Cesarean delivery

Mothers recognize their newborn babies by odor (Russell etal., 1983 Schaal etal., 1980) even if there had been little contact after a Cesarean delivery (Porter etal., 1983). Mothers distinguished the odor of their own infant from those of two other infants on a non-soiled undershirt that the infant had worn for at least 13 hours. If the mothers had been exposed to their own infant for less than 10 minutes after birth, only 20% were successful at recognition. After... 

Oxytocin is used to induce labor for conditions requiring early vaginal delivery such as Rh problems, maternal diabetes, preeclampsia, or ruptured membranes. It is also used to augment abnormal labor that is protracted or displays an arrest disorder. Oxytocin has several uses in the immediate postpartum period, including the control of uterine hemorrhage after vaginal or cesarean delivery. It is sometimes used during second-trimester abortions. 

During the antepartum period, oxytocin induces uterine contractions that transiently reduce placental blood flow to the fetus. The oxytocin challenge test measures the fetal heart rate response to a standardized oxytocin infusion and provides information about placental circulatory reserve. An abnormal response, seen as late decelerations in the fetal heart rate, indicates fetal hypoxia and may warrant immediate cesarean delivery. 

Misoprostol and oxytocin have been compared in three trials during vaginal and cesarean delivery. The first trial included 663 women (mean age 25 years, mean parity 2)... 

Transvaginal misoprostol for induction of labor caused uterine rupture in a 26-year-old woman with a previous low transverse cesarean delivery (25). 

The other two women underwent emergency cesarean deliveries because of fetal bradycardia. Both had complete uterine wall separation one had a stellate laceration involving the previous incision, and the other had a hematoma associated with the scar disruption. Outcomes were good in both cases. 

Wing DA, Lovett K, Paul RH. Disruption of prior uterine incision following misoprostol for labor induction in women with previous cesarean delivery. Obstet Gynecol 1998 91(5 Pt 2) 828-30. 

Chelmow D, Laros RK Jr. Maternal and neonatal outcomes after oxytocin augmentation in patients undergoing a trial of labor after prior cesarean delivery. Obstet Gynecol 1992 80(6) 966—71. 

Zelop CM, Shipp TD, Repke JT, Cohen A, Caughey AB, Lieberman E. Uterine rupture during induced or augmented labor in gravid women with one prior cesarean delivery. Am J Obstet Gynecol 1999 181(4) 882-6. 

Gin T, Ngan-Kee WD, Siu YK, Stuart JC, Tan PE, Lam KK. Alfentanil given immediately before the induction of anesthesia for elective cesarean delivery. Anesth Analg 2000 90(5) 1167-72. 

Park GE, Hauch MA, Curlin F, Datta S, Bader AM. The effects of varying volumes of crystalloid administration before cesarean delivery on maternal hemodynamics and colloid osmotic pressure. Anesth Analg 1996 83(2) 299-303. 

Ben-David B, Miller G, Gavriel R, Gurevitch A. Low-dose bupivacaine-fentanyl spinal anesthesia for cesarean delivery. Reg Anesth Pain Med 2000 25(3) 235-9. 

Bader AM, Tsen LC, Camann WR, Nephew E, Datta S. Clinical effects and maternal and fetal plasma concentrations of 0.5% epidural levobupivacaine versus bupivacaine for cesarean delivery. Anesthesiology 1999 90(6) 1596-601. 

Zahn PK, Van Aken HK, Marcus AE. Horner s syndrome following epidural anesthesia with ropivacaine for cesarean delivery. Reg Anesth Pain Med 2002 27(4) 445-6. 

Yeh HM, Chen LK, Lin CJ, Chan WH, Chen YP, Lin CS, Sun WZ, Wang MJ, Tsai SK. Prophylactic intravenous ondansetron reduces the incidence of intrathecal morphine-induced pruritus in patients undergoing cesarean delivery. Anesth Analg 2000 91(l) 172-5. 

Sarvela J, Halonen P, Soikkeli A, Korttila K. A double-blinded, randomized comparison of intrathecal and epidural morphine for elective cesarean delivery. Anesth Analg 2002 95(2) 436 0. 

Intravenous nalbuphine 3 mg (n — 101) has been compared with intravenous propofol 20 mg (n = 90) in a double-blind, randomized study, to determine efficacy in the treatment of intrathecal morphine-induced pruritus after cesarean delivery 10 minutes after the drug was administered (6). Nalbuphine was significantly more effective, especially in cases of moderate but not severe pruritus. Adverse effects such as reduced analgesia and increased nausea, vomiting, sedation, and dizziness were not significantly different between the two groups. 

Charuluxananan S, Kyokong O, Somboonviboon W, Lertmaharit S, Ngamprasertwong P, Nimcharoendee K. Nalbuphine versus propofol for treatment of intrathecal morphine-induced pruritus after cesarean delivery. Anesth Analg 2001 93(l) 162-5. 

Culebras X, Gaggero G, Zatloukal J, Kern C, Marti RA. Advantages of intrathecal nalbuphine, compared with intrathecal morphine, after cesarean delivery an evaluation of postoperative analgesia and adverse effects. Anesth Analg 2000 91(3) 601-5. 

The safety of glyceryl trinitrate in emergency or elective cesarean delivery has also been documented in a prospective series of 23 women, who received 400-800 micrograms of glyceryl trinitrate spray (85). However, no conclusions about the efficacy of glyceryl trinitrate were possible, owing to the lack of a control group. 

David M, Halle H, Lichtenegger W, Sinha P, Zimmermann T. Nitroglycerin to faciUtate fetal extraction during cesarean delivery. Obstet Gynecol 1998 91(l) 119-24. 

Oxytocin is a hypothalamic nonapeptide that selectively stimulates the smooth muscle of the uterus and mammary glands. It is used in the induction or augmentation of labor and to prevent postpartum hemorrhage, and is well tolerated and effective in a wide range of infusion rates and concentrations. Contraindications to its use include placenta previa or vasa previa, a previous classical uterine incision, pelvic structural deformities, and an abnormal fetal presentation. Large fetal size and high maternal parity are relative contraindications. Prior non-classical cesarean delivery should not preclude oxytocin therapy. 

In a retrospective analysis of 2774 women who had had one prior cesarean delivery, there was a 1% incidence of uterine rupture in women who were given oxytocin, compared with 0.4% in non-augmented controls with spontaneous labor (12). Six women needed emergency hysterectomy. The odds ratio for uterine rupture in the oxytocin-treated women was 4.6 by logistic regression analysis (Cl = 1.5,14). The small number of events limited the study it had only 30% power to detect changes of that magnitude. However, it is reasonable to proceed cautiously, with... 

Gambling DR, Sharma SK, Ramin SM, Lucas MJ, Leveno KJ, Wiley J, Sidawi JE. A randomized study of combined spinal-epidural analgesia versus intravenous meperidine during labor impact on cesarean delivery rate. Anesthesiology 1998 89(6) 1336-44. 

In contrast to the American Diabetes Association dietary recommendations, a Cochrane Review revealed that there is insufficient evidence to recommend dietary interventions for women with abnormal glucose tolerance in pregnancy. Neither large-birth-weight deliveries nor need for cesarean delivery was influenced by adherence to dietary interventions for gestational diabetes. ... 

Many clinicians believe that epidural analgesia is associated with a higher number of cesarean deliveries. However, two systematic reviews have not substantiated an increased rate of cesarean delivery with epidural analgesia compared with parenteral opioids. One of the reviews, however, cautioned that there may not be sufficient data to rule out such an association. ... 

Crohn s disease cesarean delivery continuous drainage cup to disc ratio... 

---