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1

Uzoigwe, Chika Edward, Kenneth Jose Porter, and Luis Carlos Sanchez Franco. "Obesity and Cesarean Section." JAMA Pediatrics 171, no. 6 (2017): 598. http://dx.doi.org/10.1001/jamapediatrics.2017.0388.

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2

Chavarro, Jorge E., Changzheng Yuan, and Audrey J. Gaskins. "Obesity and Cesarean Section—Reply." JAMA Pediatrics 171, no. 6 (2017): 598. http://dx.doi.org/10.1001/jamapediatrics.2017.0391.

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3

Kadhim, Amel, and Rabea Ali. "Effectiveness of Women's Self-care Instructions concerning Wound, Perineal & Urinary System Care post cesarean section in Baghdad teaching hospital." Iraqi National Journal of Nursing Specialties 31, no. 1 (2018): 1–13. http://dx.doi.org/10.58897/injns.v31i1.287.

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Aim: to determine the effectiveness of women's self-care instructions on their post cesarean section care in Baghdadteaching hospital.Methodology: The present study used quasi-experimental study design in maternity words in Baghdad teachinghospital. The sample was collected and follow up for the period (15) January 2014 until 15 May 2014 Nonprobability(purposive sample) of (100) women post cesarean section divided in to two groups (50) women postcesarean section considered as a study group, and another (50) women post cesarean section considered as thecontrol one, A questionnaire designed as a tool to collect data fit the purpose of the study a questionnaire includedemographic variables, Reproductive variables, instructions self-care post cesarean Wound care, a pilot study wascarried out to test the reliability, As for reliability of questionnaire has been displayed by a group of experts invarious medical specialties and nursing.Result: The study presents significant differences in implementation of instructional program for self-carepost cesarean between study and control groups on wound, there is significant differences in washing handbefore & after any procedure, Don't put ointment or cream on the wound, don't raise the dressing to see operationimmediately unless done by medical staff (P=0.000). Also significant differences are found in perineal care &urinary system post cesarean in washing hand before & after using bathroom, wash perineum area water warmwater contains a antiseptics from front of the pubic bone to the anus, place sanitary pads from front to back toprotect the inner surface from contamination, do not hold on the urine when feel the desire to urinate,practice kegel exercises 2-3 times per day, Do not have sexual intercourse during the first 6 weeks, preferred touse the western bathroom (P= 0.000).Recommendations: The study recommended the possibility of providing an educational overlap of self-careafter a cesarean delivery for all pregnant women attending antenatal care centers, primary health, constructionand application of the overlap of the mothers of the educational process to be holding them in the hospital toincrease their knowledge of self-care after a cesarean section
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Alwan, Buthaina Ahmed, Nadia Fadhil Nassar, and Sahar Abdul Baqi Sabti. "Causes of primary cesarean section in Abo Ghraib general hospital." International journal of health sciences 6, S1 (2022): 913–18. http://dx.doi.org/10.53730/ijhs.v6ns1.4845.

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Aim of the study: To evaluate the causes of primary cesarean section in Abu Ghraib general hospital with the intention to reduce cesarean section rate. Patients and methods: A descriptive study done prospectively in Abo Ghraib general hospital in Baghdad, Iraq during the period from first of January till 30th of June 2021, there were 2799 of deliveries (beyond 28 weeks of gestation), 466 of them delivered by cesarean section. The study included all cesarean sections that collected from labor ward, general and private sector. Results: The most common primary Cs (57.4%) was found in age group between (21-30) years old, then (31.4%)) in age ?20 years, (9.9 %) in age between (31-40) years, and only (1.3%) in group of age >40 years. the most common indication was fetal distress in 65 (29.1%), then FTP in 57 (25.6%), then malpresentation in 27 (12.1%) and the least cause was preeclampsia and rupture uterus in 4 (1.8 %) for each cause. Conclusion: The most common causes of primary cesarean section in Abo Ghraib general hospital was fetal distress this may be due to low hospital resources.
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Fatimah, Dania, Bushra Khan, Humaira Imran, Muhammad Asim Iqbal Qureshi, Sumera Malik, and Shermeen Kousar. "Infections in Cesarean Section Wound and its Associated Risk Factors." Pakistan Journal of Medical and Health Sciences 16, no. 8 (2022): 212–14. http://dx.doi.org/10.53350/pjmhs22168212.

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Objective: To find out how commonly infections occur in cesarean section skin wound in post operative period and what factors are commonly encountered in these patients. Design: Descriptive Case Series. Setting: Obs & Gynae Deptt., Nishtar Hospital Multan (NHM). Duration of Study: Six Months. Subjects and Methodology: 121 patients undergoing cesarean section due to various reasons were enrolled in this research. These subjects were followed till 30 days of the procedure and examined through this interval for presence/absence of wound infection . These patients were evaluated for the presence of anemia, PIH/ pre-eclampsia, DM , PROM, obesity & type of cesarean section. Results: Age range was 18 to 45 yrs & Mean calculated i.e 28.289±2.74 years, mean gestational age 37.983±1.75 weeks, mean BMI 26.281±1.47 Kg/m2 and mean parity was 1.545±1.17. Post cesarean wound infection was seen in 9.9% patients. Factors leading to post-cesarean section wound infection were anemia found in 16.7%, diabetes mellitus in 16.7%, PROM in 16.7%, hypertension in 25%, obesity in 75%, emergency caesarean section in 75% and elective caesarean section in 25% were noted. Conclusion: Identification of causative factors of cesarean section wound infection, their correction and modification may help reduce wound infection rates among postoperative patients leading to reduction in maternal morbidity. Keywords: Cesarean section, Wound infection, Factors leading to wound infection.
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Shembekar, Chaitanya A., Shantanu C. Shembekar, Manisha C. Shembekar, Parul Sharma Saoji, and Jayshree J. Upadhye. "Maternal body mass index: how much it affects mother and baby." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 3 (2020): 1050. http://dx.doi.org/10.18203/2320-1770.ijrcog20200873.

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Background: Overweight, obesity, and morbid obesity in the mother are associated with adverse obstetrics well as neonatal outcome. Aim of this study was to assess the prevalence of overweight and obesity, and the impact of body mass index (BMI) on maternal and neonatal outcome.Methods: This is a retrospective study from January 2018 to September 2018 on 180 women with singleton term pregnancies. Maternal and neonatal outcomes at delivery were noted.Results: In present study, 3 (1.66%) pregnant women were underweight, 57 (31.66%) pregnant women had normal BMI, 71 (39.44%) pregnant women were overweight while 49 (27.22%) pregnant women were obese. Gestational weight gain was less than 8 kgs in 40 (22.22%) pregnant women, weight gain was 8-15.9 kgs in 132 (73.33%) pregnant women while weight gain was more than 16 kgs in 8 (4.44%) pregnant women. Out of 3 underweight women, 1 delivered by cesarean section and 2 had normal delivery, out of 57 women with normal BMI, 21 delivered by cesarean section and 36 had normal delivery, out of 71 overweight women, 47 delivered by cesarean section and 34 had normal delivery while out of 49 obese women, 38 delivered by cesarean section and 11 had normal delivery. PET and GDM was seen in 9 (7.5%) women each while macrosomia were seen in 5 (4.16%) women.Conclusions: Increased association was seen with maternal obesity and adverse outcome of pregnancy like PIH, GDM, cesarean section.
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7

Li, Hong-tian, Yu-bo Zhou, and Jian-meng Liu. "Cesarean section might moderately increase offspring obesity risk." American Journal of Clinical Nutrition 96, no. 1 (2012): 215–16. http://dx.doi.org/10.3945/ajcn.112.038760.

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8

Давыдова, Е. А., А. П. Власов, А. Е. Маркина, and Т. И. Власова. "Disorders of homeostasis after cesarean section in obesity." International Journal of Medicine and Psychology 7, no. 2 (2024): 88–96. http://dx.doi.org/10.58224/2658-3313-2024-7-2-88-96.

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как показывает статистика, в современном мире значительно выросла частота родоразрешения путем операции кесарева сечения. Также отмечена явная тенденция увеличения числа беременных женщин с ожирением, что осложняет послеоперационный период. Само по себе ожирение уже достигло масштабов пандемии и неуклонно продолжает расти. Мы провели клинико-лабораторное исследование на 93 беременных женщинах, родоразрешение у которых произведено путем кесарева сечения и сделали выводы о взаимосвязи ожирения и нарушением гомеостаза. Исследование проводилось на 12,3,5 сутки после абдоминального родоразрешения. В ходе исследования выявили взаимосвязь между степенью ожирения и нарушением гомеокинеза. Полученные данные обрабатывали методом вариационной статистики с использованием критерия t Стьюдента. statistics show that in the modern world, the frequency of delivery by caesarean section has increased significantly. There is also a clear trend towards an increase in the number of obese pregnant women, which complicates the postoperative period. Obesity itself has already reached pandemic proportions and continues to grow steadily. We conducted a clinical and laboratory study on 93 pregnant women whose delivery was performed by cesarean section and drew conclusions about the relationship between obesity and homeostasis disorders. The study was conducted on 12, 3, 5 days after abdominal delivery. The study revealed a relationship between the degree of obesity and a violation of homeokinesis. The obtained data were processed by the method of variational statistics using the Student's t criterion.
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9

Lazurenko, Viktoriya, Oleksandr Zhelezniakov, and Denys Tertyshnyk. "Features of operative delivery in women with gestational diabetes and obesity." Perinatology and reproductology: from research to practice 4, no. 3-2 (2024): 5–13. https://doi.org/10.52705/2788-6190-2024-03.2-01.

