Caesarean Operation Research Articles

Radiological Evaluation of Uterine Tubes in Infertile Women with Previous Pelvic Surgery

Abstract Background: Infertility is a disease that affects 8%–12% of couples at their reproductive age. Tubal factors account for 20%–30% of infertility cases. Tubal infertility can be caused by infections, endometriosis, and complications from previous abdominopelvic surgery. Objectives: The objective of the study is to determine the impact of pelvic surgery on future fertility by examining the fallopian tubes for any potential damage using a hysterosalpingography (HSG) examination. Materials and Methods: A cross-sectional study was conducted at Nineveh Governorate, Iraq, in two clinics from March 2022 to September 2022 by examining 317 infertile females using HSG. The exam was done as part of an infertility workup. Results: The results revealed that the study included 317 infertile women patients with a mean age of 28.82 ± 6.9 years (range 17–49 years), of these, 184 patients (58.04%) with primary infertility, and 133 patients (41.95%) with secondary infertility. The years of infertility ranged between 1 and 20 years and a median of 4 years. The history of one or more previous pelvic interventions was recorded in 39 cases (12.3%). The prevalence of tubal abnormalities was noted in 23.1% of cases with previous pelvic intervention and 13.3% in other patients, with an odds ratio of 1.95 at a 95% confidence interval. Tubal abnormalities do not differ significantly according to the type of infertility, and the mean age of infertile women with tubal abnormalities is not statistically different from those with normal tubes. Conclusion: This study concludes that pelvic surgeries, particularly cesarean operations increase the risk of developing subsequent fallopian tube abnormalities and pelvic adhesions, which can lead to infertility.

Effect Of Providing Deep Breathing Relaxation Technique In Reducing Anxiety Levels In Section Caesarean Surgery Patients At RSIA Pasutri Bogor

Background: In patients who will perform sectio caesarea surgery in general feel feelings of excessive anxiety due to worry in the process of surgery, and fear of the equipment used in the operating room. Objective: This study aims to determine and analyze the effect of deep breathing relaxation techniques in reducing the anxiety level of sectio caesarea surgery patients in the Operating Room of RSIA Pasutri Bogor. Method: This study used a quasy experimental research design with One Group pre test - post test. The population in the study was 55 mothers who performed sectio caesarea surgery in the operating room of RSIA Pasutri Bogor. The sample technique used in this study was purposive sampling. Results: From the results of the analysis in this study using the Wilcoxon signed test obtained p value = 0.000 (α < 0.05). Conclusion: So it can be concluded that there is a significant effect of providing deep breathing relaxation techniques in reducing the anxiety level of sectio caesarea surgery patients at RSIA Pasutri Bogor. Suggestion: Conduct more studies and the application of deep breathing relaxation techniques in reducing anxiety levels in cesarean section surgery patients.

The Effect of Gelatine Colloid Preloading on Hypotension Prevention in Cesarean Section with Spinal Anesthesia at The Central Surgery Installationof Banyumas Regional Hospital

Background:Hypotension in cesarean-section patients occurs due to peripheral vasodilation. It was the result of a sympathetic blockade caused by spinal anesthesia medication. Several methods can be employed to manage hypotension during cesarean section surgery, including fluid loading and vasopressors. Preloading with colloid fluids like hydroxyethyl starch (HES) before initiating spinal anesthesia has been deemed effective in reducing the incidence and severity of hypotension. A preliminary study revealed a decrease in blood pressure (up to 20%) in the first 15 minutes after spinal anesthesia was given to 30 cesarean section patients.Method: In this research, a Quasi-Experimental method was employed with a Pretest-Posttest Control Group Design. A total of 94 respondents were selected as the research sample using a purposive sampling technique. The respondents were divided into two groups: the ephedrine group and the preloading group. The data obtained were then analyzed using Independent Sample T-Test. Results:There is a significant effect on systolic and diastolic blood pressure between the ephedrine and preloading group, with respective significance values of p 0.010 and p 0.001. Conclusion:Preloading gelatine colloid is effective in maintaining blood pressure (systolic and diastolic) in cesarean section patients with spinal anesthesia.

