History of Cesarean Delivery
Postop Complications
VBAC
Cesarean Hysterectomy
Tie my tubes!
100
This life-saving medication, discovered in 1928 by Scottish scientist and Nobel laureate Alexander Fleming and introduced for medical use circa 1940, dramatically reduced the risks for infection associated with childbirth
What is penicillin
100
This diagnosis remains the most common complication of cesarean delivery with a frequency less than 5%
What is enodmyometritis
100
This maternal factor can be considered the greatest predictor for successful VBAC
Prior vaginal delivery, including prior successful VBAC
100
This group of placental disorders is the most common indication for cesarean hysterectomy
What are placenta accreta/increta/percreta
100
This method of tubal ligation first described in 1930 is the most popular means of postpartum tubal ligation because of its simplicity.
What is Pomeroy
200
The first hysterotomy closure sutures were made of this elemental material (hint: atomic number 47)
What is silver/argentum
200
Most cesarean section wounds given this wound classification, while emergent cesarean deliveries and those associated with chorioamnionitis are considered contaminated and have higher wound infection rates.
What is clean contaminated
200
This complication is reported to occur in approximately 0.7% of TOLACs
What is uterine rupture
200
With two or more prior cesarean deliveries and an existing placenta previa, the risk for cesarean hysterectomy is in this range
What is 30-50%
200
The advantage of this tubal ligation procedure is avoidance of close approximation between the cut ends of the fallopian tubes (a potential problem accompanying the Pomeroy procedure)
What is the Parkland method
300
Before internal sutures were widely used, this additional surgical procedure was advocated to control hemorrhage and prevent infection
What is hysterectomy
300
Extreme wound discoloration, extensive infection, discoloration, gangrene, bullae, or anesthesia of the surrounding tissue should prompt consideration of this infectious complication, which is considered a surgical emergency and requires prompt debridement under anesthesia
What is necrotizing fasciitis
300
ACOG considers it reasonable to offer TOLAC to women with up to this number of prior cesarean deliveries and to counsel such women based on the combination of other factors that affect their probability of achieving a successful VBAC
What is two
300
These are the principal complications of cesarean hysterectomy
What are urologic injury and hemorrhage
300
This sterilization technique, first reported in 1924 and modified in 1950, and regarded as the most effective form of tubal sterilization, involves double suture ligature of the fallopian tube, tubal transection, dissection of the proximal portion from the mesosalpinx, and finally burial of the proximal tubal stump into an incision in the myometrium of the posterior uterine wall
What is the Irving procedure
400
Due to the risk of peritonitis, this type of cesarean delivery was advocated by Frank (1907) and Latzko (1909) and was popularized by Beck (1919) in the United States.
What is extraperitoneal cesarean
400
This is the leading cause of maternal death in developed countries
What is thromboembolic disease
400
This previous surgery can be a contraindication for TOLAC in a nulliparous patient
What is myomectomy
400
In most cases of hysterectomy following vaginal birth, this is the indication for postpartum hysterectomy
What is uterine atony with uncontrolled hemorrhage that has failed to respond to conservative measures
400
In this sterilization procedure, the muscular portion of the fallopian tube is separated from its serosal cover and divided. A 5cm segment of the proximal end is excised, and the shortened proximal tubal stump is allowed to retract into the mesosalpinx, which is gathered around the tubal stump and sutured in a pursestring fashion.
What is the Uchida procedure
500
Although the term "cesarean" was originally believed to have been derived from the birth of Julius Caesar, this aspect of his mother's history makes it unlikely this is the case
What is her survival (as evidence by her subsequent knowledge of his European invasion many years later)
500
This complication is most often a diagnosis of exclusion established in refractory cases of women being treated for endomyometritis and is treated with short-term anticoagulation
What is septic pelvic thrombophlebitis
500
These five factors are used to calculate the probability of VBAC
What are maternal age, BMI, race, +/- previous vaginal delivery and indication for first cesarean delivery
500
Abnormally implanted placentas bear some important similarities to these structures, which are single ice crystals or an aggregation of ice crystals which fall through the Earth's atmosphere after developing from supercooled cloud droplets. They come in a variety of sizes and shapes and are relatively unique in structure. Although it is not, strictly speaking, true of either placentas or these structures, it has been said that "no two are alike."
What are snowflakes
500
In performing the Uchida procedure, some surgeons alter the length of tubal segment excised for this reason
What is in case the patient wishes to have a tubal reanastomosis in the future (What???!!)
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