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The objective: to analyze cesarean section in women with gestational diabetes mellitus and obesity and to improve them to prevent complications for the mother and newborn.Materials and methods. The course of pregnancy, indications for cesarean section, surgical technique, perinatal complications, and the state of the postpartum period for 2020-2024 were analyzed according to the medical documentation of the Municipal non-profit enterprise of the Kharkiv Regional Council «Regional Clinical Hospital». The results of the examination and opera-tive delivery of 110 primiparous pregnant women are presented. They were divided into the fol-lowing clinical groups: the main group consisted of 32 pregnant women (29.1%) with GDM and obesity, the first comparison group consisted of 30 pregnant women (27.3%) with GDM, the second comparison group consisted of 28 pregnant women (25.4%) with obesity, and 20 preg-nant women (18.2%) who did not have extragenital pathology formed the control group.A general clinical examination and ultrasound examination of the fetoplacental complex were performed. The newborn’s condition was assessed using the Apgar score and by measuring the acid-base status of the umbilical cord blood. Results. When analyzing medical documentation, it was found that the number of pregnant women with obesity almost doubled from 16.5% in 2021 to 31% in 2022, which could be influ-enced by the beginning of the war, stress, being pregnant in a combat zone, psycho-emotional factors, and eating disorders. The number of patients with GDM also changed towards an in-crease in frequency from 30.7% in 2021 to 37.8% - in 2023, obesity could play an important role in this process. Based on the cesarean section technique from the clinical protocol of the Ministry of Health of Ukraine «Caesarean section»; and the NICE Guideline «Cesarea section»; proposed to supplement it with some points in women with GDM with obesity. When comparing the results of childbirth, it was determined that in the examined women, the most frequent indications for cesarean section (CS) were macrosomia, fetopathy, weakness of labor ac-tivity, ineffective induction of labor activity, and fetal distress. To prevent complications of CS in pregnant women with GDM and obesity, it was proposed to improve the protocol of the operation by finalizing some of its stages, taking into account the features of the existing extragenital pathology.Conclusions. The increase in extragenital pathology, especially during the war, among which the frequency of endocrine diseases increased, led to a rise in the frequency of operative delivery. Improving the technique of cesarean section in women with obesity and gestational diabetes mel-litus will contribute to the reduction of complications in the postoperative period on the part of the mother, perinatal morbidity, and mortality.Keywords: gestational diabetes mellitus, obesity, cesarean section.
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10

Al-Anbary, Laith A. "Evaluation of lower urinary tract symptoms post cesarean section." Muthanna Medical Journal 9, no. 1 (2022): 1–7. http://dx.doi.org/10.52113/1/1/2022-1-7.

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Lower urinary tract symptoms are common during pregnancy and shortly after it ( puerperium period ). Those symptoms usually classified into filling symptoms like urinary frequency, urgency, nocturia, and dysuria. And voiding symptoms which consist of: straining, hesitancy, post void dribbling and weak stream. Over the last decades many researcher were alert to urinary incontinence and it is possible association with childbirth type, cesarean section versus vaginal delivery. The objective of this study is to estimate the effect of cesarean section procedure on lower urinary tract function in long term. The study was conducted at Al-Imamain Al-Kadhmain medical city, Baghdad-Iraq. During the period from (August 2020) to (January 2021). Retrospective cohort study design was chosen. Target population was women with history of previous cesarean section for at least 6 months ago. Data were collected by using structured questionnaire form. 176 women were included. The analysis of data was carried out by using Microsoft excel 2013. This study went with most of the previous researcher findings as it appears that lower urinary tract symptoms (LUTS) have generally low incidence among women with cesarean section. But this study showed a possible effect of multiple cesarean sections on LUTS development , namely pervious three , which can be explained by their higher percentage in our study sample ( about 20% ) as Iraqi families have a tendency to have more children . In conclusion; this study concluded that LUTS have low frequency post caesarean section apart from the possible effect of multiple cesarean sections on LUTS development, namely pervious three .In general cesarean section could be protective against LUTS in comparison to normal vaginal delivery.
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11

Pelle, Hedvig, Ole B. Jepsen, Severin O. Larsen, et al. "Wound Infection After Cesarean Section." Infection Control 7, no. 9 (1986): 456–61. http://dx.doi.org/10.1017/s019594170006495x.

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AbstractA prospective multicenter study of 1,032 cesarean sections was performed to identify risk factors for postoperative wound infection. The overall rate of wound infection was 6.6% (3.8% in elective cases and 7.5% following nonelective operations), with considerable interhospital variation. Obesity was recognized as a patient-related risk factor, while risk factors inherent to the obstetric situation were duration of ruptured membranes prior to operation, fetal and labor monitoring by intrauterine devices, and omission of the use of plastic draping and redisinfection of the skin before closure. Logistic regression analysis was used to estimate the influence of these factors on the probability of wound infection. Certain risk factors associated with and overrepresented in nonelective operations would explain the increased infection rates in these, and the observed interhospital variations did not differ from the expected rates when the distribution of other risk factors was considered.
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12

Degez, Manon, Lucie Planche, Agnès Dorion, Alexis Duchalais, Emelyne Lefizelier, and Guillaume Ducarme. "Risk Factors for Carbetocin Failure after a Cesarean Section: Is Obesity One of Them?" Journal of Clinical Medicine 10, no. 17 (2021): 3767. http://dx.doi.org/10.3390/jcm10173767.

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Obese pregnant women have increased rates of fetal macrosomia, long labor, and cesarean sections, which lead to an increased risk of postpartum hemorrhage (PPH). Carbetocin is useful for the prevention of PPH after a cesarean section. Our study aimed to investigate predictors of carbetocin failure after a cesarean section, and specifically whether obesity is associated with carbetocin failure. We retrospectively analyzed all women who received carbetocin after a cesarean section. Carbetocin failure was defined as changes in hematocrit and hemoglobin, blood loss ≥ 1000 mL, and the need for an additional uterotonic agent or second-line therapies for persistent PPH. Univariate and multivariate analyses were performed to investigate predictors of carbetocin failure. The study included 600 women, with 131 (21.8%) obese women. Overall, 44 (7.3%) carbetocin failures were reported, and rates of obese women were similar between groups (carbetocin failure, 11.4% vs. 22.9%; p = 0.08). Previous PPH (p < 0.001), a cesarean section during labor (p = 0.01), cervical ripening (p = 0.02), and birthweight (p = 0.01) were significantly different between groups. In the multivariable logistic regression analysis adjusted for potential confounders, cervical ripening (adjusted odds ratio (OR) 2.23, 95% confidence interval (CI) 1.01–4.80), compared with spontaneous labor, was significantly associated with carbetocin failure. Obesity was not associated with carbetocin failure after cesarean sections.
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Słabuszewska-Jóźwiak, Aneta, Jacek Krzysztof Szymański, Michał Ciebiera, Beata Sarecka-Hujar, and Grzegorz Jakiel. "Pediatrics Consequences of Caesarean Section—A Systematic Review and Meta-Analysis." International Journal of Environmental Research and Public Health 17, no. 21 (2020): 8031. http://dx.doi.org/10.3390/ijerph17218031.

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Background: Cesarean section is a surgical procedure, which is the most frequently performed in gynecology and obstetrics. It is commonly believed that an operative delivery is a less painful and safer mode of delivery, which translates into an increasing number of the procedures performed without medical indications. The maternal sequelae of cesarean sections are well elucidated and widely discussed in the literature, while long-term neonatal consequences still remain the issue of research and scientific dispute. The aim of the present paper was to perform a systematic review of current literature regarding pediatrics consequences of cesarean section. Methods: We reviewed available data from PubMed, Science Direct as well as Google Scholar bases concerning early and long-term neonatal sequelae of operative deliveries. The following key words were used: “cesarean section”, “caesarean section”, “neonatal outcomes”, “respiratory disorders”, “asthma”, “obesity”, “overweight”, and “neurological disorders”. A total of 1636 papers were retrieved out of which 27 were selected for the final systematic review whereas 16 articles provided data for meta-analysis. Statistical analyses were performed using RevMan 5.4. To determine the strength of association between the caesarean section and respiratory tract infections, asthma, diabetes type 1 as well as obesity the pooled odds ratios (OR) with the 95% confidence intervals (CI) were calculated. Results: Conducted meta-analyses revealed that caesarean section is a risk factor for respiratory tract infections (pooled OR = 1.30 95%CI 1.06–1.60, p = 0.001), asthma (pooled OR = 1.23 95%CI 1.14–1.33, p < 0.00001) as well as obesity (pooled OR = 1.35 95%CI 1.29–1.41, p < 0.00001) in offspring. Conclusions: The results of the studies included indicated that children delivered by cesarean section more commonly developed respiratory tract infections, obesity and the manifestations of asthma than children delivered vaginally. The risk of developing diabetes mellitus type 1 or neurological disorders in offspring after caesarean section is still under discussion.
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Hiramatsu, Yuji. "Lower-Segment Transverse Cesarean Section." Surgery Journal 06, S 02 (2020): S72—S80. http://dx.doi.org/10.1055/s-0040-1708060.

