Comparison of maternal mortality and morbidity between trial of labor and elective cesarean section among women with previous cesarean delivery

2004 ◽  
Vol 191 (4) ◽  
pp. 1263-1269 ◽  
Author(s):  
Shi Wu Wen ◽  
◽  
I.D. Rusen ◽  
Mark Walker ◽  
Robert Liston ◽  
...  
2016 ◽  
Vol 5 (2) ◽  
pp. 85-87
Author(s):  
İbrahim Alanbay ◽  
Mustafa Öztürk ◽  
Mustafa Ulubay ◽  
Uğur Keskin ◽  
Emre Karaşahin

Abstract Septum resection using hysterescopy is safe, rapid and efective, but some late complication of it may be seen as uterine rupture or dehiscence of uterine wall during pregnancy due to myometrial damage. We present a case of recurrent large uterine fundal dehiscence conscecutive to cesarean section in a patient who had previously undergone a uterine septum resection. The patient was a 35-year-old who presented at 39 weeks of gestation (Gravida 2, Parity 1) and was admitted for an elective cesarean section. Her reproductive history included a septum resection which resulted in uterine perforation, and one previous cesarean section in which a large fundal defect was found and repaired. Then the examination had shown an aproximately 5 cm large uterine fundus defect including all three layers of uterus which had been repaired. Perforation or excessively deep incision of uterine fundus during hysteroscopic metroplasty may cause chronic weakness of the uterine wall especially at fundal localization. Our case was an incidental uterine wall dehiscence during cesarean section. Patients with an uterine septum resection history should be followed up carefully for uterine rupture during pregnancy.


2017 ◽  
Vol 35 (05) ◽  
pp. 481-485 ◽  
Author(s):  
Ziya Kalem ◽  
Tuncay Yuce ◽  
Batuhan Bakırarar ◽  
Feride Söylemez ◽  
Müberra Namlı Kalem

Objective This study aims to compare melatonin levels in colostrum between vaginal and cesarean delivery. Study Design This cross-sectional study was conducted with 139 mothers who gave live births between February 2016 and December 2016. The mothers were divided into three groups according to the mode of delivery: 60 mothers (43.2%) in the vaginal delivery group, 47 mothers (33.8%) in the elective cesarean delivery, and 32 mothers (23.0%) in the emergency cesarean delivery group. Colostrum of the mothers was taken between 01:00 and 03:00 a.m. within 48 to 72 hours following the delivery, and the melatonin levels were measured using the enzyme-linked immunosorbent assay (ELISA) and compared between the groups. Results The melatonin levels in the colostrum were the highest in the vaginal delivery group, lower in the elective cesarean section group, and the lowest in the emergency cesarean group (265.7 ± 74.3, 204.9 ± 55.6, and 167.1 ± 48.1, respectively; p < 0.001). The melatonin levels in the colostrum did not differ according to the demographic characteristics of the mothers, gestational age, birth weight, newborn sex, the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores, and for the requirement for neonatal intensive care. Conclusion Our study results showed that melatonin levels in the colostrum of the mothers who delivered vaginally were higher than those who delivered by cesarean section. Considering the known benefits of melatonin for the newborns, we believe that vaginal delivery poses an advantage.


Author(s):  
Ajini K. K. ◽  
Reena R. P. ◽  
Radha K. R.