Effects of Elective Caesarean Sections in Healthy Near-Term Ewes on Subsequent Reproductive Performance.

Post-surgical reproductive performance following ovine caesarean section has not been well studied. To assess any direct effects of surgical delivery in the absence of confounders such as dystocia or underlying diseases, we studied elective surgery performed in healthy animals for teaching purposes. Four hundred and eleven paired breeding records following vaginal delivery (n = 233), elective caesarean section (n = 122), and subsequent further vaginal deliveries in animals with a history of one prior elective caesarean operation (n = 56) were evaluated retrospectively. The overall subsequent pregnancy rate was 95%. Multivariable statistical analyses did not reveal any significant influence of planned caesarean surgery on subsequent conception, stillbirth, perinatal lamb mortality, lamb birth weights, or the incidence of premature foetal death (mummification and abortion). A significantly higher number of mating attempts was, however, necessary. Also, a significant reduction in litter size was seen in the first pregnancy immediately following a surgical delivery in comparison to animals which had previously only delivered vaginally (p = 0.001), but litter size returned to pre-caesarean levels in further follow-up pregnancies in animals with a history of one elective caesarean section (p = 0.436). Subsequent long-term reproductive performance of sheep following elective caesarean section is thus excellent, and the results encourage retention for breeding.

Hubungan Dukungan Keluarga Dengan Kemampuan Mobilisasi Dini Pada Pasien Post Operasi Sectio Metode ERACS

Electronic Based on several studies, the number of caesarean sections continues to increase and with widespread news regarding the use of the ERACS method in the caesarean section process, which is believed to optimize the mother's health and comfort both before, during and after undergoing caesarean surgery, so that mobility and the birth recovery process can be improved. fast. Early mobilization is one of a series of methods and according to theory there are several things that influence the implementation of early mobilization after surgery, one of which is the impact of support from family members. This study aims to determine the relationship between family support and the ability to mobilize early in post-SC surgery patients with the ERACS method at Azra Hospital Bogor in 2023. This type of research is observational with a cross sectional design. The research sample was 45 post-caesarean section mothers at Azra Bogor Hospital. The research results showed that the majority of 35 respondents (77.8%) had good family support, there were 37 respondents (82.2%) who had early mobilization abilities, of which 10 respondents (22.25%) had poor family support There were 8 people (17.7%) who still assisted with early mobilization. With the Chi Square analysis test, the p-value = 0.001 was obtained, so there is a significant relationship between family support and early mobilization for post-SC mothers using the ERACS method at Azra Bogor Hospital in 2023. Conclusion, the better family support, the more the patient tends to mobilize, and conversely, if the family support is not good, the ability to early mobilize tend to improve

Comparative Analysis of Perceptions of Doctors, Management, Nurses and Patients on the Use of the Enhanced Recovery After Caesarean Surgery Method Based on the Concept of Perceived Value

In this era of modernization, several companies, one of which is hospitals, are adopting E-Service Quality because currently patients prefer services that are quickly accessible wherever and whenever they are, so this adds to the main function of a service. One of the services of the Obstetrics and Gynecology unit, especially the delivery service using the ERACS (Enhanced Recovery After Caesarean Surgery) method, is a surgical procedure that increases profits for hospital Agencies. So, it can influence consumer value perceptions, perceived quality and hospital imAge and patient satisfaction. The aim of this research is to analyze differences in perceptions between the components of doctors, management, nurses and patients based on perceived value in implementing ERACS actions. This research method uses a quantitative research approach, survey method and the type of research is hypothesis testing with descriptive analysis and comparative analysis. The sampling technique used was a saturated sampling technique. The number of samples used was 50 respondents. The research results show that the Mann Whitney test analysis on the combination of all components which compares benefits and costs, shows that the p-value is 0.000 (p < 0.05), meaning there is a significant difference between benefits and costs on the combination of all components. It can be concluded that there is a significant difference between benefits and costs in the doctor, management, nurse and patient components.

