Comparison of Fetomaternal Outcome Between Planned Vaginal Delivery and Planned Cesarean Section in Women with Eclampsia: Observational Study

Author(s):  
Snehamay Chaudhuri ◽  
Dipak Kumar Giri ◽  
Arpita Mondal ◽  
Rashmi Rani ◽  
Vaitheeswari Janani ◽  
...  
2018 ◽  
Vol 17 (3) ◽  
pp. 65-72
Author(s):  
Lambros Mpoltsis ◽  
Emmanuel Stamatakis ◽  
Theodoros Xanthos ◽  
Nicoletta Iacovidou ◽  
Athanasios Chalkias ◽  
...  

Background. The 2015 European Resuscitation Council (ERC) Guidelines for Resuscitation and support of transition of babies at birth stress the importance of adequate preparation by the healthcare professionals who are going to receive the newborn immediately after birth in order to avoid preventable neonate deterioration. Midwives and pediatricians are the healthcare professionals in the frontline of neonate reception. Methods. Based on the 2015 ERC guidelines we created a 9-item checklist of indispensable actions for correct preparation for neonate reception after vaginal delivery or cesarean section. 78 midwives and 39 pediatricians were included in this prospective observational study. The impact of prior neonate life support training (NLS) on their performance was also assessed. Results. Regarding preparation for neonate reception, participants performed significantly better when the neonate was delivered by vaginal delivery (mean score 7.21±1.77 vs 5.45±1.55 for cesarean section, p<0.0005). Furthermore, midwives performed significantly better (performance score 6.88±1.87) than pediatricians even when subgroup analysis was performed for residents (5.40±1.59, p=0.002) and consultants (5.46±1.47, p=0.002). Previous NLS training resulted in significantly higher performance scores (6.57±1.81 vs 5.18±1.91 for no NLS training, p=0.004). Conclusions. In the present study midwives performed better than consultant and resident pediatricians in preparing for receiving a neonate immediately after birth and neonatal life support training led to significantly better performance when compared to particiants with no prior NLS training. To our knowledge, this is the first study to assess these skills in midwives and pediatricians.


Author(s):  
Jothi Sundaram ◽  
Divya Vinoth ◽  
Malathi Sriram

Background: In a well-equipped hospital, trial of vaginal delivery is done in selected cases of previous C-section (CS). Epidural analgesia administration has been proved to be good adjunct in trial of labor after caesarean (TOLAC).Methods: This study is a prospective observational study done in a tertiary care institution in Tamil Nadu from May 2019 to July 2019. 50 cases with previous history of one CS were selected. Single ton pregnancy, previous transverse lower segment cesarean section admitted cases with adequate pelvis with no other co-morbidities were selected. Epidural analgesia was administered once mother was in established labor. TOLAC was continued till satisfactory progress and emergency repeat caesarean was taken in case of Suspected scar dehiscence (SSD) or abnormal fetal heart rate tracings. Quantitative data was expressed in mean and standard deviation. For qualitative data percentage was used.Results: In 50 cases observed the mean age of the cases was 26±3.64 years. TOLAC was successful in 41 (82%) mothers out of 50. The mode of delivery in 41 TOLAC mothers was found to be forceps in 18 cases (36%) and ventouse delivery 18 cases (36%). Only 9 cases had needed emergency CS (18%). The major indication for CS in TOLAC was found to be fetal distress in 4 number of cases (8%). 43 babies delivered were healthy, 6 babies (12%) admitted in NICU.Conclusions: With the application of epidural analgesia on attempted vaginal delivery in previous cesarean, vaginal delivery was 82% cases.


