P-078. Profile of cesarean delivery care in hypertensive pregnant women

Abstract Background A high rate of cesarean delivery has become a cause of global concern. Although the rate of cesarean delivery has declined over recent years, it remains at a high level largely because of cesarean delivery on maternal request (CDMR). Unnecessary cesarean delivery has limited significance in benefiting maternal and infant physical health; in some ways, it might pose potential risks instead. With the implementation of the “Two-child Policy” in China, an increasing number of women plan to have a second child. Accordingly, how to handle the CDMR rate in China remains an important issue. Methods Data were collected from a longitudinal follow-up study conducted in Chongqing, China, from 2018 to 2019. A structured questionnaire was administered to subjects for data collection. Basic information, including demographic characteristics, living habits, medical history, and follow-up data of pregnant women, as well as their families and society, was collected. Additionally, delivery outcomes were recorded. Logistic regression was performed to analyze the factors influencing CDMR. Results The rate of cesarean delivery in Chongqing, China was 36.01 %, and the CDMR rate was 8.42 %. Maternal request (23.38 %), fetal distress (22.73 %), and pregnancy complications (9.96 %) were the top three indications for cesarean delivery. Logistic regression analysis showed that older age (OR = 4.292, 95 % CI: 1.984–9.283) and being a primiparous woman (OR = 6.792, 95 % CI: 3.230-14.281) were risk factors for CDMR. In addition, CDMR was also associated with factors such as the tendency to choose cesarean delivery during late pregnancy (OR = 5.525, 95 % CI: 2.116–14.431), frequent contact with mothers who had undergone vaginal deliveries (OR = 0.547, 95 % CI: 0.311–0.961), and the recommendation of cesarean delivery by doctors (OR = 4.071, 95 % CI: 1.007–16.455). Conclusions “Maternal request” has become the primary indication for cesarean delivery. The occurrence of CDMR is related to both the personal factors of women during pregnancy and others. Medical institutions and obstetricians should continue popularizing delivery knowledge among pregnant women, enhancing their own professional knowledge about delivery, adhering to the standard indications for cesarean delivery, and providing pregnant women with adequate opportunities for attempting vaginal delivery.

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Formulating an anesthetic plan using a list of high-risk pregnant women on cloud-based business communication tools: a case report

JA Clinical Reports ◽

10.1186/s40981-021-00430-2 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Junnosuke Kimura ◽

Kento Kawamura ◽

Manami Minoura ◽

Ayako Hiramoto ◽

Yoshifumi Suga ◽

...

Keyword(s):

Case Report ◽

High Risk ◽

Cesarean Section ◽

General Anesthesia ◽

Pregnant Women ◽

Cesarean Delivery ◽

Business Communication ◽

Communication Tools ◽

Case Presentation ◽

Emergency Cesarean

Abstract Background We report a case in which a list of high-risk pregnant women on cloud-based business communication tools was useful in formulating an anesthetic plan for unscheduled cesarean section. Case presentation A 37-year-old woman, who had been prescribed icosapentate for hypertriglyceridemia, received an antenatal anesthetic evaluation for possible cesarean delivery, and it was agreed that the anesthetic method for emergency cesarean section was general anesthesia if the surgery would take place within 7 days after the discontinuation of the drug, and regional anesthesia if it would take place any time later. Then this agreement was uploaded on the cloud-based business communication tools, and updated until she delivered her baby via unscheduled cesarean section. Conclusions A cloud-based business communication tools was useful in formulating an anesthesia plan for a patient undergoing a cesarean delivery. However, more discussion would be needed to utilize it in security.

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Puerperal infection from the perspective of humanized delivery care at a public maternity hospital

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692007000400003 ◽

2007 ◽

Vol 15 (4) ◽

pp. 536-542 ◽

Cited By ~ 3

Author(s):

