lscs case presentation slideshare

• My presentations

Auth with social network:

Download presentation

We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!

Presentation is loading. Please wait.

CAESAREAN SECTION.

Published by Surya Susman Modified over 5 years ago

Similar presentations

Presentation on theme: "CAESAREAN SECTION."— Presentation transcript:

Cesarean Section.

PREVIOUS C.S.. Pregnancy with history of previous C.S. is quite prevalent in present day obstetrics According to the statistics available the total cesarean.

Obstetric Haemorrhage Obstetric Emergencies Empangeni Hospital 28th July 2000.

Induction of Labor  Is the careful initiation of uterine contractions before their spontaneous onset.  Is the use of physical or chemical stimulants.

Special Tutorial programme Professor Deirdre Murphy Trinity College.

Post Partum Hemorrhage

  Not all births progress through the 3 stages of labor. If complications arise during the pregnancy or during labor, it may be necessary to perform.

Rupture of the uterus -the most serious complications in midwifery and obstetrics. -It is often fatal for the fetus and may also be responsible for the.

When the uterus is large or small for dates....

Dr. ROZHAN YASSIN KHALIL FICOG,CABOG, HDOG, MBChB 2011.

Katarina Črne Mentor: A. Žmegač Horvat

PROLONGED LABOUR Hassan, MD. PROLONGED FIRST STAGE OF LABOUR Diagnosis Deviation of line of cervical dilatation to the right of the alert line and reaches.

Cesarean section (CS) Caesarean section or c-section, is a delivary of the foetus through incisions in anterior abdominal (laparotomy) and uterine wall.

CESAREAN SECTION CS CESAREAN SECTION CS. CESAREAN SECTION Cs CESAREAN SECTION Cs Ghadeer Al-Shaikh, MD, FRCSC Assistant Professor & Consultant Obstetrics.

Healing Times Barbara Hastings-Asatourian. Pregnancy, childbirth and the post natal period These periods bring enormous changes in physical, mental, emotional,

Fourth session: Skill lab. Outline Demonstrate the indications, prerequisites, application and complications of forceps/ventouse Discuss the indications,

Cook Cervical Ripening Balloon Product information 18Fr, 40 cm Dual 80 ml balloons 100% Silicone Box of 10 J – CRB – or G48149  

Obstetrics and Gynecological Emergencies

1 Clinical aspects of Maternal and Child nursing NUR 363 Lecture 4 Intrapartum complications.

Maternal Health at the District Hospital Family Medicine Specialist CME Oct , 2012 Pakse.

About project

© 2024 SlidePlayer.com Inc. All rights reserved.

Post LSCS Pregnancy Management protocols

Sep 23, 2014

230 likes | 564 Views

Post LSCS Pregnancy Management protocols. Dr. Geetha Balsarkar, Associate Professor and Unit incharge, Nowrosjee Wadia Maternity Hospital, Seth G.S. Medical college, Parel , Mumbai Joint Asst. Secretary to the Editor, Journal of Obstetrics and Gynecology of India,

Share Presentation

• uterine rupture
• previous caesareans
• neonatal risks
• previous vaginal birth
• previous lower segment caesareans

Presentation Transcript

Post LSCS PregnancyManagement protocols

Dr. Geetha Balsarkar, Associate Professor and Unit incharge, Nowrosjee Wadia Maternity Hospital, Seth G.S. Medical college, Parel , Mumbai Joint Asst. Secretary to the Editor, Journal of Obstetrics and Gynecology of India, Secretary, AMWI, Mumbai branch

Plan of Discussion • Comparison of Trial of labour vs Planned Repeat Caesarean • Selection of patients for VBAC • Management of patients undergoing VBAC • Check list for patients planned for Trial of labour

