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Artigos Originais
Rupture and dehiscence of uterine scar: cases study at a low-risk maternity in the Brazilian Southeast
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):387-392
09-01-2014
Summary
Artigos OriginaisRupture and dehiscence of uterine scar: cases study at a low-risk maternity in the Brazilian Southeast
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):387-392
09-01-2014DOI 10.1590/SO100-720320140005053
Views129See morePURPOSE:
To evaluate the cases of uterine rupture and dehiscence of the uterine scar at a low-risk maternity and to point out possibilities for an improved approach to these complications.
METHODS:
A descriptive study was conducted at a 30-bed low-risk maternity hospital that provides care to users of the public health system. The investigation was carried out by searching for cases in the delivery room registry book and later reading the medical records in order to obtain the data. The information was inserted on a form previously elaborated for this study. Cases of uterine rupure and dehiscence of the uterine scar diagnosed from 1998 to 2012 were included, with the determination of incidence, aspects related to risk factors and diagnosis, association with the use of misoprostol and oxytocin, and the outcomes observed.
RESULTS:
A total of 39,206 deliveries were performed in this maternity during the study period, with 12 cases of uterine rupture and 16 cases of dehiscence of uterine scar being observed. The most relevant results were a high perinatal mortality associated with uterine rupture and the unsuccessful diagnosis of this complications. It was not possible to demonstrate an association with the use of misoprostol or oxytocin.
CONCLUSION:
The adverse outcomes of uterine rupture could be minimized if efforts were directed at improving the diagnostic performance of the assisting teams.
Views129
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisRupture and dehiscence of uterine scar: cases study at a low-risk maternity in the Brazilian Southeast
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):387-392
09-01-2014DOI 10.1590/SO100-720320140005053
Views129See morePURPOSE:
To evaluate the cases of uterine rupture and dehiscence of the uterine scar at a low-risk maternity and to point out possibilities for an improved approach to these complications.
METHODS:
A descriptive study was conducted at a 30-bed low-risk maternity hospital that provides care to users of the public health system. The investigation was carried out by searching for cases in the delivery room registry book and later reading the medical records in order to obtain the data. The information was inserted on a form previously elaborated for this study. Cases of uterine rupure and dehiscence of the uterine scar diagnosed from 1998 to 2012 were included, with the determination of incidence, aspects related to risk factors and diagnosis, association with the use of misoprostol and oxytocin, and the outcomes observed.
RESULTS:
A total of 39,206 deliveries were performed in this maternity during the study period, with 12 cases of uterine rupture and 16 cases of dehiscence of uterine scar being observed. The most relevant results were a high perinatal mortality associated with uterine rupture and the unsuccessful diagnosis of this complications. It was not possible to demonstrate an association with the use of misoprostol or oxytocin.
CONCLUSION:
The adverse outcomes of uterine rupture could be minimized if efforts were directed at improving the diagnostic performance of the assisting teams.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Factors associated with mode of delivery in women with pre-eclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(6):259-263
06-01-2014
Summary
Artigos OriginaisFactors associated with mode of delivery in women with pre-eclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(6):259-263
06-01-2014DOI 10.1590/S0100-720320140004812
Views60See morePURPOSE:
To analyze the factors related to route of delivery in patients with pre-eclampsia.
METHODS:
A retrospective analytical study was conducted from January 2009 to January 2011, during which 250 medical records of patients diagnosed with pre-eclampsia who gave birth to live fetuses with a gestational age of 28 weeks or more were selected. The variables evaluated were: maternal age (19 years, 20−34 years and over 35 full years), gestational age at delivery (28−37 weeks and more than 37 weeks), parity (primiparous or multiparous), previous cesarean section, history of pre-eclampsia or chronic hypertension, current diagnosis of mild or severe pre-eclampsia, and birth weight of the newborn. The information was transcribed to a questionnaire based on the variables being investigated. The chi-square test was applied to identify the relationship between the variables, with the level of significance set at p<0.05, and the Odds Ratio (OR) was calculated only for the variables showing a statistically significant difference in order to determine the odds for the patient to be submitted to a cesarean section.