2021 ◽  
Vol 8 ◽  
pp. 2333794X2110183
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa

The adverse neonatal outcome is defined as the presence of birth asphyxia, respiratory distress, birth trauma, hypothermia, meconium aspiration syndrome, neonatal intensive care admission, and neonatal death. It is a major concern in developing countries, including Ethiopia. This study tried to identify predictors of adverse neonatal outcomes at selected public hospitals in Eastern Ethiopia. A hospital-based prospective follow-up study was conducted in three public hospitals in Eastern Ethiopia from June to October 2020. A total of 2,246 laboring women and neonates born at the hospitals were enrolled in the study. Data were collected through interviews, observation checklists, and clinical chart review. Reports were presented in relative risks with 95% CIs. The overall magnitude of adverse neonatal outcome was 20.97% (95% CI: 19.33- 22.71%). It was 24.3% for babies born through cesarean section (95% CI: 21.3%, 27.5). The presence of meconium in the amniotic fluid increased the risk for neonates delivered via cesarean section (ARR, 1.52 95% CI; 1.04, 2.22). Among neonates born via vaginal delivery, the risk of adverse neonatal outcome was higher among nullipara women (ARR, 1.42 95% CI; 1.02, 1.99) and among women diagnosed with abnormal labor or pregnancy such as APH, pre-eclampsia, obstructed labor, fetal distress, and mal-presentation at admission (ARR, 1.30 95%CI; 1.01, 1.67). The risk of adverse neonatal outcome was higher among babies born through the cesarian section than those born via vaginal delivery. Abnormal labor or pregnancy and being primiparous increased the risk of adverse neonatal outcome in vaginal delivery.


Author(s):  
Kimitoshi Imai MD

Background: Multiparous women who have previously delivered vaginally are generally considered to be at low risk for cesarean section. We aimed to determine the incidence rate and indications for primary cesarean section and operative vaginal deliveries among multiparous women with previous vaginal births. Patients and methods: Multiparous women who had delivered their babies in our clinic between January 2004 and December 2019 were enrolled in this retrospective observational study. The inclusion criteria were as follows: delivery at 37 weeks of gestation or more, singleton pregnancy with a live fetus, had one or more past vaginal deliveries including instrumental vaginal birth, and no history of previous cesarean section. Women with placenta previa, abruptio placentae, severe pregnancy-induced hypertension, and uncontrolled medical diseases were referred to tertiary hospitals and excluded from this study. The frequency of occurrence and indications for cesarean section and vacuum extraction, duration of labor, and the effect of induction of labor on the cesarean section rates were analyzed. Results: A total of 3094 multiparous women were enrolled. Primary cesarean section was performed in 30 women (30/3094=0.97%). The indications for cesarean section included the following: breech presentation in 28 women, myomectomy after the first vaginal birth in one (of 29 elective cesarean sections), and failed vacuum extraction after a prolonged second stage in one (one emergency cesarean section). Vacuum extraction was performed in 61 women (61/3094=2.0%), the indications for which were non-reassuring fetal status (n=38), prolonged 2nd stage of labor (n=10), and narrow pelvic outlet (n=10). Vaginal breech delivery occurred in 11 women. Induction of labor (n=402) did not affect the cesarean section rate. Conclusion: In multiparous women, breech presentation was the main indication for primary cesarean sections, and the cesarean section rate was very low in women with cephalic presentation.


2013 ◽  
Vol 6 ◽  
pp. CCRep.S12771 ◽  
Author(s):  
Shameema A. Sadath ◽  
Fathiya I. Abo Diba ◽  
Surendra Nayak ◽  
Iman Al Shamali ◽  
Michael F. Diejomaoh

Introduction Vernix caseosa peritonitis (VCP) is a very unusual complication caused by inflammatory response to amniotic fluid spilled into the maternal peritoneal cavity. Twenty-seven cases have been reported, and all occurred after cesarean section. Case presentation We present a case of VCP following vaginal delivery; this may be the first case reported after vaginal delivery. Mrs. A, 28 years old, gravida 3, para 2, with one previous cesarean section, was admitted at 41 weeks gestation in active labor. Vacuum extraction was performed to deliver a healthy male baby, 4.410 kg, Apgar scores 7, 8. She developed fever, acute abdominal pain, and distension about 3 hours after delivery. A diagnosis of acute abdomen was made. Laparotomy was performed and it revealed neither uterine scar rupture nor other surgical emergencies, but 500 mL of turbid fluid and some cheesy material on the serosal surface of all viscera. Biopsies were taken. She had a course of antibiotics and her recovery was complete. Histology of the peritoneal fluid and tissue biopsy resulted in a diagnosis of VCP. Conclusion Clinical diagnosis of peritonitis due to vernix caseosa should be considered in patients presenting postpartum with an acute abdomen after vaginal delivery.


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