Base de dados : MEDLINE
Pesquisa : E04.520.365 [Categoria DeCS]
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[PMID]:29417680
[Au] Autor:Timmerman D
[Ad] Endereço:KU Leuven, Department of Development and Regeneration, University Hospitals Leuven, Leuven, Belgium.
[Ti] Título:Re: Validation of prediction model for successful vaginal birth after Cesarean delivery based on sonographic assessment of hysterotomy scar. A. Baranov, K. Å. Salvesen and O. Vikhareva. Ultrasound Obstet Gynecol 2018; 51: 189-193.
[So] Source:Ultrasound Obstet Gynecol;51(2):167, 2018 02.
[Is] ISSN:1469-0705
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Cicatriz
Histerotomia
[Mh] Termos MeSH secundário: Cesárea
Feminino
Seres Humanos
Parto
Gravidez
Nascimento Vaginal Após Cesárea
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1002/uog.18999


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[PMID]:28673308
[Au] Autor:Tommila M; Pystynen M; Soukka H; Aydin F; Rantanen M
[Ad] Endereço:Emergency Medical Services, FinnHEMS 20, University of Turku and Turku University Hospital, Savitehtaankatu 1, Turku, Finland. miretta.tommila@tyks.fi.
[Ti] Título:Two cases of low birth weight infant survival by prehospital emergency hysterotomy.
[So] Source:Scand J Trauma Resusc Emerg Med;25(1):62, 2017 Jul 03.
[Is] ISSN:1757-7241
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: During maternal cardiac arrest, emergency hysterotomy (EH) is recommended after four minutes of resuscitation, if no signs of spontaneous circulation are detected. This extreme procedure is believed to be potentially beneficial for both the mother and the infant. Both maternal and neonatal survivals seem to be associated to the time delay between the cardiac arrest and the delivery and in-hospital resuscitation location. In addition to this, gestational age is an important determinant to neonatal outcome. CASE PRESENTATION: We report two emergency hysterotomies executed in an out-of-hospital location. The infants delivered by EH were low birth weight infants and born 20-23 min after maternal cardiac arrest. Both infants survived and had normal physical and neurological growth at the age of two years. Unfortunately, mothers in these both cases died in the field. CONCLUSION: Contrary to earlier beliefs, it is possible to perform a successful EH also in out-of-hospital setting, even with incomplete surgical skills. However, training and preparation are extremely important for achieving the highest possible readiness to treat maternal cardiac arrest situations also prehospitally.
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar
Parada Cardíaca/cirurgia
Histerotomia
Recém-Nascido de Baixo Peso
Morte Materna
Complicações Cardiovasculares na Gravidez/cirurgia
[Mh] Termos MeSH secundário: Adulto
Emergências
Serviços Médicos de Emergência
Evolução Fatal
Feminino
Idade Gestacional
Parada Cardíaca/terapia
Seres Humanos
Recém-Nascido
Gravidez
Complicações Cardiovasculares na Gravidez/terapia
Resultado da Gravidez
Sobreviventes
Telemedicina
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170705
[St] Status:MEDLINE
[do] DOI:10.1186/s13049-017-0407-8


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[PMID]:28319267
[Au] Autor:Chiang YC; Tu YA; Yang JH; Lin SY; Lee CN; Shih JC
[Ad] Endereço:Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
[Ti] Título:Risk factors associated with failure of treatment for cesarean scar pregnancy.
[So] Source:Int J Gynaecol Obstet;138(1):28-36, 2017 Jul.
[Is] ISSN:1879-3479
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To identify risk factors associated with treatment failure among women with cesarean scar pregnancy (CSP). METHODS: In a retrospective study, the medical records of patients with CSP treated at National Taiwan University Hospital, Taipei, Taiwan, from 1994 to 2015 were reviewed. The women were managed primarily with hysterotomy, evacuation, or methotrexate. Receiver operating characteristic (ROC) curve analysis and logistic regression analysis were used to evaluate the factors associated with treatment failure. RESULTS: Among 90 patients, 44 underwent hysterotomy, 18 underwent evacuation, and 28 received methotrexate. The success rates were 100% (44/44) for hysterotomy, 83% (15/18) for evacuation, and 57% (16/28) for methotrexate (P<0.001). ROC curve analysis indicated that a pregnancy length of 8 weeks and a mean sac diameter (MSD) of 4 cm were both predictive of failure of treatment by primary evacuation and methotrexate. In multivariate logistic regression analysis, an MSD of 4 cm or more was the only independent risk factor for treatment failure (odds ratio 68.99, 95% confidence interval 6.27-759.60; P=0.001). CONCLUSION: Primary hysterotomy was suitable for treatment of CSP of any size. Failure of primary evacuation or methotrexate usually occurred when the MSD was larger than 4 cm.
[Mh] Termos MeSH primário: Cesárea/efeitos adversos
Cicatriz/complicações
Gravidez Ectópica/tratamento farmacológico
Gravidez Ectópica/cirurgia
[Mh] Termos MeSH secundário: Abortivos não Esteroides/administração & dosagem
Adulto
Feminino
Seres Humanos
Histerotomia
Metotrexato/administração & dosagem
Meia-Idade
Gravidez
Gravidez Ectópica/diagnóstico por imagem
Gravidez Ectópica/etiologia
Estudos Retrospectivos
Fatores de Risco
Falha de Tratamento
Ultrassonografia Pré-Natal
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Abortifacient Agents, Nonsteroidal); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170321
[St] Status:MEDLINE
[do] DOI:10.1002/ijgo.12157