RESULTS:
In this study, we observed a 78.4% rate of cesarean delivery, with 54.1% of the patients submitted to the procedure having a gestational age of 28 to 37 weeks (OR=3.1; p<0.01). Patients with a history of pre-eclampsia were 2.5 times more likely to have cesarean delivery (OR=2.5; p<0.02). All patients who had had a previous cesarean were submitted to cesarean delivery in the current pregnancy (p<0.01). Pregnant women with severe pre-eclampsia were 3.3 times more likely to progress to cesarean delivery than those with mild pre-eclampsia (OR=3.3; p<0.01).
CONCLUSION:
After individual analysis, only gestational age and a diagnosis of severe pre-eclampsia showed significant differences, representing risk factors for this type of delivery.
Views60This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisFactors associated with mode of delivery in women with pre-eclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(6):259-263
06-01-2014DOI 10.1590/S0100-720320140004812
Views60See morePURPOSE:
To analyze the factors related to route of delivery in patients with pre-eclampsia.
METHODS:
A retrospective analytical study was conducted from January 2009 to January 2011, during which 250 medical records of patients diagnosed with pre-eclampsia who gave birth to live fetuses with a gestational age of 28 weeks or more were selected. The variables evaluated were: maternal age (19 years, 20−34 years and over 35 full years), gestational age at delivery (28−37 weeks and more than 37 weeks), parity (primiparous or multiparous), previous cesarean section, history of pre-eclampsia or chronic hypertension, current diagnosis of mild or severe pre-eclampsia, and birth weight of the newborn. The information was transcribed to a questionnaire based on the variables being investigated. The chi-square test was applied to identify the relationship between the variables, with the level of significance set at p<0.05, and the Odds Ratio (OR) was calculated only for the variables showing a statistically significant difference in order to determine the odds for the patient to be submitted to a cesarean section.
RESULTS:
In this study, we observed a 78.4% rate of cesarean delivery, with 54.1% of the patients submitted to the procedure having a gestational age of 28 to 37 weeks (OR=3.1; p<0.01). Patients with a history of pre-eclampsia were 2.5 times more likely to have cesarean delivery (OR=2.5; p<0.02). All patients who had had a previous cesarean were submitted to cesarean delivery in the current pregnancy (p<0.01). Pregnant women with severe pre-eclampsia were 3.3 times more likely to progress to cesarean delivery than those with mild pre-eclampsia (OR=3.3; p<0.01).
CONCLUSION:
After individual analysis, only gestational age and a diagnosis of severe pre-eclampsia showed significant differences, representing risk factors for this type of delivery.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Association between risk pregnancy and route of delivery with maternal and neonatal outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(2):65-71
02-01-2014
Summary
Artigos OriginaisAssociation between risk pregnancy and route of delivery with maternal and neonatal outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(2):65-71
02-01-2014DOI 10.1590/S0100-72032014000200004
Views65See morePURPOSE:
To analyze the relationships among gestational risk, type of delivery and
immediate maternal and neonatal repercussions.METHODS:
A retrospective cohort study based on secondary data was conducted in a
university maternity hospital. A total of 1606 births were analyzed over a 9-month
period. Epidemiological, clinical, obstetric and neonatal characteristics were
compared according to the route of delivery and the gestational risk characterized
on the basis of the eligibility criteria for high clinical risk. The occurrence of
maternal and neonatal complications during hospitalization was analyzed according
to gestational risk and cesarean section delivery using univariate and
multivariate logistic analysis.RESULTS:
The overall rate of cesarean sections was 38.3%. High gestational risk was
present in 50.2% of births, mainly represented by hypertensive disorders and fetal
malformations. The total incidence of cesarean section, planned cesarean section
or emergency cesarean section was more frequent in pregnant women at gestational
high risk (p<0.001). Cesarean section alone did not influence maternal outcome, but was associated with poor neonatal outcome (OR 3.4; 95%CI 2.7-4.4). Gestational high risk was associated with poor maternal and neonatal outcome (OR 3.8; 95%CI 1.3-8.7 and OR 17.5; 95%CI 11.6-26.3, respectively). In multivariate analysis, the ratios were maintained, although the effect of gestational risk has determined a reduction in the OR of the type of delivery alone from 3.4 (95%CI 2.7-4.4) to 1.99 (95%CI 1.5-2.6) for adverse neonatal outcome.CONCLUSION:
Gestational risk was the main factor associated with poor maternal and neonatal
outcome. Cesarean delivery was not directly associated with poor maternal outcome
but increased the chances of unfavorable neonatal outcomes.Views65This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisAssociation between risk pregnancy and route of delivery with maternal and neonatal outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(2):65-71
02-01-2014DOI 10.1590/S0100-72032014000200004
Views65See morePURPOSE:
To analyze the relationships among gestational risk, type of delivery and
immediate maternal and neonatal repercussions.METHODS:
A retrospective cohort study based on secondary data was conducted in a
university maternity hospital. A total of 1606 births were analyzed over a 9-month
period. Epidemiological, clinical, obstetric and neonatal characteristics were
compared according to the route of delivery and the gestational risk characterized
on the basis of the eligibility criteria for high clinical risk. The occurrence of
maternal and neonatal complications during hospitalization was analyzed according
to gestational risk and cesarean section delivery using univariate and
multivariate logistic analysis.RESULTS:
The overall rate of cesarean sections was 38.3%. High gestational risk was
present in 50.2% of births, mainly represented by hypertensive disorders and fetal
malformations. The total incidence of cesarean section, planned cesarean section
or emergency cesarean section was more frequent in pregnant women at gestational
high risk (p<0.001). Cesarean section alone did not influence maternal outcome, but was associated with poor neonatal outcome (OR 3.4; 95%CI 2.7-4.4). Gestational high risk was associated with poor maternal and neonatal outcome (OR 3.8; 95%CI 1.3-8.7 and OR 17.5; 95%CI 11.6-26.3, respectively). In multivariate analysis, the ratios were maintained, although the effect of gestational risk has determined a reduction in the OR of the type of delivery alone from 3.4 (95%CI 2.7-4.4) to 1.99 (95%CI 1.5-2.6) for adverse neonatal outcome.CONCLUSION:
Gestational risk was the main factor associated with poor maternal and neonatal
outcome. Cesarean delivery was not directly associated with poor maternal outcome
but increased the chances of unfavorable neonatal outcomes.This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Impact of vaginal delivery after a previous cesarean section on perinatal outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(11):516-522
01-10-2013
Summary
Artigos OriginaisImpact of vaginal delivery after a previous cesarean section on perinatal outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(11):516-522
01-10-2013DOI 10.1590/S0100-72032013001100007
Views86See morePURPOSE: To analyze the impact of vaginal delivery after a previous cesarean section on perinatal outcomes. METHODS: Case-control study with selection of incident cases and consecutive controls. Maternal and perinatal variables were analyzed. We compared secundiparas who had a vaginal delivery after a previous cesarean delivery (VBAC) (n=375) with secundiparas who had a second cesarean section (CS) (n=375). Inclusion criteria were: secundiparas who underwent a cesarean section in the previous pregnancy; singleton and term pregnancy; fetus in vertex presentation, with no congenital malformation; absence of placenta previa or any kind of bleeding in the third quarter of pregnancy. RESULTS: The rate of vaginal delivery was 45.6%, and 20 (5.3%) women had forceps deliveries. We found a significant association between VBAC and mothers younger than 19 years (p<0.01), Caucasian ethnicity (p<0.05), mean number of prenatal care visits (p<0.001), time of premature rupture of membranes (p<0.01), labor duration shorter than 12 hours (p<0.04), Apgar score lower than seven at 5th minute (p<0.05), fetal birth trauma (p<0.01), and anoxia (p<0.006). In the group of newborns delivered by cesarean section, we found a higher frequency of transient tachypnea (p<0.014), respiratory disorders (p<0.048), and longer time of stay in the neonatal intensive care unit (p<0.016). There was only one case of uterine rupture in the VBAC group. The rate of neonatal mortality was similar in both groups. CONCLUSIONS: Vaginal delivery in secundiparas who had previous cesarean sections was associated with a significant increase in neonatal morbidity. Further studies are needed to develop strategies aimed at improving perinatal results and professional guidelines, so that health care professionals will be able to provide their patients with better counseling regarding the choice of the most appropriate route of delivery.