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AbstractCesarean section is the ultimate method of successful delivery of infants under various circumstances and is an indispensable operation in obstetrics. However, the degree of difficulty varies greatly depending on the gestational weeks, number of fetuses, number of previous cesarean sections, degree of placental adhesion, presence of uterine myomas, maternal obesity, and other factors. In addition, emergency cesarean section is a battle against time, and prompt surgery is required.During training in cesarean section, surgeons must master the basic techniques in cases of term head presentation first. They must then master the techniques in cases involving complications such as malpresentation, preterm birth, placenta previa, abruptio placentae, uterine myomas, and other conditions.Cesarean section itself is a simple operation. However, there are many difficult cases, and many complications such as placenta accreta and defects of the incision scar may occur after cesarean section.The present report describes the basic procedures and cautionary points to perform the cesarean section without complications.
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Visan, Feah, Jenalyn Castro, Yousra Siam Shahada, Naser Al Ansari, and Almunzer Zakaria. "Risk Factors for Cesarean Section Surgical Site Infections: A Systematic Review." Infection Control & Hospital Epidemiology 41, S1 (2020): s377. http://dx.doi.org/10.1017/ice.2020.1009.

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Background: According to the CDC NHSN, surgical site infections (SSI) are wound infections that develop within 30 days postoperatively for nonimplanted surgeries such as cesarean sections. SSIs is shown to manifest in a continuum of a purulent discharge from surgical site to severe sepsis. It contributes to rising morbidity, mortality and prolonged length of stay. Objective: To describe risk factors to the development of SSI in cesarean section in descriptive studies. Methods: The Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guidelines is used as method for this systematic review. A PubMed literature search was conducted, limited to published articles in English from 1998 to 2016 using the broad key terms “cesarean section,” “surgical site infection,” and “risk factor.” The following inclusion criteria were applied to all reviews: (1) peer-reviewed journal, (2) computed risk factor for SSI development, and (3) calculated SSI rate. Reviews of references of the include studies were conducted, and 7 studies were appraised, with only 1 accepted. Results: After extracting data from 52 article reviews, 23 were finally accepted based on the inclusion criteria. Most studies were multivariate studies (n = 8) followed by cohort studies (n = 6). Unique numerators and denominators for SSI reviews were mentioned in all 23 studies, of which 22 studies followed the CDC NHSN definitions for SSI. Within the 23 studies, most studies showed that obesity (11.46%) is a common maternal risk factor for the development of postoperative cesarean section SSI. Conclusions: Identifying that obesity is a major contributor of surgical site infection in postoperative cesarean section women is a topic that warrants exploration. The relationship of cesarean section SSI to obesity should be investigated, specifically highlighting the level of obesity based on the WHO international body mass index (BMI) classification and the development of SSI. A correlation between increasing wound infection rates and increasing body mass index should be studied further. Published recommendations for preventing SSIs in this population should be reviewed.Funding: NoneDisclosures: None
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Trisovic, M., O. Kontic, I. Babovic, D. Plecas, and D. Kisic Tepavcevic. "The influence of obesity on abdominal cesarean section delivery." Clinical and Experimental Obstetrics & Gynecology 42, no. 4 (2015): 498–500. http://dx.doi.org/10.12891/ceog1888.2015.

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Bjorklund, Jenny, Eva Wiberg-Itzel, and Tove Wallstrom. "Is there an increased risk of cesarean section in obese women after induction of labor? A retrospective cohort study." PLOS ONE 17, no. 2 (2022): e0263685. http://dx.doi.org/10.1371/journal.pone.0263685.

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Background Obesity is increasing in Sweden and is also of huge global concern. Obesity increases the risk of complications during pregnancy and the need for the induction of labor. Induction of labor increases the number of complications during delivery, leading to women with more negative birth experience. This study investigated how maternal body mass index (BMI) during antenatal care enrollment affects labor outcomes (proportion of cesarean section at induction of labor). Method This was a retrospective cohort study of 3772 women with mixed parity and induction of labor at Soderhospital, Stockholm, in 2009–2010 and 2012–2013. The inclusion criteria were simplex, ≥34 gestational weeks, cephalic presentation and no previous cesarean section. The women were grouped according to BMI, and statistical analyzes were performed to compare the proportion of cesarean sections after induction of labor. The primary outcome was the proportion of cesarean section after induction of labor divided by group of maternal BMI. The secondary outcomes were postpartum hemorrhage >1000 ml, time of labor, fetal outcome data, and indication for emergency cesarean section. Result The induction of labor in women with a high BMI resulted in a significantly increased risk of cesarean section, with 18.4–24.1% of deliveries, depending on the BMI group. This outcome persisted after adjustment in women with BMI 25–29.9 (aOR 1.4; 95% CI; 1.1–1.7) and BMI 30–34.9 (aOR 1.5; 95% CI; 1.1–2.1). There was also a significantly higher risk for CS among primiparous women (aOR 3.6; 95% CI; 2.9–45) and if the newborn weighted ≥ four kilos (aOR 1.6; 95% CI; 1.3–2.0). Conclusion Our findings show that a higher BMI increased the risk of cesarean section after induction of labor in the groups with BMI 25–34.9. Parity seems to be the strongest risk factor for CS regardless other variables.
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Habasha, Zainab Faisal. "Synergistic effect of inthrathecal fentanyl and bupivacaine in spinal anesthesia for cesarean section in Baghdad city." International Journal Of Community Medicine And Public Health 9, no. 6 (2022): 2462. http://dx.doi.org/10.18203/2394-6040.ijcmph20221521.

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Background: Potentiating the effect of intrathecal local anesthetics drugs by addition of intrathecal opiods for intra-abdominal surgeries had been used lately. In this study by addition of fentanyl, we tried to minimize the dose of bupivacaine thereby reducing the side effect caused by higher doses of intrathecal bupivacaine in cesarean section, and to improve the quality of block.Methods: Study was performed on sixty patients underwent cesarean section they were divided into 6 groups as B10, B 12.5, B15 mg of bupivacaine and FB10, FB12.5, FB15 received a combination of 25 µg intrathecal fentanyl respectively, the parameter taken into consideration were visceral pain, hemodynamic stability (hypotension and bradycardia) intra operative sedation, nausea, vomiting and post-operative pain. Results: Onset of sensory block to T6 occurred faster with increasing bupivacaine doses in bupivacaine only groups and bupivacaine fentanyl combination groups. Alone lower concentration of bupivacaine could not completely remove the visceral pain. Blood pressure declined with increasing the concentration of bupivacaine and fentanyl. The incidence of nausea and vomiting was reduced significantly while post-operative pain relief and hemodynamics stability increased by adding fentanyl. Pruritis, maternal respiratory depression and changes in APGAR score of babies did not occur with fentanyl. Conclusions: Spinal anesthesia among the neuro axial blocks in obstetric patients’ needs strict dose calculation because minimal dose changes results in more complications and side effects Here the synergistics potentiating effects of fentanyl (an opiod) on bupivicaine (local anesthetic) in spinal anesthesia for cesarean section is presented. Fentanyl is able to reduce a dose of bupivicaine and therefore its harmful effect.
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Premlata Mital, Aditi Arora, Sachin Chakarrvarti, et al. "Performance of maternal abdominal subcutaneous fat thickness in predicting cesarean section." International Journal of Science and Research Archive 6, no. 1 (2022): 040–46. http://dx.doi.org/10.30574/ijsra.2022.6.1.0105.

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Introduction: Overweight and obesity during pregnancy is associated with increased risk for cesarean delivery. BMI is the most frequently used parameters to define and to assess risk of pregnancy related complications. Maternal abdominal subcutaneous fat thickness (SCFT) can be used as a measure of obesity. The present study was done to find association of maternal SCFT with risk of cesarean section. Methods: 200 women with singleton live pregnancy at 16-18 weeks were included in the study after obtaining written informed consent. Ultrasonography was done to assess foetal wellbeing and rule out congenital malformation. Maternal abdominal subcutaneous thickness was measured. All women were followed during labour till discharge. ROC curve analysis was done to predict the risk of cesarean section. Odd ratio for SCFT mediated risk of cesarean section was calculated. Results: 32.5% women had cesarean delivery. Mean SCFT was also significantly more in women delivered by cesarean than who delivered vaginally (p <0.001). ROC curve analysis for SCFT showed that SCFT above 11.5 mm (AUC=0.735) predicted LSCS with a sensitivity of 86.2% and specificity of 47.4% and Youden index of 0.34. Increased abdominal SCFT was significantly associated with increased risk of LSCS. . Using 11.5 mm cut -off value (by ROC curve) for SCFT, the odd ratio of LSCS was 7.5 (95% CI 3.4056 – 16.5837, p <0.0001). Stitch line infection was seen in 15.38% women. Conclusion: This study observed that measurement of SCFT by ultrasonography at 16-18 weeks pregnancy is a significant predictor of cesarean section.
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Asakeeva, R. S., Ch K. Kalkanbaeva, G. K. Zhalieva, F. R. Niyazova, and N. Dzh Shoonaeva. "The role of obesity in the development of labor and postpartum abnormalities." Kazan medical journal 99, no. 4 (2018): 575–79. http://dx.doi.org/10.17816/kmj2018-575.

