Sonographic evaluation of caesarean scar defects in speculation of obstetric and gynaecologic sequelae
In the recent decade, there was a significant increase in the rate of caesarean section delivery, either because of closer fetal monitoring during labour or because of availing the technology to anticipate antepartum and intrapartum complications. The most common cause of elective caesarean section is a previous caesarean section (CS). As the number of women with the caesarean section is on the increase, the implications of caesarean section scar defects (CSD) are looked into as cause for various clinical symptoms both in obstetrics and gynaecology. Many studies were conducted on the sonographic evaluation of scar defects, and only a few
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The studies were conducted both on pregnant and nonpregnant women. The scar defects were evaluated based on shape, size, and thickness of residual myometrium. In an unscarred, the lower uterine segment (LUS) is viewed as three-layered structure. The inner layer includes chorioamniotic membrane and endometrial layer. Middle layer includes myometrium, and outer layer includes peritoneal reflection and bladder wall (Cheung 2004). As the pregnancy progress, the LUS develops and the layers changes in sonographic resolution. Myometrium becomes thinner gradually and less distinguished later on in the pregnancy. Whereas in as scarred uterus different layers are not well demarcated, the LUS is comparatively thin. It is considered as scar defect if there is a window or defect in the myometrium. The CS scar was measured in two planes, transverse and sagittal. In the sagittal plane, scar depth, width and residual myometrial thickness (RMT, between hypoechoic indentation at the bottom of the scar to the hyperechoic line of the uterovesical fold) measured and the length of the scar measured in the transverse plane (Naji 2012).
Gotoh H et al. (2000) have assessed the changes in LUS thickness from 19weeks to 39 weeks in women with previous caesarean delivery (caesarean group) and compared with the LUS thickness in nulliparous and multiparous women (control group). Serial measurements of the thickness of LUS showed a steady
Injuries occurring during birth are denoted to as birth trauma or obstetrical injuries and they are associated with different etiological causes. The important causes of birth trauma are macrosomia, breech presentation, shoulder dystocia, and forceps-assisted deliveries [3]. Traumatizing maneuvers during the deliveries will result in these fractures in the assisted deliveries [4]. The trauma may occur due to use of forces, excessive traction or pulling, unintended pressure on soft organs such as eyes. Trauma to the limb usually occurs when the limb is pulled in cases of obstructed labor or shoulder dystocia (Head out, shoulder stuck). An Indian study on birth trauma revealed that the fractured clavicle was commonest bone fractured
Consequently, cervical damage is another leading cause of long term complications following abortion. Normally the cervix is rigid and tightly closed. In order to perform an abortion, the cervix must be stretched open with a great deal of force. During this forced dilation there is almost always caused microscopic tearing of the cervix muscles and occasionally severe ripping of the uterine wall, as well. About 10% suffer immediate complications; one-fifth are life-threatening: • hemorrhage • infection • ripped or perforated uterus • cervical injury • embolism • anesthesia complications • convulsions • chronic abdominal pain • gastro-intestinal disturbances • endotoxin shock • second-degree burns • Rh
Because damaged fetal tissues do not produce the same types of growth factors that the tissues do. The result is a thickened mass of scar tissue that begins at the site
Vacuum assisted deliveries are a method to help facilitate a vaginal birth even if the mother is becoming to exhausted to push or if the baby has reached a difficult position during labor and is prevented from progressing. While the vacuum may be helpful for the labor it runs the risk of causing a subgaleal hemorrhage (SHG) in newborns this condition is a result of the connection between the sinuses of the scalp and the veins of the brain have been ruptured which causes bleeding and swelling of the head and can lead to severe hypovolemia and death (Davis, 2001). SGH occurrences after vacuum delivery are in the range of 26 to 45 per 1000 vaginal deliveries (Modanlou, 2010). In order to treat and correct SGH nurses are
tissue to form in the fallopian tubes. If the tube is only partially scarred, the fertilized egg cannot
day one they watch their beautiful healthy child grow up and live a normal life.
In endometriosis, this endometrial tissue begins to grow in places outside the uterus. Typical sites include the fallopian tubes, intestines, vagina, and on scars that my form after abdominal surgery. The misplaced endometrial tissue thickens, engorges with blood and bleeds during the menstrual cycle, just like the normal tissue in the uterus. However, there is no place for the abnormally placed endometrial tissue outside the uterus to shed blood. This results in the formation of cysts, scars, and adhesions. This process can also block or affect the fallopian tubes so that conception and pregnancy are less likely to happen. It can also result in complete infertility. Other symptoms of endometriosis are often associated with heavy or painful periods. Risk factors for the development of endometriosis include having a mother or sister with the disorder, never having children, starting the menstrual period at an early age, and frequent or long periods. According to Dr. Camron Nezhat, Laparoscopic Surgeon at Stanford University, 5.5% of women in the U.S are infected with Endometriosis and 30% to 40% are infertile as a result of it.