Views86This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisImpact of vaginal delivery after a previous cesarean section on perinatal outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(11):516-522
01-10-2013DOI 10.1590/S0100-72032013001100007
Views86See morePURPOSE: To analyze the impact of vaginal delivery after a previous cesarean section on perinatal outcomes. METHODS: Case-control study with selection of incident cases and consecutive controls. Maternal and perinatal variables were analyzed. We compared secundiparas who had a vaginal delivery after a previous cesarean delivery (VBAC) (n=375) with secundiparas who had a second cesarean section (CS) (n=375). Inclusion criteria were: secundiparas who underwent a cesarean section in the previous pregnancy; singleton and term pregnancy; fetus in vertex presentation, with no congenital malformation; absence of placenta previa or any kind of bleeding in the third quarter of pregnancy. RESULTS: The rate of vaginal delivery was 45.6%, and 20 (5.3%) women had forceps deliveries. We found a significant association between VBAC and mothers younger than 19 years (p<0.01), Caucasian ethnicity (p<0.05), mean number of prenatal care visits (p<0.001), time of premature rupture of membranes (p<0.01), labor duration shorter than 12 hours (p<0.04), Apgar score lower than seven at 5th minute (p<0.05), fetal birth trauma (p<0.01), and anoxia (p<0.006). In the group of newborns delivered by cesarean section, we found a higher frequency of transient tachypnea (p<0.014), respiratory disorders (p<0.048), and longer time of stay in the neonatal intensive care unit (p<0.016). There was only one case of uterine rupture in the VBAC group. The rate of neonatal mortality was similar in both groups. CONCLUSIONS: Vaginal delivery in secundiparas who had previous cesarean sections was associated with a significant increase in neonatal morbidity. Further studies are needed to develop strategies aimed at improving perinatal results and professional guidelines, so that health care professionals will be able to provide their patients with better counseling regarding the choice of the most appropriate route of delivery.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Preference in the process of parturition: a comparison between primiparous and nulliparous women
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(6):281-285
08-02-2013
Summary
Artigos OriginaisPreference in the process of parturition: a comparison between primiparous and nulliparous women
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(6):281-285
08-02-2013DOI 10.1590/S0100-72032013000600008
Views95See morePURPOSE: It was to describe and compare the preference of nulliparous and primiparous women for a particular mode of delivery and to determine whether the previous experience of childbirth influences the delivery process. METHODS: We conducted a prospective cross-sectional study. One-hundred interviews were held with 56 nulliparous and 44 primiparous women using previously prepared questionnaires. The quantitative and categorical data were evaluated by the chi-square or Fisher's Exact Test. RESULTS: 60.7% of nulliparous women and 70.5% of primiparous women reported to prefer vaginal delivery. When analyzing the answers about receiving sufficient information about the type of delivery, the presence or absence of influence on the choice of route of delivery and the preferred route of delivery by the partner, there were no statistically significant differences between the two groups. The level of significance used for the tests was 0.05. CONCLUSIONS: This study permitted us to conclude that the previous experience of delivery does not influence the expectation of the delivery process or the choice for a specific mode of delivery. When choosing the route of delivery, women seek to ensure the health of mother and neonate, as well as to avoid the process of pain and suffering.
Views95This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisPreference in the process of parturition: a comparison between primiparous and nulliparous women
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(6):281-285
08-02-2013DOI 10.1590/S0100-72032013000600008
Views95See morePURPOSE: It was to describe and compare the preference of nulliparous and primiparous women for a particular mode of delivery and to determine whether the previous experience of childbirth influences the delivery process. METHODS: We conducted a prospective cross-sectional study. One-hundred interviews were held with 56 nulliparous and 44 primiparous women using previously prepared questionnaires. The quantitative and categorical data were evaluated by the chi-square or Fisher's Exact Test. RESULTS: 60.7% of nulliparous women and 70.5% of primiparous women reported to prefer vaginal delivery. When analyzing the answers about receiving sufficient information about the type of delivery, the presence or absence of influence on the choice of route of delivery and the preferred route of delivery by the partner, there were no statistically significant differences between the two groups. The level of significance used for the tests was 0.05. CONCLUSIONS: This study permitted us to conclude that the previous experience of delivery does not influence the expectation of the delivery process or the choice for a specific mode of delivery. When choosing the route of delivery, women seek to ensure the health of mother and neonate, as well as to avoid the process of pain and suffering.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Relato de Caso
Conservative management of ectopic pregnancy in cesarean scar: case report
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):233-237
07-05-2013
Summary
Relato de CasoConservative management of ectopic pregnancy in cesarean scar: case report
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):233-237
07-05-2013DOI 10.1590/S0100-72032013000500008
Views59Implantation of a pregnancy within a cesarean delivery scar is considered to be the rarest form of ectopic pregnancy, with a high morbidity and mortality. Pregnancy in a cesarean delivery scar may cause catastrophic complications which may result in hysterectomy and compromise the reproductive future of a woman. We report an ectopic pregnancy in cesarean scar case in a 28-year old pregnant woman that was treated with success with the association between three treatment modalities (methotrexate, uterine artery embolization and curettage) and preserve her fertility.