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Aim. Comparative assessment of the features of the course of labor and postpartum period in women with obesity of various classes.
 Methods. During 2014-2016, a cohort retrospective and prospective study included 318 birth records. The main group consisted of 198 case records of women with different severity of obesity (122 with obesity class I, 57 with class II and 19 with class III), and the control group included 120 case records of women without obesity.
 Results. In women with obesity class II and III (p=0.003 and p <0.001) had preterm birth more often than in the control group. Patients with obesity class III had the cesarean section significantly more often than in the control group (p=0.043), in the same group hypertensive disorders in labor and intrauterine hypoxia of the fetus developed more frequently (p=0.009 and p=0.039). In the postpartum period with class III obesity, postpartum haemorrhage was significantly more frequent than in the control group (p=0.045). Among complications of postpartum period in patients with obesity class II, a loychiometer (by 1.7 times), endometritis (by 1.6 times), complications after cesarean section (by 2.1 times) were registered more often than in the control group, and in obesity class III - subinvolution of the uterus (by 2.1 times), endometritis (by 2.4 times), complications after cesarean section (by 3.2 times), divergence of the seams on the perineum (by 2.4 times), but these parameters were not statistically significantly different.
 Conclusion. The negative impact of excess body weight on the labor course was shown, moreover, labor in obesity class I is more favorable than in class II and III.
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Давыдова, Е. А., А. П. Власов, А. Е. Маркина, Д. Г. Сардаева, Т. И. Власова, and Е. В. Вешкина. "The severity of endogenous intoxication in the early stages after cesarean section in obesity." International Journal of Medicine and Psychology 7, no. 3 (2024): 42–48. http://dx.doi.org/10.58224/2658-3313-2024-7-3-42-48.

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изучение выраженности эндогенной интоксикации в ранние сроки после кесарева сечения у женщин с ожирением представляет значимость для понимания и лечения данного состояния. В данной аннотации прослеживается связь между кесаревым сечением, ожирением и уровнем эндогенной интоксикации у пациенток. Исследование проведено с использованием методов анализа биохимических показателей крови и клинических симптомов у женщин, перенесших кесарево сечение. Результаты исследования указывают на увеличенный уровень эндогенной интоксикации в ранние сроки после операции у пациенток с ожирением, что может свидетельствовать о наличии возможных осложнений. Дальнейшие исследования по данной теме необходимы для разработки эффективных стратегий лечения и профилактики осложнений после кесарева сечения у женщин с ожирением. the study of the severity of endogenous intoxication in the early stages after cesarean section in obese women is important for understanding and treating this condition. This annotation traces the relationship between cesarean section, obesity and the level of endogenous intoxication in patients. The study was conducted using methods for analyzing blood biochemical parameters and clinical symptoms in women who underwent cesarean section. The results of the study indicate an increased level of endogenous intoxication in the early stages after surgery in obese patients, which may indicate the presence of possible complications. Further research on this topic is needed to develop effective strategies for the treatment and prevention of complications after cesarean section in obese women.
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Rahayu, Rahayu. "OBESITY AS A RISK FACTOR FOR SURGICAL SITE INFECTION AFTER TRANSPERITONEAL CESAREAN SECTION." Sains Medika : Jurnal Kedokteran dan Kesehatan 9, no. 1 (2018): 46. http://dx.doi.org/10.30659/sainsmed.v9i1.1594.

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Surgical site infection (SSI) is one of the main complications that can increase morbidity and mortality in obese women after cesarean section. Surgical site infection can be caused by endogenous or exogenous factors. This was a case of a woman, G4P3A0, 32 years, after trans-peritoneal cesarean section for indications of breech presentation; primary uterine inertia; premature rupture + 22 hours with BMI = 30.80 kg/m2. This case report discusses how obesity causes surgical site infection and its management.
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Nagy, Sándor. "Changing trends and indications for cesarean section in the last few decades." Orvosi Hetilap 155, no. 29 (2014): 1140–46. http://dx.doi.org/10.1556/oh.2014.29931.

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Cesarean section rates are increasing worldwide, which has been paralelled by an increase in primary cesarean delivery and decrease in vaginal birth after cesarean section. Behind the different frequencies there is a number of interrelated factors including advanced maternal age, increasing incidence of obesity, assisted reproductive technologies, and maternal request for non-medical reasons. The sub-optimal management of labor and the concerns about medical liability claims and litigations increase the number of abdominal deliveries. The author reviews the changing indications for cesarean deliveries in the last few decades and summarizes the effects on the obstetrical clinical practice. Orv. Hetil., 155(29), 1140–1146.
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Maruf, Abdullah Al, Md Mustafa Kamal, Sharif Uddin Siddique, and Mehdi Hassan. "Anaesthetic Management of a Morbidly Obese Parturient Undergoing Cesarean Section." Journal of the Bangladesh Society of Anaesthesiologists 35, no. 2 (2022): 58–62. http://dx.doi.org/10.3329/jbsa.v35i2.67897.

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An increasing number of women with a morbid obesity are requiring anaesthetic care for labour anddelivery. Management of these patients presents obstetric, anesthetic, and logistical challenges. Wereport our experience in the management of elective Caesarian section of a morbidly obese (BMI 61.6kg/m2) parturient under epidural anaesthetictechnique. Despite the increased risk of morbidity andmortality, our patient had an optimal outcome. An awareness of the hemodynamic and respiratorystability during anaesthetic management, postoperative analgesia and careful thromboprophylaxiswillbenefit parturient with morbid obesity. JBSA 2022; 35 (2) : 58-62
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Wang, Ran, Xin Liang, and Xing-Yan Su. "Analysis of risk factors for postpartum depression after cesarean section in women with early-onset preeclampsia." World Journal of Psychiatry 14, no. 10 (2024): 1448–57. http://dx.doi.org/10.5498/wjp.v14.i10.1448.

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BACKGROUND Early-onset preeclampsia significantly increases maternal and fetal morbidity and mortality. Many pregnant women with early onset preeclampsia choose cesarean section as their delivery method. Although extensive research has explored the association between postpartum depression (PPD) and cesarean section, few studies have investigated the risk factors after cesarean section in women with early-onset preeclampsia. AIM To examine these risk factors through a retrospective, observational analysis of 287 women who underwent a cesarean section for early preeclampsia between June 2014 and March 2024. METHODS Participants were assessed in person during the 32nd week of pregnancy, 2 days post-cesarean, and 6 weeks postpartum. According to the Edinburgh Postnatal Depression Scale (EPDS), participants who underwent cesarean section were divided into PPD (n = 60) and non-PPD groups (n = 227). Furthermore, PPD was diagnosed at 6 weeks postpartum according to depressive symptoms (EPDS score ≥ 11). The demographic and clinical features of PPD were screened. Multivariate logistic regression analysis was used to identify PPD risk factors. RESULTS The prevalence of PPD was 20.9% (60/287) among the 287 women who underwent cesarean section for early-onset preeclampsia. Multivariate logistic regression analyses revealed that advanced age (age > 40 years) [odds ratio (OR) = 1.93, 95%CI: 1.31-2.82], previous preeclampsia (OR = 7.15, 95%CI: 5.81-8.85), pre-pregnancy obesity (OR = 2.42, 95%CI: 1.62-3.63), gestational diabetes mellitus (OR = 3.52, 95%CI: 2.51-4.92), preexisting hypertension (OR = 1.35, 95%CI: 1.03-1.89), PPD symptoms (EPDS ≥ 11) at 2 days postpartum (OR = 6.15, 95%CI: 1.32-28.35), high prenatal self-rating anxiety scale score (OR = 1.13, 95%CI: 1.06-1.18), and pain at 6 weeks postpartum (OR = 2.16, 95%CI: 1.28-3.66) were independently associated with PPD. CONCLUSION Risk factors for PPD after cesarean section in women with early-onset preeclampsia include advanced age (age > 40 years), pre-pregnancy obesity, previous preeclampsia, gestational diabetes mellitus, preexisting hypertension, PPD symptoms (EPDS ≥ 11) at 2 days postpartum, prenatal anxiety, and pain at 6 weeks postpartum. The early identification of these factors and interventions can mitigate the risk of PPD.
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Turcsányiová, Zuzana, Petra Gašparová, Zuzana Ballová, and Erik Dosedla. "The impact of delivery mode on epigenetic changes in newborns and their health outcomes." Česká gynekologie 89, no. 4 (2024): 329–34. http://dx.doi.org/10.48095/cccg2024329.

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Recent decades have seen a notable increase in cesarean section rates. Although lifesaving, cesarean delivery is associated with an elevated risk of adverse health outcomes in newborns, including respiratory diseases, atopic disorders, obesity, diabetes, and severe autoimmune conditions. The exact mechanisms underlying these associations remain elusive; however, epigenetic modifications have emerged as a plausible molecular basis linking perinatal factors with future disease susceptibility. This review summarizes current literature, revealing that the delivery method may influence epigenetic markers in neonates, primarily through alterations in global DNA methylation and gene-specific methylation patterns. Key words: epigenetics – DNA methylation – cesarean section
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Li, H. T., Y. B. Zhou, and J. M. Liu. "The Impact of Cesarean Section on Offspring Overweight and Obesity." Obstetrical & Gynecological Survey 69, no. 1 (2014): 9–11. http://dx.doi.org/10.1097/01.ogx.0000442815.27237.2a.

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Muhammad, :. Dalia Magdy Mokhtar. "External Negative Pressure Dressing System(ENDPS) VS. Traditional Wound Dressing for Cesarean Section Incision in Obese Women: A Randomized Controlled Trial." Biomedical and Case Reports Open Access Open Journal 2, no. 1 (2021): 58–62. http://dx.doi.org/10.33169/biomcase.bacroaoj-2-116.

