جستجوی مقالات مرتبط با کلیدواژه « سزارین » در نشریات گروه « پزشکی »

Considering the importance of complications caused by cesarean sections performed during the second stage of labor for both the mother and the newborn, as well as its impact on future pregnancies, the purpose of this study is to investigate the complications associated with cesarean sections during the second stage of labor.

Materials & Methods :

In this case-control study, the case group includes patients who underwent cesarean section in the second stage of labor, and the control group includes patients who underwent elective cesarean section. Finally, the clinical findings obtained between the two groups of cases and controls were analyzed.

Out of 60 mothers in this study, 30 were in the control group and 30 were in the intervention group. The duration of hospitalization for the control and intervention groups was 2.94 ± 1.14 days and 4.03 ± 1.35 days, respectively. Statistically, the difference between the two groups was significant (P = 0.002). Additionally, the average volume of bleeding, as indicated by the number of sterile gauzes used, was 7.9 ± 1.3 gauzes in the control group and 13.9 ± 2.8 gauzes in the intervention group. The difference in the volume of bleeding between the two groups was statistically significant (P < 0.001).

Cesarean section in the second stage of labor is associated with higher maternal complications compared to elective cesarean sections. These complications include a higher rate of hemodynamic instability and blood pressure disorders, more bleeding, a higher blood transfusion rate, extension of unintentional uterine incision, uterine atony, sepsis, fever, more antibiotic treatment, more admissions to the ICU, longer hospitalization days after cesarean section, need for hysterectomy, longer operation time, re-laparotomy, postoperative pyrexia, and wound infection.

  Caesarean section saves the life of mother and child. Unnecessary cesarean has complications. To reduce unnecessary cesarean sections, the health transformation plan was implemented. By editing this program in 2013, team services were added to it. The present study was conducted with the aim of investigating the status of team work among gynecologists and midwives.

The current research is a descriptive-analytical study that was carried out cross-sectionally in the year 2021. The sample population included all the 45 gynecologists and midwives working in the maternity block of hospitals affiliated with Islamic Azad University of Tehran, and sampling method was convenience sampling. Nachioni questionnaire with appropriate CVI (0.87-1) and Cronbach's alpha coefficient of 0.94 was used to collect data. Statistical analysis of data was done using wilcoxon test with SPSS24 software.

The results of this study showed that the state of teamwork and its dimensions in the studied group are significantly higher than the average (p<0/001). The highest score in the dimensions of the questionnaire was related to the objective dimension (3/97 ± 0/63) and the lowest score was related to the constructive approach dimension (3/39 ± 0/35).

The score of team work in the study group was medium to high. The highest score belonged to the dimensions of objective, trust, and accountability . It should be noted that the study cases have scored lower in the two dimensions of constructive interaction and responsibility.

Complete intraspinal anesthesia is a rare but life-threatening complication and is characterized by decreased level of consciousness, drop in blood pressure, bradycardia and respiratory failure. The present study reported a case of complete spinal anesthesia in caesarean section surgery.

The patient, a 33-year-old woman with gravid 2, referred to Motahari Hospital in Jahrom city for a cesarean section. Spinal anesthesia was performed in a sitting position with a spinal needle size 25and with the first attempt at the L3-L4 level, and then the patient was placed in the supine position and with a brief Trendelenburg position, the level of anesthesia was increased to T4, and after ensuring the sensory block and Motor (T8), the patient's bed was placed in a flat state without position. The patient's blood pressure 3 minutes after spinal anesthesia was 103.72 mmHg and heart rate was 84 times per minute. At this moment and before making the surgical incision, suddenly the patient's level of consciousness dropped drastically; so that she did not respond to verbal commands and breathing stopped completely and respiratory apnea occurred and the patient's saturation decreased to about 78%, but the patient's blood pressure and heart rate did not decrease significantly. Immediately and without delay and without giving any anesthetic, the patient was intubated with a size 7 tracheal tube and connected to the anesthesia machine and saturation reached 98%. The operation started and the baby was born with fifth minute Apgar score of 9 and the patient woke up completely at the end of the operation and was extubated and transferred to recovery without any special complications.

The present study adds a special and uncommon case of complications of spinal anesthesia to the previously reported limited cases and shows the clinical characteristics and appropriate treatment performance in the face of complete spinal anesthesia during cesarean section. Therefore, by knowing the effective factors in reducing this complication, an effective step can be taken to reduce it as much as possible.