Enhanced Recovery After Caesarean Surgery (ERACS) versus Non-ERACS Delivery: A Comparative Study on the Effectiveness of Exclusive and Early Initiation of Breastfeeding

Background: Exclusive breastfeeding (EBF) for up to 6 months postpartum provides numerous benefits to both mother and child. Despite these advantages and the recommendation for EBF during the first 6 months postpartum, the global prevalence of EBF is on the decline. The method of delivery is one of the many factors that influence EBF rates. Enhanced Recovery After Cesarean Section (ERACS) has been shown to improve breastfeeding rates in comparison to the standard Cesarean section. Objectives: The purpose of this study was to investigate the association between ERACS and non-ERACS delivery methods with EBF and the early initiation of breastfeeding (EIBF). Methods: This cross-sectional study involved a minimum of 96 subjects for each category. Non-ERACS delivery was categorized into vaginal delivery and standard Cesarean section. The success rates of EBF at 0, 1, 3, and 6 months were evaluated using an exclusive breastfeeding questionnaire, which demonstrated a Cronbach's Alpha of 0.931, indicating a high level of reliability (≥ 0.60). The association between the variables was analyzed using the chi-square test. Results: The study identified a significant association between the method of delivery and EBF (P = 0.036), with vaginal delivery having a Relative Risk (RR) of 1.286 (0.858 - 1.927) and standard Cesarean section an RR of 1.679 (1.156 - 2.437) for not engaging in EBF for 6 months in comparison to ERACS. Furthermore, a significant association was observed between delivery methods and EIBF (P < 0.001), with an RR of 1.190 (0.717 - 1.967) for vaginal delivery and an RR of 2.667 (1.762 - 4.035) for standard Cesarean section for not initiating breastfeeding early compared to ERACS. Conclusions: There is a significant association between ERACS and non-ERACS delivery methods with both EBF and EIBF. Both vaginal delivery and standard Cesarean section are associated with a higher risk of not engaging in exclusive breastfeeding at 6 months and not initiating breastfeeding early, compared to ERACS.

The Relation Of Placenta Previa With History Of Previous Cesarean Section And Miscarriages

Background and objectives: The factors that increase the risk of placenta previa in subsequent pregnancies include past miscarriages and the scar from a previous cesarean operation. This study aimed to determine whether a history of cesarean section or miscarriage was related to placenta previa at Sulaimani Maternity Teaching Hospital. Methods: At the Sulaimani Maternity Teaching Hospital, this case-control study was conducted between the 11th of September 2021 to the 31st of June.2022. A total of 100 women provided information, which was divided into two groups: Group A, which included 50 pregnant women with gestational ages between 30 and 40 weeks and confirmed placenta previa, and Group B, which included 50 pregnant women randomly selected with pregnancy lengths of 30 to 40 weeks and the placenta was in its usual location. Detailed history was taken from each woman, through this the relationship of placenta previa with previous cesarean section and miscarriages was studied. Results: The results of this study revealed that prior cesarean sections were previously performed in 74% of cases of placenta previa, compared to 46% of controls (p value = 0.004). In addition; there was no correlation between placenta previa and prior miscarriages (p value= 1.000), and a highly significant correlation was seen between the rise in previous cesarean deliveries and the presence of accreta (p value = 0.003). Conclusion: The likelihood of placenta previa in subsequent pregnancies is dramatically increased in this study by past cesarean deliveries; previous miscarriages have no significant impact on placenta previa development.

