Open access peer-reviewed Edited Volume

Caesarean Section

Panagiotis Tsikouras

Democritus University of Thrace, Komotini

Dr. Panagiotis Tsikouras has authored and co-authored multiple peer-reviewed scientific papers and presented works at many national and international conferences. His contributions have acclaimed recognition from honorable subject experts around the world. Dr. Tsikouras has great experience in check control of high-risk pregnancies such as ART pregnancies, twin pregnancies, teenage pregnancies. Except for this, he is responsible for the termination of high pregnancies.

Co-editors:

Nikolaos Nikolettos

Democritus University of Thrcae

Werner Rath

University Kiel

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Georg Friedrich Von Tempelhoff

St. Vinzenz Hospital Hanau

Covering

Vaginal Microbiome Pregnancy Twin Pregnancies Modus of Terminating Births Caesarean Section Indications Contraindications ART Pregnancies High-Risk Factors HPV Infection Timing Management

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About the book

Forty years ago CS was not a common Obstetric surgery with a frequency of just over or less than 10%. In the following decades, there was a dramatic increase in the frequency of the order> 1% / year.
The tendency to have a smaller number of children led to a higher percentage of primigravidas who are at increased risk for caesarean section. The widespread application of assisted reproduction methods has led to increased rates of twin (35%) and multiple (77%) pregnancies and consequently a rise in the percentage of CS's.
There is a trend that supports the view that the induction of childbirth between 39-40 weeks of pregnancy will help to reduce the incidence of stillbirths.
Active birth control is mainly used to reduce cesarean sections. However, epidural analgesia may increase the frequency (13% vs. 8% in the US).

The passage of the newborn through the mother's vagina, the skin contact after childbirth as well as breastfeeding give the newborn the advantage to colonize with the beneficial germs of his mother, for which has already have antibodies from the fetal life. Their penetration into the digestive system of the newborn contributes to the creation of the normal intestinal flora, along with the activation of its defense system with the possibility of maximum development.
Microbes that their mother does not have are dangerous to them. When a field of labor is sterile, such as a caesarean section, the newborn will be colonized by the first germs it comes in contact with, which are other than those of its mother. From a microbiological point of view, the newborn needs to be in contact with a single person, his mother.
CS is a surgical procedure that should be done only on real medical indications, as it can lead to potential consequences such as infection, thrombosis, bleeding, emergency hysterectomy, persistent pelvic pain, infertility, even death.
The final decision on how to terminate the pregnancy is individualized for each woman individually, based on the particular medical - obstetric indications of the pregnant woman, her personal medical and surgical souvenir but also her needs and preferences that must always be taken seriously by the responsible Obstetrician-Gynecologist.
Extremely important is the role of thorough information, based on documented knowledge, that every pregnant woman should take from health professionals before making any decision.

The consulting role of the Obstetrician-Gynecologist is catalytic, in order to responsibly and objectively inform the pregnant woman both about the special, possibly, conditions of the specific pregnancy, and about the general documented scientific guidelines on the choice of the way of termination of the pregnancy.
It is important that the recording of the provided information, the special indications (with the identification of the prominent one), and the signed consent of the pregnant woman for a caesarean section after her thorough information are included in a special form of her medical file.

Equally important is the provision of informed information to the pregnant woman during pregnancy and not only at the end of it or during the delivery process, regarding the possibility of cesarean section and the accompanying parameters: indications (such as fetal distress, or failure to progress during childbirth, breech presentation, etc.), methods, relative risks and benefits, potential effects on future pregnancies and deliveries.
The common consent and the choice of the woman for the way of the outcome of her childbirth are the main reasons for the change of the obstetric practice.

The use of documented guidelines is one of the appropriate ways and their implementation will mean the reduction of CS percentages.