Key-words Case reportsCesarean sectionCicatrixCurettageMethotrexatePregnancy, ectopicUterine artery embolizationSee moreViews59This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Relato de CasoConservative management of ectopic pregnancy in cesarean scar: case report
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):233-237
07-05-2013DOI 10.1590/S0100-72032013000500008
Views59Implantation of a pregnancy within a cesarean delivery scar is considered to be the rarest form of ectopic pregnancy, with a high morbidity and mortality. Pregnancy in a cesarean delivery scar may cause catastrophic complications which may result in hysterectomy and compromise the reproductive future of a woman. We report an ectopic pregnancy in cesarean scar case in a 28-year old pregnant woman that was treated with success with the association between three treatment modalities (methotrexate, uterine artery embolization and curettage) and preserve her fertility.
Key-words Case reportsCesarean sectionCicatrixCurettageMethotrexatePregnancy, ectopicUterine artery embolizationSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Article
Obstetric outcomes in the second birth of women with a previous caesarean delivery: a retrospective cohort study from Peru
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):148-152
06-06-2013
Summary
ArticleObstetric outcomes in the second birth of women with a previous caesarean delivery: a retrospective cohort study from Peru
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):148-152
06-06-2013DOI 10.1590/S0100-72032013000400003
Views62PURPOSE: To examine obstetric outcomes in the second birth of women who had undergone a previous cesarean delivery. METHODS: This was a large hospital-based retrospective cohort study. We included pregnant women who had a previous delivery (vaginal or cesarean) attending their second birth from 2001 to 2009. Main inclusion criteria were singleton pregnancies and delivery between a gestation of 24 and 41 weeks. Two cohorts were selected, being women with a previous cesarean delivery (n=7,215) and those with a vaginal one (n=23,720). Both groups were compared and logistic regression was performed to adjust for confounding variables. The obstetric outcomes included uterine rupture, placenta previa, and placental-related complications such as placental abruption, preeclampsia, and spontaneous preterm delivery. RESULTS: Women with previous cesarean delivery were more likely to have adverse outcomes such as uterine rupture (OR=12.4, 95%CI 6.8-22.3), placental abruption (OR=1.4, 95%CI 1.1-2.1), preeclampsia (OR=1.4, 95%CI 1.2-1.6), and spontaneous preterm delivery (OR=1.4, 95%CI 1.1-1.7). CONCLUSIONS: Individuals with previous cesarean section have adverse obstetric outcomes in the subsequent pregnancy, including uterine rupture, and placental-related disorders such as preeclampsia, spontaneous preterm delivery, and placental abruption.
Key-words Cesarean sectionDelivery, obstetricsInfant, newbornObstetric labor, prematurePre-eclampsiaPregnancyPregnancy outcomeSee moreViews62This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
ArticleObstetric outcomes in the second birth of women with a previous caesarean delivery: a retrospective cohort study from Peru
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):148-152
06-06-2013DOI 10.1590/S0100-72032013000400003
Views62PURPOSE: To examine obstetric outcomes in the second birth of women who had undergone a previous cesarean delivery. METHODS: This was a large hospital-based retrospective cohort study. We included pregnant women who had a previous delivery (vaginal or cesarean) attending their second birth from 2001 to 2009. Main inclusion criteria were singleton pregnancies and delivery between a gestation of 24 and 41 weeks. Two cohorts were selected, being women with a previous cesarean delivery (n=7,215) and those with a vaginal one (n=23,720). Both groups were compared and logistic regression was performed to adjust for confounding variables. The obstetric outcomes included uterine rupture, placenta previa, and placental-related complications such as placental abruption, preeclampsia, and spontaneous preterm delivery. RESULTS: Women with previous cesarean delivery were more likely to have adverse outcomes such as uterine rupture (OR=12.4, 95%CI 6.8-22.3), placental abruption (OR=1.4, 95%CI 1.1-2.1), preeclampsia (OR=1.4, 95%CI 1.2-1.6), and spontaneous preterm delivery (OR=1.4, 95%CI 1.1-1.7). CONCLUSIONS: Individuals with previous cesarean section have adverse obstetric outcomes in the subsequent pregnancy, including uterine rupture, and placental-related disorders such as preeclampsia, spontaneous preterm delivery, and placental abruption.