INCIDENCE OF HYPOTENSION AND NAUSEA VOMITING IN SUBARACHNOID BLOCK ANESTHESIA TECHNIQUE IN CESAREAN SURGERY

Hypotension and nausea vomiting are common side effects in patients undergoing cesarean surgery with subarachnoid block anesthesia techniques. Cases of hypotension and nausea vomiting in this case are often found but research data in Indonesia, especially in Bali, is still very limited. Therefore, this research is important to do with the aim of knowing the incidence of hypotension and nausea vomiting in cesarean surgery with the subarachnoid block anesthesia technique at Prof. Dr. I.G.N.G Ngoerah General Hospital Denpasar. This study used a prospective cross-sectional observational descriptive method. The study data were taken from the presence or absence of hypotension and nausea vomiting during and after cesarean surgery from April 2022 – June 2022. The data were analyzed using Microsoft Excel 2013 software to obtain characteristics of patient demographic data in the form of maternal age and gestational age, patient distribution based on height of sensory blockade, type and dose of antiemetics, type and dose of opioids, bleeding, incidence of hypotension, and incidence of nausea vomiting. The results showed that the number of patients who experienced hypotension was 13 people (28.3%), and those who did not experience hypotension were 33 people (71.7%). A total of 30 people (65.2%) patients did not experience nausea vomiting, 8 people (17.4%) experienced nausea and 8 people (17.4%) experienced vomiting. By taking good precautions, it can reduce the side effects of hypotension and nausea vomiting.

The Effect of Spinal Needle Type on Post-Dural Puncture Headache in Spinal Anesthesia: Prospective Randomized Study.

Postdural puncture headache is a headache that occurs after a dura puncture, especially in caesarean sections, and afects patient comfort and mobilization. In this study, we compared the efects of pencil-tipped spinal needles and especially curved, bilateral atraumatic spinal needles in individuals undergoing elective caesarean sections. A total of 886 patients, aged 20-50 years, who had cesarean sections with spinal anesthesia and had American Society of Anesthesiologists II and III scores, were included in the study. The patients were allocated into 3 groups using the closed envelope randomization technique: Group 1 (n=250) received spinal insertions using 25-gauge pencil-point needles; Group 2 (n=245) received spinal insertions using 26-gauge atraumatic needles; and Group 3 (n=250) received spinal insertions using 27-gauge pencil-point needles. Records were kept of the quantity of spinal needle referrals, the type of treatment, the length of hospital stays, and complications. In the study, 745 patients who had cesarean section operations under spinal anesthesia were further analyzed. The mean incidence of post-dural puncture headache (PDPH) was 3.2% (n=24). The incidence of PDPH was higher in group 2 than in group 3 and group 1 (Group 1: 2.8%; Group 2: 6.8%; Group 3: 0%) (P <0.05). Among other complications, low back, back, shoulder, and surgical complications were similar for all 3 groups. In caesarean section operations, pencil-point spinal needles were found to have a lower incidence of postdural puncture headache than Atraucan-cut needles, regardless of needle thickness.

STUDYING THE STRUCTURE OF CESAREAN SECTION IN SAMARKAND

Cesarean section surgery is included in moderate to severe caesarean section surgery. According to various sources, complications after surgery rangefrom 7-19.5%. These complications are explained by obstetric and extragenital pathology. The first stage lasts on average 2-7 days from the moment of injury, its duration depends on the size and type of injury. Developing changes in microcirculation depend on changes in vascular tone, impaired permeability of vascular walls, and the nature of the biosynthesis of biologically active substances.

Effectiveness of Early Mobilization and Administration of Cork Fish Extract on Wound Healing of Sectio Caesarean Surgery at Noemuti Health Center

This study aims to determine the effectiveness of early mobilization and administration of cork fish extract on wound healing after Sectio caesarea surgery at Puskesmas Noemuti. The problem faced is the high rate of cesarean delivery in Indonesia which can cause complications such as surgical wound infection and increase maternal and infant mortality. The method used is a type of quasy experimental research with a static group comparison design approach. The results showed that early mobilization and administration of cork fish extract were effective in improving sectio caesarean wound healing. The treatment group given the intervention of early mobilization and administration of cork fish extract had a better level of surgical wound healing compared to the control group which was only given the standard hospital intervention. This study can contribute to improving the quality of health services in Indonesia, especially in the handling of labor through cesarean section.

