Vacuum-assisted vaginal deliveries among parturients with congenital uterine anomalies; risk factors and outcomes

2021 ◽  
Vol 265 ◽  
pp. 113-118
Author(s):  
Reut Rotem ◽  
Moshe Barg ◽  
Hen Y. Sela ◽  
Sorina Grisaru-Granovsky ◽  
Misgav Rottenstreich
Keyword(s):  
Risk Factors ◽  
Vaginal Deliveries ◽  
Uterine Anomalies

scholarly journals 446 Risk factors and outcomes of vacuum assisted vaginal deliveries among parturients with congenital uterine anomalies

2021 ◽  
Vol 224 (2) ◽  
pp. S282-S283
Author(s):  
Moshe Barg ◽  
Reut Rotem ◽  
Zvi Erlich ◽  
Hen Sela ◽  
Sorina Grisaru-Granovsky ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vaginal Deliveries ◽  
Uterine Anomalies

scholarly journals Risk factors for third- and fourth-degree perineal tears during vaginal delivery

2011 ◽  
Vol 25 (1) ◽  
pp. 2
Author(s):  
Leonard Juul ◽  
Gerhard B. Theron
Keyword(s):  
Risk Factors ◽  
Shoulder Dystocia ◽  
Control Group ◽  
Study Group ◽  
Tertiary Referral Hospital ◽  
Retrospective Case ◽  
Fourth Degree ◽  
Perineal Tears ◽  
Vaginal Deliveries ◽  
Hiv Negative

<strong>Objective</strong>. To identify risk factors for thirdand fourth-degree perineal tears, so as to anticipate and intervene in order to prevent this complication that can severely affect a woman’s quality of life. The study design was a retrospective case control study. <strong>Method</strong>. Ninety-three cases of third- and fourth-degree perineal tears were identified from the birth register of a tertiary referral hospital (Tygerberg Hospital). One hundred and nine patients with normal vaginal deliveries in the same time period were used as control group. <strong>Results</strong>. An analysis of the results revealed that there were no significant differences between cases and controls with regards to age, body mass index (BMI), gestation at delivery, duration of second stage, episiotomy and birth weight. However, there were significantly more primigravidas, assisted deliveries (forceps and vacuum), occipitoposterior positions, HIV negative patients and shoulder dystocia in the study group. <strong>Conclusions</strong>. Antenatal risk factors for thirdand fourth-degree tears are difficult to identify. However, intrapartum occipitoposterior and assisted deliveries, especially in the primigravid patient, should warn the obstetrician/ midwife about the risk of a severe tear. A restrictive episiotomy policy should be practiced. Shoulder dystocia was invariably associated with third- and fourth-degree tears in this study. The higher incidence of HIV negative patients in the study group requires further research.

scholarly journals Prevalence of Episiotomy and Perineal Lacerations in a University Teaching Hospital, North-Central Nigeria

2018 ◽  
Vol 1 (2) ◽  
pp. 142-147
Author(s):  
S K Hembah-Hilekaan ◽  
A O Ojabo ◽  
O Audu ◽  
P E Onche ◽  
M T Maanongun
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Teaching Hospital ◽  
Maternal Age ◽  
Fetal Weight ◽  
University Teaching ◽  
Warning Sign ◽  
Perineal Laceration ◽  
Perineal Lacerations ◽  
Vaginal Deliveries

Episiotomy is an incision on the introitus and the perineum to increase pelvic outlet to facilitate childbirth and prevent trauma to fetal and maternal tissues. Episiotomy and perineal laceration may predispose the woman to short and long term complications. The objective of this study was to determine the prevalence of episiotomy and perineal lacerations and their associated risks factors at Benue State University Teaching Hospital, Makurdi, Nigeria. Retrospective data of all women who had spontaneous vagina delivery over a 3 year period with perineal laceration/episiotomy were reviewed. Data was obtained from the records and information on the socio-demographic variables, episiotomies, lacerations and the birth weight of infants. The associated risk factors were recorded using Statistical Package for Social Sciences version 22.Of the 636 vaginal deliveries, 85(13.4%) had lacerations with 65(10.2%) first degree, 19(3.0%) second degree and 1(0.2%) major laceration. Episiotomy rate was 132(20.8%). The mean parity and birth weight of infants were 2.62(SD= ± 1.83) and 3.1 kg (SD= ± 0.767) respectively. The highest number of perineal tears 69(10.8%) were in the lower age group (≤ 30 years). A similar observation was noted in respect of episiotomies which rate however decreased with parity. The relationship between maternal age, parity, booking status, fetal weight and the perineal status at delivery was statistically significant (P≤ 0.05). Episiotomy and perineal laceration rates in our institution were low. The major risk factors were low parity, young maternal age and increasing fetal weight at birth and their presence should be an early warning sign. We advise perineal support for all women during delivery.

