Pub Date : 2018-09-26DOI: 10.5772/INTECHOPEN.75365
Cengiz Tokgöz, Ş. Hatırnaz, Oğuz Güler
Additional surgical interventions apart from emergencies during cesarean section are not recommended in the textbooks; thus, surgical procedures like myomectomy as an adjunct to cesarean section remains a hot topic of discussion. There are many publications supporting serosal myomectomy during cesarean section, but studies published so far are poor in quality of evidence. To clarify the efficacy and safety of cesarean myomectomy, large-scale randomized controlled studies and studies explaining the mid-term and long-term outcomes of the cesarean myomectomy are required. Traditionally, cesarean myomectomy is performed from the uterine serosa as in the usual abdominal myomectomy. Although the surgical technique is the same as intracapsular myomectomy, a novel cesarean myomectomy technique, endometrial myomectomy, introduced into the obstetrics practice for minimizing the risk of adhesion formation and diminishing the blood loss during surgery. Further, strong studies are needed to overcome the controversy on cesarean myomectomy.
{"title":"Pros and Cons of Myomectomy during Cesarean Section","authors":"Cengiz Tokgöz, Ş. Hatırnaz, Oğuz Güler","doi":"10.5772/INTECHOPEN.75365","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.75365","url":null,"abstract":"Additional surgical interventions apart from emergencies during cesarean section are not recommended in the textbooks; thus, surgical procedures like myomectomy as an adjunct to cesarean section remains a hot topic of discussion. There are many publications supporting serosal myomectomy during cesarean section, but studies published so far are poor in quality of evidence. To clarify the efficacy and safety of cesarean myomectomy, large-scale randomized controlled studies and studies explaining the mid-term and long-term outcomes of the cesarean myomectomy are required. Traditionally, cesarean myomectomy is performed from the uterine serosa as in the usual abdominal myomectomy. Although the surgical technique is the same as intracapsular myomectomy, a novel cesarean myomectomy technique, endometrial myomectomy, introduced into the obstetrics practice for minimizing the risk of adhesion formation and diminishing the blood loss during surgery. Further, strong studies are needed to overcome the controversy on cesarean myomectomy.","PeriodicalId":245098,"journal":{"name":"Caesarean Section","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123909238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-26DOI: 10.5772/INTECHOPEN.80297
Georgios Androutsopoulos
{"title":"Introductory Chapter: Is It Time to Reconsider the Importance of Cesarean Section?","authors":"Georgios Androutsopoulos","doi":"10.5772/INTECHOPEN.80297","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.80297","url":null,"abstract":"","PeriodicalId":245098,"journal":{"name":"Caesarean Section","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127666309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-26DOI: 10.5772/INTECHOPEN.75900
Z. Saadia, Nadiah AlHabardi, I. Adam
Cesarean delivery is needed (indicated) for many reasons such as failure to progress, cephalopelvic disproportion, antepartum hemorrhage, preeclampsia, and repeated cesareans. The increase of the cesarean delivery rate is accompanied with an increase in the maternal and perinatal morbidities and increase in maternal mortality such as complications of anesthesia, injury to the nearby structure, respiratory distress syn- drome, childhood allergy and childhood obesity. Vaginal delivery after cesarean section (VBAC) is one of the tools that aimed to reduce the rate of cesarean delivery. Here in this chapter we would like to highlight the different guidelines for VBAC, the success rate of VBAC, the determinant of the success rate, maternal and perinatal outcomes of VBAC. Then the arena of using oxytocic drugs in VBAC is discussed in details too.