The advancement of medical technology has made it possible to detect medical abnormalities while a child is still a fetus and can create difficult choices for parents to make if severe anomalies are discovered. There are many theories regarding the moral status of the fetus that can be applied when deciding how to proceed if these abnormalities are detected. In the fetal abnormality case study, Jessica, Marco, Maria, and Dr. Wilson each have varying opinions on what course of action to take based on these different theories of moral status.
Nathaniel Hawthorne wrote a time of great change in America. In the mid-nineteenth century, Americans began to experience a shift in focus from the once stringent religious outlook to a more scientific view of the world and its natural wonders. Americans, however, did look at these new scientific discoveries with much hesitation, questioning their long-term effects on society as a whole. Hawthorne’ s work, “The Birth Mark echoes these sentiments and combine natural faith with a confidence in science to make a very interesting tale. This tale and its morality convey a message to the reader that there is a price for tampering with the natural order of things.
In depth discussion of planned and emergency C/S deliveries were also discussed. Planned C/S births were defined as “breech presentation, multiple pregnancy, preterm birth, small for gestational age, placenta praevia, morbidly adherent placenta, cephalopelvic disproportion in labor, mother-to-child transmission of maternal infection, Hepatitis B and C viruses, Herpes, and maternal request for C/S birth was outlined” (National Guideline Clearinghouse, 2011). An in-depth outline of anesthesia and surgical techniques followed. It seems that this source addressed nearly every type of C/S birth technique, including “method of placental removal, exteriorization of the uterus, closure of the uterus, peritoneum, abdominal wall, and subcutaneous tissue, use of superficial wound drains, closure of skin, and even timing of antibiotic administration and thromboprophylaxis for C/S births. Care of the woman after C/S surgery, routine monitoring, pain management, eating and drinking after surgery, and removing the urinary catheter after C/S surgeries was also discussed(National Guideline Clearinghouse, 2011)”. There is even a benefits/harms section that looks at potential risks and successes of C/S deliveries. The National Guidelines Clearinghouse
Many woman give up in labor and beg the doctor to perform a cesarean section or many times the doctor does not want to wait for the laboring patient to progress on their terms and will call for a cesarean section. A cesarean section is a major abdominal surgery. Many woman are not educated in the short and long term effects of having one to be able to stay as far away from them. Maternal complications can be both physical and emotional due to the fact that the woman will not be able to care for her infant exclusively on her own during the recovery period. The first and most common complication with a cesarean section is surgical site infections. This could be caused by many things. It could be a cause of not cleaning the skin properly, a break in sterile technique, or personal hygiene of the wound during the recovery period. It can also be caused by the way the incision is closed. “ The use of staples for skin closure was associated with a marginally statistically significant increase in surgical site infections” (Corcoran 2013, pg. 1262). Infections can also be seen as urinary tract infections, endometritis, and pneumonia. Another complication that can occur from a cesarean section is a thrombus which can lead to pulmonary embolism. When a person has a cesarean section, they are bed bond more than a vaginal delivery. This causes the blood to not circulate in their legs
 A Story of Love and Science A Story of Love and Science & nbsp; Nathaniel Hawthorne is a nineteenth century American Novelist whose works are deeply concerned with the ethical problems of sin, punishment, and atonement (Adams 168). The New England writer also handles the romantic theme very well and is a master of historical fiction. Hawthorne was a descendant of one of the judges at the Salem witch trials, and he set many of his works in Puritan New England and during early crises in American history (Encarta). “The Birthmark,” like many of Hawthorne’s stories deals with
Cesarean section occurs through an incision in the abdominal wall and uterus rather than through the vagina. Women are suffering from various health complexities after the cesarean section. There are many kinds of health complexities like infection, hemorrhage or increased blood loss, injury to organs, adhesions, extended hospital stay, extended recovery time, reactions to medications, risk of additional surgeries, maternal mortality and so on. Among my 12 cesarean respondents 3 were suffered from infection, 2 were suffered from increased blood loss, 1 from injury to organs, 4 from weakness and 2 from extended recovery time. Among my 8 normal delivery respondents 2 were suffered from weakness and 1 from
Umbilical Hernia is a medical condition in which there formed a bulge in the abdominal region just underneath or right beside the navel. The main reason behind this happening is that the navel wall is damaged and hence either body fat or the small intestine makes its way outwards hence forming a bulge.
There are other complications that are not life threatening but are still dangerous to the mother’s health. One example is uterine perforation, occurring when the abortionist misses the child with his knife and cuts the mother’s uterus. This may cause hemorrhaging and complications in childbirth later on. The uterus now cannot hold a child and may rip; causing problems in birth that may lead to the death of the child. Prominent damage to the uterus may require a hysterectomy (“A List of Major Physical Sequelae Related to Abortion”). Another complication is cervical lacrations, which are the tearing of the cervix. These are prominent in childbirth also. These lacerations cause major hemorrhaging and may result in cervical incompetence, premature delivery, and complications of labor (“A List of Major Physical Sequelae Related to Abortion”). Cervical incompetence causes miscarriages. Another complication is placenta previa, which is the “abnormal development of the placenta due to uterine damage” (“A List of Major Physical Sequelae Related to Abortion”). This