scholarly journals Impact of maternal age on intrapartum caesarean delivery rate in nulliparas with spontaneous labour

2019 ◽  
Vol 48 (6) ◽  
pp. 407-411 ◽  
Author(s):  
Simon Crequit ◽  
Diane Korb ◽  
Thomas Schmitz ◽  
Cécile Morin ◽  
Olivier Sibony
Keyword(s):  
Maternal Age ◽  
Caesarean Delivery ◽  
Delivery Rate ◽  
Spontaneous Labour ◽  
Caesarean Delivery Rate

scholarly journals Teaching and performing audits on caesarean delivery reduce the caesarean delivery rate

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0202475
Author(s):  
Emmanuelle Lesieur ◽  
Julie Blanc ◽  
Anderson Loundou ◽  
Arnaud Claquin ◽  
Michele Marcot ◽  
...  
Keyword(s):  
Caesarean Delivery ◽  
Delivery Rate ◽  
Caesarean Delivery Rate

scholarly journals Attributable factors for the rising caesarean delivery rate over three decades: an observational cohort study

2021 ◽  
Author(s):  
Bradley de Vries ◽  
Rhett Morton ◽  
Alice Burton ◽  
Praneel Kumar ◽  
Jon Hyett ◽  
...  
Keyword(s):  
Cohort Study ◽  
Caesarean Delivery ◽  
Observational Cohort Study ◽  
Delivery Rate ◽  
Multiple Gestation ◽  
Clinical Factors ◽  
Tertiary Referral Hospital ◽  
Obstetric Management ◽  
Observational Cohort ◽  
Caesarean Delivery Rate

Objective: Caesarean delivery rates continue to rise globally the reasons for which are poorly understood. We aimed to characterize attributable factors for increasing caesarean delivery rates over a 30-year period within our health network. Design: Observational cohort study. Setting: Two hospitals (large tertiary referral hospital and metropolitan hospital) in Sydney, Australia, across two time periods: 1989-1999 and 2009-2016, between which the caesarean delivery rate increased from 19% to 30%. Participants: All women who had a caesarean delivery after 24 weeks gestation Methods: Data were analysed using multiple imputation and robust Poisson regression to estimate the changes in the caesarean delivery rate attributable to maternal and clinical factors. Main outcome measures: Caesarean delivery. Results: Fifty-six percent of the increase in the rate of caesarean delivery was attributed to changes in the distribution of maternal factors including maternal age, body mass index, parity and history of previous caesarean delivery. When changes in the obstetric management of multiple gestation, malpresentation and preterm singleton birth were considered, 66% of the increase in caesarean rate was explained. When pre-labour caesarean deliveries for maternal choice, suspected fetal compromise, previous pregnancy issues and suspected large fetus were excluded, 78% of the increase was explained. Conclusions: Most of the steep rise in the caesarean delivery rate from 19% to 30% is attributable to changes in maternal demographic and clinical factors.

scholarly journals Induction of Labour an Audit of Indications and Obstetrical Outcome in a Tertiary Care Hospital

2016 ◽  
Vol 10 (2) ◽  
Author(s):  
G Jalil ◽  
R M. Malik ◽  
N Sohail ◽  
A Razaque
Keyword(s):  
Caesarean Delivery ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Induction Of Labour ◽  
Delivery Rate ◽  
Labour Induction ◽  
Care Hospital ◽  
Increased Risk ◽  
The Impact ◽  
Caesarean Delivery Rate

Objective: To examine the indications of induction of labour at Services Hospital Lahore, a tertiary) care hospital and to study the maternal and fetal outcomes of this obstetrical intervention. Study design:: This study involved a retrospective analysis of 100 patients with Bishop score Of ≤ 6, admitted for induction of labour, done with Prostaglandin E2 , pessary (Dinoprostone 3mg), followed by amniotomy and / or oxytocin infusion. A comparison of indications and outcomes was made among nullipara and multipara. Data was analyzed by X2’ and Student’s / test. Results: The induction rate was 8% and the commonest indication was hypertensive disorders of pregnancy 42%, followed by prolonged pregnancy 22% and pre- labour  rupture of membranes 21% . The mean induction to delivery interval was 21.2 hours for nullipara and 15. 1 hours  for parous   women,    p   =  0.00 was   statistically   significant.   The caesarean delivery rate was  higher   with   induced   labours  in nullipara 52% than in multipara 22%, the difference was statistically significant. 21% babies born with induced labours had Apgar score ≤ 4 and 8% required admission in neonatal intensive care unit. 17% patients had postnatal or post-operative complications. There were perinatal or maternal losses. Conclusion: It was concluded from  the  study  that  labour induction results in increased risk of operative delivery and longer hospital stay. Therefore,  all  obstetrical  units should monitor the frequency of labour  induction,  scrutinize  the  indications  and  assess  the  impact  of  induction  to  determine  the effect on caesarean delivery rate and perinatal  outcome.

scholarly journals Interinstitutional Variation of Caesarean Delivery Rates According to Indications in Selected Obstetric Populations: A Prospective Multicenter Study

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Gianpaolo Maso ◽  
Monica Piccoli ◽  
Marcella Montico ◽  
Lorenzo Monasta ◽  
Luca Ronfani ◽  
...  
Keyword(s):  
Caesarean Delivery ◽  
Relative Size ◽  
Group Classification ◽  
Prospective Multicenter Study ◽  
Nulliparous Women ◽  
Spontaneous Labour ◽  
Multiparous Women ◽  
Regional Centers ◽  
Spearman’S Correlation ◽  
Failure To Progress

The aim of the study was to identify which groups of women contribute to interinstitutional variation of caesarean delivery (CD) rates and which are the reasons for this variation. In this regard, 15,726 deliveries from 11 regional centers were evaluated using the 10-group classification system. Standardized indications for CD in each group were used. Spearman’s correlation coefficient was used to calculate (1) relationship between institutional CD rates and relative sizes/CD rates in each of the ten groups/centers; (2) correlation between institutional CD rates and indications for CD in each of the ten groups/centers. Overall CD rates correlated with both CD rates in spontaneous and induced labouring nulliparous women with a single cephalic pregnancy at term (P=0.005). Variation of CD rates was also dependent on relative size and CD rates in multiparous women with previous CD, single cephalic pregnancy at term (P<0.001). As for the indications, “cardiotocographic anomalies” and “failure to progress” in the group of nulliparous women in spontaneous labour and “one previous CD” in multiparous women previous CD correlated significantly with institutional CD rates (P=0.021,P=0.005, andP<0.001, resp.). These results supported the conclusion that only selected indications in specific obstetric groups accounted for interinstitutional variation of CD rates.

scholarly journals Spontaneous Rupture of the Anterior Vaginal Wall during the First Stage of Labour

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Meleesa Joy Schultz ◽  
Triveni Nanda
Keyword(s):  
Uterine Rupture ◽  
Spontaneous Rupture ◽  
Rare Case ◽  
Caesarean Delivery ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Multiparous Woman ◽  
Obstructed Labour ◽  
Trial Of Labor ◽  
Spontaneous Labour

The risk of uterine rupture during attempted trial of labor after caesarean delivery (TOLAC) is well documented. However, vaginal rupture (in the absence of obstructed labour) is exceptionally uncommon. Below is described the rare case of a 37-year-old multiparous woman attempting TOLAC, who suffered a vaginal—rather than uterine—rupture, during the first stage of spontaneous labour. This case is an important reminder to obstetricians that concealed ruptures of both the vagina and uterus do occur and must be considered in clinical situations where another explanation is not apparent.

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