Background: Stillbirth is a distressing event, both for the expecting mother and the obstetrician. Several maternal, social and circumstantial factors influence its occurrence. These women with intrauterine fetal death need to be treated in a considerate manner. Our aim was to analyse different methods   of induction, management of labour and their outcomes in women with antepartum fetal demise.Methods: All women admitted to a tertiary care centre with intrauterine fetal death after 22 weeks during the study period of 24 months were recruited. Maternal sociodemographic characteristics and relevant investigations were studied. Induction of labour was achieved with mechanical and pharmacological methods.  Stillborn babies, placentae and umbilical cord were examined after delivery.Results: There were 175 women with IUFD   admitted during the study period. The stillbirth rate was 38.6 per1000 live births.148 women (84.57%) required induction of labour while16 women had spontaneous onset of labour. Among the 44 women with previous Cesarean section, 11 underwent elective Cesarean section. 19 women (57.6%) out of 33 cases of trial of labour after Cesarean had a successful vaginal delivery. There were 2 cases of rupture uterus and 10 women required ICU admissions. Intrauterine growth restriction was the leading cause of stillbirth (41.8%) followed by hypertensive disorders (27.7%).Conclusions: Present study has shown that vaginal birth can be achieved in most women with mechanical and pharmacological methods of induction within a reasonable period of time.


Author(s):  
Anubha Varshney ◽  
Zehra Mohsin

Background: The objective of this study is to evaluate the outcomes of induction of labor in women attempting trial of labor after cesarean delivery and to compare maternal and neonatal morbidity and mortality in women who were induced to those delivering spontaneously.Methods: The prospective study was carried out in the Department of Obstetrics and Gynecology in collaboration with the Neonatal Section, Department of Pediatrics at J.N. Medical College and Hospital, AMU Aligarh. The sample included 280 women with one previous cesarean section, of whom 130 women underwent induction of labor (study group) and 150 were admitted with spontaneous onset of labor. Prostaglandin gel and intracervical Foley’s were used for cervical ripening in the study group. Indication of cesarean section, mode of delivery, maternal and neonatal outcome were studied in between groups.Results: Overall rate of vaginal delivery after cesarean section was 45.3% and 56% in both study and control group respectively. The rate of cesarean section were higher in women who were induced and having unfavorable cervix. Maternal and neonatal morbidity were not significantly higher as compared in both groups, however one case of scar rupture was found in study group.Conclusions: Induction of labor in women with previous cesarean section had higher rates of cesarean section however it does not adversely affect neonatal and maternal morbidity. Overall vaginal birth is safe and effective in women with previous cesarean section by prostaglandin gel or intracervical Foley’s. Authors cautiously suggest, induction of labor should be considered in preselected patient with strict monitoring.


PEDIATRICS ◽  
1971 ◽  
Vol 48 (1) ◽  
pp. 148-150
Author(s):  
R. C. Montgomery ◽  
M. H. Poindexter ◽  
G. H. Hall ◽  
John E. Leigh

Annular pancreas presenting as high intestinal obstruction in the newborn has been reported on numerous occasions.14 The purpose of this paper is to report the occurrence of annular pancreas causing duodenal obstruction in the newborn in two consecutive siblings. Case Reports Case 1, D.B., a male, was born August 31, 1966. The mother was gravida III, para II. Her expected date of confinement was September 12, 1966. The pregnancy had been uneventful except that she had minimal polyhydramnios. The mother had been on no medications during her pregnancy except a prenatal vitamin and iron. On August 31, 1966 the mother underwent an elective cesarean section because of previous cesarean sections which were performed for cephalo-pelvic disproportion.


2016 ◽  
Vol 15 (4) ◽  
pp. 546-550 ◽  
Author(s):  
Huma Tasleem ◽  
Haider Ghazanfar

Objectives: To determine the frequency of successful Vaginal Birth after One Cesarean Section in our tertiary care institution and to determine the causes of its failure.Material and Methods: This study was conducted in department of Obstetrics and Gynecology of Shifa International Hospital and Shifa Foundation Community Health Centre Islamabad Pakistan from Feb 2011 to Dec 2014. This study included 592 patients who presented in labor room emergency reception of Obs/Gynae department at term with previous one scar having fulfilled the laid down inclusion criteria for VBAC during ante-natal care. The patients were admitted in hospital and were allowed to proceed for spontaneous labor under vigilant monitoring on complications of trial of scar. Immediate emergency cesarean sections were performed, where indicated.Results: Out of 592 patients 70.7% were delivered vaginally after previous one cesarean section and 29.3% had emergency cesarean section. Leading indications for repeat cesarean section was fetal distress, failure to progress and scar tenderness. No maternal and fetal complication occurred in our study. The success rate of Trial of labor after one previous cesarean delivery was lower in obese (64.38%) as compared to non-obese women (82.06%) (p<0.001). Women with previous successful vaginal delivery had a success rate of 88.2% compared with 62.25% in women without such a history (OR 4.4; 95% CI 2.7-7.2 p <0.001).Conclusion: Vaginal birth after one lower segment cesarean section should be encouraged with vigilant monitoring provided no obstetric contra-indication to vaginal birth exists.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.546-550


