.Objective: To see the epidemiological and clinical profile of pediatric inmates hospitalized for unable to respire normally exacerbations in a highly complex metropolitan emergency room.Methods: A retrospective explanatory study that included all children old between 4 to 14 age with a diagnosis of intensification or asthmatic crisis sick in one period period was performed. The dispassionate records were reviewed, and mathematical and clinical history particularly directed to identified various phenotypes and comorbidities were analyzed.Results: Fifty unable to respire normally children met the addition criteria. Prior to treatment, 66% had moderate asthma, and 10% had severe asthma. Persistent rhinitis was found in 66%, and 40% had a annals of at least one former hospitalization for asthma attacks, place 20% had been hospitalized accordingly in the last year and 18% had not completely one previous regimen in the ICU or CPU. Only 70% of the patients had a earlier established diagnosis of asthma and 28% had able compliance with two together treatment and attendance at healing controls. On admission, 20% were obese. In 54% of the cases, individual or both persons reported smoking all along the research period. Symptoms duration superior to admission was inferior 24 hours in 40% of the patients, and 34% could be delineated with doubtful asthma. Twenty two percent of the patients were conceded to the ICU or CPU, of which 45% started their symptoms in less than 24 hours and 36% more can be defined as bearing unstable asthma.Conclusions: We raise a group of patients who, in spite of not presenting syndromes and apparent clinical signs of harsh asthma, some of them accompanying a history of premature hospitalizations, suddenly presented an unable to respire normally exacerbation that progressed in a few hours with respiring failure and requiredadmission to hospital ICU or CPU. Further description is necessary for the instruction, management, and personalized situation of this group cause they resemble a different phenotype earlier described as type II labile asthma in men.

Asthma exacerbations are outlined as an acute or subacute worsening of syndromes and lung function concerning the usual conditions of the patient. Asthma is a assorted disease and various phenotypes have been identified.Objective: To see the epidemiological and clinical profile of pediatric inmates hospitalized for unable to respire normally exacerbations in a highly complex metropolitan emergency room.Methods: A retrospective explanatory study that included all children old between 4 to 14 age with a diagnosis of intensification or asthmatic crisis sick in one period period was performed. The dispassionate records were reviewed, and mathematical and clinical history particularly directed to identified various phenotypes and comorbidities were analyzed.Results: Fifty unable to respire normally children met the addition criteria. Prior to treatment, 66% had moderate asthma, and 10% had severe asthma. Persistent rhinitis was found in 66%, and 40% had a annals of at least one former hospitalization for asthma attacks, place 20% had been hospitalized accordingly in the last year and 18% had not completely one previous regimen in the ICU or CPU. Only 70% of the patients had a earlier established diagnosis of asthma and 28% had able compliance with two together treatment and attendance at healing controls. On admission, 20% were obese. In 54% of the cases, individual or both persons reported smoking all along the research period. Symptoms duration superior to admission was inferior 24 hours in 40% of the patients, and 34% could be delineated with doubtful asthma. Twenty two percent of the patients were conceded to the ICU or CPU, of which 45% started their symptoms in less than 24 hours and 36% more can be defined as bearing unstable asthma.Conclusions: We raise a group of patients who, in spite of not presenting syndromes and apparent clinical signs of harsh asthma, some of them accompanying a history of premature hospitalizations, suddenly presented an unable to respire normally exacerbation that progressed in a few hours with respiring failure and requiredadmission to hospital ICU or CPU. Further description is necessary for the instruction, management, and personalized situation of this group cause they resemble a different phenotype earlier described as type II labile asthma in men.

Author(s) Details:

Isabel Gárate,
Children´s Hospital Dr. Exequiel González Cortés, Santiago de Chile, Chile.

Guido Girardi,
Department of Pediatrics, School of Medicine University of Chile, Santiago de Chile, Chile.

María Angélica Pérez,
Department of Pediatrics, School of Medicine University of Chile, Santiago de Chile, Chile.
Arnoldo Quezada,
Department of Pediatrics, School of Medicine University of Chile, Santiago de Chile, Chile.

Please see the link here: https://stm.bookpi.org/PRAMR-V5/article/view/9137

Epidemiological and Clinical Profile of Emergencies Received at the Maternity Unit of Saint-Louis Regional Hospital, Senegal: A Retrospective Cross-sectional and Descriptive Study| Chapter 15 | Current Innovations in Medicine and Medical Science Vol. 8

 The aim of this study search out provide the epidemiological and clinical traits of women taken in emergency at the maternity part of the regional clinic of Saint-Louis. In Senegal, reducing motherly mortality is one of the main preference of the National Health Development Plan.On the basis of the office for a year, a retrospective, cross-divided, and descriptive study was transported (July 1, 2017 - June 30, 2018). Out of 5822 collected files, skilled were 1364 evacuations (23.43%). The majority of women were under 25 age of age (42.53%), ignorant (60.92%), married (97.73%), low-gains (96.68%), first-time meaningful (37.91%), prim pregnant (38.57%), with a full-term gestation (85.28%) and less than 4 fetal consultations (56.02%).The most common pathologies were dystocic (20.16%), hypertensive (18.40%), and hemorrhagic (8.65%). Medical treatment (72.87%) was governed by vascular filling, medicine and antihypertensive medication, ancestry transfusion, and magnesium sulphate injection. Gynaeco-obstetrical care contained 42 abortions, 834 births, and 303 caesarean divisions, for a total of 1179 cases (86.44%).It is concluded that improving the position requires a more learned population and a better systematized network of “obstetric and neonatal emergency care (ONEC)” services (healing transport, sufficient and improved staff, better maternity and neonatology, correct suffused databases).

Author(s) Details:

Niang Khadim,
Department of Preventive Medicine and Public Health, Gaston Berger University (UGB) of Saint-Louis, Senegal.

Sylla Béïtyr,
Department of Preventive Medicine and Public Health, Gaston Berger University (UGB) of Saint-Louis, Senegal.

Thiam Ousmane,
Genecology and Obstetric Service, Gaston Berger University (UGB) of Saint-Louis, Senegal.

Ndiaye Papa,
Department of Preventive Medicine and Public Health, Gaston Berger University (UGB) of Saint-Louis, Senegal.

Please see the link here: https://stm.bookpi.org/CIMMS-V8/article/view/8732

Discussion on Rational Mind and Heuristics in Medical Diagnostic Decision Making | Chapter 1 | Highlights on Medicine and Medical Research Vol. 1

The most critical process of patient care is the medical diagnostic mark. It is not easy but very important to make diagnostic decisions. Diagnosis is a crucial aspect of health care because it impacts not just the patient, but society as a whole. The decision process includes the caregiver's thought process, which functions differently in emergencies and in outpatient clinics. In coping with emergencies, the heuristic component of the mind is more powerful than the slower examination of the mind in an outpatient environment. In fast decisions and emergency response, the heuristic approach is beneficial, while the slower step-by-step approach to outpatient treatment can help to minimize inquiries, medical mistakes and care costs. In the emergency environment, a properly configured and qualified system1 needs to play a dominant position. In the outpatient environment, the activated and time consuming system2 needs to be more involved. In both outpatient and emergency settings, the combination of system1 and system will possibly provide the most likely diagnosis. The article also offers an evidence-based template based on positive and negative probability ratios for predicting the disease phase.

Author (s) Details

Dr. T. Anil Kumar
Department of Medicine, Esic Medical College, Rajajinagar, Bangalore, India.

View Book :- https://stm.bookpi.org/HMMR-V1/issue/view/2