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[PMID]:28277363
[Au] Autor:Belfort MA; Whitehead WE; Shamshirsaz AA; Bateni ZH; Olutoye OO; Olutoye OA; Mann DG; Espinoza J; Williams E; Lee TC; Keswani SG; Ayres N; Cassady CI; Mehollin-Ray AR; Sanz Cortes M; Carreras E; Peiro JL; Ruano R; Cass DL
[Ad] Endereço:Departments of Obstetrics and Gynecology, Neurosurgery, Surgery, Anesthesiology, Pediatrics, and Radiology, Baylor College of Medicine, and Texas Children's Fetal Center, Houston, Texas; and the Departments of Obstetrics and Gynecology and Surgery, Vall D'Hebron Hospital, Barcelona, Spain.
[Ti] Título:Fetoscopic Open Neural Tube Defect Repair: Development and Refinement of a Two-Port, Carbon Dioxide Insufflation Technique.
[So] Source:Obstet Gynecol;129(4):734-743, 2017 Apr.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe development of a two-port fetoscopic technique for spina bifida repair in the exteriorized, carbon dioxide-filled uterus and report early results of two cohorts of patients: the first 15 treated with an iterative technique and the latter 13 with a standardized technique. METHODS: This was a retrospective cohort study (2014-2016). All patients met Management of Myelomeningocele Study selection criteria. The intraoperative approach was iterative in the first 15 patients and was then standardized. Obstetric, maternal, fetal, and early neonatal outcomes were compared. Standard parametric and nonparametric tests were used as appropriate. RESULTS: Data for 28 patients (22 endoscopic only, four hybrid, two abandoned) are reported, but only those with a complete fetoscopic repair were analyzed (iterative technique [n=10] compared with standardized technique [n=12]). Maternal demographics and gestational age (median [range]) at fetal surgery (25.4 [22.9-25.9] compared with 24.8 [24-25.6] weeks) were similar, but delivery occurred at 35.9 (26-39) weeks of gestation with the iterative technique compared with 39 (35.9-40) weeks of gestation with the standardized technique (P<.01). Duration of surgery (267 [107-434] compared with 246 [206-333] minutes), complication rates, preterm prelabor rupture of membranes rates (4/12 [33%] compared with 1/10 [10%]), and vaginal delivery rates (5/12 [42%] compared with 6/10 [60%]) were not statistically different in the iterative and standardized techniques, respectively. In 6 of 12 (50%) compared with 1 of 10 (10%), respectively (P=.07), there was leakage of cerebrospinal fluid from the repair site at birth. Management of Myelomeningocele Study criteria for hydrocephalus-death at discharge were met in 9 of 12 (75%) and 3 of 10 (30%), respectively, and 7 of 12 (58%) compared with 2 of 10 (20%) have been treated for hydrocephalus to date. These latter differences were not statistically significant. CONCLUSION: Fetoscopic open neural tube defect repair does not appear to increase maternal-fetal complications as compared with repair by hysterotomy, allows for vaginal delivery, and may reduce long-term maternal risks. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, https://clinicaltrials.gov, NCT02230072.
[Mh] Termos MeSH primário: Dióxido de Carbono/uso terapêutico
Vazamento de Líquido Cefalorraquidiano
Fetoscopia
Insuflação
Complicações Pós-Operatórias/diagnóstico
Disrafismo Espinal
[Mh] Termos MeSH secundário: Adulto
Vazamento de Líquido Cefalorraquidiano/diagnóstico
Vazamento de Líquido Cefalorraquidiano/etiologia
Pesquisa Comparativa da Efetividade
Feminino
Fetoscopia/efeitos adversos
Fetoscopia/métodos
Idade Gestacional
Seres Humanos
Histerotomia/efeitos adversos
Histerotomia/métodos
Recém-Nascido
Insuflação/efeitos adversos
Insuflação/métodos
Procedimentos Neurocirúrgicos/efeitos adversos
Procedimentos Neurocirúrgicos/métodos
Avaliação de Processos e Resultados (Cuidados de Saúde)
Gravidez
Resultado da Gravidez
Estudos Retrospectivos
Disrafismo Espinal/diagnóstico
Disrafismo Espinal/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
142M471B3J (Carbon Dioxide)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170621
[Lr] Data última revisão:
170621
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000001941