Delivery Outcomes • Planned repeat caesarean delivery (PRCD) - Maternal morbidity – 3.6% • Trial of labour after caesarean • Emergency repeat caesarean delivery (ERCD) - Maternal morbidity – 14.1% • Vaginal birth after caesarean (VBAC) - Maternal morbidity – 2.4%

Maternal Consequences of PRCD • Anesthesia risks – high spinal, Mendelson’s syndrome, gastro intestinal symptoms • ↑ risk of short term maternal morbidity – increased bleeding, wound healing • Placenta praevia in future pregnancies • Morbid adhesions of placenta in future pregnancies

Advantages of VBAC over PRCD • ↓ febrile morbidity (OR 0.7) • ↓ blood transfusion (OR 0.6) • ↓ rates of Hysterectomy (OR 0.4) • ↓ venous thrombo- embolism (OR 0.4)

Neonatal Risks of PRCD • Neonatal respiratory morbidity • ↑ admission to NICU (7% vs 4.6% for attempted VBAC)* * ‘Healthy cohort selection bias’

Neonatal / Fetal advantages of PRCD • ↓ incidence of neonatal trauma, intra-cranial haemorrhage & Hypoxic ischaemic encephalopathy (vs attempted VBAC) • ↓ incidence of unexplained antepartum stillbirth

Maternal Risks of VBAC • Perineal / Vaginal lacerations • Emergency caesarean delivery • Uterine rupture • PRCD 1.6 / 1000 • Spontaneous labour 5.2 / 1000 • Induction with oxytocin 7.7 / 1000 • Induction with prostaglandins 24.5 / 1000

Long Term Maternal Consequences of VBAC • Urinary incontinence (prevalence 21% vs 15.9% for PRCD) • Uterovaginal prolapse

Fetal / Neonatal Risks of VBAC • Fetal death following uterine rupture • Neonatal sepsis following failed VBAC • ↑ incidence of perinatal death (OR 1.7) (Absolute risk 0.6%) • Women with a previous caesarean have a two to three fold ↑ incidence of unexplained stillbirth after 39 weeks gestation (Absolute risk 0.1%)

Risks of Failed VBAC • Intra-operative injury during emergency LSCS (1.3% vs 0.6% for PRCD) • Non significant trend towards increased maternal mortality

Prediction of Success • Maternal age • Maternal obesity • Indication of previous CS • Previous vaginal delivery • Gestational diabetes • Birth weight • Spontaneous or induced labour • Progress in early labour

Prediction of rupture • Previous non lower segment incision • Number of previous caesareans (2 – 3 fold increase in women with two previous caesareans as compared to only one previous caesarean) • Previous rupture • No previous vaginal birth • Single layer closure (4 fold increase) • Interval between previous caesarean and next pregnancy (3 fold increase with interdelivery interval < 18 months) • Use of prostaglandins (RR 4.7)

Influence of Patient intentions • Patient willingness to undergo VBAC (Informed consent) • Future reproductive intentions

Prerequisites to Attempting VBAC • Obstetrician available continuously to monitor labour • Availability of emergency anaesthesia, neonatal and blood banking services • Availability of continuous electronic fetal monitoring • Institutional capability of decision to incision interval of < 30 minutes for performing emergency surgery

Management During Attempted VBAC • Absolute risk of uterine rupture – 1:100 to 1:200 • Continuous electronic fetal monitoring • Epidural analgesia is not contraindicated • Use of Intra-uterine pressure catheters is not necessary • Partogram to assess progress • Oxytocin for augmentation to be used with caution and only for inadequate uterine activity • Second stage to be shortened • Exploration of the uterine scar after delivery not necessary

CHECK LIST FOR SELECTING VBAC

Are there any contraindications to VBAC ? • Number of previous lower segment caesareans • J shaped / Inverted T scar on uterus • A scar other than on the lower uterine segment • Past H/O uterine rupture / dehiscence of scar • Presence of an obstetric indication for LSCS • Doubtful adequacy of the pelvis / suspicion of feto-pelvic disproportion • Institutional policy on induction of labor in a scarred uterus • Lack of capability to provide continuous supervision during trial of labour • Lack of institutional capability to undertake expeditious operative delivery

