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Background: Delivery in a scarred uterus is nowadays a real problem in Obstetrics practice, due to the inflation in the number of caesarean sections and the non-unanimous attitude of Obstetrics' teams towards uterine scars. The factors associated with failed vaginal birth attempts after caesarean section (VBAC) are crucial information that would contribute effectively to deciding on the most appropriate mode of delivery for the mother and her fetus. Their identification would enable us to detect pregnant women at high risk of failure to attempt vaginal birth after caesarean section, and thus contribute to reducing the complications associated with this failure. Objective: We will study the factors associated with failure to vaginal delivery trial after caesarean section at the University Clinics of Kinshasa (UCK). Methods: This study will be a cross-sectional descriptive study with analytical aims. The minimum sample size will be 239. Our study population will consist of records of pregnant women with unicatricial uterus who underwent attempted vaginal delivery after caesarean section at UCK from January 2014 to June 2023. Results will be reported as percentage proportion and mean plus or minus standard deviation. Comparison of means between groups will be made using Student's t-test, and of proportions using Pearson's Chi-square test. Logistic regression will be used to generate Odds Ratios to measure the strength of association between variables. The test will be statistically significant for a p value < 0.05. Data will be collected and processed confidentially and anonymously. Conclusion: This study will identify the factors associated with the failure of attempted vaginal delivery after caesarean section in order How to cite this paper: Mbangama, M.A.,
Background: Delivery in a scarred uterus is nowadays a real problem in Obstetrics practice, due to the inflation in the number of caesarean sections and the non-unanimous attitude of Obstetrics' teams towards uterine scars. The factors associated with failed vaginal birth attempts after caesarean section (VBAC) are crucial information that would contribute effectively to deciding on the most appropriate mode of delivery for the mother and her fetus. Their identification would enable us to detect pregnant women at high risk of failure to attempt vaginal birth after caesarean section, and thus contribute to reducing the complications associated with this failure. Objective: We will study the factors associated with failure to vaginal delivery trial after caesarean section at the University Clinics of Kinshasa (UCK). Methods: This study will be a cross-sectional descriptive study with analytical aims. The minimum sample size will be 239. Our study population will consist of records of pregnant women with unicatricial uterus who underwent attempted vaginal delivery after caesarean section at UCK from January 2014 to June 2023. Results will be reported as percentage proportion and mean plus or minus standard deviation. Comparison of means between groups will be made using Student's t-test, and of proportions using Pearson's Chi-square test. Logistic regression will be used to generate Odds Ratios to measure the strength of association between variables. The test will be statistically significant for a p value < 0.05. Data will be collected and processed confidentially and anonymously. Conclusion: This study will identify the factors associated with the failure of attempted vaginal delivery after caesarean section in order How to cite this paper: Mbangama, M.A.,
PURPOSE To characterize the artifacts of an 18-gauge coaxial nickel-titanium needle using a balanced steady-state free precession sequence in magnetic resonance imaging-guided interventions at 3.0 tesla. METHODS The influence of flip angle (FA), bandwidth, matrix, slice thickness (ST), and read-out direction on needle artifact behavior was investigated for different intervention angles (IA). Artifact diameters were rated at predefined positions. Subgroup differences were assessed using Bonferroni-corrected non-parametric tests and correlations between continuous variables were expressed using the Bravais–Pearson coefficient. Interrater reliability was quantified using intraclass correlation coefficients (ICCs), and a contrast-enhanced target lesion to non-enhanced muscle tissue contrast ratio was quantified. RESULTS The artifact diameters decreased with an increase in FA for all IAs ( P < 0.001) and with an increase in ST for IAs of 45°–90° (all P < 0.05). Tip artifacts occurred at low IAs (0°–45°) and gradually increased in size with a decrease in IA ( P = 0.022). The interrater reliability was high (ICC: 0.994–0.999). The contrast-enhanced target lesion to non-enhanced muscle tissue contrast ratio presented positive correlations with increasing FAs and matrices ( P < 0.001; P = 0.003) and a negative correlation with increasing STs ( P = 0.007). CONCLUSION To minimize needle artifacts, it is recommended to use FAs of 40°–60°, a ST of >7 mm, and, if possible, an IA of 45°–60°. The visibility of the target lesion and the needle’s artifact behavior must be weighed up against each other when choosing the ST, while higher FAs (40°–60°) and matrices (224 × 224/256 × 256) are associated with low artifacts and sufficient lesion visibility.
Background: Cesarean section is the most frequently performed surgery worldwide. Massage is one of the cheapest and cost-effective methods to reduce pain among post-cesarean mothers. Materials and methods: In this study, a true experimental research design was used. The population of the study was post-cesarean mothers during first postoperative day. A sample of 90 post-cesarean mothers was selected by using a simple random sampling technique, with 30 mothers in each group: group I received hand massage, group II received foot massage, and group III (control group) received daily routine care. Pre-and posttest pain levels were assessed by using a numerical pain rating scale. The duration of intervention was 20 minutes for two times at an interval of 60 minutes. Result: Hand massage and foot massage were effective on post-cesarean mothers in both group I and group II. Upon comparing the effectiveness of hand massage and foot massage, it was statistically significant at p < 0.001. The study finding reveals that foot massage was effective in reducing pain among post-cesarean mothers. Conclusion: Thus, the study concludes that foot massage is effective in reducing pain in the incision site among post-cesarean mothers. Therefore, the health professionals must explore alternative approaches to provide better care.
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