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[PMID]:28253572
[Au] Autor:Chen ZY; Zhao L; Nusilati A; Zhao D; Zhou M; Zhang XM
[Ad] Endereço:Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
[Ti] Título:[Clinical comparative analysis of surgical resection of the pregnancy by hysterotomy and hysterectomy for cesarean scar pregnancy].
[So] Source:Zhonghua Fu Chan Ke Za Zhi;52(2):98-102, 2017 Feb 25.
[Is] ISSN:0529-567X
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To assess the indication and safety of surgical resection of the pregnancy by hysterotomy (SRPH) and hysterectomy for cesarean scar pregnancy (CSP). A retrospective study of women with CSP was conducted at the Women's Hospital, School of Medicine, Zhejiang University, from Jan. 2003 to Mar. 2016. The women underwent SRPH (SRPH group, =35) and hysterectomy (Hysterectomy group, =14) were included. The gestational age (GA), size of gestational mass(GM), level of serum ß-hCG, previous treatments and clinical outcomes were analyzed. The median GA, the mean size of GM, median serum ß-hCG level, median amount of blood loss, rate ot blood transfusion, rate of persistent CSP, and rate of motal status in SRPH group versus Hysterectomy group were 66 versus 84 days, (65±22) versus (92±36) mm, 23 755 versus 802 U/L, 400 versus 650 ml, 11% (4/35) versus 13/14, 49% (17/35) versus 12/14, 20% (7/35) versus 14/14, respectively (all 0.05). In SRPH group, median amount of blood loss was 500 ml in patients with GA≥10 weeks versus 300 ml in patients with GA<10 weeks ( 0.05). Serious complication occurred in 7 patients: severe pelvic inflammation in 1 patient and hematomas in the uterine isthmus in 1 patient in SRPH group; severe pelvic inflammation in 2 patients and hemorrhagic shock and DIC in 3 patients in Hysterectomy group. No blaader damage occurred. SRPH is effective and safe for patients with CSP with GA of 9-10 weeks, a diameter of 60-90 mm and stable hemodynamics. Hysterectomy is an alternative to SRPH for patiens in motal status with advanced GA more than 12 weeks.
[Mh] Termos MeSH primário: Cesárea/efeitos adversos
Cicatriz/complicações
Histerectomia
Histerotomia
Útero/cirurgia
[Mh] Termos MeSH secundário: Adulto
Gonadotropina Coriônica Humana Subunidade beta/sangue
Feminino
Idade Gestacional
Seres Humanos
Gravidez
Gravidez Ectópica
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Chorionic Gonadotropin, beta Subunit, Human)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170304
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0529-567X.2017.02.006


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[PMID]:27984036
[Au] Autor:Belfort MA; Shamshiraz AA; Fox K
[Ad] Endereço:Texas Children's Percreta Center and Baylor College of Medicine, Section of Maternal Fetal Surgery, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Houston, TX. Electronic address: belfort@bcm.edu.
[Ti] Título:Minimizing blood loss at cesarean-hysterectomy for placenta previa percreta.
[So] Source:Am J Obstet Gynecol;216(1):78.e1-78.e2, 2017 Jan.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Preventing blood loss at the time of a cesarean delivery during a scheduled, nonemergent cesarean hysterectomy for placenta percreta may reduce the need for crystalloid and blood product transfusion. Commonly a classical hysterotomy is created and this can result in as much as a 500-800 mL blood loss before the hysterotomy is closed. Our technique involves placement of 4 full-thickness interrupted sutures in a box pattern to create an unperfused area of upper uterine segment. Diathermy is used to open the uterus to the membranes in the center of the "box" without blood loss. A finger is then inserted between the membranes and uterus to create a space into which 1 side of an 80-mm linear cutting stapler is introduced. The other side of the stapler is then attached and clamped closed, and the stapler is activated. Forward motion of the lever lays down 2 rows of staples, and backward movement of the lever divides the uterine muscle between the 2 staple lines. The stapler is removed and reloaded and reintroduced 1 or 2 times as needed to create an avascular hysterotomy large enough to atraumatically deliver the baby. The membranes are then opened and the baby is delivered. Following this the umbilical cord is clamped and cut without any attempt to remove the placenta, replaced in the uterine cavity, and the hysterotomy is closed with a running locked suture that incorporates the membrane edges. The hysterectomy then proceeds. In most cases there is minimal blood loss (usually <20 mL) from the cesarean delivery.
[Mh] Termos MeSH primário: Cesárea/métodos
Hemostasia Cirúrgica/métodos
Histerectomia/métodos
Histerotomia/métodos
Placenta Acreta/cirurgia
Placenta Prévia/cirurgia
[Mh] Termos MeSH secundário: Perda Sanguínea Cirúrgica
Eletrocoagulação/métodos
Feminino
Seres Humanos
Gravidez
Grampeamento Cirúrgico/métodos
Técnicas de Sutura
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170531
[Lr] Data última revisão:
170531
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161217
[St] Status:MEDLINE


