Frequency Of CS Research Articles

Caesarean Section frequency in Nulliparous Women induced at 39 weeks versus conventional management: An open label random allocation study.

To compare frequency of caesarean section in singleton primary-para women induced at 39 week and its comparison with conventional management. The other objective was comparison of perinatal and neonatal outcomes. Open random allocation study was conducted at Gynae/Obst Department JPMC during period from 1st June 2022 to 30th September 2023. Primiparous women with singleton pregnancy without risk factors with gestational age 38 weeks 0 days to 38 weeks six days attending the anti-natal clinic offered to participate after consent. Non-probability convenience sampling method was used for induction. Randomization was done using random number table into one of the two groups, Group-A in which induction was done at 39 weeks while in Group-B induction was done conventionally. Mean age ±SD, gestational age and delivery time was calculated and compared by Student's t test. Frequency of CS, perinatal and neonatal outcomes was compared by χ2 test. Eighty-two women were inducted in Group-A and eighty-five in Group-B. The mean delivery time in Group-A was significantly more at 8.12±2.77 hours while in Group-B was 7.0±2.62 hours (p = .005). Frequency of CS between two groups was not statistically significant, it was 5 (6.1%) in Group-A and 2 (2.4%) in Group-B (p = 0.412). No significant difference in frequency of NICU admission was seen, in Group-A 8.54% babies were admitted to NICU while in Group-B 16.47% were admitted to NICU (p = 0.122). No significant difference was observed in frequencies of CS, Foetal, Neonatal, and Maternal outcomes.

Assessment of the frequency of cesarean section according to the criteria of M. Robson in the Regional perinatal center №1 of Turkestan region

Objective. To identify and analyze the groups of women who contribute the greatest and least to the frequency of caesarean sections in general. Conducting an assessment of the frequency of caesarean sections in the Regional Perinatal Center №1 of the Turkestan region according to the classification of M. Robson.Materials and methods. We conducted a retrospective analysis of the history of 5286 births in the Regional Perinatal Center No. 1. The history of childbirth of women who gave birth in 2022 was taken into account. According to the history of each birth to complete the table: method of delivery (delivery through the birth canal, caesarean section); parity (first time , repeated); number of fetuses (one, two, three or more); delivery period (up to 37 weeks., 37-40 weeks., 41-42 or more); type of fetal malformation (head, pelvis, transverse/ oblique); induction of labor (induction was carried out, induction was not carried out); spontaneous childbirth; the number of caesarean sections in the history (one or more) was taken into account.Results and discussion. The group contributed the most to the total CS frequency were 5 groups – with a history of one or more CSs, one fetal head arrival, ≥37 weeks – 24.1%; the group contributed the least to the total CS frequency was 9 groups – single fetal pregnancy, women with a horizontal or oblique fetal position, including women with a history of one or more CSs – 2.2%.Conclusion. The largest share of the group in the total frequency of CSwas Group 5 – 22.1% of all births, 888 (75.9%) of 1,170 women in this group underwent surgery, all pregnant women with scars on the uterus ; group 9 – 0.7% of births accounted for the smallest share of the group in the total frequency of CS, 100% of 38 women gave birth with CS.

Women’s preferences of mode of delivery in rural and urban communities- gharbia governorate, Egypt

Background: The birth process carries many risks for women during pregnancy, delivery, and the postpartum period. The delivery route choice is critical to the mother's and child's health. The increasing rate of CS worldwide is an alarming concern for public health and obstetricians. Objective: To identify the frequencies and the determinants for the preferences of mode of delivery in urban and rural communities. Methods: The study was a cross-sectional study carried out on 304 mothers attending vaccination sessions for the scheduled vaccines in the second and ninth months of child age at Said Primary Healthcare Center, and Shobar Primary Healthcare Unit in Al-Gharbia Governorate, Egypt. The data was collected by interviewing the mothers using a predesigned tested questionnaire. Results: Regarding the preferred mode of delivery, CS were preferred by 40.2% and 15% of females in urban and rural communities. However, 83.6% were delivered by CS at the last pregnancy. Immediate contact with the baby, immediate breastfeeding, better care for the baby and hand no scar were the most significant determinants for VD. Being easier than VD and safer for the baby were the most significant determinants for CS. Urban residence, age >25 and living in a separate home, primiparity, no abortion, and previous CS delivery were the most significant determinants of delivery mode. Conclusion: The frequency of CS was higher than VD. Urban residence, age group 25- and living in shared home were the most important determinants for CS.

Clinical and functional impact of central sensitization on patients with familial Mediterranean fever: a cross-sectional study.

