Cesarean delivery rates in California and the United States rose by 50% between 1998 and 2008 and vary widely among states, regions, hospitals, and health care providers. The leading driver of both the rise and the variation is first-birth cesarean deliveries performed during labor. With the large increase in primary cesarean deliveries, repeat cesarean delivery now has emerged as the largest s...

A healthy, 30-year-old woman at 32 weeks gestation presented to the emergency department with sudden-onset headache and abdominal pain. On physical exam, she was hypertensive (188/69 mm Hg) and had mild tenderness to palpation in the right upper quadrant. Initial laboratory studies revealed proteinuria, aspartate aminotransferase at 730 U/L, and alanine aminotransferase at 478 U/L. She was diag...

We report the case of a 42-year-old patient with hypertrophic cardiomyopathy (HCM) who presented to the emergency department with severe shortness of breath one week following uneventful cesarean delivery. Thoracic CT ruled out pulmonary embolus and confirmed pulmonary edema. Asymmetric interventricular septal thickening was clearly identified, demonstrating that the heart may be evaluated even...

Amniotic fluid embolism (AFE) is a rare but fatal obstetric emergency, characterized by sudden cardiovascular collapse, dyspnea or respiratory arrest and altered mentality, disseminated intravascular coagulation (DIC). It can lead to severe maternal morbidity and mortality, but the prediction of its occurrence and treatment are very difficult. We experienced a case of AFE during emergent Cesare...

BACKGROUND The relationship between population trends in delaying childbirth and rising rates of primary cesarean delivery is unclear. The aims of the present study were (1) to characterize the association between maternal age and the outcome of labor, (2) to determine the proportion of the increase in primary cesarean rates that could be attributed to changes in maternal age distribution, and ...

Guillain-Barré syndrome is an acute inflammatory demyelinating polyradiculopathy characterized by progressive motor weakness, areflexia, and ascending paralysis. Guillain-Barré syndrome is extremely rare in pregnant patients, and there are no established guidelines for delivery or safest anesthetic methods. We report a Cesarean delivery in the case of a 32-year old woman who was diagnosed with ...

Splenic rupture during pregnancy is considered a catastrophic condition associated with high maternal and fetal mortality and morbidity. Herein, we report a case of severe preeclampsia that underwent cesarean delivery with subsequent spontaneous splenic rupture. A 21-year-old primigravid woman was transferred to our center due to severe preeclampsia that underwent cesarean delivery because of u...

A twenty two year old primigravida, at thirty four weeks gestation delivered a 1.7 kg baby by emergency lower segment cesarean section. Cesarean section was done in view of severe intrauterine growth retardation and severe oligohydramnios. There was no history of diabetes mellitus or gestational diabetes in the mother, no history of any chronic medical illness, any drug intake or consanguinity ...

OBJECTIVE To analyze the trend of the monthly "caesarean section rate" (CSR) at the DISA V Lima-Ciudad Hospitals during the period 2001 - 2008. MATERIAL AND METHODS Ecological study that aim to analyze the monthly reports of all DISA V Lima-Ciudad Hospitals that attends childbirths, and by analyzing the trend of theirs monthly caesarean section ratio or monthly CSR (TCM = total caesarean birt...

OBJECTIVE To investigate the effect of in situ simulation (ISS) versus off-site simulation (OSS) on knowledge, patient safety attitude, stress, motivation, perceptions of simulation, team performance and organisational impact. DESIGN Investigator-initiated single-centre randomised superiority educational trial. SETTING Obstetrics and anaesthesiology departments, Rigshospitalet, University o...