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[PMID]:28132038
[Au] Autor:Tussupkaliyev A; Daribay Z; Saduov M; Dossimbetova M; Rakhmetullina G
[Ad] Endereço:West-Kazakhstan State M. Ospanov Medical Universyti, Aktobe, Kazakhstan.
[Ti] Título:[METROPLASTY FOR OBSTETRIC PERITONITIS, ARISING IN THE BACKGROUND SUTURE FAILURE OF THE UTERUS].
[So] Source:Georgian Med News;(261):26-331, 2016 Dec.
[Is] ISSN:1512-0112
[Cp] País de publicação:Georgia (Republic)
[La] Idioma:rus
[Ab] Resumo:Improving treatment outcomes obstetric peritonitis after cesarean section on the basis of organ-preserving treatment and reasonable intensive care in the postpartum period. Fifteen clinical cases in which on the background of peritonitis were made conserving surgery, which included: excision of necrotic areas on the uterus, uterine cavity curettage, metroplasty. Nasointestinal bowel intubation and drainage of the abdominal cavity. It is discussed tactics of postpartum women with obstetric peritonitis on the background of insolvency seams on the uterus, currently existing criteria for evaluation and treatment of patients data. The necessity of using in the algorithm survey postpartum women with obstetric peritonitis diagnostic criteria SIRS, leukocyte index of intoxication, integrated scales organ dysfunctions. Modern approaches to surgical treatment, the starting antibiotic therapy antibiotics ultra wide spectrum of action, combined with early intensive treatment in an intensive care unit avoids removal of the uterus as a primary focus.
[Mh] Termos MeSH primário: Cesárea/efeitos adversos
Peritonite/terapia
Infecção da Ferida Cirúrgica/complicações
Útero/cirurgia
[Mh] Termos MeSH secundário: Adulto
Antibacterianos/uso terapêutico
Cefalosporinas/uso terapêutico
Feminino
Seres Humanos
Histerotomia
Tratamentos com Preservação do Órgão
Ozônio/uso terapêutico
Peritonite/etiologia
Peritonite/cirurgia
Sepse/etiologia
Sepse/terapia
Síndrome de Resposta Inflamatória Sistêmica/etiologia
Síndrome de Resposta Inflamatória Sistêmica/terapia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Cephalosporins); 66H7ZZK23N (Ozone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170130
[St] Status:MEDLINE


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[PMID]:27895842
[Au] Autor:Chilopora G; Pereira C; Kamwendo F; Chimbiri A; Malunga E; Bergström S
[Ad] Endereço:Department of Obstetrics and Gynaecology, University of Malawi, College of Medicine, Blantyre, Malawi.
[Ti] Título:Postoperative outcome of caesarean sections and other major emergency obstetric surgery by clinical officers and medical officers in Malawi.
[So] Source:Malawi Med J;28(3):94-98, 2016 Sep.
[Is] ISSN:1995-7270
[Cp] País de publicação:Malawi
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. METHODS: During a three month period, data from 2131 consecutive obstetric surgeries in 38 district hospitals in Malawi were collected prospectively. The interventions included caesarean sections alone and those that were combined with other interventions such as subtotal and total hysterectomy repair of uterine rupture and tubal ligation. All these surgeries were conducted either by clinical officers or by medical officers. RESULTS: During the study period, clinical officers performed 90% of all straight caesarean sections, 70% of those combined with subtotal hysterectomy, 60% of those combined with total hysterectomy and 89% of those combined with repair of uterine rupture. A comparable profile of patients was operated on by clinical officers and medical officers, respectively. Postoperative outcomes were almost identical in the two groups in terms of maternal general condition - both immediately and 24 hours postoperatively - and regarding occurrence of pyrexia, wound infection, wound dehiscence, need for re-operation, neonatal outcome or maternal death. CONCLUSIONS: Clinical officers perform the bulk of emergency obstetric operations at district hospitals in Malawi. The postoperative outcomes of their procedures are comparable to those of medical officers. Clinical officers constitute a crucial component of the health care team in Malawi for saving maternal and neonatal lives given the scarcity of physicians.
[Mh] Termos MeSH primário: Cesárea/estatística & dados numéricos
Histerectomia/estatística & dados numéricos
Histerotomia/estatística & dados numéricos
Complicações do Trabalho de Parto/cirurgia
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Emergências
Feminino
Hospitais de Distrito
Seres Humanos
Histerectomia/métodos
Malaui/epidemiologia
Mortalidade Materna
Complicações Pós-Operatórias/etiologia
Hemorragia Pós-Parto/epidemiologia
Gravidez
Resultado da Gravidez
Estudos Prospectivos
Esterilização Tubária/estatística & dados numéricos
Resultado do Tratamento
Ruptura Uterina/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170608
[Lr] Data última revisão:
170608
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161130
[St] Status:MEDLINE


