Cesarean section is the most common surgery in obstetrics. Several techniques are proposed according to the indication and the degree of urgency. Usually laparotomy followed by hysterotomy with a low transverse incision is preferable. However, in cases in which it is difficult to access the lower uterine segment, such as that in preterm labor, dense adhesion, placenta previa/accrete a vertical hysterotomy (classical cesarean section) may be needed. Although a smooth and gentle delivery of the fetus is possible through the vertical incision, uterine closure is technically difficult. To decrease the risks of hemorrhage and adhesion, a speedy and skillful technique is mandatory. The most serious risk of vertical incision in the contractile corpus is uterine rupture in the subsequent pregnancy. Therefore, cases of prior classical cesarean section are contraindicated for trial of labor after cesarean section.
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http://dx.doi.org/10.1055/s-0039-3402072 | DOI Listing |
J Endocr Soc
November 2024
Medizinische Klinik and Poliklinik IV, Klinikum der Universität München, LMU München, Munich 80336, Germany.
Objective: To study pregnancy outcomes and complications in women with congenital adrenal hyperplasia (CAH).
Methods: A retrospective multicenter study was conducted at tertiary reference centers in 5 countries (Austria, Germany, Italy, Sweden, USA), including 72 adult women with CAH (nonclassic [NC] n = 34, simple virilizing [SV] n = 21, salt wasting [SW] n = 17).
Results: A total of 133 pregnancies, 112 live births, and 25 abortions were documented.
Medwave
December 2024
Departamento de Obstetricia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
The partogram is a graphic tool used to monitor labor progression. This article reviews the recent literature on the use of the partogram, aiming to evaluate whether its implementation reduces cesarean section rates and to determine which model is more appropriate. Studies that compared using the partogram with not using it were analyzed, as well as studies that contrasted different partogram models.
View Article and Find Full Text PDFClin Case Rep
December 2024
Department of Outcomes Research, Anesthesiology Institute Cleveland Clinic Cleveland Ohio USA.
Cureus
October 2024
Department of Pathology, Armed Forces Hospital Southern Region, Khamis Mushait, SAU.
Congenital renal tumors are rare. In infancy, congenital mesoblastic nephroma is the most commonly reported renal tumor. It is recognized antenatally due to polyhydramnios and presents clinically as a palpable abdominal mass in the neonatal period.
View Article and Find Full Text PDFSAGE Open Med Case Rep
October 2024
Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana.
A 40-year-old patient underwent laparotomy at term gestation for a 25-cm lower abdominal mass arising from the lateral wall of the uterus, with an extensive secondary blood supply from the lower uterus and bladder, preventing access to the anterior lower uterine segment. The gravid uterus was exteriorised over the patient's thighs. A transverse posterior lower uterine segment hysterotomy was performed and a healthy 2920 g baby was delivered.
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