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About the editor

Panagiotis Tsikouras

Democritus University of Thrace, Komotini

CURRICULUM VITAE PROFESSOR DR. PANAGIOTIS TSIKOURAS OBSTETRICIAN-GYNECOLOGIST DEMOCRITUS UNIVERSITY OF THRACE ,GREECE I was born in Didymoteicho on June 2-6, 1962. I am married with two children, one son and one daughter. I speak fluently German and English language. I graduated from the 1st High School of Didymoteicho in 1980.In the same year, after successfully passing the Hellenic entrance exams, I enrolled in the Department of Economics of the Aristotle University inThessaloniki.1980-1981 German Language Preparation at the following Schools berlitz schule in Freiburg Germany, neue sprachschule in Freiburg Germany, goethe institut Freiburg Germany Vorkurs University Heidelberg.During the period 1981-1982 preparation for University in a German University at Studienkolleg University of Heidelberg. Enrollment in medical university of Freiburg October 1982 after successful exams at Freiburg University School of Medicine in Germany. In November 1988, after 6 years of study, I received my Bachelor of Medicine degree. I completed my Phd and received the diploma of thesis in Freiburg University School of Medicine on November 9, 1989 with a degree of (very good) cum laude. From December 1988 to December 1989 I worked as a specialized physician in Radiological and Nuclear Medicine at the Freiburg Diakonie-Karlsruhe-Germany University Hospital From 01.01.1990 to 31.03.1993 I worked as a specialized physician in Obstetrics and Gynecology at the University Obstetrics-Gynecology Clinic of the University of Göttingen From 01.04.1993 to 01.02.1995 completing my specialty in Obstetrics and Gynecology at the University Midwifery-Gynecology Clinic of Aschaffenburg-Würzburg University Hospital. On 22 February 1995, after successful exams, I received the title of Special Obstetrician-Gynecologist. Munich - Professor DR.kröner During the period 22/02/1995 - 30/08/1995 after receiving my specialty I worked as (Consultant in the Obstetrics-Gynecology Clinic of the University Hospital of Aschaffenburg-Würzburg, Germany. During this time, along with my basic clinical service, I worked with rotation in the Departments-Laboratories: Gynecologic Oncology-Andrology-Gynecological Urology-Mastology and Doppler-Ultrasound I served in the military service from September 1996 to September 1997 in the Air Force.From 30.10.1995 to 30-12-1995 I served as a specialized assistant in the Gynecological Clinic of 251 GN. Aviation. Also, during my military service I volunteered (01-01-1996 to 27-08-1996) for the Midwifery-Gynecological Clinic of Didymoteich Hospital as a specialized external physician. From 27-09-1996 to 16.11.1999 I worked first as a medical doctor at the Rural medical health center Soufli and then as Consultant at the department of obstetrics and gynecology of DUTH Clinic. I have participated as a Surgeon and as an assistant in a large number of Obstetric and Gynecological surgeries, I also train in Obstetrics and Surgery Gynecology Consultant doctor in the department of Obstetrics-Gynecology Clinic of DUTH and participated in the education of 5 and 6 year medical students.From 07-07-1997 to 16.11.1999 I was the Head of the department of the Family Planning Center of the DUTH On 16th-11th-1999 (an Lecturer in Obstetrics-Gynecology at the School of Medicine of the DUTH From 17.11.1999 to 2003 I worked as a Lecturer in Obstetrics-Gynecology Clinic of DUTH. On the 16th-12th, 2003 I became Assistant Professor of Obstetrics-Gynecology at the School of Medicine of the DUTH after positive election of all univerity members From 24.06.2004 to 18.03.2008 I worked as an Assistant Professor at Obstetrics - Gynecology Clinic of DUTHFrom 01-5th 2006 until 31-10th 2006 I subspecialized at the University of Würzburg Medical School (Klinikum Aschaffenburg-Akademisches Lehrkrankehaus der Universität Würzburg) in the subjects of Rectal Minor Pelvic Surgery-Breast Surgery and Gynecologic Surgery as well as in Gynecology approach and treatment of climacteric and menopausal disorders with active participation in research protocols of the above clinic.On 19-3-2008, I became an Assistant Professor of Obstetrics-Gynecology at the School of Medicine of the DUTH. after positive election of all univerity membersFrom 19-3rd 2008. Until 29.04.2013 I worked as an Assistant Professor in Obstetrics-Gynecology Clinic of DUTH. From 01-8th 2011 to 31-01-2012 Clinikum Aschaffenburg-Teaching Hospital at the University of Würzburg Medical School and I subspecialized for a second time in the subjects of Minor Pelvic Risk Surgery and Active Breast Surgery as well as in Pediatric Surgery research protocols of the above clinic.From 30.04.2013 I became Associate Professor of Obstetrics-Gynecology at the School of Medicine of DUTH after positive election of all Univerity members and I have been working till now as an Associate Professor of Obstetrics-GynecologyFrom 22.02.2019 I became Professor of Obstetrics-Gynecology at the School of Medicine of DUTH after positive election of all univerity members My Clinical and Surgical activity covers the entire spectrum of Obstetrics-Gynecology (Perinatal-Fetal Medicine, Surgical Gynecology, Breast Surgery, Gynecological Oncology and Gynecological Endoscopy). I have been in charge of the Departments of Obstetrics, Outpatient Medicine,Participation in Obstetrics Gynecology courses Manosmed University (Mastology association of northen and southern Mediterranean mobile university of mastology) Academic year 2017-2018 RESEARCH - COPYRIGHT ACTIVITY Doctoral Thesis on "Verbesserung der aussagekraft der enzymdiagnostik be lebererkrankungen mit hilfe der 5 - nucleotidase und glutamatdehydrogenase" Participation in European research on the position of modern Greek women and, consequently, European contraception. Participation in research concerning The role of inflammatory cytokines and fibronectin in vaginal and cervical secretions Participation in a multicenter research program by the Greek Obstetrics and Gynecology Society to conduct Pan-Hellenic Caesarean section research to record data regarding this intervention. Participation in EurOSA ,HRT role in pre-and postmenopausal women Participation in a research program at the University of Würzburg Medical School, Aschaffenburg University Hospital of Obstetrics and Gynecology, on "Techniques for cleaning lymph nodes in gynecological cancer surgery". Participation in a research program at the Aschaffenburg University Hospital Medical School, University of Würzburg Medical School, entitled "Methods and complications in the application of remedial techniques to surgical patients". International and Greek Conferences as well as Publications in valid International and Greek Scientific Journals. 5 CHAPTERS IN GREEK BOOKS 14 CHAPTERS IN INTERNATIONAL BOOKS Writing a monograph for the needs of the chosen course entitled "Child Adolescent Gynecology" Writing a monograph "Pregnancy in rheumatic diseases". 220 presentations (oral or poster) in international congresses and 200 presentations (oral or poster) in national congresses INTERNATIONAL PUBLICATIONS Research Gate Library 222 Publications, Scopus Research Library 146 Publications Pubmed Research Library 129 Publications Conference papers: 12 Papers Reviewer in international journals 4000 Papers

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