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[PMID]:27862078
[Au] Autor:Belfort M; Deprest J; Hecher K
[Ad] Endereço:Department Obstetrics and Gynecology, Baylor College of Medicine, Texas Medical Center, Houston, TX, USA.
[Ti] Título:Current controversies in prenatal diagnosis 1: in utero therapy for spina bifida is ready for endoscopic repair.
[So] Source:Prenat Diagn;36(13):1161-1166, 2016 Dec.
[Is] ISSN:1097-0223
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Fetoscopia
Disrafismo Espinal/cirurgia
[Mh] Termos MeSH secundário: Feminino
Fetoscopia/efeitos adversos
Fetoscopia/métodos
Idade Gestacional
Seres Humanos
Histerotomia
Gravidez
Resultado da Gravidez
Diagnóstico Pré-Natal
Fatores de Risco
Disrafismo Espinal/diagnóstico
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161119
[St] Status:MEDLINE
[do] DOI:10.1002/pd.4972


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[PMID]:27617416
[Au] Autor:Kataoka S; Tanuma F; Iwaki Y; Iwaki K; Fujii T; Fujimoto T
[Ad] Endereço:Department of Obstetrics and Gynecology, Hakodate Central General Hospital, Hakodate, Japan.
[Ti] Título:Comparison of the primary cesarean hysterotomy scars after single- and double-layer interrupted closure.
[So] Source:Acta Obstet Gynecol Scand;95(12):1352-1358, 2016 Dec.
[Is] ISSN:1600-0412
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: It is unclear whether hysterotomy closure techniques can affect niche development. Therefore, this study aimed to analyze the effect of single-layer and double-layer interrupted closures of hysterotomy incisions during primary cesarean section on the formation of uterine niches. MATERIAL AND METHODS: A prospective cohort study of women undergoing primary cesarean section was performed between June 2011 and July 2014. Saline contrast sonohysterography was used to measure the niche depth and residual myometrium. The ratio of the niche depth to the sum of the niche depth and residual myometrium thickness (niche ratio) was calculated. RESULTS: Niches were identified in 14/58 (24.1%) women with single-layer sutures and 55/209 (26.3%) women with double-layer sutures (p = 0.74). Single-layer closure was associated with more than a five-fold increase in the odds of a niche ratio ≥0.4 (odds ratio 5.59; 95% CI 1.71-18.28). CONCLUSION: Single-layer closure may be associated with an increased risk of larger niches (niche ratio ≥0.4), although it may not increase the overall frequency of niche formation.
[Mh] Termos MeSH primário: Cesárea/efeitos adversos
Cicatriz/etiologia
Histerotomia/efeitos adversos
Complicações Pós-Operatórias/etiologia
Técnicas de Sutura/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Cesárea/métodos
Cicatriz/diagnóstico por imagem
Cicatriz/epidemiologia
Feminino
Seres Humanos
Histerotomia/métodos
Modelos Logísticos
Análise Multivariada
Miométrio/diagnóstico por imagem
Miométrio/patologia
Miométrio/cirurgia
Avaliação de Resultados (Cuidados de Saúde)
Complicações Pós-Operatórias/diagnóstico por imagem
Complicações Pós-Operatórias/epidemiologia
Estudos Prospectivos
[Pt] Tipo de publicação:CLINICAL TRIAL; COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160913
[St] Status:MEDLINE
[do] DOI:10.1111/aogs.13015



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