Vaginal cesarean section: heir to, but not legacy of Dührssen’s incision

Kadhel, Philippe; Toto, Teddy; Janky, E.

doi:10.1007/s00404-014-3539-3

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…Three patients (11.5%) presented complications related to the intervention (Table 1). This rate was similar to these reported recently by Kadhel et al [1]. Reddy et al [5] found the same rate of composite serious maternal complications when abdominal cesarean section was performed between 23 and 27 weeks of gestation.…”

supporting

confidence: 91%

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Vaginal caesarian section for emergency delivery, short and long term complications: a retrospective study over 15 years

Markou

Nikpayam

Muray

et al. 2016

European Journal of Obstetrics & Gynecology and Reproductiv

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Vaginal Cesarean Section (VCS) is a little known surgicalobstetrical technique that is rarely practiced today. The main indication to perform a VCS remained an urgent fetal extraction early in the course of a pregnancy. In life-threatening situations where an emergency extraction of the fetus and the termination of the pregnancy is deemed necessary, and in very early pregnancies, this technique could be an interesting alternative to conventional Abdominal Cesarean Section (ASC) [1]. The theoretical advantage of VCS was to avoid a myometrial incision and to spare a maximum of myometrial muscular fibers. Furthermore, it was a simple et rapid procedure, with moderate peri operative bleeding and simple postoperative period [2]. The medical method, with premedication by mifepristone, 36-48 h before vaginal misoprostol administration and additional delivery induction interval, is a long procedure for emergency situations such as sepsis, total placenta praevia complicated by hemorrhage [1]. We conducted a retrospective study in the Obstetrical and Gynecologic Department at a single tertiary-care hospital (René Dubos Hospital) in Pontoise, France, between 01/01/2000 and 31/ 12/2014. Cases with VCS were identified from the birth registry, and demographic data were obtained from clinical records. All women who underwent VCS, had subsequently both gynecological and obstetrical follow up for subsequent pregnancies in our institution. VCS section was performed according to the modified Dü hrssen's incision [3] as described by Lacomme [4]. During the study period 26 women delivered by VCS. The major indication (42.3%) for VCS was an emergency termination of pregnancy for a life-threatening obstetrical complication, such as severe preeclampsia, eclampsia, HELLP syndrome, or chorioamniotitis associated with sepsis. In 34.7% of the cases, the indication was complete placenta praevia associated with severe hemorrhage, and in 23% the indication was labor induction failure for intrauterine fetal death or medical interruption for fetal reasons. The median gestational age was 23 weeks + 4 days

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confidence: 91%

“…Previous publications suggested an increased complication rate during subsequent pregnancies, such as cervical incompetence, cervical dystocia, late fetal loss, preterm delivery, premature rupture of membranes, and uterine rupture [1]. These complications were not observed in our experience.…”

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confidence: 64%

Vaginal caesarian section for emergency delivery, short and long term complications: a retrospective study over 15 years

Markou

Nikpayam

Muray

et al. 2016

European Journal of Obstetrics & Gynecology and Reproductiv

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“…кесарево сечение, при последующих беременностях нарушение лактации составляет 57 %. В случае невозможности применения терапевтического метода и при необходимости выполнения оперативного прерывания беременности следует выбирать малое кесарево сечение по способу Лейбчика [21,22] (при наличии у хирурга необходимых знаний и навыков для выполнения данной операции) либо проводить операцию кесарева сечения в нижнем сегменте матки. Учитывая ожирение, рыхлость мышц, «свежий» рубец, пациентка относится к группе риска по разрыву матки и должна была наблюдаться в женской консультации в группе высокого риска.…”

Section: клинический случайunclassified

“Slow” Cesarean Section by Inconsistent Corporal Scar (Clinical Case)

Сафиуллин

Мусин

Molokanova

2018

Kreativnaâ hirurgiâ i onkologiâ

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Introduction. Increasing the initial number of caesarean delivery operations involves certain risks when planning and carrying subsequent pregnancies. Despite the trend towards operative childbirth being gradually being replaced by natural, the frequency of recurrent caesarean is higher than the prevailing rate due to scar inconsistency and the presence of a “classic” (corporal) scar on the uterus. The use of corporal access to date is gradually being replaced by less traumatic access. The operation of “slow” caesarean section is considered as an alternative approach to surgical delivery.Purpose and objectives. To analyse the operation of “slow” caesarean section in the presence of corporal scars on the uterus.Materials and methods. The resulted clinical case of incomplete rupture of the uterus by corporal scar in the second pregnancy at a period of 38 weeks. Corporal scarring as a result of caesarean operations in the case of interruption of first pregnancy at a period of 22–23 weeks.Results. The patient was discharged in a satisfactory condition on the 5th day with the child. Postoperative period without complications; results of analyses performed prior to discharge within normal limits.Discussion. The conducted corporal incision at the first pregnancy was inexpedient due to presenting increased risks in subsequent pregnancies. For the termination of pregnancy in the second trimester, it was necessary to consider therapeutic methods, the operations of a minor caesarean section or a caesarean section in the lower segment of the uterus.Conclusion. Conducting “slow” caesarean section has the following advantages over classic caesarean section: soft adaptation of the foetus to environmental conditions, purification of the mucous oropharynx of the foetus, establishing a stronger bond between the mother and her future child. In future, we plan to conduct a clinical evaluation of children delivered through a “slow” caesarean section.

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“…Für die Zuverlässigkeit des in demselben gebrachten Tatsachenmaterials kann ich mich verbürgen …" [14]. [17,18].…”

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