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What is already known on this subject? AND What does this study add? Obesity is associated with increased cesarean section delivery rates and surgical site wound complication with associated increased post-operative morbidity, post-operative pain and length of hospital stay. What does this study add? Negative pressure wound therapy (NPWT) technology could be used as a prophylactic measure to reduce surgical site wound complications in obese women undergoing cesarean section by immediate postoperative application in clean-contaminated, closed surgical incisions.
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Siddiqui, Maria, Syeda Sahar Zahra, Syeda Taskeen Ejaz, Bazgha Sahar, Nabila Eajaz, and Saima Raees Ahmad. "Comparison of Wound Infection with Absorbable Suture Versus Non-Absorbable Suture after Cesarean Section." Pakistan Journal of Medical and Health Sciences 16, no. 11 (2022): 264–66. http://dx.doi.org/10.53350/pjmhs20221611264.

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Objective: To compare the frequency of wound infection with absorbable suture and non-absorbable suture after cesarean section. Study Design: A randomized controlled trial. Place and Duration: Department of Obstetrics and Gynaecology, Nisthar Hospital, Multan from August 2021 to June 2022. Methodology: A total of 826 women (413 in each group) undergoing cesarean section were included. In Group-A absorbable suture was employed while in Group-B, non-absorbable suture was used. Post-operatively, all patients were followed up weekly and the final assessment of wound infection was done after 15 days. Results: In a total of 826 cases, mean age was 26.47±3.42 years. Mean body mass index was 25.62±1.87 kg/m2 and obesity was present in 166 (20.1%). Of these 826 study cases, emergency cesarean section was performed in 593 (71.8%). Mean duration of procedure was 38.43±12.21 minutes and 562 (68.0%) had duration of procedure below 40 minutes. Overall, wound infection was noted in 145 (17.6%) women, In Group-A, wound infection was noted in 96 (23.2%) women and in Group-B it was in 49 (11.9%) (p<0.0001). Practical Implications: Clinicians can employ non-absorbable sutures to decrease the risk of post-operative wound infection after cesarean section. Conclusion: We found non-absorbable sutures after cesarean section to yield significantly less rates of wound infection when compared to absorbable sutures. Keywords: Absorbable suture, Non-absorbable suture, wound infection, cesarean section.
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Naoom, Manal B., Ahmed A. Abdul-Zahra, and Yasir A. Alsaadi. "Respiratory Distress in Full Term Outborn Neonates: A Hospital Based Study." Journal of the Faculty of Medicine Baghdad 54, no. 4 (2013): 306–9. http://dx.doi.org/10.32007/jfacmedbagdad.544712.

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Summary:Background: Respiratory distress remains a major problem post adaptation and one of the most common reasons for admission of neonates to Intensive Care.Objectives: To study the causes and short term outcomes of respiratory distress in full term neonates and its correlation to mode of delivery.Patients and Methods: A cross sectional study was carried out on 100 full termoutborn neonates with respiratory distress admitted to Neonatal care unit of Children Welfare Teaching Hospital, Medical City, Baghdad from 1st of April to 31st of August 2011.Results: Hundred full term neonateswerestudied, 66% were boys and 81% born by cesarean section (elective cesarean sectionin 62%). In both sexes, Transient TachypneaofNewbornand pneumothorax ranked the 1st and 2nd among other causes.Among boys, early onset sepsis/pneumonia ranked 3rd, whereas late pneumonia and hyaline membrane disease among girls.The proportion ofTransient TachypneaofNewborn was higher in those who were delivered by cesarean section(86.66%).There was no significant correlation between the mode of delivery and respiratory distress in congenital heartdisease, birth asphyxia, meconium aspiration andtracheoesophagel fistula.The case fatality was 100% in birth asphyxia, 16.66% in sepsis/pneumonia, 9.09% in hyaline membrane disease and 5.88%in pneumothorax.Conclusions:Transient tachypnea was the commonest cause of hospitalizations among term neonates with respiratory distress. Elective cesarean sectionwas correlated with neonatal respiratory distress.Key Words: Respiratory Distress, Full Term Outborn neonates
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Zhou, Yunping, Yanqing Zhang, Yun Sun, and Dongfeng Zhang. "Association of Cesarean Birth with Body Mass Index Trajectories in Adolescence." International Journal of Environmental Research and Public Health 17, no. 6 (2020): 2003. http://dx.doi.org/10.3390/ijerph17062003.

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Background: This study aimed to identify patterns of body mass index (BMI) changes in adolescence and to assess whether delivery mode (Cesarean and vaginal delivery) was associated with BMI trajectories. Methods: This study was conducted among 569 adolescents aged 10–15 years that resided in the city of Zibo, China. The height and weight of each participant were repeatedly measured at 10, 11, 12, 13, 14 and 15 years. Group based trajectory modeling (GBTM) was used to estimate BMI change trajectories, and multinomial logistic regression was conducted to evaluate the independent association of delivery mode and BMI trajectory classes. Results: Of the 569 participants, 407 (71.5%) were vaginal deliveries and 162 (28.5%) were Cesarean deliveries. Five distinct long-term BMI trajectories were identified: “persistent healthy weight” (57.5%), “persistent underweight” (6.5%), “obesity to healthy weight” (7.8%), “progressive overweight” (10.6%), “progressive obesity” (17.6%). Adjusted multinomial logistic models revealed a twofold increase in risks between ages 10–15 years of “progressive obesity” trajectory (OR = 2.50, 95% CI: 1.42, 4.41) for children born through Cesarean section compared with vaginal birth. Conclusions: Five distinct long-term BMI trajectories were identified during adolescence in our research, and we confirmed that Cesarean birth was significantly increased the risk of “progressive obesity” trajectory but not the “obesity to healthy weight” trajectory.
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PAN, KAIYU, CHENGYUE ZHANG, and JUN TIAN. "The Effects of Different Modes of Delivery on the Structure and Predicted Function of Intestinal Microbiota in Neonates and Early Infants." Polish Journal of Microbiology 70, no. 1 (2021): 45–55. http://dx.doi.org/10.33073/pjm-2021-002.

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Several studies have shown that an increased risk of metabolic and immune disorders associated with cesarean section mode of delivery may exist. However, such studies have not been conducted in the Chinese population. Stool sample sequencing of the gene encoding the 16S rRNA of 82 prospectively enrolled 3- and 30–42-day-old vaginal and cesarean section delivered newborns was performed to study the composition and predicted function of the intestinal microbiota. In the samples from the 3-day-old neonates, the levels of Escherichia-Shigella in the two groups were similar. The genera Bifidobacterium, Lactobacillus, and Bacteroides were more prominent in the vaginal delivery than in the cesarean section group, which showed a predominance of Staphylococcus, Streptococcus, and Corynebacterium. The differences between the two groups were statistically significant (p < 0.05). In the samples from 30- to 42-day-old infants, Bifidobacterium, Lactobacillus, Escherichia-Shigella, and Bacteroides were the main genera present in the vaginal delivery group, while in the cesarean section delivery group; the predominant genera were Escherichia-Shigella, Bifidobacterium, Bacteroides, and Staphylococcus. Predicted functions of the vaginal delivery group revealed higher metabolic and biodegradation rates of carbohydrates, vitamins, and xenobiotics than those in the cesarean section group, which contributed to the stability of the microbiota in the former. The abundance of probiotic bacteria such as Bifidobacterium and Lactobacillus, and the negative correlation between obesity and Bacteroides presence were higher in vaginally delivered infants than in cesarean-delivered infants at both studied time points.
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Simko, Martin, Adrian Totka, Diana Vondrova, et al. "Maternal Body Mass Index and Gestational Weight Gain and Their Association with Pregnancy Complications and Perinatal Conditions." International Journal of Environmental Research and Public Health 16, no. 10 (2019): 1751. http://dx.doi.org/10.3390/ijerph16101751.

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This study aimed to evaluate the impact of selected pregnancy pathologies statistically depending on overweight/obesity and excessive maternal weight gain during pregnancy on women who gave birth in the years 2013–2015 at the Second Department of Gynecology and Obstetrics at the University Hospital in Bratislava, Slovakia. In a retrospective study, we analyzed data gathered from the sample, which consisted of 7122 women. Our results suggest a statistically significant, higher risk for the groups of women with overweight and obesity and gestational hypertension (adjusted odds ratio (AOR) = 15.3; 95% CI 9.0−25.8 for obesity), preeclampsia (AOR = 3.4; 95% CI 1.9−6.0 for overweight and AOR = 13.2; 95% CI 7.7−22.5 for obesity), and gestational diabetes mellitus (AOR = 1.9; 95% CI 1.2−2.9 for overweight and AOR = 2.4; 95% CI 1.4−4.0 for obesity). A higher incidence of pregnancies terminated by cesarean section was observed in the group of obese women. Gestational weight gain above IOM (Institute of Medicine) recommendations was associated with a higher risk of pregnancy terminated by C-section (AOR = 1.2; 95% CI 1.0−1.3), gestational hypertension (AOR = 1.7; 95% CI 1.0−2.7), and infant macrosomia (AOR = 1.7; 95% CI 1.3−2.1). Overweight and obesity during pregnancy significantly contribute to the development of pregnancy pathologies and increased incidence of cesarean section. Systematic efforts to reduce weight before pregnancy through prepregnancy dietary counseling, regular physical activity, and healthy lifestyle should be the primary goal.
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Regmi, Astha, Neebha Ojha, Meeta Singh, Asmita Ghimire, and Nisha Kharel. "Risk Factors Associated with Surgical Site Infection following Cesarean Section in Tertiary Care Hospital, Nepal." International Journal of Reproductive Medicine 2022 (May 16, 2022): 1–11. http://dx.doi.org/10.1155/2022/4442453.