Elisângela Euripedes Resende Guimarães ◽

Tânia Couto Machado Chianca ◽

Adriana Cristina de Oliveira

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cesarean Delivery ◽

Maternity Hospital ◽

Delivery Care ◽

Cesarean Sections ◽

Normal Delivery ◽

Puerperal Infection ◽

Concurrent Study ◽

Effective Conditions

This is an epidemiological, prospective and non-concurrent study of the cohort type about puerperal infection from the perspective of humanized delivery care, based on information from 5,178 records of patients who went through the experience of humanized delivery. The study aimed at describing the women who underwent humanized delivery, determining the incidence and time for manifestation of puerperal infections and investigating the association between the infection and the risk factors. An accumulated puerperal infection rate of 2.92% was found. The risk factors associated to puerperal infection in Cesarean delivery were the duration of labor and the number of digital examinations. No variable behaved as a risk factor for infection in normal delivery. Cesarean delivery was an important risk factor for puerperal infection. The results reinforce the need to develop alternative forms of delivery care that provides effective conditions for normal delivery, in order to reduce the number of Cesarean sections.

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Determinants of utilization of antenatal and delivery care at the community level in rural Bangladesh

PLoS ONE ◽

10.1371/journal.pone.0257782 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257782

Author(s):

Jesmin Pervin ◽

Mahima Venkateswaran ◽

U. Tin Nu ◽

Monjur Rahman ◽

Brian F. O’Donnell ◽

...

Keyword(s):

Logistic Regression ◽

Antenatal Care ◽

Pregnant Women ◽

Facility Delivery ◽

Health Facilities ◽

Community Level ◽

Delivery Care ◽

Multivariate Logistic Regression ◽

Antenatal Care Visit ◽

Care Visit

Background Timely utilization of antenatal care and delivery services supports the health of mothers and babies. Few studies exist on the utilization and determinants of timely ANC and use of different types of health facilities at the community level in Bangladesh. This study aims to assess the utilization, timeliness of, and socio-demographic determinants of antenatal and delivery care services in two sub-districts in Bangladesh. Methods This cross-sectional study used data collected through a structured questionnaire in the eRegMat cluster-randomized controlled trial, which enrolled pregnant women between October 2018-June 2020. We undertook univariate and multivariate logistic regression analysis to determine the associations of socio-demographic variables with timely first ANC, four timely ANC visits, and facility delivery. We considered the associations in the multivariate logistic regression as statistically significant if the p-value was found to be <0.05. Results are presented as adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results Data were available on 3293 pregnant women. Attendance at a timely first antenatal care visit was 59%. Uptake of four timely antenatal care visits was 4.2%. About three-fourths of the women delivered in a health facility. Women from all socio-economic groups gradually shifted from using public health facilities to private hospitals as the pregnancy advanced. Timely first antenatal care visit was associated with: women over 30 years of age (AOR: 1.52, 95% CI: 1.05–2.19); nulliparity (AOR: 1.30, 95% CI: 1.04–1.62); husbands with >10 years of education (AOR: 1.40, 95% CI: 1.09–1.81) and being in the highest wealth quintile (AOR: 1.49, 95% CI: 1.18–1.89). Facility deliveries were associated with woman’s age; parity; education; the husband’s education, and wealth index. None of the available socio-demographic factors were associated with four timely antenatal care visits. Conclusions The study observed socio-demographic inequalities associated with increased utilization of timely first antenatal care visit and facility delivery. The pregnant women, irrespective of wealth shifted from public to private facilities for their antenatal care visits and delivery. To increase the health service utilization and promote good health, maternal health care programs should pay particular attention to young, multiparous women, of low socio-economic status, or with poorly educated husbands. Clinical trial registration ISRCTN69491836; https://www.isrctn.com/. Registered on December 06, 2018. Retrospectively registered.

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Anesthesiologic management of pregnant women with SARS-COV-2 infection undergoing cesarean delivery

Clinical and Experimental Obstetrics & Gynecology ◽

10.31083/j.ceog.2021.03.2446 ◽

2021 ◽

Vol 48 (3) ◽

pp. 628

Keyword(s):

Pregnant Women ◽

Cesarean Delivery

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CLINICAL CHARACTERISTICS AND FETO-MATERNAL OUTCOMES IN PREGNANT WOMEN WITH COVID -19 INFECTIONS

10.36106/ijsr/6704051 ◽

2021 ◽

pp. 30-32

Author(s):

Gulshan Bano ◽

Anubha Prashad ◽

Rakhee Soni ◽

Mohammed Mishal

Keyword(s):