The health system transformation plan has been implemented since 2014, and one of its goals is the reduction of cesarean rate to 25%-30%. The present study aimed to assess the rate of cesarean delivery and vaginal delivery before and after the implementation of the health system reform plan in Lorestan, Iran.

This descriptive study was conducted in 2020. The research population included all the women who had given birth in one of the public hospitals of Lorestan province during 2011-2016. The sampling method was the census, which was based on the statistics of the vice-chancellor of treatment at Lorestan University of Medical Sciences. After data collection, they were analyzed using descriptive statistics.

The results of the study demonstrated that contrary to expectations, the cesarean section overall rate increased by about 3.4% after the implementation of the health system transformation plan, compared to before the implementation of this plan. It is worth noting that in some hospitals, including Khorramabad Asali Hospital, Khorramabad Social Security Hospital, and Broujerd Kowsar Hospital, the rate of cesarean section increased by 4.6%, 6.5%, and 5.9%, respectively, after the implementation of the health system transformation plan.

It seems that according to the rate of cesarean delivery in this province that is higher than standard and the ineffectiveness of the health system transformation plan in this field, more efforts should be made with the use of extensive programs in order to increase the awareness and culturalization of the society.

Postoperative ileus is one of the common problems of abdominal surgeries such as Cesarean section, which significantly slows down wound healing, reduces patient satisfaction and increases treatment costs. It seems that the Paula exercise method and chewing gum is likely to reduce the risk of ileus. The purpose of this study was to investigate and compare the effects of Paula exercise method and chewing gum on ileus after Cesarean section.

This random clinical trial included 90 women who were candidates for Cesarean section. Participants were divided into three groups of 30; including chewing gum, Paula technique and control groups. The first intervention group, chewed gum after the operation for 15 minutes, three times a day (45 minutes in total). The second intervention group received Paula exercise method for 5 minutes every two hours, six times a day. The control group received only routine care. Data on the evaluation indicators of the patients, including the first time of passing gas, the first stool excretion, and the time of the first postoperative patient movement and duration of hospitalization were assessed in the three groups.

The average time of the first passing gas (P <0.001), the first stool excretion (P <0.05) and duration of hospitalization (P <0.05) in the Paula and chewing gum group were less than those of the control group. However, there was no significant statistical difference in terms of the movement of the patients among the groups.

Paula and chewing gum appears to be effective in improving bowel function and duration of hospitalization after Cesarean section.

Anxiety is a common problem in caesarean section patients that can have adverse consequences. Benson relaxation can be useful as a complementary medicine method to reduce anxiety. The aim of this study was to determine the effect of Benson's relaxation on the anxiety level of primiparous pregnant women applying for cesarean section.

This semi-experimental interventional study was conducted among 132 primiparous pregnant women who had beeb referred to the Shahada Qain Medical Training Center for elective cesarean section in 2021. The participants in the study were selected by available sampling method and were randomly divided into two intervention and control groups. In the intervention group, the samples were given relaxation training through headphones. The Spielberger questionnaire was used to determine anxiety. Data were analyzed using SPSS software (version 16) and paired t-test, independent t-test and chi-square . The significance level of P<0.05 was considered.

Before the intervention, there was no significant difference between the demographic and background variables, the mean variables, overt, hidden, and total anxiety in the two groups (P>0.05). After the intervention, the comparison of the two groups showed that the mean scores of overt, hidden and total anxiety in the intervention group significantly decreased compared to the control group (P<0.05).

Despite the reduction of anxiety in the intervention group, the results indicated that the total and obvious anxiety in the control group also decreased significantly after the intervention. It seems that factors other than Benson's relaxation technique in this research, such as studying mothers, participating in pregnancy classes have been able to reduce anxiety among the research samples.

The term gossypiboma is used to describe surgical sponges or gauzes that remain in the patient's body after a surgery. The present study reports a case of a large multiloculated cyst following the retention of a long gas in an emergency cesarean section.

A 37-year-old female patient underwent a cesarean section at a gestational age of 38 weeks due to labor pains and rupture of the membranes, and the baby was delivered and the patient was discharged without any complications. About 5 months later, the patient referred because of right flank pain. In the ultrasound, a large multiloculate cyst was reported on the right side of the pelvis and slightly above it. The general surgeon requested a CT scan, which revealed a cyst-like mass on the right side of the abdominal cavity with fluid and gas accumulation. Finally, after months of waiting for various imaging, the X-ray image diagnosed the foreign body of long gauze after 11 months. For this reason, the patient was hospitalized and underwent surgery, and then the cyst, which consisted of long gas and a thick wall of ammentum around it, was released and removed. A week later, the patient had a general condition without problems.