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Background. Cesarean section (CS) is one of the most performed surgeries in obstetrics. Surgical site infection is the major cause of morbidity and mortality causing an increase in the duration of hospitalization as well as the cost of admission for the patient. Objective. To determine incidence of surgical site infection following cesarean section, classify them according to CDC criteria, and identify the different risk factors. Methodology. This is a case-control study conducted at the Department of Obstetrics and Gynecology at Tribhuvan University Teaching Hospital (TUTH), main campus of Institute of Medicine (IOM), Kathmandu, Nepal. Surgical site infections (SSI) in patients who underwent cesarean sections from February 2019 to August 2019 were taken as cases, while the patients who underwent cesarean section before or after the procedure and did not develop SSI comprised the controls. Visual inspection during ward rounds, reports from laboratory, and postprocedure follow-ups for up to 30 days formed the basis of identifying infections on the patients. Risk factors were identified by bivariate and multivariate logistic regression. Results. Out of 1135 cases of cesarean sections, 97 of them developed SSI with incidence rate of 8.54%. Among them, 94.85% were superficial incisional and 5.15% were deep incisional type of SSI with no organ space type. Cases had higher mean age 26.88 ± 4.38 years compared to 24.81 ± 5.08 years in controls. Host-related risk factors which led to higher odds of developing surgical site infection (SSI) were obesity with adjusted odds ratio (AOR) 15.72 (confidence interval (CI): 4.60-53.67), diabetes/hypertension in pregnancy with AOR 4.75(CI 1.69-13.32), and other medical diseases with AOR 9.38 (CI 2.89-30.46). Duration of the rupture of membrane for more than 18 hours with AOR 8.38 (CI 1.48-47.35), more than five per vaginal (PV) examination with AOR 1.93 (95% CI 1.03-3.64), and in labor status with AOR 6.52 (CI 1.17-36.38) were some procedure-related factors resulting into higher odds of infection. Conclusion. Multiple risk factors like age, obesity, medical complications during pregnancy, occurrence of labor status during cesarean section, prolonged duration of rupture of membrane for more than 18 hours, and more than five vaginal examinations before the procedure increases the chance of surgical site infection (SSI) following cesarean section.
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Christyani, Fenyta, and Sigit Pradono Diptoadi. "Hernia Umbilikalis Post Sectio Sesarea pada Kehamilan Ganda: Sebuah Laporan Kasus." Indonesian Journal of Obstetrics & Gynecology Science 6, no. 1 (2023): 145–48. http://dx.doi.org/10.24198/obgynia.v6n1.338.

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Tujuan: Mengetahui faktor risiko dan mekanisme terjadinya hernia umbilikalis pada pasien wanita post partum Metode:Teknik pengumpulan data melalui wawancara, pemeriksaan, observasi, serta dokumentasi Kasus: Perempuan G2P1A0 hamil 35-36 minggu, bekas sectio sesarea, janin ganda intrauterine dengan rencana sectio sesarea. Riwayat ANC rutin dan tidak ditemukan kelainan. Dua hari setelah operasi section sesarea pasien mengeluhkan mual, muntah, dan ditemukan massa pada regio umbilikalis dengan konsistensi keras, immobile, terdapat nyeri tekan dan suara bising usus. Luka operasi baik. Pada pemeriksaan USG abdomen tampak gambaran hernia ventralis paramedian kanan abdomen. Pasien kemudian dilakukan operasi laparotomi hernioraphy Diskusi: Hernia umbilikal merupakan penonjolan usus yang berlokasi dekat umbilikus. Hal ini disebabkan oleh peningkatan tekanan intraabdominal dan kelemahan dari dinding perut. Terdapat beberapa faktor risiko yang mencetuskan. Faktor risiko pada kasus ini adalah obesitas, riwayat operasi sectio sesarea, dan kehamilan. Obesitas menyebabkan peningkatan tekanan intraabdominal, terjadi stress mekanik yang mengakibatkan gangguan dari metabolisme kolagen. Kesimpulan: Pada wanita dengan kehamilan ganda, obesitas dan riwayat operasi sebelumnya menjadi faktor risiko terjadinya kejadian hernia umbilikal. Umbilical Hernia Post Sectio Caesarea in Multiple Pregnancies: A Case Report Abstract Objective: To know the risk factors and mechanism of umbilical hernia in post partum female patients Methods:Techniques through interviews, examinations, observations, and documentation Case: G2P1A0 woman 35-36 weeks, former cesarean section with intrauterine multiple fetus with planned cesarean section. A history of routine ANC and no abnormalities were found. Two days after cesarean section the patient complained of nausea, vomiting, and found a mass in the umbilical region with a firm consistency, immobile, tenderness and bowel sounds. The surgical wound is good. On ultrasound examination of the abdomen showed a picture of the right paramedian ventral hernia of the abdomen. The patient then underwent laparotomy for hernioraphy Discussion: Umbilical hernia is a protrusion of the intestine that is located near the umbilicus. It is caused by increased intraabdominal pressure and weakness of the abdominal wall. There are several risk factors that trigger it. The risk factors in this case were obesity, history of cesarean section, and pregnancy. Obesity causes an increase in intraabdominal pressure, mechanical stress occurs which results in disruption of collagen metabolism. Conclusion: In women with multiple pregnancies, obesity and a history of previous surgery are risk factors for the occurrence of umbilical hernia Key words: Umbilical hernia, cesarean section, multiple pregnancies
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Mueller, N. T., R. Whyatt, L. Hoepner, et al. "Prenatal exposure to antibiotics, cesarean section and risk of childhood obesity." International Journal of Obesity 39, no. 4 (2014): 665–70. http://dx.doi.org/10.1038/ijo.2014.180.

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Gojnic, M., M. Pervulov, S. Petkovic, and T. Mostic. "Obesity in termin pregnancies as a possible indication for cesarean section." International Journal of Gynecology & Obstetrics 70 (2000): B55. http://dx.doi.org/10.1016/s0020-7292(00)86287-6.

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Hasan, Rajaa, and Iqbal Abbas. "Effectiveness of lactation counseling on maintenance of breastfeeding." Iraqi National Journal of Nursing Specialties 25, no. 3 (2018): 20–34. http://dx.doi.org/10.58897/injns.v25i3.141.

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Objective(s): To determine the effectiveness of lactation counseling on maintenance of breastfeeding aftercesarean section for study group.Methodology: A quasi-experimental study was conducted on non probability sample (purposive) of (60) womenwho had cesarean section and sample divided in to two groups (30) of them as a study group from Fatima AlZahra'aMaternity and Pediatric Teaching Hospital & implement lactation counseling on it and another group (30)as control group from Baghdad Teaching Hospital in Baghdad City. Study implemented for the period of April 24th2011 to August 2nd 2011. A questionnaire was used as a tool of data collection to fulfill with objective of the studyand consisted of three parts, including demographic, reproductive characteristics and maintenance ofbreastfeeding of the sample. A pilot study was carried out to test the reliability of the questionnaire and contentvalidity was carried out through the 11 experts. Descriptive and inferential statistical analyses were used toanalyze the data.Results: The results of the study revealed that most mothers their ages within ideal fertility age which rangedbetween (20-24) years, and most of them had low educational level, and were housewives, and live in urbanarea, with moderate socioeconomic status, and (53.3%), (50%) respectively of them were primigravida. Thestudy shows that (100%) of the study group had continued breastfeeding, while (76.7%) of the control group hadcontinued breastfeeding and the reasons for discontinuation of breastfeeding for control group are not enoughmilk and newborn refuse lactation, (73.3%) of the study group had exclusive breastfeeding, while (26%) of thecontrol group had exclusive breastfeeding.Recommendations: The study recommended to reactivate the role of Baby-Friendly Hospitals Initiative inpromoting of breastfeeding by implementation of ten steps successful of breastfeeding, and breastfeedingcounseling for women during pregnancy and after birth especially who have cesarean section which has importantrole on maintenance of breastfeeding up to 6 months after birth.
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Seligman, Luiz Carlos, Bruce Bartholow Duncan, Leandro Branchtein, Dea Suzana Miranda Gaio, Sotero Serrate Mengue, and Maria Inês Schmidt. "Obesity and gestational weight gain: cesarean delivery and labor complications." Revista de Saúde Pública 40, no. 3 (2006): 457–65. http://dx.doi.org/10.1590/s0034-89102006000300014.

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OBJECTIVE: To assess the association between pre-gestational obesity and weight gain with cesarean delivery and labor complications. METHODS: A total of 4,486 women 20-28 weeks pregnant attending general prenatal care clinics of the national health system in Brazil from 1991 to 1995 were enrolled and followed up through birth. Body mass index categories based on prepregnancy weight and total weight gain were calculated. Associations between body mass index categories and labor complications were adjusted through logistic regression analysis. RESULTS: Obesity was present in 308 (6.9%) patients. Cesarean delivery was performed in 164 (53.2%) obese, 407 (43.1%) pre-obese, 1,045 (35.1%) normal weight and 64 (24.5%) underweight women. The relative risk for cesarean delivery in obese women was 1.8 (95% CI: 1.5-2.0) compared to normal weight women. Greater weight gain was particularly associated with cesarean among the obese (RR 4th vs 2nd weight gain quartile 2.2; 95% CI: 1.4-3.2). Increased weight at the beginning of pregnancy was associated with a significantly higher adjusted risk of meconium with vaginal delivery and perinatal death and infection in women submitted to cesarean section. Similarly, greater weight gain during pregnancy increased the risk for meconium and hemorrhage in women submitted to vaginal delivery and for prematurity with cesarean. CONCLUSIONS: Pre-gestational obesity and greater weight gain independently increase the risk of cesarean delivery, as well as of several adverse outcomes with vaginal delivery. These findings provide further evidence of the negative effects of prepregnancy obesity and greater gestational weight gain on pregnancy outcomes.
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MAZHIDOVA, Z. SH, I. I. MUSIN, A. G. YASHCHUK, E. A. BERG, and A. G. IMELBAEVA. "Role of genetic factors in the development of purulent-septic complications in obstetrics." Practical medicine 21, no. 4 (2023): 113–15. http://dx.doi.org/10.32000/2072-1757-2023-4-113-115.