Assessment of prognostic factors for a successful VBAC • Indication of previous caesareans (Dystocia / Non dystocia) • Past H/O vaginal birth • Maternal age • Maternal obesity • Post datism • Station and attitude of vertex • Favourability of cervix • Spontaneous or induced labour

Assessment of Prognostic Factors for Uterine Rupture During Trial of Labour • Unknown uterine scar • Uterine closure during previous caesarean (Single / Double layer closure) • Post operative recovery following previous caesarean • Inter delivery interval • Fetal macrosomia • Thickness of the lower uterine segment (if possible to assess) • Spontaneous or induced labour • Delay in progress of labour • Augmentation of labour

Patients intention • Informed consent

• More by User

Case Management Safety PROTOCOLS

Case Management Safety PROTOCOLS. SAFETY FIRST “THE SAFE WAY IS THE BEST WAY ”. THANK YOU TO THE SAFETY COMMITTEE FOR ALL OF YOUR INPUT AND WORK ON THIS PROJECT!. TRAINING AGENDA FOR TODAY. YOUR SAFETY ALWAYS COMES FIRST DOCUMENTING CLIENT SAFETY ISSUES IN CARE

274 views • 15 slides

POST APPROVAL CHANGE MANAGEMENT PROTOCOLS IN THE EUROPEAN UNION

POST APPROVAL CHANGE MANAGEMENT PROTOCOLS IN THE EUROPEAN UNION. (EC) No 1234/2008 1 October 2012 CHMP / CVMP Quality Working Party /EMA. Summary. 1. Post approval change management protocol (PACMP) 2. Concepts 3. Variation categories in the EU

803 views • 17 slides

Post term Pregnancy

Post term Pregnancy. Definitions:. postdates pregnancy - patient who has not delivered by end of 42nd week or 294 days from first day of last menstrual period (LMP) prolonged pregnancy - exceeds 40 weeks (280 days) from known time of ovulation. Incidence:.

1.24k views • 15 slides

Corrective Exercises Post-Pregnancy Physical Issues

Corrective Exercises Post-Pregnancy Physical Issues. Lisbeth Geertsen, CMT, CES. The Many Joys of Pregnancy . 20-45 years . Exercised before and during pregnancy. Started exercising after the birth of your first or second child. Postural imbalances developed during pregnancy .

580 views • 19 slides

Diabetes Management During Pregnancy

Diabetes Management During Pregnancy. Seyed Adel Jahed, M.D. Islamic Azad University, Tehran Medical Branch Gabric Diabetes Education Association 20 th Dec 2013 Laleh Hospital , Tehran, Iran. AGENDA. The 2013 Endocrine Society Clinical Practice Guideline

772 views • 59 slides

Network Management Protocols

Network Management Protocols. Network Management Spring 2014 Bahador Bakhshi CE &amp; IT Department, Amirkabir University of Technology. This presentation is based on the slides listed in references. Outline. Introduction Communication Patterns SNMP CLI syslog Netconf NetFlow /IPFIX.

1.38k views • 118 slides

1.23k views • 23 slides

Prolonged pregnancy Post term pregnancy = prolonged pregnancy

Prolonged pregnancy Post term pregnancy = prolonged pregnancy - post maturity : describe neonate that have specific characteristics as long nails ,loose skin ,peeling of epidermis. Prolonged pregnancy increase risk of perinatal morbidity &amp; mortality rate

869 views • 33 slides

Management of Pregnancy

Management of Pregnancy. Opioid Addiction Treatment. Perinatal Opioid Addiction. Pharmacotherapy and co-ordination of care are essential elements in the comprehensive care of pregnant patients with opioid addiction.