This study aimed to investigate the frequency of CS and its clinical and functional effects on familial Mediterranean fever (FMF). A hundred FMF patients were included in this study. The presence of CS was investigated by the central sensitization inventory (CSI). In addition to the detailed clinical features of patients and genetic mutations, quality of life, disability, sleep disorders, depression, anxiety, and fibromyalgia frequency were examined to evaluate the negative effects of CS on the individual. Patients were divided into groups according to the presence and severity of CS, and their results were compared. Correlation and multivariate regression analysis wereperformed to investigate the association of CS withselected demographic and clinical parameters. The mean CSI was 37.72 (SD: 19.35), and thirty-eight (38%) patients had CS. Sacroiliitis occurred in 11 patients (11%), amyloidosis in 3 (3%), and erysipelas-like erythema in 11 (11%). The most prevalent genetic mutation was M694/any compound heterogeneous (35.7%), followed by M69V homogeneous (30%). Regarding comparing the patients with and without CS, the number of attacks, disease activity, daily colchicine dose, and all investigated comorbidities were significantly higher in the patients with CS (p < 0.05). In regression analysis, gender, colchicine dose and sleep disturbance were detected as related parameters with CS (OR (95% CI): 6.05 (1.39; 26.32), p: 0.017, OR (95% CI): 6.69 (1.65; 27.18), p: 0.008, OR (95% CI): 1.35 (1.35; 1.59), p: 0.001, respectively). Concomitant pain sensitization appears to be related to FMF patients' clinical and functional characteristics. These results suggest taking into consideration CS in the management of FMF patients.

Obstetric audit of cesarean sections according to M. Robson classification criteria – the experience of St. Petersburg in 2020-2021

An external audit of the childbirth outcomes was conducted in accordance with M. Robsons 10-group classification. The main determinants of indications and the frequency of cesarean section in obstetric medical organizations of St. Petersburg in 2020-2021 were analyzed in order to find effective mechanisms for reducing the frequency of сesarean delivery within the framework of compliance with modern principles of perinatal-oriented obstetrics and the preservation of a womans reproductive health. Possible effective reserves for reducing the frequency of CS are presented: personalized pre-gravidar preparation in high-perinatal risk women groups, personalized approach to methods of pre-induction and induction of labor in high-risk groups patients, rational management of labor in compliance with modern clinical recommendations, wider use of current classical external manual methods for antenatal correction of fetus pelvic presentation, prevention the primary cesarean deliveries, increase in the rate of vaginal deliveries among women with previous cesarean deliveries, optimization of effective antenatal psychological consultation about the delivery methods among pregnant women with breech presentation, previous cesarean deliveries and multiple pregnancy.

Prevalence, incidence and survival outcomes of cardiac sarcoidosis in the South Island, New Zealand

AimsCardiac sarcoidosis (CS) is an important cause of mortality in patients with sarcoidosis. The aim of this retrospective cohort study was to characterize the prevalence, incidence, clinical features and outcomes of CS in the southern region of New Zealand. Methods and results45 patients were identified: 23 fulfilling international classification criteria, 9 fulfilling physician consensus criteria, and 13 classified as possible CS. As of June 2021, 26 patients were living and domiciled in the Canterbury district; estimated point prevalence was 4.43 cases per 100,000 people. The average annual incidence was 0.24 cases per 100,000 people between 2016 and 2020. We estimated a 5.14% frequency of CS in patients with sarcoidosis. Median age at presentation was 56 years (range 31–72). Common presentations included heart failure, heart block and life threatening ventricular and supraventricular arrhythmias. Electrocardiogram abnormalities were found in 93.3% and cardiac MRI was often relied upon by physicians for diagnosis. The 10-year survival was 94% (95% CI 78–99%). ConclusionOur study provides further insight into the epidemiology of CS. In this retrospective cohort the frequency of CS amongst patients with sarcoidosis was estimated at 5%, whilst the estimated point prevalence of the disease was twice that of a contemporary report from the Northern hemisphere. The 10-year survival was similar to contemporaneous reports from other developed countries.

