Comparison of planned caesarean delivery and planned vaginal delivery in women with a twin pregnancy: A nation wide cohort study

2018 ◽  
Vol 221 ◽  
pp. 97-104 ◽  
Author(s):  
Simone M.T.A. Goossens ◽  
Sabine Ensing ◽  
Mark A.H.B.M. van der Hoeven ◽  
Frans J.M.E. Roumen ◽  
Jan G. Nijhuis ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Twin Pregnancy

scholarly journals Evaluation of the risk of umbilical cord prolapse in the second twin during vaginal delivery: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046616
Author(s):  
Rokuhiro Asahina ◽  
Hiroyuki Tsuda ◽  
Yuki Nishiko ◽  
Kazuya Fuma ◽  
Momoko Kuribayashi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vaginal Delivery ◽  
Umbilical Cord ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Cord Prolapse ◽  
Umbilical Cord Insertion ◽  
Umbilical Cord Prolapse ◽  
Second Twin

ObjectiveThis study aimed to evaluate the success rate of vaginal delivery, the reasons for unplanned caesarean delivery, the rate of umbilical cord prolapse and the risk of umbilical cord prolapse in twin deliveries.DesignRetrospective cohort study.SettingSingle institution.ParticipantsThis study included 455 women pregnant with twins (307 dichorionic and 148 monochorionic) who attempted vaginal delivery from January 2009 to August 2018. The following criteria were considered for vaginal delivery: diamniotic twins, cephalic presentation of the first twin, no history of uterine scar, no other indications for caesarean delivery, no major structural abnormality in either twin and no fetal aneuploidy.ResultsThe rate of vaginal delivery of both twins was 89.5% (407 of 455), caesarean delivery of both twins was 7.7% (35 of 455) and caesarean delivery of only the second twin was 2.9% (13 of 455). The major reasons for unplanned caesarean delivery were arrest of labour and non-reassuring fetal heart rate pattern. The rate of umbilical cord prolapse in the second twin was 1.8% (8 of 455). Multivariate analysis revealed that abnormal umbilical cord insertion in the second twin (velamentous or marginal) was the only significant factor for umbilical cord prolapse in the second twin (OR, 5.05, 95% CI 1.139 to 22.472, p=0.033).ConclusionsAbnormal umbilical cord insertion in the second twin (velamentous or marginal) was a significant factor for umbilical cord prolapse during delivery. Antenatal assessment of the second twin’s umbilical cord insertion using ultrasonography would be beneficial.

scholarly journals The new clinical application of bilateral-contralateral cervix clamp in postpartum hemorrhage: a retrospective cohort study

2020 ◽  
Author(s):  
QianWen Zhang ◽  
Tao Li ◽  
Yu Xu ◽  
Yayi Hu
Keyword(s):  
Cohort Study ◽  
Informed Consent ◽  
Blood Transfusion ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Control Group ◽  
Efficacy And Safety ◽  
Complementary Treatment

Abstract Background: To assess the efficacy and safety of bilateral-contralateral cervix clamp firstly applied in postpartum hemorrhage caused by uterine tony of lower segment.Methods: Totally 47 pregnant women with postpartum hemorrhage secondary to lower uterine segment atony in vaginal delivery or after caesarean delivery were included from March 1, 2020 to May 31, 2020. According to patient’s informed consent, 22 women accepted cervical clamp to treat and 25 only used uterotonics in control group.Then hemostatic efficacy and safety of bilateral-contralateral cervix clamp were assessed by retrospective analysis.Results: It was found that mean blood loss in clamp group was much less during vaginal delivery (656.2±72.79g vs 811.8±86.07g, p=0.001) or after caesarean delivery (42.8±6.60g vs 126.3±86.97g, p=0.007), and incidence of uterotonic repeated usage (81.8% vs 36%, 18.2 % vs 64%, p=0.001) or side effect (18.2% vs 48.0%, p=0.031) appeared less than control group, but there was no statistical differences on hospital stay(4.1±1.57days vs 3.8±1.61days, p=0.535), hemoglobin(119±4.10g vs 121.4±4.19g, p=0.058)，blood transfusion(9.1% vs 12%,p=0.746), surgical procedures(4.5% vs 4.0%, p=0.93), also no clamp complications occurred.Conclusions: The bilateral-contralateral cervix clamp was effective and safe, this new technique could be a complementary treatment for postpartum hemorrhage.