Spinal Anesthesia with Ultrasonography (USG) Marker in Morbidly Obese Pregnant Women Undergoing Cesarean Section Surgery: A Case Report

Background: Spinal anesthesia is a regional anesthesia technique used to provide analgesia or numbness in the lower part of the body. This technique has long been employed in childbirth and cesarean section surgeries due to its numerous advantages for pregnant women. Obese pregnant patients often have increased adipose tissue in the back area, making it challenging to identify the appropriate interspinous space.&#x0D; Case presentation: A 26-year-old primigravida at 38 weeks of gestation with morbid obesity, standing at 158 cm tall and weighing 140 kg, with a body mass index (BMI) of 56.1 kg/m², underwent cesarean section surgery under spinal anesthesia. The identification of the spinal needle insertion site was performed using pre-procedural ultrasound (USG) marker at the L3-L4 level, with heavy bupivacaine 0.5% 12.5 mg used as the anesthetic agent. The surgery lasted for 1 hour and 20 minutes, with stable hemodynamics and a blood loss of 450 ml. A female infant was delivered, weighing 3080 grams, with a length of 50 cm and an APGAR score of 8-9-10.&#x0D; Conclusion: The use of USG markers can assist in determining the precise location for spinal anesthesia injection, thereby reducing complications from repeated needle insertions.

Comparison of the Effect of Ondansetron and Dexamethasone on Postoperative Shivering After Cesarean Section in Patients Undergoing Spinal Anesthesia

Background: Shivering is one of the most common problems after spinal anesthesia, which can cause many complications. Various methods and drugs have been used to prevent and treat postoperative shivering. In the present study, the pretreatment effect of ondansetron and dexamethasone in reducing the incidence of shivering after elective caesarean section by the spinal method has been investigated. Methods: In this study, 78 patients undergoing elective cesarean surgery who were eligible to enter the study were evaluated and randomly divided into two groups: 8mg of ondansetron and 4mg of dexamethasone 15 minutes before the end of surgery. Then, the incidence of shivering was measured at specific time intervals after surgery. Statistical analysis was done using SPSS software. Results: The two groups were similar in terms of age, height, weight, and BMI (p-value &gt; 0.05). The incidence of shivering at the time of entering the recovery, 10, 20, and 30 minutes in the ondansetron group was 23.1%, 20.5%, 12.8% and 0% and in the dexamethasone, group was 20.5%, 15.4%, 5.2% and 0%, respectively. Statistical analysis showed that these differences are not significant at the significance level of 0.05. These two drugs have the same effectiveness in controlling shivering after cesarean section under spinal anesthesia (p-value &gt; 0.05). Conclusion: Dexamethasone and ondansetron will be able to control shivering after caesarean section with spinal anesthesia.

Near miss cases during cesarean hysterectomy due to morbid adherence of placenta at Al-Yarmouk Teaching Hospital

Background: Placental adhesion disorder, or placenta accreta, is caused by a decidua basalis shortage that leads to the chorionic villi penetrating the myometrium. Different types of placental adhesion disorders are classified according to the degree of uterine adhesion. Cesarean Hysterectomy is indicated in cases of morbid adherence of the placenta in various age groups during childbearing age. Objectives: Evaluation of the influence of placental adhesion on hysterectomy at the time of cesarean in near-missed pregnant women and assessment of factors that increase its incidence among Iraqi women. Methods: This research encompassed a case-control study involving 64 pregnant women, with the participants selected from Al-Yarmouk Teaching Hospital. The pregnant patients were divided into two groups. The first group consisted of thirty-two pregnant women with emergency cesarean hysterectomy due to placental adhesion. The second group was made up of thirty-two pregnant women with elective cesarean hysterectomy due to placental adhesion. Results: In the present study, it has been found that there are no significant differences in the age of patients who undergo elective cesarean hysterectomy as compared to emergency cesarean hysterectomy (p &gt; 0.05). Also, according to the gestational age, most elective surgery patients are full-term pregnancies; meanwhile, the emergency cases are mostly preterm. Elective patient parity was higher than emergency cases at three parity 13 vs 9. The patients with emergency cesarean hysterectomy showed that the presence of two or more scars in the uterus was accreta in about 72% of patients. Meanwhile, the elective patients with placental adherence showed a higher frequency of two or more scars, the same as observed in emergency cases. Still, there were more emergency cases than elective cases. Conclusion: There are elevations in the incidences of placental adhesion, reflecting the increase in cesarean hysterectomy surgeries and near-miss cases.