V11 The trends of the indications and outcomes of cesarean section in Bukavu - A single-center cross-sectional study

IntroductionCesarean sections (CS) can avert maternal and fetal death and disability. The CS rate varies considerably around the world. While in underserved regions, CS rates are low, in higher income settings, there appears to be too many CS. The objective of this study was to describe the temporal evolution of the indications, practice, and outcomes of CS in Bukavu, Democratic Republic of Congo.MethodsThis cross-sectional study was conducted using the hospital records of women who delivered by CS from January 01, 2014, to December 31, 2017, at the University clinics of Bukavu. Summary descriptive, bivariate, and regression analyses were conducted. The threshold of significance of the alpha was set at 0.05.ResultsOut of the 3,772 women who gave birth, 502 delivered by CS (CS rate=13.3%). The mean age of the women was 26.1 ± 6.4 years, mean gravidity was 3.5 ± 3.0, and the mean parity was 3.3 ± 2.7. Both gravidity (p = 0.007) and parity (p = 0.013) were significant variables in the regression model. 98.2% of CS were emergent, and a general practitioner performed 97.6%. Robson group 1 (30.0%), 5 (29.5%), and 3 (27.1%) were the major CS indications. The complication rate was 7.6%. Surgeons registered 29 (5.8%) intraoperative bleeds, 4 (0.8%) bladder injuries, 5 (1.0%) postpartum hemorrhages, 3 (0.6%) functional ileus, 3 (0.6%) superficial surgical site infections, and 7 (1.4%) endometritis.ConclusionThe frequency of CS is optimal at the University Clinics of Bukavu. Its indications are evolving with time.

Features of climacteric syndrome in women with endometriosis

Share of patients with endometriosis among women of perimenopausal age is about 50% thus the problem of climacteric syndrome (СS) is extremely actual. The processes of maladaptation of neurocircular regulation are observed at reproductive age especially in this category of women. Considering the above-mentioned, research of the CS`s run of the disease; against the background of endometriosis and the choice of the correct tactics of the management of such patients becomes extremally crucial. The article deals with issues of identification of the frequency of CS in patients with endometriosis and features of development of the disease.The exanimated group of patients consisted of 1055 women of late reproductive and perimenopausal women (from 39 to 55 years), 520 of them had diagnosis endometriosis (control group) and 535 without endometriosis(comparison group). At the next stage were examined 323 women: 170 with endometriosis and 153 without this pathology, which were divided into groups depending on the presence or absence of CS’s symptoms. Also were searched four electronic databases.During the analysis of groups of patients were studied, it was found that the incidence of CS in group of women with endometriosis was significantly higher (p &lt;0.05) than in the comparison group, with manifestations of the CS earlier than in women of the general population. Were found the following risk factors for the development of a climacteric syndrome against the backdrop of endometriosis: psychical and intellectual overload, the presence of chronic stressful situations, adverse environmental conditions of living and harmful factors of labor, menstrual disorders in reproductive age, especially abnormal uterine bleeding, premenstrual syndrome, three or more abortions, the absence of birth in the history, the presence of postoperative surgical interventions in reproductive age, as well as significant somatic burdened anamnesis.Given the results of the study, it can be argued that the CS is the psycho-emotional and vegetative crisis which in combination with severe premorbid background – endometriosis, significantly increases the impact on the general condition of both physical and mental health, including social activity and quality of life than the development of an independent disease. This determines the relevance of the study of the possibilities of using therapeutic and preventive measures not only for the safe correction of menopausal disorders, but also to relief the severity of the symptoms of endometriosis.

A New Way of Evaluating Cesarean Section Birth: The Robson's Ten Group Classification System

ABSTRACT Introduction Cesarean section (CS) is the most common obstetric surgery and one of the most rewarding surgeries performed. The number of CSs has been growing rapidly, and concern has been expressed at the growing rate in some countries, with some referring to it as an emerging “global epidemic.” Aim The purpose of this study was to study the incidence and analyze different indications of CS in our institution and to compare the frequency of CS in Robson's ten group classification system (TGCS). Materials and methods A prospective hospital-based study for a duration of 3 months (January 2012 to March 2012) was conducted in the Department of Obstetrics and Gynecology, Umaid Hospital, Jodhpur. All patients admitted beyond 20 weeks gestation were included in the study, and record of all births during this period was evaluated. Each delivery was then classified into one of ten mutually exclusive categories according to obstetric characteristics. The information was used to identify the group that accounted for largest proportion of women or group that contributed most to CS and identify the areas for potential modification. Results We found cesarean rate of 28.6% during our study period, which is well above the World Health Organization guidelines. Group V (single, term, cephalic, previous CS) was the largest contributor to CS rates (30.4%). Groups I and II were the 2nd and 3rd largest contributors, i.e., 27.5 and 17.5% respectively. Maximum CS rate of 100% was found in group IX (abnormal lie), which was within the expected range. Group 2 had CS rate more than that of group I, and IV had a rate more than that of group I, which indicates that induction and cesarean before labor increases cesarean rate in both multiparous and nulliparous women. In our study, Robson's TGCS demonstrated the need to focus on groups I, II, III, and V because the contribution of these groups to overall cesarean rate was 82%. Clinical significance Ten group classification system was found to be a useful framework for auditing and analyzing different CS rates and their reasons. This will help in not only identifying the priority areas for the changes in clinical practice but also reducing cesarean rate. How to cite this article Bhati I, Jha A, Agarwal N. A New Way of Evaluating Cesarean Section Birth: The Robson's Ten Group Classification System. J South Asian Feder Obst Gynae 2016;8(3):212-216.