Pregnant Women ◽

Cesarean Delivery ◽

Clinical Features ◽

Clinical Characteristics ◽

Maternal Outcomes ◽

Hypertensive Disorder ◽

Co Morbidity ◽

Hypertensive Disorder Of Pregnancy ◽

The Mean ◽

In Pregnancy

Background and objectives:-COVID-19 is ongoing pandemic, caused by novel Corona Virus. There is very scarce information is available about clinical features and feto-maternal outcomes of COVID-19 in pregnancy. Therefore, this study was aimed to determine clinical characteristics and feto-maternal outcomes of pregnant women with COVID-19. Methods- In this retrospective study, we included all pregnant women admitted with COVID-19 over three months. Clinical features, laboratory ndings and feto-maternal outcomes were assessed.Results:-The mean age of the patients was 24 years. Hypertensive disorder of pregnancy was most common associated co-morbidity. Majority of patients (81%) were asymptomatic. Lymphocytopenia was seen in 58% of the patients and 47% had elevated levels of CRP. All patients who presented in rst trimester had spontaneous abortion. There is relatively higher rate of preterm birth (21%) and cesarean delivery(43%). All the neonates were tested negative for COVID-19. Conclusion;- There is relatively higher rate of cesarean delivery. Overall feto-maternal outcome was good and there was no evidence of vertical transmission.

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When Consent Does Not Help

American Journal of Law & Medicine ◽

10.1177/0098858817753405 ◽

2017 ◽

Vol 43 (4) ◽

pp. 388-425 ◽

Cited By ~ 2

Author(s):

Hindi E. Stohl

Keyword(s):

Informed Consent ◽

Pregnant Women ◽

Cesarean Delivery ◽

Medical Malpractice ◽

Reproductive Rights ◽

Vaginal Birth ◽

Legal Remedy ◽

Malpractice Reform

Pregnant women with a prior cesarean delivery face challenges in accessing a vaginal birth due to both hospital and provider preferences and practices. Although the doctrine of informed consent secures women's reproductive rights, it is not a viable legal remedy. Instead, women should champion increased maternity-related education and transparency as well as medical malpractice reform to increase the desired access.

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Antimicrobial Dressing versus Standard Dressing in Obese Women Undergoing Cesarean Delivery: A Randomized Controlled Trial

American Journal of Perinatology ◽

10.1055/s-0040-1721112 ◽

2020 ◽

Author(s):

Antonio F. Saad ◽

Ashley E. Salazar ◽

Lindsey Allen ◽

George R. Saade

Keyword(s):

Randomized Controlled Trial ◽

Patient Satisfaction ◽

Pregnant Women ◽

Cesarean Delivery ◽

Wound Dressing ◽

Controlled Trial ◽

Population Characteristics ◽

Standard Group ◽

Provider Satisfaction ◽

Randomized Controlled

Objective This study aimed to evaluate the effect of a novel antimicrobial dressing on patient satisfaction and health-related quality of life (HRQoL) following a cesarean delivery. Study Design This was an open-label, single-center, two-arm randomized controlled trial. This study was done at the tertiary center, maternal unit, Galveston, TX. Pregnant women with body mass indices ≥35 kg/m2 were screened for eligibility. Women were randomized to ReliaTect Post-Op Dressing (RELIATECT) or standard wound dressing (STANDARD). Primary outcome was patient satisfaction and HRQoL using validated questionnaires. Secondary outcomes were provider satisfaction, surgical site infection (SSI) rates, and wound complications. Results In total, 160 women were randomized. Population characteristics were not significant among groups. RELIATECT dressing group had an overall higher score of satisfaction and HRQoL compared with STANDARD group. Women in the RELIATECT group reported less incision odor and incisional pain. Compared with the STANDARD group, most women in RELIATECT dressing group reported better daily activities, self-esteem, personal hygiene, body image, and sleep. Providers reported that the RELIATECT dressing allowed better assessment of the surgical incision site, allowed patients to shower early, and did observe less wound dressing leakage. No differences were found in other secondary end points. Conclusion Postcesarean RELIATECT dressing for wound care in pregnant women with obesity had better patient and provider satisfaction as well as better HRQoL scores. Further, level 1 evidence is needed to assess its impact on SSI rates and wound complication, as this trial was not powered to accomplish this goal. Key Points

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