{"title":"Vaginal Delivery after Cesarean Section","authors":"Z. Saadia, Nadiah AlHabardi, I. Adam","doi":"10.5772/INTECHOPEN.75900","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.75900","url":null,"abstract":"Cesarean delivery is needed (indicated) for many reasons such as failure to progress, cephalopelvic disproportion, antepartum hemorrhage, preeclampsia, and repeated cesareans. The increase of the cesarean delivery rate is accompanied with an increase in the maternal and perinatal morbidities and increase in maternal mortality such as complications of anesthesia, injury to the nearby structure, respiratory distress syn- drome, childhood allergy and childhood obesity. Vaginal delivery after cesarean section (VBAC) is one of the tools that aimed to reduce the rate of cesarean delivery. Here in this chapter we would like to highlight the different guidelines for VBAC, the success rate of VBAC, the determinant of the success rate, maternal and perinatal outcomes of VBAC. Then the arena of using oxytocic drugs in VBAC is discussed in details too.","PeriodicalId":245098,"journal":{"name":"Caesarean Section","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129920308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-26DOI: 10.5772/INTECHOPEN.75901
Enrique Rosales Aujang
In the last decades, there has been a huge increase in the incidence of the cesarean sec- tion that worldwide became a routine procedure in most hospitals despite the potential complications which in some cases can cause permanent damage or can even be fatal, affecting both the mother and the fetus. In this chapter, we will discuss the most frequent complications that occur in the cesarean section both in the surgical act and after the event.
{"title":"Complications of Cesarean Operation","authors":"Enrique Rosales Aujang","doi":"10.5772/INTECHOPEN.75901","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.75901","url":null,"abstract":"In the last decades, there has been a huge increase in the incidence of the cesarean sec- tion that worldwide became a routine procedure in most hospitals despite the potential complications which in some cases can cause permanent damage or can even be fatal, affecting both the mother and the fetus. In this chapter, we will discuss the most frequent complications that occur in the cesarean section both in the surgical act and after the event.","PeriodicalId":245098,"journal":{"name":"Caesarean Section","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115789872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-26DOI: 10.5772/INTECHOPEN.78040
Jan-Simon Lanowski, C. Kaisenberg
Caesarean section is the most frequent obstetric operation which is associated with increased maternal morbidity and mortality. Although these risks are low, affected women may suffer from severe consequences and this may affect subsequent pregnan - cies and deliveries. A variety of surgical approaches have been described, however, on low evidence level. The objective of this chapter is therefore to systematically search the literature and analyse the available evidence including preoperative workup, prophylac tic antibiotics, skin disinfection, preoperative bladder catheterization as well as details of the individual steps of the actual operation itself such as skin incision types, preparation of soft tissue and womb, removal of the placenta, cervical dilatation and stitching of the womb, peritoneum, rectus muscle, fascia, subcutaneous fat, and skin. We systematically searched for meta-analysis, systematic reviews, and big studies and evaluated the evi - dence for each individual step.
{"title":"The Surgical Technique of Caesarean Section: What is Evidence Based?","authors":"Jan-Simon Lanowski, C. Kaisenberg","doi":"10.5772/INTECHOPEN.78040","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.78040","url":null,"abstract":"Caesarean section is the most frequent obstetric operation which is associated with increased maternal morbidity and mortality. Although these risks are low, affected women may suffer from severe consequences and this may affect subsequent pregnan - cies and deliveries. A variety of surgical approaches have been described, however, on low evidence level. The objective of this chapter is therefore to systematically search the literature and analyse the available evidence including preoperative workup, prophylac tic antibiotics, skin disinfection, preoperative bladder catheterization as well as details of the individual steps of the actual operation itself such as skin incision types, preparation of soft tissue and womb, removal of the placenta, cervical dilatation and stitching of the womb, peritoneum, rectus muscle, fascia, subcutaneous fat, and skin. We systematically searched for meta-analysis, systematic reviews, and big studies and evaluated the evi - dence for each individual step.","PeriodicalId":245098,"journal":{"name":"Caesarean Section","volume":"07 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127415393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-26DOI: 10.5772/INTECHOPEN.78667
D. Morrish, I. Hoskins
Cesarean sections are the most commonly performed surgery in the USA. Changing poli- cies and clinical information have resulted in improved outcomes for both mothers and babies. We describe evidence-based best practices for a multi-strategy approach to reduce cesarean section rates, increasing safety and success of vaginal births after cesarean section, decreasing complication rates in higher order cesarean sections, and accurate estimations of blood loss. In addition, we present a novel approach of utilizing venous lactate levels to identify the need for blood transfusions in the resuscitation of women with postpar- tum hemorrhage. Given that pregnancy is a life event, we describe increased self-reported stress levels in women during pregnancy and after the birth. In summary, adoption of the best practices outlined herein will greatly enhance the safe practice of cesarean sections.