Failure to prevent the occurrence of Gossypiboma is one of the most important issues that causes serious complications such as large cysts in patients. Therefore, all scrub and circular personnel in the operating room should use all their attention when performing instrument counts.

Considering the high prevalence of cesarean section and the methods of conducting it, this study was performed with aim to determine the relationship between rectus ablation in cesarean section and postoperative pain, thickness and distance of abdominal wall muscles.

This randomized controlled clinical trial study was conducted in 2022 80 pregnant women candidates for caesarean section referred to the Ayatollah Taleghani hospital in Tehran. The subjects were randomly divided into two groups of intervention (n=40, rectus muscle repair) and control (n=40). Pain, thickness and distance of abdominal wall muscles were evaluated. Patients' pain in the first 72 hours after entering recovery (12, 24 and 72 hours after surgery) as well as pain when leaving the bed and pain in the interval of one week after surgery was measured using the visual pain index (VAS). Data were analyzed using SPSS software (version 23) and Shipro-Wilk, t-test, Mann-Whitney and Chi-square tests. P<0.05 was considered statistically significant.

The intensity of pain in the control group compared to the intervention, when getting out of bed (P<0.001) and at 12 hours (P<0.001), 24 hours (P<0.001), 72 hours (P<0.001) and one week later (P<0.001) was lower. In the intervention group compared to the control, the need for painkillers was more (P=0.001) and diastasis recti in the epigastric area (P<0.001) and hypogaster (P<0.001) were lower.

The re-approximation of rectus abdominis muscle during cesarean section reduces the thickness of the abdominal wall muscles and diastasis recti, but on the other hand, it increases the amount of pain and the need for painkillers.

The high prevalence of caesarean section is a global health concern, especially in Iran. Considering the possibility of complications caused by cesarean section and the importance of identifying the development process of this delivery method, the present research was conducted with the aim of determining the factors influencing the behavioral intention and the choice of the type of delivery by pregnant women of Bojnord city based on the theory of planned behavior.

The current cross-sectional study was conducted in 2021 on 369 pregnant women first abdomen who referred to comprehensive health centers in Bojnurd city. The sampling method was multi-stage. The data collection tool was a questionnaire based on the theory of planned behavior. The data were analyzed by SPSS 21 software by using t-test, Mann-Whitney, and Chi-square tests. 

72.6% of the participants wanted to give birth naturally and 27.4% had a cesarean birth. People who intended to have a natural birth significantly had better knowledge, a more positive attitude towards natural birth, and a better perceived behavioral control (P<0.001). The two constructs of attitude (β=-0.234) and perceived behavioral control (β=-0.215) had the most negative and significant predictors of the behavioral intention to perform cesarean delivery (P<0.001). The results of the subjective norms showed that the doctor's opinion and the mass media had the greatest and least influence on the choice of the type of delivery in pregnant women, respectively. The constructs of the theory of planned behavior together predicted 17.2 of the variance of natural childbirth intention in pregnant women.

The theory of planned behavior can be effective by identifying the factors of pregnant women's intention in choosing natural delivery. It is suitable with training and interventions to reduce the rate of cesarean section for pregnant women using this theory.

Previous cesarean sections are the most common cause of increased cesarean section in many parts of the world, although it is not always necessary. Considering the high statistics of cesarean section in Iran and especially the high rate of repeat cesarean section and creating motivation for vaginal birth after cesarean section, this study was conducted in order to investigate the maternal and neonatal outcomes of vaginal birth after one cesarean section.

This cross-sectional study was conducted on 104 pregnant women with a previous caesarean section and transverse incision on the lower segment in Ayatollah Rouhani Hospital of Babol in two groups; 50 people in the first group who underwent repeat emergency cesarean section and 54 people in the second group who consented to vaginal birth after cesarean section (VBAC). Demographic characteristics and maternal and neonatal complications were investigated and compared between the two groups.

In this study, there were no significant differences between the two groups in terms of demographic characteristics. Infant mortality rate was reported in 6 cases (12%) in the first group and 2 cases (3.7%) in the second group. Furthermore, 3 babies (6%) in the repeat cesarean section group and 9 babies (16.7%) in the vaginal birth group after cesarean section were admitted to the neonatal intensive care unit. The 5-minute Apgar was also significantly higher in the babies of the vaginal birth group after cesarean section (p=0.04). The duration of mother's hospitalization was 3.98±5.53 and 2.11±0.31 days in the repeat cesarean and vaginal birth groups, respectively (p=0.02).