521 views • 20 slides

Network Protocols UNIT V – NETWORK MANAGEMENT PROTOCOLS

Network Protocols UNIT V – NETWORK MANAGEMENT PROTOCOLS. Background and security threats SNMPv3 Architecture SNMPv3 Applications Message Format User-based Security Model (USM) View-based Access Control Model (VCAM). SNMPv3. SGMP: monitor gateways

1.06k views • 84 slides

HIGH RISK PREGNANCY MANAGEMENT

HIGH RISK PREGNANCY MANAGEMENT. Prof. Roshan Ara Qazi Chairperson OBGYN, LUMHS, PAKISTAN. Definition. High risk pregnancy is one in which maternal and fetal morbidity &amp; mortality is more than the normal population OR

5.53k views • 68 slides

Post-term Pregnancy - Surveillance Strategies

Post-term Pregnancy - Surveillance Strategies. Dr. Yasir Katib MBBS, FRCSC, Perinatologist. Definitions. Post mature Post dates Post-term Prolonged. Definitions. Post term

829 views • 38 slides

Post Pregnancy Weight Control

Add more fiber to your diet, as well as to work with your metabolism, you need to make you feel full faster so that you do not overeat. Despite all the good practice to some extent enhance metabolism, any program that relies on it to help you lose weight quickly is important to add weight lifting exercises. This will allow you to lose weight quickly build lean muscle and fitness will allow lean sexy. Lean muscle is built every day as a weight training session and muscle repair after burns more fat. Lean muscle growth, increase your metabolism, and the best single way to achieve rapid weight. Without having to make additional changes in your life that you simply ignore this change in your diet is an area that does not pay attention.

103 views • 4 slides

Post Pregnancy Diet Plan

Post Pregnancy Diet Plan Your body needs time to recover from labor and delivery. That’s why an effective post pregnancy diet pan full of nutrients and calories is needed after giving birth to child. VISIT AT:- No. 106, Pocket- B, Sector-13, Dwarka, New Delhi - 110078, India Contact Person: Dr. Anjana Kalia Phone: 91360-02676 Mobile: 91-98182-24438 E-mail: [email protected] Visit: - http://www.dranjanakalia.com/post-pregnancy-diet-plan.htm

122 views • 6 slides

10 Healthy Foods for Post Pregnancy | healthy pregnancy tips

Getting back into shape is an important milestone for a new mom but it is important to have healthy foods for post pregnancy. Visit on AllAboutKiids.com

51 views • 3 slides

Post-Pregnancy Problems

Everything in this world follows a balance between light and dark. Similarly, Pregnancy too is a combination of both light and dark experiences. People speak a lot about what a blessing Pregnancy is but not a lot of them come forth to speak about the shadow of Pregnancy! So, here I came forth with my truth! Read more.... http://www.whatiwrite.com/pregnancy-and-post-pregnancy-problems/

38 views • 3 slides

Best post pregnancy diet plan

There is a lot of weakness and nutritional deficiency in women after pregnancy and they need a diet which is very rich in vitamins and minerals, protein and all important nutrients. Dr Anjana Kalia will suggest you a best highly customised diet plan post pregnancy.

55 views • 5 slides

Motivation required post pregnancy

Yuvraj human is one of the best motivational speakers in India. We give speeches to inspire and motivate people. So we can say that being inspirational speaker in India is one of the difficult tasks to perform.

120 views • 11 slides

POST TERM PREGNANCY &amp; IOL

POST TERM PREGNANCY &amp; IOL. Dr. Salwa Neyazi Assistant professor and consultant OBGYN KSU Pediatric and adolescent gynecologist. OBJECTIVES. Definition of post term pregnancy Incidence Diagnosis Complications Managemnt Induction of labour Indications/ contraindications

210 views • 13 slides

Post Pregnancy Diet

As one of the best dietitian in Chandigarh, Diet Clinic helps in providing in customised pregnancy plan so that both the mother and the bay stays healthy.

