1. Introduction
Cesarean section is one of the most commonly performed surgical procedures in obstetrics [1-6]. Maternal mortality associated with the procedure is becoming rare as a result of improved anesthetic techniques, thromboprophylaxis, and a wider choice of potent antibiotics [7]. However, women who have undergone cesarean sections may still experience some preventable morbidities including urinary tract infections and voiding difficulties. Efforts should be intensified to reduce the occurrence of these morbidities to ensure that the postoperative recovery period is without complication.
One of the preoperative preparations for cesarean section is the placement of an indwelling Foley urinary catheter. The catheter is placed to decompress the bladder to improve visualization during the procedure and to facilitate development of the bladder flap; postoperatively it avoids the need for the woman to get out of bed to urinate or use a bedpan while she is still recovering from the effects of analgesia.
Some studies have shown that use of an indwelling urinary catheter during cesarean section was associated with an increased risk of urinary tract infection [1-11]. Furthermore, other studies have shown a significant reduction in the rate of urinary tract infections in women who were not catheterized for cesarean section [2-5]. However, what is not known is whether the timing of removal of the urinary catheter after cesarean section has a significant effect on the risk of occurrence of urinary tract infections.
The aim of the present study was to investigate whether immediate postoperative removal of the urinary catheter after elective cesarean section had a lower risk of urinary tract infection compared with removal 6 hours...
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[13] Onile TG, Kuti O, Orji EO, Ogunniyi SO. A prospective randomized clinical tirla of urethral catheter removal following elective cesarean delivery. Int J Gynecol Obstet 2008;102(3):267-70.
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[15] Kerr-Wilson RH,McNally S. Bladder drainage for caesarean section under epidural analgesia. Br J Obstet Gynaecol 1986;93(1):28-30.
The Bishop score is a pelvic scoring system developed to make it easier to determine whether a multiparous woman was a suitable candidate for induction of pregnancy. Although the information in the Bishop score was known by many obstetricians for many years, Edward H. bishop is credited because he pulled the pieces together and formed an organized system accompanied by research and statistics to back up his findings. His paper is called the “Pelvic Scoring for Elective Induction”. In this paper, Bishop describes basic minimal requirements that must be met before any patient can be considered for elective induction of labor (1964).
This systematic review conducted by Takeda A, Taylor SJC, Taylor RS, Khan F, Krum H, Underwood M, (2012) sourced twenty-five trials, and the overall number of people of the collective trials included was 5,942. Interventions were classified and assessed using the following headings.-
In order to be completely informed a mother needs to know what exactly an epidural is and how it works. An epidural is the most popular form of pain relief during labor. An epidural is a regional pain reducer. An epidural is analgesia, which is meant for pain relief. This is much different than an anesthesia, which provides total lack of feeling to a region of the body. Epidurals are giving intravenously. There are two types of epidurals a woman can get. The first method is a regular epidural. In a regular epidural, after the catheter is in place, a combination of narcotic and anesthesia is administered either by a pump or by periodic injections into the epidural space. The second type of epidural is a combined spinal-epidural, these are often called the “”walking epidural”. In this type of epidural, an initial dose of narcotic, anesthetic or a combination of the two is injected beneath the outermost membrane covering the spinal cord.
Catheter Acquired Urinary Tract Infections (CAUTIs) has become to be classified as one among the leading infections which most individuals end up being susceptible to acquire while at the hospital. Healthcare-associated or acquired infections (HAIs) are a significant cause of illness, death, and more often than not, have resulted to cost the tax payers potentially high medical expenses in most health care settings. ("Agency for Healthcare Research and Quality," para. 1) Due to this, 1 out of every 20 patients will end up with CAUTI within the US hospitals and this has caused Agency for healthcare research and quality (AHRQ) to embark on nationwide plans to help in the eradication and control of CAUTI incidences. ("Agency
A urinary tract infection in humans is caused when a pathogen such as Escherichia coli that normally resides in our intestinal tract is transferred through inadvertent means to a urethra. McCance (20...