According to the results of this study, maternal and neonatal complications did not increase in vaginal birth after cesarean section, and if the mother wishes, vaginal birth can be performed after one cesarean section.

Endometritis and wound infection after caesarean section is the most common complication of caesarean section and is associated with many problems and complications. The present study was conducted with aim to determining the effect of vaginal washing with chlorhexidine before cesarean section on endometritis and wound infection after cesarean section.

This randomized clinical trial study with a control group was conducted in 2021-2022 on 320 patients with indications for cesarean section referred to the Kowsar Hospital in Qazvin, Iran. Before cesarean section, the patients were divided into two groups of test (vaginal prep with chlorhexidine) and control (vaginal prep with normal saline serum). During the first 10 days after cesarean section, the patients were examined for symptoms of endometritis and abdominal incision site infection. Data analysis was done using SPSS statistical software (version 25) and independent t-tests, Mann-Whitney, Chi-square and Fisher's exact test. P<0.05 was considered significant.

Vaginal preparation with chlorhexidine has reduced the incidence of infection in the test group (P<0.05). Although the vaginal preparation with chlorhexidine in the case group decreased the incidence of endometritis compared to the control group, this difference was not significant (P>0.05).

The vaginal preparation with chlorhexidine had positive effects in reducing the incidence of infection and endometritis. Therefore, it is recommended to do the vaginal preparation with chlorhexidine in addition to routine abdominal washing to prevent infections after cesarean section.

Global reimbursement is a hospital payment method. In some global surgeries, the billing cost of treatment differs from the tariff set by the Supreme Council of Insurance, leading to financial losses for hospitals or insurance companies. This study compares the billing costs of childbirth services with the approved tariffs.

This descriptive-analytical study examined the billing costs of all childbirth cases (natural and cesarean section) covered by health insurance at three specialized maternity hospitals (A, B, C) in Tehran province in 1400. Data were sourced from health insurance company dashboards, compiled in Excel, and analyzed using SPSS software.

The study evaluated 3,742 childbirth cases, with 35% being natural births and 65% cesarean sections. The comparison between billing costs and approved tariffs showed that Hospital A's costs for both natural and cesarean childbirths exceeded the set tariffs. However, the billing costs in the other two hospitals were below the approved tariffs. Additionally, the actual hospitalization days for cesarean sections were shorter than those covered by the tariff in all three hospitals.

This study highlights variations in childbirth billing costs compared to the approved global tariffs across different hospitals. These findings underline the necessity of cost control in hospitals and suggest a need to revise the approved tariffs to align with the actual hospitalization duration for patients.

Assessing maternal satisfaction with spinal anesthesia is important for determining changes that is needed to improve the overall quality of patient care delivery. In this study, the aim of this study was to investigate the main complaints of mothers after cesarean surgery with spinal anesthesia.

This cross-sectional analytical study was performed on pregnant women undergoing caesarean section with spinal anesthesia in 2022 in Alzahra Hospital, Rasht. First, the purpose and method of the research was explained to the patients and informed consent was obtained. Then a questionnaire containing demographic data and patients complaints of spinal anesthesia was filled out.

The results of this study showed that 92 (38.5%) of the total 239 pregnant women mentioned complaints after the anesthesia procedure, while most of them 147 (61.5%) had no complaints. Nausea-vomiting (37.7%), shivering (23.9%) and repeated needling (16.7%) were the most common complaints mentioned by mothers. Based on the results of this study, there was no statistically significant relationship between complaints of spinal anesthesia and the variables of age, education, employment status, place of residency, number of pregnancies, BMI, time of termination of the pregnancy and history of spinal anesthesia (All P < 0.05).

Pregnant women who underwent cesarean section with spinal anesthesia in this center, reported limited and preventable complaints from this procedure. The mentioned complications did not lead to lasting and serious injury in mothers and were often controlled with routine therapeutic interventions without adverse consequences.

Natural childbirth after caesarean section can prevent the recurrence of caesarean section and its many complications, so this study was conducted with the aim of examining the explaining the lived experiences and psychological function of these mothers.

This research was conducted with a qualitative approach of hermeneutic phenomenology. Participants included 17 women with a history of natural childbirth after cesarean section, who were selected purposefully from among women in hospitals and medical centers in Tehran, Karaj, Mashhad, and Qom. The research tool was an unstructured interview, and the process of completing the interviews continued until data saturation was reached. Dikelman et al.'s seven-step model was used to collect and analyze data.