54 views • 4 slides

Diabetes Management in Pregnancy

Navigating the journey of pregnancy while dealing with diabetes management can be both challenging and rewarding. Striking a balance between maintaining maternal health and finding happiness during this precious time requires careful planning and proactive measures. Our team at FMRC Clinics provide best telehealth services. For more information visit our site https://fmrcclinics.com/diabetes-management-in-pregnancy-balance-health/

14 views • 6 slides

Embracing Your Post-Pregnancy Body

Navigating the emotional challenges of embracing your post-pregnancy body is a personal and transformative journey. By expressing your feelings, seeking support, embracing change, and cultivating self-love, you can navigate this period with grace and resilience. Remember that your body is a testament to the incredible journey of motherhood, and with time, patience, and self-compassion, you can truly embrace and celebrate the unique beauty of your post-pregnancy self. https://www.todayonline.com/singapore/doctor-fined-censured-failing-consider-privacy-minor

12 views • 11 slides

THE 10 BEST Tyumen Specialty Lodging

Tyumen specialty lodging, property types, distance from, traveler rating, hotel class.

• Best Value Properties ranked using exclusive Tripadvisor data, including traveler ratings, confirmed availability from our partners, prices, booking popularity and location, as well as personal user preferences and recently viewed hotels.
• Traveler Ranked Highest rated hotels on Tripadvisor, based on traveler reviews.
• Distance to city center See properties located closest to the center first with confirmed availability for your dates from our partners

1. Atma House

2. Apart Hotel Abazhur

3. Tyumen Time Hotel

4. Zhemchuzhina

6. apartamenty na osipenko, 7. apart-hotel rehome, 8. happy apartments on semenova 31.

9. Apartments on Malygina

11. 7 floors apart hotel tyumen centre, 12. apartamenty central park na tavricheskoy 9k1, 13. granny hostel, 14. kristall, 15. apartments in novin kvartal, 16. 2k prostornaya kvartira v samom serdtse goroda, 17. apartamenty na maksima gor'kogo 59, 18. apartment on 50 let oktyabrya 51 tyumgngu, 19. otel' apel'sin, 20. hotel complex open thermal pool, 21. hotel apelsin, 22. apartamenty rayon ashan, 23. hotel mandarin, 24. gostevoi dom aelita, 25. salut apartments, 26. vydoma on 50 let vlksm 13, 27. apartments on maxima gorkogo, 28. apartamenty v novom zhilom komplekse kristall, 29. apartamenty m90, 30. kharkovskaia 64, tyumen hotels information.

• Apart Hotel Abazhur
• Tyumen Time Hotel
• Zhemchuzhina
• Apartamenty Na Osipenko
• Apart-hotel REHOME
• Happy Apartments On Semenova 31
• Apartments on Malygina

• Bahasa Indonesia
• Slovenščina
• Science & Tech
• Russian Kitchen

The bourgeois charm of Siberia's oil capital

If you’re driving west across Russia from the Pacific Ocean, the first thing that you notice upon entering the city of Tyumen is the McDonalds. Tyumen has long been one of the only Siberian cities with a McDonalds restaurant. Although the fast-food giant has plans to open locations in nearby Novosibirsk and other regional cities, Siberia still contains one of the longest distances on earth outside of Africa where you can remain on a major highway and not see a McDonalds. Until you reach Tyumen, that is.

A stop in Tyumen provides an interesting glimpse into how modern Russia’s oil revenue has influenced Siberia’s oldest Russian city. Tyumen is a great stopover point on the Trans-Siberian Railroad and a short ride from Yekaterinburg (five hours) or Tobolsk (four hours).

In the 16th century, Russia started expanding eastward into parts of Central Asia ruled by the Tatars, an Islamic people who still live thoughout Russia. A band of Cossacks wrested control of Tyumen from the Tatars in 1580. Six years later, Russians established a fort in Tyumen on the Tura River.

