Keywords : Cesarean Section


Relationship between Amniotic Fluid Lactate and Delivery by CS Due to Dystocia

Manal Madany A. Qader

Iraqi Postgraduate Medical Journal, 2016, Volume 15, Issue 4, Pages 499-505

ABSTRACT:
BACKGROUND:
Lactate level in uterine muscles can be visualized by analysis of amniotic fluid lactase which used as bedside test with partogram to acquire good prediction of labour outcome.
OBJECTIVE:
To assess the relationship between amniotic fluid lactase level of full term pregnant women and their mode of delivery.
PATIENTS AND METHODS:
A cross sectional study carried out in Labour room of Al-Yarmouk Teaching Hospital through the period from the 1st of July to the end of December, 2015 on a convenient sample of 100 women of term pregnancy. Each woman participated in the study was in an active phase of labour with cervical dilation > 4 cm and before artificial rupture of membranes .By coscus speculum the cervix was visualized with 2-3 ml of liquor was taken by a syringe while the amniotic fluid still in the uterus to prevent vaginal contamination, then collected liquor in plain tube after centrifuge was stored in refrigerator at -20° for not more than 3 days before it sent to a private laboratory for analysis of lactase.
RESULTS:
Mean maternal age was 26.5±5.4 years and mean gestational age was 38.6±1.1 weeks. Thirty three pregnant women had elevated lactase level and 31 women were delivered with cesarean section. A significant association was observed between elevated amniotic fluid lactate level (≥10nm) among pregnant women and cesarean section delivery mode (p<0.001). Amniotic fluid lactate was a significant predictor of delivery mode (p=0.001) with odds ratio (5.5).
CONCLUSION:
Amniotic fluid lactate could be a significant predictor of labour outcome for term pregnant women.

Body Surface Area and Sheath Size as a Risk Factors for Vascular Complications After Coronary Angiography Via Femoral Approach

Salah Mahdy Majeed; Ali Mohammed Jawad; Haithem Ahmed Al-Rubaie; Zahraa Akram Thabit; Saad kadhum Kareem; Manal Madany A. Qader; Shatha Sami; Wisam Akram; Faten Shalal; Mustafa Nema; Mudher Al-Khairalla

Iraqi Postgraduate Medical Journal, 2016, Volume 15, Issue 4, Pages 481-485

ABSTRACT:
BACKGROUND:
Vascular complications have been recognized as an important factor in morbidity after diagnostic and percutaneous coronary interventions.
OBJECTIVE:
This study sought to evaluate vascular body mass index and sheath size as risk factors for vascular complications after diagnostic coronary angiography via femoral approach.
PATIENTS AND METHODS:
This historical prospective cohort study was carried out from February 2012 till January 2013, at the Iraqi Center for the Heart Disease. A total number of 2400 patients underwent 3600 procedures, diagnostic coronary angiography (2196) and PCI(1404) via their common femoral arteries.
Result: Body surface area > 2m2 is a statistically significant factor for vascular complications, and <1.6m2 is also an important statistically significant risk for vascular complications.
The results of the current study according to sheath size show:- during the diagnostic coronary angiograph procedures, sheath size 5F was the least(n=34), in which no reported vascular complications. Sheath size 6F (n = 1661) with (75) 4.5% complicated vs. (1586) 95.5% didn’t, sheath size 7F used among (501) patients, vascular complications developed in (171) 34.1% vs. (330) 65.9%. In comparison between the incidence of vascular complications among sheath sizes (6F, 7F) vs. 5F the P value < 0.001 for both.
During the PCI procedures, sheath size 6F was used among (140) patients, with vascular complications in one patient (0.7%). 7F used among (1219), with vascular complications in (115) 9.4%, and 8F used in (45) patients with vascular complications in (45) 100%. By using 6F as a referent, sheaths 7F&8F were statistical significant(p

Keywords

KEY WORDS: body surface area
---
sheath size
---
vascular complications.

Cesarean Section Rate for Induction of Labor Using Low Dose Oxytocin in the Presence of an Unfavorable Cervix

Yosra Tahir Jarjees

Iraqi Postgraduate Medical Journal, 2011, Volume 10, Issue 2, Pages 224-228

ABSTRACT:
BACKGROUND:
Induction of labor (IOL) implies stimulation of uterine contractions before the spontaneous onset of labor, with or without ruptured membranes. The condition or favorability of the cervix is important to labor induction. Induction to active labor is usually successful with a cervical score of 9 or greater.
OBJECTIVE:
(A) to estimate the cesarean section rate for induction of labor with low dose Oxytocin in the presence of unfavorable cervix. (B) To analyze the possible predictors of unsuccessful induction.
PATIENTS AND METHOD:
This is a case series study done at Al-Batool Maternity Teaching Hospital with a total of 13000 deliveries per year.
Eighty pregnant ladies that underwent labor induction at 37 weeks of gestation or more with an unfavorable cervix (Bishop score
5). The study was conducted at Al-Batool Maternity Teaching Hospital in Mosul, north of Iraq from January to August 2005. The patients were assigned to receive 2 mIU/ min. oxytocin in one pint of intravenous fluid at day one. When contractions did not start by this dose, the patient is postponed to the second day to receive 2 and 4 mIU/min. oxytocin in two pints, respectively. If there was no response, we started the third day with 4, 8 and 16 mIU/min. in 3 pints, respectively, maintaining these doses if the contractions started. The primary outcomes were successful induction rate and cesarean delivery rate and fetal condition at birth.
RESULTS:
Primary cesarean delivery rate was (27.9%). Increasing Bishop Scores decreased the risk of failed induction.
CONCLUSION:
The use of the daily repeated low dose oxytocin infusion with gradual increase in this study is safe and may reduce the high rate of operative delivery associated with induction of labor