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The purpose to study the role of polymorphisms of endothelial nitric oxide synthase (eNOS3 G894T), transforming growth factor beta TGF-β (CA rs1800470) and plasminogen activator inhibitor (SERPINE-1 5G (-675)4G) in full-term pregnant women in the development of purulent-septic complications after cesarean section in the lower uterine segment. Material and methods. The authors analyzed obstetric complications after cesarean section in the lower uterine segment. Prospectively, 81 maternity patients after single-fetus delivery by caesarean section in the lower uterine segment were monitored and treated for emergency indications in order to diagnose purulent-septic complications and perform genetic analysis. The Statistica 10.0 and Eviews 12.0 software packages were used for statistical processing of the obtained results. Results. A direct correlation was established between the presence of a homozygous mutation of the transforming growth factor-β1 gene (TGF-β (CA rs1800470)), as well as the presence of a homozygous mutation of the endothelial nitric oxide synthase eNOS3 (G894T) gene, with significant risk factors for purulent-septic complications after cesarean section in full-term pregnancy: obesity 3-grade II (rs = 0.467, p < 0.001; rs = 0.461, p = 0.005) and pathological overall weight gain during pregnancy (rs = 0.660, p < 0.001; rs = 0.385, p = 0.024). Conclusion. The genetic study data allow concluding that homozygous polymorphisms of the studied genes of transforming growth factor-β1 (TGF-β (CA rs1800470)) and endothelial nitric oxide synthase eNOS3 (G894T) are associated both with the presence of purulent-septic diseases in the postpartum period after cesarean section in the lower uterine segment, and with metabolic disorders such as obesity of the 3rd degree and pathological overall weight gain during pregnancy. It is the combination of these factors that significantly increases the risks of obstetric purulent-septic complications in women with this genotype.
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41

Traboulsi, Mayssa A., Abdellatif Boussaid, and Zainab El Alaoui Talibi. "Obesity and Lifestyle Indicators Impact on Obstetric Complications and Fetal Outcome in North Lebanon Population." International Journal of Biology and Biomedical Engineering 15 (January 11, 2021): 9–17. http://dx.doi.org/10.46300/91011.2021.15.3.

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Worldwide, obesity has been shown to negatively affect women especially during pregnancy. In this work, a retrospective cohort study for 1308 women, who gave birth between 2014 and 2016 in public and private hospitals, was conducted to evaluate the impact of weight, demographic and lifestyle indicators on many pregnancy and fetal outcomes in Northern Lebanon. The frequent health complications related to pregnancy were cesarean-section (31.1%) followed by post-hemorrhage (25.1%), induced labor (23.5%) and macrosomia (11.4%). Multivariate analysis showed that the main complications were highly correlated to obesity, macrosomia, weight gain, multiparity and mother’s age. High values from adjusted odds ratios were mainly associated to obesity, multiparity and weight gain. Obese pregnant women had a significant increased risk of having cesarean-section (p<0.001), preeclampsia (p<0.0001), labor induction (p<0.0001) and postpartum hemorrhage (p<0.0001). Adverse fetal outcomes such as macrosomia were also correlated with high BMI (p<0.0001). The risk was even greater for multiparous, older women that carried excessive weight gain. There is therefore a need to increase awareness among the target population and encourage prevention of the dangers related to obesity and weight gain.
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Traboulsi, Mayssa A., Abdellatif Boussaid, and Zainab El Alaoui Talibi. "Obesity and Lifestyle Indicators Impact on Obstetric Complications and Fetal Outcome in North Lebanon Population." International Journal of Biology and Biomedical Engineering 15 (January 11, 2021): 9–17. http://dx.doi.org/10.46300/91011.2021.15.3.

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Worldwide, obesity has been shown to negatively affect women especially during pregnancy. In this work, a retrospective cohort study for 1308 women, who gave birth between 2014 and 2016 in public and private hospitals, was conducted to evaluate the impact of weight, demographic and lifestyle indicators on many pregnancy and fetal outcomes in Northern Lebanon. The frequent health complications related to pregnancy were cesarean-section (31.1%) followed by post-hemorrhage (25.1%), induced labor (23.5%) and macrosomia (11.4%). Multivariate analysis showed that the main complications were highly correlated to obesity, macrosomia, weight gain, multiparity and mother’s age. High values from adjusted odds ratios were mainly associated to obesity, multiparity and weight gain. Obese pregnant women had a significant increased risk of having cesarean-section (p<0.001), preeclampsia (p<0.0001), labor induction (p<0.0001) and postpartum hemorrhage (p<0.0001). Adverse fetal outcomes such as macrosomia were also correlated with high BMI (p<0.0001). The risk was even greater for multiparous, older women that carried excessive weight gain. There is therefore a need to increase awareness among the target population and encourage prevention of the dangers related to obesity and weight gain.
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43

Hussein, Reyam Khalaf, and Nadia Aziz Nasir. "Indications and Rate of Cesarean Section in Al-Yarmouk Teaching Hospital 2022." Iraqi Journal of Community Medicine 38, no. 2 (2025): 117–22. https://doi.org/10.4103/irjcm.irjcm_42_24.

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Abstract Background: Cesarean section (CS) is a life-saving surgical procedure when certain complications arise during pregnancy and labor. Analysis of CS rates is useful for health institution to assess overall progress in maternal and fetal health and to plan emergency obstetric care and resource utilization. Objectives: The objective is to study the rate of CSs in Al-Yarmouk Teaching Hospital in Baghdad and to study the indications of CSs during the study. Patients and Methods: A cross sectional study was conducted among 250 women admitted to Al-Yarmouk Teaching Hospital and delivered by CS for various reasons, from March 1 to last of June 2022. Data were collected by interviewing with participation. Results: The rate of CS during the data collection period was 53.6%. Of these procedures 63.6% were elective. The main indications for elective CS were: previous CS 75.5%. Among the emergency CS, fetal distress was responsible for 28.6% of these operations. Conclusion: The rate of CS reported in this study was very high. The rate of planned CS is higher than that of emergency CS. Scarred uterus is the most common reasons for planned CS.
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44

I Nyoman Hariyasa Sanjaya, Cokorda Istri Mirayani Pemayun, Ni Wayan Dewi Purwanti, et al. "The Incidence of Vaginal Deliveries in Obese Mothers at Prof Dr. I.G.N.G Ngoerah Hospital In 2022." Indonesian Journal of Perinatology 4, no. 1 (2023): 7–9. http://dx.doi.org/10.51559/inajperinatol.v4i1.30.

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Introduction: One of the risk factors seen most frequently in obstetric practice is maternal obesity. Women who were overweight or obese made up more than half of all female fatalities due to direct or indirect causes. Obesity increases the chance that the mother will experience obstetric problems during pregnancy, labour, and delivery, making fetal assessment more technically difficult. Methods: This study uses quantitative descriptive univariate analysis. The type of data is secondary data taken from the birth register. This study examines women who gave birth in 2022 and were identified as belonging to the obesity category by Prof. Dr. I. G. N. G. Ngoerah Denpasar General Hospital. Results: At Prof.dr.I.G.N.G Ngoerah Denpasar General Hospital, 21 obese pregnant women will give birth throughout 2022. Of the 21 people, 81% give birth by emergency C-section, 4,8% by elective C-section, and 14,2% give birth vaginally. Obese pregnant women have a higher risk of needing a cesarean section. Patients with obese class III had a significantly higher risk of infant morbidity than those with a normal BMI, according to their findings. Conclusions: Obese pregnant women are at increased risk of having a cesarean section. Therefore, health workers must provide knowledge to pre-pregnant or pre-marital women to maintain their BMI so they do not become obese during pregnancy. Thus, morbidity and mortality rates can also be reduced.
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Carvajal, Jorge A., and Joaquín I. Oporto. "The Myometrium in Pregnant Women with Obesity." Current Vascular Pharmacology 19, no. 2 (2020): 193–200. http://dx.doi.org/10.2174/1570161118666200525133530.

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: Obesity is a worldwide public health problem, affecting at least one-third of pregnant women. One of the main problems of obesity during pregnancy is the resulting high rate of cesarean section. The leading cause of this higher frequency of cesarean sections in obese women, compared with that in nonobese women, is an altered myometrial function that leads to lower frequency and potency of contractions. In this article, the disruptions of myometrial myocytes were reviewed in obese women during pregnancy that may explain the dysfunctional labor. The myometrium of obese women exhibited lower expression of connexin43, a lower function of the oxytocin receptor, and higher activity of the potassium channels. Adipokines, such as leptin, visfatin, and apelin, whose concentrations are higher in obese women, decreased myometrial contractility, perhaps by inhibiting the myometrial RhoA/ROCK pathway. The characteristically higher cholesterol levels of obese women alter myometrial myocyte cell membranes, especially the caveolae, inhibiting oxytocin receptor function, and increasing the K+ channel activity. All these changes in the myometrial cells or their environment decrease myometrial contractility, at least partially explaining the higher rate of cesarean of sections in obese women.
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46

AYESHA, NASREEN, SHAZIA, JAWARIA, and H. RAFIQUE. "RISK FACTORS FOR SURGICAL SITE INFECTION FOLLOWING CESAREAN SECTION." Biological and Clinical Sciences Research Journal 2024, no. 1 (2024): 1309. https://doi.org/10.54112/bcsrj.v2024i1.1309.