Chirp-corrected, nanosecond Ti:sapphire laser with 6 MHz linewidth for spectroscopy of antiprotonic helium

A nanosecond titanium sapphire laser with spectral linewidth Gamma(pl)~6 MHz and pulse energy of 50-100 mJ was demonstrated by using an intracavity electro-optic modulator to correct the frequency chirp in the output beam. The laser was referenced against a femtosecond frequency comb and used to measure the 6s-8s (F=4) two-photon transition frequency of Cs with a precision of 1.4 parts in 10(9).

Competitive physical activity early in life is associated with bone mineral density in elderly Swedish men

In this population-based study of 75-year-old men (n = 498), we investigated the association between physical activity (PA) early in life and present bone mineral density (BMD). We demonstrate that a high frequency of competitive sports early in life is associated with BMD at several bone sites, indicating that increases in BMD following PA are preserved longer than previously believed. Physical activity (PA) increases bone mineral density (BMD) during growth. It is unclear if the positive effects remain at old age. In this study, we aimed to determine if PA early in life was associated with BMD in elderly men. In this population-based study, 498 men, 75.2 +/- 3.3 (mean+/-SD) years old, were included. BMD was assessed using DXA. Data concerning lifetime PA, including both competitive (CS) and recreational sports (RS), and occupational physical load (OPL), were collected at interview. Subjects in the highest frequency group of CS in the early period (10-35 years), had higher BMD at the total body (4.2%, p < 0.01), total hip (7.0%, p < 0.01), trochanter (8.7%, p < 0.01), and lumbar spine (7.9%, p < 0.01), than subjects not involved in CS. A stepwise linear regression model showed that frequency of CS in the early period independently positively predicted present BMD at the total body (beta = 0.12, p < 0.01), total hip (beta = 0.11, p < 0.01), trochanter (beta = 0.12, p < 0.01), and lumbar spine (beta = 0.11, p = 0.01). We demonstrate that PA in CS early in life is associated with BMD in 75-year-old Swedish men, indicating that increases in BMD following PA are preserved longer than previously believed.

Lethal Sectoring, Genomic Instability, and Delayed Division Delay in HeLa S3 Cells Surviving Alpha- or X-irradiation

Lethal sectoring (LS) is the process for survival in which lethal damage remaining in irradiated cells is eliminated as lethal sector (offspring without reproductive integrity). This process occurs through the postirradiation 1st to 4th divisions with the accompanying appearance of a clonogenic progenitor (clonogen) (clonogenic sectoring: CS). The features of LS or CS and genomic instability (GI) were explored by analyzing the pedigrees of HeLa cells surviving alpha- (0.45 Gy) or X-irradiation (3 Gy) (20% survival dose). Most (approximately 70%) of the lethal latent damage was eliminated from alpha-particle survivors through the 1st to 2nd divisions, but it persisted in X-ray survivors until the 2nd generation. Although the frequency of CS was similar to that of LS for alpha-irradiation, CS was higher than LS for X-irradiation. Nonlethal damage remaining in the clonogens led to an elevated incidence of cell death in their progeny. The mean incidence was higher for alpha-particle (16.3%) than X-ray survivors (8.3%), indicating the greater potentiality for GI by alpha-particles. Evidence is available to suggest the intrinsic difference in the mechanisms of GI induction by these two radiations: the association of misrepaired clustered DNA damage (CD) with alpha-particles and unrepaired PLD with X-rays. A novel phenomenon, delayed division delay (DDD) was noticed, though occasionally (approximately 10% per cell), with the progeny during the postirradiation 1st-3rd generations. DDD was much longer in alpha- (mean: approximately 11 h) than X-irradiated cells (approximately 4 h). Supposedly DDD was triggered by chromosome breakage. However, a significant shortening of cell-cycle time at the postirradiation 1st generation was recognized with X-ray survivors.