Efficacy of esketamine for the treatment of postpartum depression and pain control following cesarean section: a randomized, double-blind, controlled clinical trial

BackgroundPostpartum depression (PPD) following a cesarean delivery is a frequently seen complication. Despite the prophylactic effects of ketamine, the impact of esketamine on PPD in women undergoing cesarean section remains uncertain. This study aimed to assess the effectiveness of esketamine as an adjunct to patient-controlled intravenous analgesia (PCIA) in preventing PPD in women undergoing caesarean section.MethodsA total of 275 parturients undergoing caesarean section and subsequent patient-controlled intravenous analgesia (PCIA) were randomly assigned to receive either the control treatment (sufentanil 2 µg/kg + tropisetron 10 mg) or the experimental treatment with additional esketamine (1.5 mg/kg). The primary outcome measured was the incidence of postpartum depression (PPD), classified by Edinburgh Postnatal Depression Scale (EPDS) scores equal to or greater than 13 indicating PPD. Secondary outcomes included cumulative sufentanil consumption during specific time periods (0–24 h, 24–48 h, and 0–48 h) after the surgical procedure and numerical rating scale (NRS) scores at rest and during movements.ResultsThe final analysis included a total of 246 postpartum women who had undergone caesarean delivery. On postoperative day 42, the incidence of depression among the control group was 17.6%, which was significantly higher compared to the esketamine group with a rate of 8.2% (P = 0.02). The EPDS scores also showed a significant difference between the two groups, with a mean score of 9.02 ± 2.21 in the control group and 6.87 ± 2.14 in the esketamine group (p < 0.0001). In terms of pain management, the esketamine group showed lower sufentanil consumption in the 0–24 h (42.5 ± 4.58 µg vs. 50.15 ± 5.47 µg, P = 0.04) and 0–48 h (87.40 ± 9.51 µg vs. 95.10 ± 9.36 µg, P = 0.04) postoperative periods compared to the control group. Differences in movement were also observed between the two groups at 24 and 48 h after the cesarean Sect. (3.39 ± 1.57 vs. 4.50 ± 0.80, P = 0.02; 2.43 ± 0.87 vs. 3.56 ± 0.76, P = 0.02). It is worth noting that the frequency of side effects observed in both groups was comparable.ConclusionsEsketamine at a dose of 1.5 mg/kg, when used as a supplement in PCIA, has been shown to significantly reduce the occurrence of PPD within 42 days. Additionally, it has been found to decrease cumulative consumption of sufentanil over a 48-hour period following cesarean operation, all without increasing the rate of adverse effects.Trial registrationRegistered in the Chinese Clinical Trial Registry (ChiCTR2200067054) on December 26, 2022.

Cost efficiency of cesarean section surgery with eracs method compared to the conventional method

Background: The enhanced recovery after caesarean surgery (ERACS) method is a new protocol for cesarean delivery, which improves recovery by optimizing maternal health during periods of prenatal, intranatal, and postnatal. This study aimed to analyze the effectiveness of the ERACS versus the conventional method in PKU Muhammadiyah, Pamotan, and Rembang Hospital. Methods: A cross-sectional design was used in this study. One hundred and twenty pregnant women who scheduled elective section cesarean surgery with class II The National Health Insurance in July – December 2022 were the samples in this study. Pregnant women who delivered in normal, emergency sectio caesarea and delivery except sectio caesarea procedure were excluded from this study. Results: This study indicates that the mobilization period of the ERACS method is faster (8.83 hours) post-cesarean surgery than that of the conventional method (18.47 hours). The hospital stay in the ERACS method is shorter (1 day) than the conventional method (2.35 days). The total cost of hospital care in the ERACS method is significantly lower (Rp 5,993,800,-) than the conventional method (Rp 7,810,699,-). Conclusion: The section caesarea with the ERACS was more efficient than the conventional method.