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Surgical site infections (SSIs) following cesarean sections (CS) are significant contributors to maternal morbidity and healthcare burdens worldwide. Despite adherence to preoperative guidelines, certain risk factors remain associated with increased SSI rates. Identifying and addressing these factors is essential for improving patient outcomes. Objective: To identify and evaluate the risk factors associated with surgical site infection (SSI) following cesarean section (CS) based on the World Health Organization’s recommended preoperative measures in a tertiary care hospital in Mirpur, AJ & K. Methods: A prospective cohort study was conducted from January 2022 to December 2023 at a tertiary care hospital in Mirpur, AJ&K. A total of 1,500 patients undergoing cesarean sections were enrolled and followed for 30 days post-surgery to monitor for the occurrence of SSI. Data on potential risk factors, such as body mass index (BMI), diabetes, hypertension, preoperative antibiotic use, duration of surgery, type of cesarean section (elective vs. emergency), anemia, and personal hygiene practices, were collected at baseline. The primary outcome was the incidence of SSI, diagnosed according to the Centers for Disease Control and Prevention (CDC) criteria. Risk factors were compared between patients who developed SSI (cases) and those who did not (controls). Statistical analyses, including Chi-squared and Fisher’s Exact tests, were performed to identify significant risk factors. Multivariate logistic regression was used to control for confounding factors. Results: Out of the 1,500 patients, 18% (n=270) developed SSI within 30 days of surgery. Significant risk factors for SSI included obesity (BMI >30), which increased the odds of SSI by 2.5 times (p=0.001); prolonged hospital stay of more than 5 days, associated with a 1.8-fold increase in SSI risk (p=0.004); emergency cesarean sections, which raised the risk by 2.1 times compared to elective procedures (p=0.002); and anemia (hemoglobin <10 g/dL), which increased SSI risk by 1.9 times (p=0.005). Poor personal hygiene practices were also significantly associated with a higher incidence of SSI (p=0.003). On the other hand, the use of preoperative prophylactic antibiotics was protective, reducing the incidence of SSI by 3.2-fold (p=0.0001). No significant associations were observed between the duration of surgery (p=0.21) or patient age (p=0.15) and the occurrence of SSI. Conclusions: This prospective cohort study identified obesity, prolonged hospital stay, emergency cesarean section, anemia, and personal hygiene practices as significant risk factors for the development of SSI following cesarean section, consistent with the World Health Organization’s preoperative guidelines. The use of preoperative prophylactic antibiotics was shown to be an effective intervention in reducing SSI risk. These findings underscore the importance of targeted preventive measures, including weight management, prompt hospital discharge, enhanced personal hygiene education, and the routine use of prophylactic antibiotics, in reducing the burden of SSIs in cesarean sections.
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Ali, Yousaf, Muhammad Waseem Khan, UbaidUllah Mumtaz, Aneel Salman, Noor Muhammad, and Muhammad Sabir. "Identification of factors influencing the rise of cesarean sections rates in Pakistan, using MCDM." International Journal of Health Care Quality Assurance 31, no. 8 (2018): 1058–69. http://dx.doi.org/10.1108/ijhcqa-04-2018-0087.

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PurposeThe rate of cesarean sections has been rapidly increased in the last few decades in all the developing as well as developed countries. The rate of cesarean sections determined by the World Health Organization has been crossed by many countries, like Brazil, India, China, USA, Australia, etc. Similarly, this rate has also increased in Pakistan. The purpose of this paper is to explore and identify the factors that are responsible for the rising rate of cesarean sections in Pakistan.Design/methodology/approachThese factors are categorized under medical and non-medical factors. The medical factors include the obesity of mother, age of mother, weight of the baby, umbilical cord prolapse, fetal distress, abnormal presentation, dystocia and failure to progress. The non-medical factors include financial incentives of doctors, time convenience for doctors, high tolerance to surgery, patient’s preference toward cesarean section, private hospitals, public hospitals, income status of patients, rural areas, urban areas and the education of patients. To identify the critical factors, data have been collected and a multi-criteria decision-making technique, called Decision Making Trial and Evaluation Laboratory, is used.FindingsThe result shows that the medical factors that are responsible for the rise in the rate of cesarean sections are umbilical cord prolapse, age of mother and obesity of mother. On the other hand, the non-medical factors that are the reasons for the increase in cesarean sections are the large number of private hospitals and the unethical acts of the doctors in these hospitals, preference of patients, and either the unavailability of doctors or poor conditions of hospitals in rural areas.Originality/valueCesarean section is an important surgical intervention and is considered to be very essential in the cases of existing as well as potential medical problems to the mother or the baby. Cesarean section is also performed for non-medical reasons. In Pakistan, the number of private hospitals has increased and these hospitals provide good health care. However, these hospitals do not work under the rules and regulations set by the government. The doctors in private hospitals perform unnecessary cesarean sections in order to fulfill the demands of private hospital’s owners. In addition to this, it is also found that, nowadays, most women prefer to give birth through cesarean section in order to eliminate the pain of normal vaginal delivery.
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Mahmood, Dekan, and Rozhan Khalil. "THE EFFECTS OF OBESITY ON THE ACTIVE PHASE OF THE FIRST STAGE OF LABOR." JOURNAL OF SULAIMANI MEDICAL COLLEGE 12, no. 4 (2022): 417–24. http://dx.doi.org/10.17656/jsmc.10386.

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Background 
 Obesity is carrying many pregnant women now a day and has many risks for complications. There is an association between body mass index and the progression of the active phase of first-stage labor.
 Objectives 
 To estimate and detect obesity’s effect on the duration and progression of the active phase of labor and the outcomes of the deliveries, either by vaginal delivery or cesarean section.
 Patients and Methods
 A prospective observational cross-sectional study was designed and conducted at Sulaimani maternity teaching hospital in Sulaimani City. From 1st February 2020 to 1st February 2021, about labor study included the progression of 184 multiparous women (para1-4) with a single vertex presentation from (37+1 to 41+6) weeks of complete gestation. Either by spontaneous or induction labor (misoprostol or oxytocin). Between four groups, defined by body mass index according to the world health organization. Normal (n=88), over weight (n=3), obesity class 1(n=43), obesity class 2(n=50)
 Results
 A total of 184 patients were collected in this study. The mean ± SD (standard deviation) age/year of participants was (27, 49 ±5.54 SD) minimum age was 17 years, and the maximum age was 44 years. A high percentage of them (51.6%) were living in urban. About (27.2%) were classified as obesity class 2, which carries a high percentage of cases that ends by cesarean section C/S (n=9) 81.8%, with prolonged duration of active phase by mean (4.988) and standard deviation (1.9302) in comparison with other classes. 
 Conclusion
 The duration of the active phase of labor, cesarean section rate, and the time for induction until the active phase of labor were increased by increasing body mass index.
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VanDeCappelle, Caitlin, HK Ma, and E. Ho. "Cesarean section under combined spinal epidural in parturient with frontal glioma." Journal of Neuroanaesthesiology and Critical Care 03, no. 02 (2016): 129–32. http://dx.doi.org/10.4103/2348-0548.182346.

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AbstractOur patient presented to hospital in acute asthma exacerbation and foetal distress. Past history was remarkable for pregnancy at 35 weeks, morbid obesity, uncontrolled asthma, seizure disorder and known frontal glioma. Here we highlight the neuraxial management of this patient for cesarean section and discuss the central dogma of neuraxial technique in the face of known intracranial neoplasm.
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Novikova, Evgenia, Natalia Belkova, Anna Pogodina, et al. "Gut Microbiota Shift in Obese Adolescents Born by Cesarean Section." International Journal of Biomedicine 10, no. 4 (2020): 424–29. http://dx.doi.org/10.21103/article10(4)_oa19.

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Background: It is known that in the early postnatal period a variety of factors affect the gut microbiota (GM) composition, including delivery mode. The effect of delivery mode on the human GM in the late postnatal period remains unexplored. A shift of GM composition due to delivery mode may contribute to the development of obesity in adulthood. Methods and Results: The study included six adolescents aged between 11 and 17 years treated and examined at the Clinic of the Scientific Center for Family Health and Human Reproduction (Irkutsk, Russia) in 2016. Stool samples were collected following the standard operating procedures according to the International Human Microbiome Standards. Metasequencing of V3-V4 variable regions of the 16S rRNA gene was performed by the Novogene Company (China) on the Illumina platform. Bioinformatic analysis was done by the bri-shur.com services. Sequencing reads were presented as normalized values. In general, the GM composition of obese adolescents born by cesarean section was characterized by composition heterogeneity within the Bacteroidetes phylum and the dominance of certain phylotypes as signs of dysbiosis for each adolescent. We detected an increased abundance of phyla Bacteroides and Proteobacteria, and an absence of Tenericutes in obese adolescents born by Caesarean section. On the level of genera, the prevalence of Bacteroides and Bacteroides S24-7 phylotypes, and the absence of the RF39 phylotype, led to the GM shift associated with a cesarean section or obesity. Conclusion: Obese adolescents born by cesarean section delivery present the shift in GM composition.
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