Key-words Cesarean sectionDelivery, obstetricsInfant, newbornObstetric labor, prematurePre-eclampsiaPregnancyPregnancy outcomeSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Article
Assessment of pelvic floor by three-dimensional-ultrasound in primiparous women according to delivery mode: initial experience from a single reference service in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(3):117-122
03-25-2013
Summary
ArticleAssessment of pelvic floor by three-dimensional-ultrasound in primiparous women according to delivery mode: initial experience from a single reference service in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(3):117-122
03-25-2013DOI 10.1590/S0100-72032013000300005
Views126See morePURPOSE: To evaluate changes to the pelvic floor of primiparous women with different delivery modes, using three-dimensional ultrasound. METHODS: A prospective cross-sectional study on 35 primiparae divided into groups according to the delivery mode: elective cesarean delivery (n=10), vaginal delivery (n=16), and forceps delivery (n=9). Three-dimensional ultrasound on the pelvic floor was performed on the second postpartum day with the patient in a resting position. A convex volumetric transducer (RAB4-8L) was used, in contact with the large labia, with the patient in the gynecological position. Biometric measurements of the urogenital hiatus were taken in the axial plane on images in the rendering mode, in order to assess the area, anteroposterior and transverse diameters, average thickness, and avulsion of the levator ani muscle. Differences between groups were evaluated by determining the mean differences and their respective 95% confidence intervals. The proportions of levator ani muscle avulsion were compared between elective cesarean section and vaginal birth using Fisher's exact test. RESULTS: The mean areas of the urogenital hiatus in the cases of vaginal and forceps deliveries were 17.0 and 20.1 cm², respectively, versus 12.4 cm² in the Control Group (elective cesarean). Avulsion of the levator ani muscle was observed in women who underwent vaginal delivery (3/25), however there was no statistically significant difference between cesarean section and vaginal delivery groups (p=0.5). CONCLUSION: Transperineal three-dimensional ultrasound was useful for assessing the pelvic floor of primiparous women, by allowing pelvic morphological changes to be differentiated according to the delivery mode.
Views126This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
ArticleAssessment of pelvic floor by three-dimensional-ultrasound in primiparous women according to delivery mode: initial experience from a single reference service in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(3):117-122
03-25-2013DOI 10.1590/S0100-72032013000300005
Views126See morePURPOSE: To evaluate changes to the pelvic floor of primiparous women with different delivery modes, using three-dimensional ultrasound. METHODS: A prospective cross-sectional study on 35 primiparae divided into groups according to the delivery mode: elective cesarean delivery (n=10), vaginal delivery (n=16), and forceps delivery (n=9). Three-dimensional ultrasound on the pelvic floor was performed on the second postpartum day with the patient in a resting position. A convex volumetric transducer (RAB4-8L) was used, in contact with the large labia, with the patient in the gynecological position. Biometric measurements of the urogenital hiatus were taken in the axial plane on images in the rendering mode, in order to assess the area, anteroposterior and transverse diameters, average thickness, and avulsion of the levator ani muscle. Differences between groups were evaluated by determining the mean differences and their respective 95% confidence intervals. The proportions of levator ani muscle avulsion were compared between elective cesarean section and vaginal birth using Fisher's exact test. RESULTS: The mean areas of the urogenital hiatus in the cases of vaginal and forceps deliveries were 17.0 and 20.1 cm², respectively, versus 12.4 cm² in the Control Group (elective cesarean). Avulsion of the levator ani muscle was observed in women who underwent vaginal delivery (3/25), however there was no statistically significant difference between cesarean section and vaginal delivery groups (p=0.5). CONCLUSION: Transperineal three-dimensional ultrasound was useful for assessing the pelvic floor of primiparous women, by allowing pelvic morphological changes to be differentiated according to the delivery mode.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cesarean section Archives - Page 3 of 8 - Revista Brasileira de Ginecologia e Obstetrícia