For centuries, Tyumen vied with the nearby city of Tobolsk—once the official capital of Siberia—for the prestige of the region’s most important city. Tyumen won in the end, when the Trans-Siberian Railroad bypassed Tobolsk and was routed through this now oil-rich city.

Tyumen played an important role in Russian history during times of war. At the beginning of the Russian Civil War, the Bolshevik Red Army slowly pushed the White Army, commanded by Admiral Alexander Kolchak, into Siberia. Kolchak and his anti-Bolshevik forces holed up in Tyumen until the Red Army overtook them in January of 1918.

During the Second World War, many Russian industries were moved away from the front to Siberian cities. Tyumen had already become an industrial capital during the early Soviet era, and the city became an ideal spot to relocate Russia’s western factories. As Nazi forces approached Russia in 1941, the embalmed body of Vladimir Lenin was sent from the Lenin Mausoleum in Moscow’s Red Square by train to the Tyumen State Agricultural Academy for safekeeping. In 1945, Lenin’s body was shipped back to Moscow.

Some of the factories relocated to Tyumen during wartime remained in the city. The discovery of oil in the region catapulted Siberia’s oldest Russian settlement to further prosperity. Modern Tyumen is a vibrant city with a number of universities and a revamped center well-suited for exploration by foot.

Start your walking tour around central Tyumen on Ulitsa Respubliki. The city’s main drag has fine pedestrian walkways and leads wanderers past an impressive collection of tsarist-era buildings that recall Tyumen’s importance in the beginning of Russia’s colonization of Siberia.

From the southeastern end of Ul. Respubliki, head north toward the Tura River and take a brief side trip onto Ul. Ordzhonikidze to visit the Fine Arts Museum (47 Ul. Ordzhonikidze) which houses exhibits of classical Russian and Soviet art as well as traditional bone carving and works produced by the native people who live in the far north of Tyumen Oblast.

Back on Ul. Respubliki, you’ll soon see the city’s requisite Lenin statue by the local government buildings. A block away, opposite Lenin, is Tyumen’s city park, a delightful place to walk or hop on one of its amusement rides.

Most Siberian cities developed under the watchful eyes of the atheist Soviet regime and churches are usually not Siberia’s strongpoint. But this isn’t true in four-centuries-old Tyumen. Strolling up Ul. Respubliki, you’ll soon come to the Church of the Saviour (41 Ul. Lenina) and the Znamensky Cathedral (13 Ul. Semakova). Each of these stunning Baroque-influenced churches are located right off Ul. Respubliki and were built in the late 18th century.

Tyumen is also famous for its historic wooden houses. Heading further up Ul. Respubliki, stop to wander around some of the side streets and snap photos of these ornate wooden structures which provide a glimpse back in time. Near the Tura River, you’ll pass a civil war monument in remembrance of the Tyumen natives who died fighting the White Army and the Tyumen State Agricultural Academy (7 Ul. Respubliki) an impressive building in its own right where Lenin was stored during the Second World War.

Near the end of Ul. Respubliki, take a walk over the Tura River on the Lover’s Bridge, a suspension bridge open to foot traffic only that has become one of Tyumen’s iconic sights. The other side of the river is a great place to see more of Tyumen’s signature wooden houses as well as take in the churches scattered around the city center.

Save the best for last and visit the Trinity Monastery (10 Ul. Kommunisticheskaya) at the end of Ul. Respubliki. A white wall surrounds the monastery, giving it the appearance of a mini-kremlin, and the golden onion domes of the 18th century churches within should not be missed.

Although navigating Tyumen is straightforward enough, the St. Petersburg-based travel company OSTWEST can arrange a city tour in Tyumen and the surrounding countryside.

All rights reserved by Rossiyskaya Gazeta.

to our newsletter!

Get the week's best stories straight to your inbox

This website uses cookies. Click here to find out more.