scholarly journals Postpartum urinary tract infection by mode of delivery: a Danish nationwide cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e018479 ◽  
Author(s):  
Tina Djernis Gundersen ◽  
Lone Krebs ◽  
Ellen Christine Leth Loekkegaard ◽  
Steen Christian Rasmussen ◽  
Julie Glavind ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Cohort Study ◽  
Urinary Tract ◽  
Tract Infection ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
Spontaneous Vaginal Delivery ◽  
Increased Risk ◽  
Actual Mode

ObjectivesTo examine the association between postpartum urinary tract infection and intended mode of delivery as well as actual mode of delivery.DesignRetrospective cohort study.Setting and participantsAll live births in Denmark between 2004 and 2010 (n=450 856). Births were classified by intended caesarean delivery (n=45 053) or intended vaginal delivery (n=405 803), and by actual mode of delivery: spontaneous vaginal delivery, operative vaginal delivery, emergency or planned caesarean delivery in labour or prelabour.Primary and secondary outcome measuresThe primary outcome measure was postpartum urinary tract infection (n=16 295) within 30 days post partum, defined as either a diagnosis of urinary tract infection in the National Patient Registry or redemption of urinary tract infection-specific antibiotics recorded in the Register of Medicinal Product Statistics.ResultsWe found that 4.6% of women with intended caesarean delivery and 3.5% of women with intended vaginal delivery were treated for postpartum urinary tract infection.Women with intended caesarean delivery had a significantly increased risk of postpartum urinary tract infection compared with women with intended vaginal delivery (OR 1.33, 95% CI 1.27 to 1.40), after adjustment for age at delivery, smoking, body mass index, educational level, gestational diabetes mellitus, infection during pregnancy, birth weight, preterm delivery, preterm prelabour rupture of membranes, pre-eclampsia, parity and previous caesarean delivery (adjusted OR 1.24, 95% CI 1.17 to 1.46).Using actual mode of delivery as exposure, all types of operative delivery had an equally increased risk of postpartum urinary tract infection compared with spontaneous vaginal delivery.ConclusionsCompared with intended vaginal delivery, intended caesarean delivery was significantly associated with a higher risk of postpartum urinary tract infection. Future studies should focus on reducing routine catheterisation prior to operative vaginal delivery as well as improving procedures related to catheterisation.

scholarly journals The new clinical application of bilateral-contralateral cervix clamp in postpartum hemorrhage: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qianwen Zhang ◽  
Tao Li ◽  
Yu Xu ◽  
Yayi Hu
Keyword(s):  
Cohort Study ◽  
Informed Consent ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Control Group ◽  
Efficacy And Safety ◽  
Lower Segment ◽  
Complementary Treatment

Abstract Background To assess the efficacy and safety of bilateral-contralateral cervix clamp firstly applied in postpartum hemorrhage caused by uterine tony of lower segment. Methods Totally 47 pregnant women with postpartum hemorrhage secondary to lower uterine segment atony in vaginal delivery or after caesarean delivery were included from March 1, 2020 to May 31, 2020. According to patient’s informed consent, 22 women accepted cervical clamp to treat and 25 only used uterotonics in control group. Then hemostatic efficacy and safety of bilateral-contralateral cervix clamp were assessed by retrospective analysis. Results It was found that mean blood loss in clamp group was much less during vaginal delivery (656.2±72.79 g vs 811.8±86.07 g, p = 0.001) or after caesarean delivery (42.8±6.60 g vs 126.3±86.97 g, p = 0.007), and incidence of uterotonic repeated usage (81.8% vs 36, 18.2% vs 64%, p = 0.001) or side effect (18.2% vs 48.0%, p = 0.031) appeared less than control group, but there was no statistical differences on hospital stay (4.1±1.57 days vs 3.8±1.61 days, p = 0.535), hemoglobin (119±4.10 g vs 121.4±4.19 g, p = 0.058), blood transfusion (9.1% vs 12%,p = 0.746), surgical procedures (4.5% vs 4.0%, p = 0.93), also no clamp complications occurred. Conclusions The bilateral-contralateral cervix clamp was effective and safe, this new technique could be a complementary treatment for postpartum hemorrhage.