Overview of the Incidence of Post Operative Nausea and Vomiting in Spinal Anesthesia for Sectio Caesarea Patients in the Recovery Room of Fatimah Cilacap Islamic Hospital

Background: Post operative nausea vomiting (PONV) is nausea and vomiting that occurs after surgery and before the patient returns from the hospital. PONV must be taken seriously because it can have an impact on the length of the patient's recovery period, hamper activities, and increase the cost of care that must be incurred. PONV or nausea and vomiting. Aim: what is the description of the incidence of PONV in spinal anesthesia in SC patients in the recovery room (RR) RSI Fatimah Cilacap. Method: Quantitative descriptive with a cross section approach, the sample used total sampling of 31 respondents instruments using the Simplified Postoperative Nausea and Vomiting Impact Scale for Audit and Post-Discharge. Findings: PONV sufferers were 19 respondents (59.4%), based on age 26-34 years as many as 16 respondents (51.6%), at BMI the incidence of PONV was obese as many as 11 respondents (35.5%), in the length of surgery the most PONV was found in women as many as 4 respondents (11.4%), in the length of surgery the incidence of PONV was found to be mostly 1-2 hours as many as 10 respondents (32.3%), and in the previous PONV history the incidence of PONV was found to have all experienced PONV before as many as 13 respondents (16.1%). Conclusion: the frequency distribution of PONV incidence on respondents who are female, obese IMT operation duration and PONV history with spinal anesthesia technique in cesarean section surgery.

Uterine Rupture: A Distressing Catalyst for Severe Postpartum Hemorrhage

Uterine rupture is a disruption of the uterine scar, causing foetal expulsion into the peritoneal cavity. This condition, primarily caused by the separation of uterine scar tissue from previous caesarean surgery, reduces foetal survival and increases maternal morbidity and mortality. A 32-year-old woman with a history of four vaginal deliveries and one caesarean section was diagnosed with uterine rupture, leading to a laparotomy procedure and obstetric hysterectomy. Consistent antenatal care can prevent uterine rupture.

Effect of Beta Thalassemia Trait in Pregnancy

A cross-sectional, observational study was conducted to determine the effects of beta thalassemia trait in pregnancy. A total of 150 pregnant women diagnosed with beta thalassemia trait in Bangladesh Navy Ship (BNS) Patenga Hospital, at Chattogram, Bangladesh, having regular antenatal care and delivery, between January and December of 2022, were included in the study. Thalassemia status was diagnosed by Hb-electrophoresis. Most of the patients belonged to the age group 19-35 years. 30.46% of women had normal hematocrit level. During pregnancy women suffered from severe anemia (14%) and mild anemia (55.33%) (P&lt;0.001). Blood transfusion needed during 1st trimester (1.3%), 2nd trimester (4.6%), 3rd trimester (8%) and at postpartum period (9.3%) (P&gt;0.05). Most of the women (76.66%) delivered babies at her 36-39 weeks of gestational age,18.67% delivered at or after 40 weeks of gestation and 4.67% delivered baby before 36 weeks (P&lt;0.05). 66.67% had normal vaginal delivery, while 33.33% underwent Caesarean section operation due to several complications. Observed obstetric complications were: pregnancy induced hypertension (6.6%), gestational diabetes (4%), oligohydramnios (11.33%, premature rupture membrane (3.3%), preterm labor (8.66%), and placental abruption (1.33%). Adverse fetal outcomes observed were: prematurity (4.6%), intrauterine growth retardation (5.33%), still birth (0.6%), and fetal asphyxia (3.33%). Neonatal admission at NICU was needed in 2(1.33%) cases. CBMJ 2024 January: vol. 13 no. 01 P: 77-82