scholarly journals A case of fracture of humerus in newborn delivered by elective caesarean section

2015 ◽  
Vol 1 (2) ◽  
pp. 134
Author(s):  
Devindra Kaur ◽  
Harminder Singh
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Vaginal Deliveries ◽  
Vertex Presentation ◽  
Fracture Humerus

<p class="abstract"><span lang="EN-US">Birth fractures are common during vaginal deliveries and with breech presentations. This case report of fracture humerus during elective LSCS done for previous LSCS with vertex presentation and with no predisposing risk factors.</span></p>

The Association between Shirodkar Cerclage and Preterm Premature Rupture of Membranes in Singleton Pregnancies

2020 ◽  
Author(s):  
Alberto Muniz Rodriguez ◽  
Andrew Pastor ◽  
Nathan S. Fox
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Control Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Increased Risk ◽  
Uterine Anomalies ◽  
Underlying Risk ◽  
Singleton Pregnancies

Objective The aim of this study was to estimate if preterm premature rupture of membranes in women with cerclage is due to the cerclage itself or rather the underlying risk factors for preterm birth in this population. Study Design This was a retrospective cohort study of singleton pregnancies who underwent Shirodkar cerclage by a single maternal–fetal medicine practice between 2005 and 2019. The control group was an equal number of randomly selected women with a singleton gestation who had a prior preterm birth and were treated with 17-OH-progesterone but no cerclage. Patients with major uterine anomalies or fetal anomalies were excluded. The primary outcome was preterm premature rupture of membranes prior to 34 weeks. Chi-square and logistic regression were used. Results A total of 350 women with cerclage (154 [44%] history-indicated, 137 [39%] ultrasound-indicated, and 59 [17%] exam-indicated) and 350 controls were included. Preterm premature rupture of membranes prior to 34 weeks did not differ between the groups (8.9% in cerclage vs. 6.0% in controls, p = 0.149, adjusted odds ratio 0.62, 95% confidence interval: 0.24–1.64) nor between the different cerclage indications (9.1% of history-indicated, 7.3% of ultrasound-indicated, and 11.9% of exam-indicated, p = 0.582). This study had 80% power with an α error of 0.05 to detect an increase in preterm premature rupture of membranes prior to 34 weeks from 6.0% in the control group to 12.0% in the cerclage group. Conclusion Cerclage does not increase the risk of preterm premature rupture of membranes prior to 34 weeks compared with other women at increased risk of preterm birth. The observed association between cerclage and preterm premature rupture of membranes is likely due to underlying risk factors and not the cerclage itself. The risk of preterm premature rupture of membranes prior to 34 weeks in women with cerclage is 10% or less and does not appear to differ based on cerclage indication. Key Points

scholarly journals Incidence and Risk Factors of Obstetric Anal Sphincter Injuries after Various Modes of Vaginal Deliveries in Chinese Women

2015 ◽  
Vol 128 (18) ◽  
pp. 2420-2425 ◽  
Author(s):  
Tung Chi Wai ◽  
Cheon Willy Cecilia ◽  
Tong Wai Mei Anny ◽  
Leung Hau Yee
Keyword(s):  
Risk Factors ◽  
Anal Sphincter ◽  
Chinese Women ◽  
Obstetric Anal Sphincter Injuries ◽  
Vaginal Deliveries

scholarly journals Risk factors for post-partum hemorrhage in patients who underwent operative vaginal delivery in a tertiary care center

2021 ◽  
Author(s):  
Gayatri Devi Sivasambu ◽  
Sujani B. Kempaiah ◽  
Urvashi Thukral
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Tertiary Care ◽  
Significant Risk ◽  
Post Partum Hemorrhage ◽  
Second Stage ◽  
Operative Vaginal Delivery ◽  
Vaginal Deliveries

Background: Operative vaginal delivery is a timely intervention to cut short second stage labor when imminent delivery is in the interests of mother, fetus, or both. It reduces second stage cesarean section morbidity and uterine scar and its influence on future obstetric career. The possible structural neonatal adverse outcomes due to operative vaginal delivery are well quantified. However, its effects on maternal outcome need to be understood better. In this paper, we study the effect of operative vaginal delivery on maternal post-partum hemorrhage (PPH) and the associated risk factors.Methods: It was a retrospective study carried out for the period July 2016 to July 2020 at Ramaiah Medical College, Bengaluru. Total number of vaginal deliveries in this period were 6318. Out of these, 1020 patients underwent assisted vaginal delivery using vacuum/ forceps/ sequential use of instrument. Blood loss greater than 500 ml is considered PPH for the purpose of this study. 15% of the study population was noted to have PPH. We employ a multivariate logistic regression to identify statistically significant risk factors for PPH in women undergoing operative vaginal delivery.Results: The logistic regression model identifies multiparity, maternal age, neonatal birth weight more than 3.5 kg, application of forceps in women with hypertensive disorders, III-degree tear, cervical tear to significantly increase the risk of PPH in our study population.Conclusions: Certain factors seem to increase the risk of PPH in operative vaginal delivery. The risks and benefits must be weighed properly before use of instruments.