Predictive Factors for Successful Vaginal Delivery after a Trial of External Cephalic Version: A Retrospective Cohort Study of 946 Women

2021 ◽  
Author(s):  
Asaf Bilgory ◽  
Olena Minich ◽  
Maria Shvaikovsky ◽  
Genady Gurevich ◽  
Joseph B. Lessing ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vaginal Delivery ◽  
Predictive Factors ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Goodness Of Fit ◽  
External Cephalic Version ◽  
Nulliparous Women ◽  
Tertiary Center ◽  
Vertex Presentation

Objective Our aim was to find the factors which predict a vertex presentation of vaginal delivery (VD) in women who are admitted for a trial of external cephalic version (ECV). Study Design This is a retrospective cohort study of women who underwent a trial of ECV and delivered between November 2011 and December 2018 in a single tertiary center. The main outcome measure was successful VD of a fetus in the vertex presentation. Women who achieved VD in the vertex presentation or underwent cesarean delivery were compared on the basis of variety of predictive factors. Adverse neonatal and maternal outcomes were reported. Logistic regression was used for the multivariate analysis. Results A total of 946 women were included; 717 (75.8%) women had a successful ECV and 663 (70.1%) women had a VD in the vertex presentation. Parous women had 79.3% VD rate (570/719) and nulliparous women had 41.0% VD rate (93/227). Women with an amniotic fluid index (AFI) of 50 to 79, 80 to 200, and >200 mm had 34.8, 71.0, and 83.1% VD rate, respectively. Parous versus nulliparous women had an adjusted odds ratio (aOR) of 5.42 (95% confidence interval [CI] 3.90–7.52, p < 0.001), women with AFI 50 to 79 mm compared with AFI 80 to 200 mm had an aOR of 0.21 (95% CI 0.12–0.37, p < 0.001), and women with an AFI >200 mm compared with AFI 80 to 200 mm had an aOR of 1.74 (95% CI 1.03–2.92, p = 0.037) to achieve VD. The final prediction model for the chances of a VD based on data on admission for ECV was reported. The Hosmer-Lemeshow test was used to evaluate the goodness of fit of the model (p = 0.836). Conclusion Being parous and having an AFI >200 mm are positive independent predictive factors for achieving VD of a vertex presenting fetus after ECV. Whereas AFI 50 to 79 mm is a negative independent predictive factor. Key Points

A STUDY OF POSTPARTUM INTRAUTERINE CONTRACEPTIVE DEVICE INSERTIONS IN CAESAREAN SECTIONS AND FOLLOWING VAGINAL DELIVERIES

2021 ◽  
pp. 1-3
Author(s):  
Shweta Pathak ◽  
Manaswita Samanta ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Clinical Outcomes ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Contraceptive Device ◽  
Obstetrics And Gynaecology ◽  
Vaginal Deliveries ◽  
Intrauterine Contraceptive

Aim: To study clinical outcomes of immediate postpartum IUCD insertion and to compare immediate postpartum IUCD insertion as a factor of route of insertion (caesarean vs. vaginal). Material and methods: This prospective study was conducted in a Department of Obstetrics and Gynaecology, College of medicine and JNM Hospital, Kalyani, Nadia. Duration of the study was one and half years [ 15 months inclusion, 3 months follow up]. Total 100 cases are included [50 vaginal and 50 caesarean]. Women who were attending or referred to OPD or ER of Dept. of Obst and Gynae, College of medicine and JNM Hospital and delivering either vaginally or by caesarean section, have received counseling for postoperative contraception and have consented to PPIUCD insertion Result:It was found that in Caesarean, 26(52.0%) patients had bleeding P/V 6 weeks. In Vaiginal, 28(56.0%) patients had bleeding P/V 6 weeks. Association of bleeding P/V 6 weeks vs. group was not statistically signicant (p=0.61968). In Caesarean, 11(22.0%) patients had bleeding P/V 3 weeks. In Vaiginal, 13(26.0%) patients had bleeding P/V 3 weeks. Association of bleeding P/V 3 weeks vs. group was not statistically signicant (p=0.6395). Conclusion:Infection was not statistically signicant in two groups at 6 week and 3 month.Missing thread was signicantly higher caesarean delivery compared to vaginal delivery.It was also found that refusal/ continuation was more common in vaginal delivery compared to caesarean delivery, which was not statistically signicant.

Sign in / Sign up

Export Citation Format

Share Document