2013 ◽  
Vol 20 (04) ◽  
pp. 526-529
Author(s):  
BUSHRA MUKHTAR, ◽  
BUSHRA KHAN ◽  
NUZHAT RASHEED

Objective: To compare the fetal outcome of elective cesarean section with elective vaginal birth for Term Breechpresentation in terms of APGAR Score, Respiratory Distress Syndrome, Admission in Neonatology Unit and Neonatal mortality. Design:Quasi experimental study. Setting: Department of Obstetrics & Gynaecololgy Bahawal Victoria Hospital, Bahawalpur. Methods: Total 120cases were included in the study divided into two groups, each having 60 fulfilling the inclusion criteria. Group 'A' had those who deliveredby planned cesarean and Group 'B' comprised those having planned vaginal delivery. Results: It was found that neonatal mortality was3.33 in vaginal and 0 in cesarean group. Mean APGAR Score at 1 and 5 minute was 8.47 and 9.53 in vaginal and 8.58 and 9.62 incesarean group. RDS was more in cesarean (5) than vaginal group (1.6). Admission in Neonatalogy Unit was more in vaginally deliveredgroup (8.33) as compared to the cesarean section group (5). Conclusion: Planned cesarean delivery in breech presentation at term isassociated with a reduction in neonatal mortality and morbidity as compared to the planned vaginal birth.


2017 ◽  
Vol 9 (1) ◽  
pp. 14-17
Author(s):  
Kiran Javaid ◽  
Abida Sultana ◽  
Muneeba Faisal ◽  
Rahim Iqbal ◽  
Mohammad Bin Khalid ◽  
...  

ABSTRACT Aim To assess the indications of emergency vs elective cesarean section in patients at Holy Family Hospital, Rawalpindi. Materials and methods A descriptive cross-sectional study was conducted on 675 women who underwent cesarean section in the Gynecology and Obstetrics Department of the Holy Family Hospital, Rawalpindi, Pakistan over a period of 2 months. Sociodemographic features, type of cesarean, and their indications were recorded on a structured questionnaire. Data were analyzed by using Statistical Package for the Social Sciences version 23. Results A total of 675 women underwent cesarean section during the study period. The emergency cesarean section rate was 70.4%, while elective cesarean constituted of 29.6% cases. The most common indications for emergency cesarean were fetal distress (43.2%) followed by previous cesarean (19.2%) and failure to progress (9.3%), while that for elective cesarean were previous cesarean (41%) and malpresentation (24.5%). Conclusion Fetal distress and previous scar are the leading causes of cesarean section in our study. The improvement of maternal and child health facilities at basic health units, appropriate training of lady health workers and midwives, timely involvement of senior obstetrician, and formation of strict policies regarding cesarean section can have a profound effect in decreasing the rate of cesarean section. Clinical significance This study can prove to be of profound value in getting an insight into the continuously increasing rate of cesarean section. In developing countries like Pakistan, these increasing cesarean deliveries prove to be a burden on the already-constrained resources. How to cite this article Sultana A, Faisal M, Iqbal R, Javaid K, Khalid MB, Khalid MA. Indications of Emergency vs Elective Cesarean Section: Cross-sectional Study done at Holy Family Hospital, Rawalpindi, Pakistan. J South Asian Feder Obst Gynae 2017;9(1):14-17.


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