scholarly journals Incidence and Risk Factors of Postpartum Hemorrhage in China: A Multicenter Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Sijian Li ◽  
Jinsong Gao ◽  
Juntao Liu ◽  
Jing Hu ◽  
Xiaoxu Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Cesarean Section ◽  
Subgroup Analysis ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Predictive Performance ◽  
Vaginal Deliveries ◽  
Twin Pregnancies

Background: Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide but the incidence and its risk factors in China is limited. The objective of this study is to investigate the incidence and the risk factors of PPH in Chinese women.Methods: A multi-center retrospective study of pregnant women at ≥28 weeks of gestation was conducted. Logistic regression was used to identify potential risk factors of PPH and receiver operating characteristic curve was used to evaluate the predictive performance of the identified risk factors. Subgroup analysis focusing on the number of fetus and the mode of delivery was conducted.Results: A total of 99,253 pregnant women were enrolled and 804 (0.81%) experienced PPH. The subgroup analysis revealed that the incidence of PPH was 0.75, 2.65, 1.40, and 0.31% in singletons, twin pregnancies, cesarean sections, and vaginal deliveries, respectively. Placenta previa and placenta accreta were the predominant risk factors of PPH in the overall population and all subgroups. A twin pregnancy was a risk factor for PPH regardless of the mode of delivery. Obesity, and multiparity were risk factors for PPH in both singletons and cesarean section cases, but the latter predicted a reduced probability of PPH in vaginal deliveries. Macrosomia was associated with increased risk of PPH in singletons or vaginal deliveries. In women who delivered vaginally, preeclampsia was associated with a higher risk of PPH. The areas under the curve for the overall cohort, singletons, twin pregnancies, cesarean section cases, and vaginal deliveries were 0.832 (95% confidence interval [CI] 0.813–0.851), 0.824 (95% CI 0.803–0.845), 0.686 (95% CI 0.617–0.755), 0.854 (95% CI 0.834–0.874), and 0.690 (95% CI 0.646–0.735), respectively.Conclusions: The risk factors of PPH varied slightly based on the number of fetuses and the mode of delivery, while placenta previa and placenta accreta were the two major risk factors. A combination of the identified risk factors yielded a satisfactory predictive performance in determining PPH in the overall cohort, singletons pregnancies, and women who delivered by cesarean section, whereas the performance was moderate in twin pregnancies and in women delivering vaginally.

scholarly journals Failure of intrauterine contraception in a multigravida lady with an undiagnosed uterus didelphys: a case report

2020 ◽  
Vol 10 (1) ◽  
pp. 397
Author(s):  
Shreemanti Bhattacharyya ◽  
Partha S. Sarkar
Keyword(s):  
Uterine Horn ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Uterus Didelphys ◽  
Intrauterine Contraception ◽  
Vaginal Deliveries ◽  
Uterine Anomalies ◽  
Intrauterine Contraceptive ◽  
History Of ◽  
Uterine Malformations

Uterus didelphys remains one of the rarest uterine anomalies partly because; majority women experience no symptoms with an uneventful reproductive life. Despite the cost-effectiveness and efficacy paired with fewer side effects and convenience of using an intrauterine contraceptive device, it is most likely to prove futile in an unsuspected case of didelphic uterus resulting in an unintended pregnancy. Hence, intrauterine contraception is generally considered a contraindication in cases of uterine malformations. We present a case of a multigravida mother (G7 P3 L3 A3) with a history of three term vaginal deliveries, with an undiagnosed uterus didelphys, carrying a single live intrauterine pregnancy of approximately 6 weeks period of gestation, in the right uterine horn and a copper containing intrauterine contraceptive device in the left uterine horn, willing to undergo medical termination of pregnancy. A high index of suspicion, on the part of the gynaecologist as well as the radiologist, is required to investigate concurrent pregnancy with a history of an intrauterine contraceptive device insertion, in order to rule out rarer uterine malformations like uterus didelphys. Thorough history taking and clinical examination accompanied by improved imaging techniques should be performed at the time of first pregnancy in order to avoid an unsuitable placement of an intrauterine contraceptive device.

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