Prevalence and Risk Associated With Bladder Injuries During Caesarean Section in a Secondary Care Hospital.

Introduction Bladder injury during caesarean section (CS) is not uncommon. Various factors increase the risk of bladder injury during CS, including prolonged labor with bladder distension, pregnancy with a scarred uterus, suspected intra-abdominal adhesions, distorted local anatomy, cesarean hysterectomy, and an increasing number of previous CS. Vigilant preoperative assessment and surgical precision are essential to mitigate these risks and ensure optimal outcomes for mother and child. Objectives To find out the prevalence and risk factors associated with bladder injuries during caesarean section. Methodology Hospital-based retrospective record review of 3600 pregnant women who had undergone cesarean section during the period January 2015 to December 2023 were included in the study. Data was analyzed using SPSS software, version 22 (trial version) (IBM Corp., Armonk, NY). The Chi-square test and Fisher's exact test were used. Ethical clearance was obtained from the Institutional Ethics Committee at Tata Main Hospital Noamundi (approval number NI/CMO/26/24). Result Bladder injury prevalence was reported to be 1.1%. Bladder injuries were significantly (p<0.0001) more among the CS cases with underlined complications as compared to CS cases without any underlined complications. Repeat CSs were found to have a significantly (p<0.001) higher proportion of bladder injuries compared to primary CS.  Conclusion Bladder injuries during cesarean section are a significant concern. The risk factors identified, such as the number of previous cesarean sections and complications during pregnancy, highlight the importance of careful preoperative assessment and surgical precision to prevent such injuries.

A Case of Steroid-Induced Gastric Perforation in a Ten-Year-Old Child.

Gastric perforation is a rare yet critical clinical disorder that demands prompt medical attention. Gastric ulcers often manifest on the anterior wall of the stomach, underscoring the importance of early detection for an improved prognosis. This study delves into a specific case, shedding light on a 10-year-old male child diagnosed with steroid-induced gastric perforation. The diagnosis was established through a meticulous examination of the clinical history and a plain abdominal X-ray, culminating in a timely and decisive surgical intervention for repair.