Lethal Sectoring, Genomic Instability, and Delayed Division Delay in HeLa S3 Cells Surviving Alpha- or X-irradiation

Lethal sectoring (LS) is the process for survival in which lethal damage remaining in irradiated cells is eliminated as lethal sector (offspring without reproductive integrity). This process occurs through the postirradiation 1st to 4th divisions with the accompanying appearance of a clonogenic progenitor (clonogen) (clonogenic sectoring: CS). The features of LS or CS and genomic instability (GI) were explored by analyzing the pedigrees of HeLa cells surviving alpha- (0.45 Gy) or X-irradiation (3 Gy) (20% survival dose). Most (approximately 70%) of the lethal latent damage was eliminated from alpha-particle survivors through the 1st to 2nd divisions, but it persisted in X-ray survivors until the 2nd generation. Although the frequency of CS was similar to that of LS for alpha-irradiation, CS was higher than LS for X-irradiation. Nonlethal damage remaining in the clonogens led to an elevated incidence of delayed cell death in their progeny. The mean incidence was higher for alpha-particle (16.3%) than X-ray survivors (8.3%), indicating the greater potentiality for GI by alpha-particles. Evidence is available to suggest the intrinsic difference in the mechanisms of GI induction by these two radiations: the association of misrepaired clustered DNA damage (CD) with alpha-particles and unrepaired PLD with X-rays. A novel phenomenon, "delayed division delay (DDD)" was noticed, though occasionally (approximately 10% per cell), with the progeny during the postirradiation 1st-3rd generations. DDD was much longer in alpha- (mean: approximately 11 h) than X-irradiated cells (approximately 4 h). Supposedly DDD was triggered by delayed chromosome breakage. However, a significant shortening of cell-cycle time at the postirradiation 1st generation was recognized with X-ray survivors.

Genetic background of lactose intolerance and implications for diagnosis

with both CC and LC, and if there was associated entempathy. Methods: 32 patients with microscopic colitis (17 CC, 15 LC) diagnosed using objective histological criteria were included. Serum IgA-antiendomysial (AEA) and lgA-human tissue antitransglutaminase (AtTG) antibodies (IIF and ELISA assays, respectively) were investigated, after ruling-out lgA deficiency. The DQ2 hapforype (DQAI*0501 + DQBI*0201) was deterrmned by PCRSSP. This method detects the presence or absence of at least one copy of the haplotype. HLA-DQ2 was also assayed in 50 healthy controls from the general population. Endoscopic biopsies from 2d-3rd portions of duodenum were obtained in DQ2 + patients. The number of intraepithefial lymphocytes (IEL) (N<8 x 20 epithelial cells), their distribution pattern, and the architecture of villi were assessed. Results: 13 of 32 (40.6%) patients with microscopic colitis and 9 of 50 (18%) controls had DQ2 + (p = 0.025). There were no differences between CC and LC (35.3 vs 47%). A LC patient had positive AEA and AtTG, and biopsy with IEL increase (11x20 epithelial cells) without atrophy (Marsh 1); she was diagnosed of CS and a gluten-free diet was started. In the other 30 patients, AEMAtTG were negative. In 7 DQ2 + patients the number of [EL was normal and there was no villous atrophy (in 5 patients endoscopic biopsies were not available). Conclusions: in the present series, the frequency of CS in microscopic colitis patients was 3.2%, lower than that previously described, but higher than that observed in the general population in our country (0.03%). The high frequency of DQ2 haplotype observed in patients with CC/LC confirms the existence of a high genetic susceptibility to CS in these patients, and suggests that class II HLA genes might be implicated in the pathogenesis of microscopic colitis.

Multiple-unit activity of the rabbit cerebral cortex during stimulus generalization of avoidance behavior

Multiple-unit neuronal activity was recorded from three “nonspecific” polysensory regions of the cerebral cortex of rabbit during a test for stimulus generalization of an avoidance CR. Behavioral and cortical data obtained during the acquisition of the CR were reported in a previous paper. These data showed acquisition and maintenance of cortical multiple-unit responses in two of the three cortical areas, paralleling acquisition and maintenance of the CR. The present results show significant behavioral gradients of stimulus generalization to manipulation of frequency of the tonal CS used in conditioning. In addition, significant generalization gradients based upon cortical multiple-unit responses to the CS and test stimuli were obtained from one of the two cortical areas showing an acquisition effect. The peaks of behavioral and cortical gradients were invariably associated with the CS frequency in different groups of rabbits trained with different CS frequencies. Thus, a “prewiring” interpretation of the tonal effects was ruled out. Our data indicate that the two characteristics of acquired stimulus control (acquisition and stimulus specificity) commonly observed for behavioral conditioned responses can be demonstrated using neuronal responses of the CNS. Further, such effects appear to occur within limited regions of the brain.