In the data analysis, the main theme was identified as post-traumatic growth, which indicates the improvement of psychological function. This theme was formed by five sub-themes of threat perception and effective coping strategies, replacing successful identity instead of failed identity, understanding experiences and strengthening spiritual beliefs, developing and improving interpersonal emotional relationships, and strengthening self-efficacy beliefs.

Based on the data analysis, it was concluded that women with vaginal delivery after caesarean section were able to cope with it successfully and reach higher levels of psychological performance and positive change in cognition and emotion and then behavior by using personal and social resources to fight against mental barriers and internal and external challenges of natural childbirth after caesarean section.

Background and Objectives Anesthesia is one of the major risks of cesarean surgery, and the decision to choose the type of anesthesia depends on various reasons. This study aimed to identify Reasons for using different methods of anesthesia in cesarean section in selected teaching hospitals located in Khuzestan province. Subjects and Methods The present qualitative research was conducted using the content analysis method. The research population included all doctors and anesthesiologists working in two teaching hospitals located in two cities. The necessary information was obtained through a semi-structured interview with a purposeful sampling method until the theoretical saturation of the data. The data were analyzed using the qualitative content analysis method. Results To choose the type of anesthesia, two main themes of preference from the doctor and preference from the organization were obtained, which preference from the doctor includes the priority of the type of service (patient and surgeon preference) and specialized reasons (fewer side effects, scientific and technical) and priority from the side of the organization, they include hospital routine (majority choice) and time management (better control of operating room time). Conclusion The preferred method of the anesthesiologist for the health of the patient is determined in addition to scientific and technical reasons according to the priorities of the surgeon and the patient as well as the desired priorities of the organization. It is necessary to establish training courses for anesthesiologists and create platforms for informed choice by providing about the complications and benefits of the chosen method for the patient.

Women with drug use disorder probably need larger amounts of drugs for analgesia during and after childbirth; however, due to the limited number of studies in this field, the present study was conducted with aim to evaluate drug use disorder and how to manage it in women with history of caesarean section.

In this systematic review study which was conducted during 2000 until the first six months of 2022, in order to find related articles (published in both Persian and English), databases of PubMed, EMBASE, Cochrane Library, Web Of Science, Scopus, Mag-Iran and SID were searched using the keywords of pain, pain intensity, acute pain, chronic opioid pain, cesarean section, cesarean delivery, drug abuse disorder, pain management, prevention and analgesia.

Women with a history of caesarean who had drug use disorders faced unique challenges in accessing appropriate treatment and support. The results focused on the importance of integrated care models that addressed both the physical and psychological aspects of drug use disorder management. Additionally, specialized interventions tailored to the needs of this population, such as trauma-informed care and perinatal substance use programs, were found to be effective in improving outcomes.

Optimal control of post-cesarean pain in women with drug abuse disorder includes a multifaceted strategy using intrathecal or epidural drugs, acetaminophen and non-steroidal anti-inflammatory agents as the first line.

Despite the adverse effects of post-caesarean pain relievers, few studies have compared non-pharmacological methods of pain control. The present study was conducted with aim to compare the effects of foot reflexology and Benson's relaxation on pain levels in women candidates for caesarean section.

This randomized controlled clinical trial study was conducted in 2019-2020 on 135 women candidates for caesarean section in Persian Gulf Martyrs hospital, Bushehr. The participants were selected via convenience sampling and divided into three groups using block randomization: reflexology, Benson's relaxation, and control. In the reflexology and Benson's relaxation groups, the intervention was performed two hours post-operation and six hours after the first time. Pain levels were measured using a visual pain scale immediately, 30 and 60 minutes after the procedure. The amount of pain medication was also recorded. Data were analyzed using SPSS (version 19) and chi-square, Fisher's exact, One-way ANOVA, Kruskal-Wallis, Mann-Whitney, Friedman, and Wilcoxon tests. P<0.05 was considered statistically significant.

Before the intervention, the mean pain ranks were not significantly different among the three groups (P>0.05). Immediately, 30 and 60 min after the intervention, the mean pain ranks were significantly lower in the two intervention groups than the control group (P<0.05). There were no significant differences among the three groups in pethidine intake (P=0.193). However, the control group received significantly higher amounts of ketorolac and diclofenac when compared to the two intervention groups (P<0.05).

Reflexology and Benson's relaxation techniques can reduce post-cesarean pain and analgesics. Therefore, nurses can use these two non- pharmacological pain control methods.