{"title":"Improving Obstetrical Outcomes in Cesarean Sections, by Utilizing Evidence-Based Strategies","authors":"D. Morrish, I. Hoskins","doi":"10.5772/INTECHOPEN.78667","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.78667","url":null,"abstract":"Cesarean sections are the most commonly performed surgery in the USA. Changing poli- cies and clinical information have resulted in improved outcomes for both mothers and babies. We describe evidence-based best practices for a multi-strategy approach to reduce cesarean section rates, increasing safety and success of vaginal births after cesarean section, decreasing complication rates in higher order cesarean sections, and accurate estimations of blood loss. In addition, we present a novel approach of utilizing venous lactate levels to identify the need for blood transfusions in the resuscitation of women with postpar- tum hemorrhage. Given that pregnancy is a life event, we describe increased self-reported stress levels in women during pregnancy and after the birth. In summary, adoption of the best practices outlined herein will greatly enhance the safe practice of cesarean sections.","PeriodicalId":245098,"journal":{"name":"Caesarean Section","volume":"383 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124073632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-26DOI: 10.5772/INTECHOPEN.76883
S. Cambrea, Anca Daniela Pînzaru
The international main goal is to reduce mother-to-child HIV transmission. The appro- priate birth delivery for seropositive woman has been analyzed since the beginning of the twenty-first century. Although at the beginning of HIV pandemic delivery by caesarian section (C-section) was considered mandatory in many studies and meta-analyses, recent information reveal limited benefits. Mother-to-child transmission is higher when moth - ers are diagnosed late during pregnancy, in advanced stages with a high HIV viral load, and labor with membranes ruptured for more than 4 h, especially when the antiretrovi- ral treatment is not respected. During vaginal delivery, the risk of HIV transmitting to infant is due to microtransfusions during uterine contractions or by newborn exposure to cervicovaginal secretions or blood. Although the indication of C-section in HIV-positive women is controversial, there are some situations in which C-section remains manda- tory. In mothers diagnosed late during pregnancy, in situation in which HIV viral load is not affordable in real time in the last trimester of pregnancy, and in mothers with poor adherence to antiretroviral treatment, C-section remains one of the most important measures of prevention for HIV mother-to-child transmission.
{"title":"Value of Caesarian Section in HIV-Positive Women","authors":"S. Cambrea, Anca Daniela Pînzaru","doi":"10.5772/INTECHOPEN.76883","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.76883","url":null,"abstract":"The international main goal is to reduce mother-to-child HIV transmission. The appro- priate birth delivery for seropositive woman has been analyzed since the beginning of the twenty-first century. Although at the beginning of HIV pandemic delivery by caesarian section (C-section) was considered mandatory in many studies and meta-analyses, recent information reveal limited benefits. Mother-to-child transmission is higher when moth - ers are diagnosed late during pregnancy, in advanced stages with a high HIV viral load, and labor with membranes ruptured for more than 4 h, especially when the antiretrovi- ral treatment is not respected. During vaginal delivery, the risk of HIV transmitting to infant is due to microtransfusions during uterine contractions or by newborn exposure to cervicovaginal secretions or blood. Although the indication of C-section in HIV-positive women is controversial, there are some situations in which C-section remains manda- tory. In mothers diagnosed late during pregnancy, in situation in which HIV viral load is not affordable in real time in the last trimester of pregnancy, and in mothers with poor adherence to antiretroviral treatment, C-section remains one of the most important measures of prevention for HIV mother-to-child transmission.","PeriodicalId":245098,"journal":{"name":"Caesarean Section","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129987813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-26DOI: 10.5772/INTECHOPEN.77309
A. Sarmiento
Cesarean section (CS) is part of the standard of care in modern obstetrics. Its availability, practicity, high acceptance among patients, and the permanent improvement in surgical techniques, anesthesia, blood replacement, and neonatal care have popularized the procedure as a safe and reasonable alternative to vaginal delivery for any individual born in the twenty-first century. Beyond an established recommended rate of 15% for all births, presently the main challenge in obstetrical care is to limit its use to patients that need the procedure in order to keep an adequate perinatal outcome. The rate of CS has been used in many healthcare settings as an indicator of an individual or institutional obstetrical performance. The issue of overuse of CS as a birth alternative beyond clear maternal or fetal indications has received extensive analysis not only from the reproductive medicine point of view but also from neonatal, ethical, financial, and public health stakeholders. Its place in modern obstetrics, and its impact on short-and long-term maternal and neonatal outcomes, health financial budgets, and in public health policies, have positioned CS a mayor issue to take care of in modern medicine.