The scientific name of a kidney infection is known as pyelonephritis. There are two types of pyelonephritis infections, acute and chronic. Acute pyelonephritis is sudden and limited and can be cured/treated using antibiotics. However, if it is a chronic infection, it is long-lasting and occurs due to birth defects; it can lead to scarring in the kidneys, as well. Kidney infections can occur in both men and women. Although, according to Chih-Yen’s study of chronic infection, “Females (36.1%, 60/166) were more prone to have upper UTIs than males (11.8%, 13/110)” (Chih-Yeh, 2014; Chih-Yeh et al., 2014). In addition, age is not an important number due to the presence of Escherichia coli present in everyone’s body. It is dependent on time and health of an individual for the infection to present itself. Moreover, a study on children and adolescent transplantation concluded that, “UTI was uncommon in children after the first month of transplantation. Two significant risk factors for UTI were female gender and neurogenic bladder in this transplant population” (Fallahzadeh, 2011; Fallahzadeh et al., 2011). From the peer-reviewed papers, it is clear that females are more prone to UTI infection, overall, than
Potter, J. E., White, K., Hopkins, K., Amastae, J., & Grossman, D. (2010). Clinic Versus Over-
A weak bladder can lead to more frequent urination. Approximately 50% of first-time mothers develop bladder weakness and almost 80% for the second-time mom’s. Overactive bladder can also lead to urinary tract infection or UTI and pregnant women are more prone, especially during 6 to 24 weeks. The uterus which houses the baby is directly on top of the bladder and when this is compressed it can interfere with the elimination. If the urine builds up in the urinary tract and bladder, bacteria can also accumulate causing infection.
Central lines (CL) are used frequently in hospitals throughout the world. They are placed by trained health care providers, many times nurses, using sterile technique but nosocomial central line catheter associated blood stream infections (CLABSI) have been a dangerous issue. This is a problem that nurses need to pay particular attention to, and is a quality assurance issue, because CLABSI’s “are associated with increased morbidity, mortality, and health care costs” (The Joint Commission, 2012). There have been numerous studies conducted, with the objective to determine steps to take to decrease CLABSI infection rate, and research continues to be ongoing today. The problem is prevalent on many nursing units, with some patients at great risk than others, but some studies have shown if health care providers follow the current literature, or evidence based guidelines, CLABSIs can be prevented (The Joint Commission, 2012). The purpose of this paper is to summarize current findings related to this topic, and establish a quality assurance (QA) change plan nurses can implement for CL placement and maintenance, leading to decreased risk of nosocomial CLABSIs.
Postpartum hemorrhage is the leading cause of maternal mortality in the world, according to the World Health Organization. Postpartum hemorrhage (PPH) is generally defined as a blood loss of more than 500 mL after a vaginal birth, more than 1000 mL after a cesarean section, and a ten percent decrease in hematocrit levels from pre to post birth measurements (Ward & Hisley, 2011). An early hemorrhage occurs within 24 hours of birth, with the greatest risk in the first four hours. A late hemorrhage happens after 24 hours of birth but less than six weeks after birth. Uterine atony—failure for the uterine myometrium to contract—is the most common postpartum hemorrhage (Venes, Ed.).(2013). Other etiologies include lower genital tract lacerations, uterine inversion, retained products of conception and bleeding disorders (Kawamura, Kondoh, Hamanishi, Kawasaki, & Fujita, (2014).
O'Brien, D. (2009). Randomized controlled trials (RCTs). In R. Mullner (Ed.), Encyclopedia of health services research. (pp. 1017-1021). Thousand Oaks, CA: SAGE Publications, Inc. doi: http://dx.doi.org.proxy1.ncu.edu/10.4135/9781412971942
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Turner, B. J., Newschaffer, C. J., Zhang, D., Fanning, T., & Hauck, W. W. (1999). Translating clinical trial results into practice. Annals of Internal Medicine, 130(12), 979-986.
Unlike vaginal birth delivery, the process of a cesarean delivery is quite different, but just as safe as giving vaginal birth (Taylor, 1). When delivering a baby using the cesarean method, there are two ways anesthetic can be used. The women can be put into an unconscious state using the anesthetic, therefore she will be asleep during the entire operation and her coach may not be present. The other way for the anesthetic to be used would be in an epidural or spinal block to temporarily numb the woman from her waist down. In this case the mother will be awake and her coach may be present to give her extra support. Once the anesthetic is working, an incision is made in the abdomen either horizontally or vertically, depending on the reason for the cesarean delivery. A vertical incision is made when the baby is in trouble and needs to be out as quickly as possible, when there is more time the horizontal incision is used. The baby is then lifted out of the uterus and gone for the APGAP procedure. The placenta is then removed and the mother’s reproductive organs are examined before closing the incision (Taylor, 1).
"Transactions of the Washington Obstetrical and Gynecological Society."Google Books. N.p., n.d. Web. 20 May 2014.