{"title":"Trends in Cesarean Section","authors":"A. Sarmiento","doi":"10.5772/INTECHOPEN.77309","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.77309","url":null,"abstract":"Cesarean section (CS) is part of the standard of care in modern obstetrics. Its availability, practicity, high acceptance among patients, and the permanent improvement in surgical techniques, anesthesia, blood replacement, and neonatal care have popularized the procedure as a safe and reasonable alternative to vaginal delivery for any individual born in the twenty-first century. Beyond an established recommended rate of 15% for all births, presently the main challenge in obstetrical care is to limit its use to patients that need the procedure in order to keep an adequate perinatal outcome. The rate of CS has been used in many healthcare settings as an indicator of an individual or institutional obstetrical performance. The issue of overuse of CS as a birth alternative beyond clear maternal or fetal indications has received extensive analysis not only from the reproductive medicine point of view but also from neonatal, ethical, financial, and public health stakeholders. Its place in modern obstetrics, and its impact on short-and long-term maternal and neonatal outcomes, health financial budgets, and in public health policies, have positioned CS a mayor issue to take care of in modern medicine.","PeriodicalId":245098,"journal":{"name":"Caesarean Section","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124023046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-26DOI: 10.5772/INTECHOPEN.76582
Y. Stjernholm
According to data from 150 countries, the worldwide caesarean section rate increased from 7% in 1990 to 19% in 2014. Latin America and the Caribbean region reported the highest CS rate 42%, followed by North America 32%, Oceania 31%, Europe 25%, Asia 19%, and Africa 7%. This trend is accompanied by increasing reports of severe adverse outcomes, such as invasive placenta, peripartum hysterectomy, and massive obstetric bleeding. The World Health Organization stated in 2015 that caesareans are effective in saving maternal and infant lives only when they are required for medically indicated reasons and that caesarean rates higher than 10–15% at a population level are not associated with reduced maternal or newborn mortality rates. More than 90% of women claim that they want to give birth in a natural way. In contrast, recent studies suggest that the majority of planned caesareans are carried out for psychosocial or nonmedical reasons. Knowledge about the indications for caesareans is a prerequisite in order to define actions to prevent unnecessary caesareans. The aim of this chapter was to present a review of the history behind, and to evaluate the indications for, caesarean sections in order to suggest appropriate actions to prevent unnecessary caesareans.
{"title":"Caesarean Section: Reasons for and Actions to Prevent Unnecessary Caesareans","authors":"Y. Stjernholm","doi":"10.5772/INTECHOPEN.76582","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.76582","url":null,"abstract":"According to data from 150 countries, the worldwide caesarean section rate increased from 7% in 1990 to 19% in 2014. Latin America and the Caribbean region reported the highest CS rate 42%, followed by North America 32%, Oceania 31%, Europe 25%, Asia 19%, and Africa 7%. This trend is accompanied by increasing reports of severe adverse outcomes, such as invasive placenta, peripartum hysterectomy, and massive obstetric bleeding. The World Health Organization stated in 2015 that caesareans are effective in saving maternal and infant lives only when they are required for medically indicated reasons and that caesarean rates higher than 10–15% at a population level are not associated with reduced maternal or newborn mortality rates. More than 90% of women claim that they want to give birth in a natural way. In contrast, recent studies suggest that the majority of planned caesareans are carried out for psychosocial or nonmedical reasons. Knowledge about the indications for caesareans is a prerequisite in order to define actions to prevent unnecessary caesareans. The aim of this chapter was to present a review of the history behind, and to evaluate the indications for, caesarean sections in order to suggest appropriate actions to prevent unnecessary caesareans.","PeriodicalId":245098,"journal":{"name":"Caesarean Section","volume":"133 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123453274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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