scholarly journals 3096 Estimation of the Prevalence of Cesarean Delivery for the Extremely Preterm Fetus in Breech Presentation

2019 ◽  
Vol 3 (s1) ◽  
pp. 43-43
Author(s):  
Alissa Dangel ◽  
Janis L Breeze ◽  
Gordon Huggins ◽  
Michael House ◽  
Kumaran Kolandaivelu
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Breech Presentation ◽  
Vital Statistics ◽  
Target Range ◽  
Multiple Gestation ◽  
Cross Sectional ◽  
Cesarean Deliveries ◽  
Vaginal Deliveries ◽  
Extremely Preterm

OBJECTIVES/SPECIFIC AIMS: Cesarean delivery is typically performed in the extremely preterm period (23 to 28 weeks) when the fetus is in breech presentation to avoid the potential risk of head entrapment by an insufficiently dilated cervix during a vaginal delivery. Assessment of the prevalence of extremely preterm breech cesarean delivery would help to appropriately guide future clinical interventions designed to increase the feasibility of vaginal delivery for this sub-group of patients. METHODS/STUDY POPULATION: We performed a cross-sectional study of the 2106 U.S. National Vital Statistics birth certificate database to estimate the prevalence of cesarean deliveries performed during the period of gestation from 23 to 28 weeks with a fetus in breech presentation. RESULTS/ANTICIPATED RESULTS: An analysis of the total births in the 2016 registry (3,945,875) was performed. The gestational age was limited to the target range of 23 0/7 to 27 6/7 weeks. Multiple gestation deliveries were excluded. This yielded 16,092 births of which 4,849 were noted to have breech presentation. The proportion of cesarean deliveries performed for singleton breech fetuses at this gestational range was 87% (4,203/4,849). DISCUSSION/SIGNIFICANCE OF IMPACT: The probability of undergoing a cesarean delivery for an extremely preterm fetus in breech presentation is notably higher (87%) when compared to an overall cesarean delivery rate of 31.9%. Specific interventions to allow for vaginal delivery in this particular sub-group of the obstetric population would be useful to reduce maternal morbidity by increasing vaginal deliveries. Future work will attempt to address innovative solutions to prevent head entrapment by the cervix in this particular population and ultimately avoid cesarean delivery.

scholarly journals Fetomaternal outcome in operative vaginal delivery

2021 ◽  
Vol 10 (11) ◽  
pp. 4096
Author(s):  
Jeyamani B. ◽  
Nashreen Dhasleema A.
Keyword(s):  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Breech Presentation ◽  
P Value ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Second Stage ◽  
Operative Vaginal Delivery ◽  
Vaginal Deliveries ◽  
Assisted Delivery

Background: Operative vaginal deliveries (OVD) were performed with the help of vacuum or forceps in the second stage of labor when mother and foetus condition is threatening. A successful assisted vaginal delivery avoids caesarean section and its associated morbidity and implications for future pregnancy. The aim of the study was to assess the maternal and neonatal outcome of vacuum and forceps assisted vaginal deliveries.Methods: It was a retrospective comparative cross sectional study done in VMKVMCH, Salem in obstetrics and gynecology department, from the period of April to June 2021. All the mothers delivered by operative vaginal delivery were included. Mothers with multiple pregnancies, preterm and breech presentation were excluded. Data collected using patients information sheet and analysis was done using SPSS 23. P value <0.05 was considered significant.Results: The most common age group was 21-25 years of age in both groups and most commonly used in primigravida. The most common indication for forceps assisted delivery in our study was the prolonged second stage labour and in vacuum delivery was poor maternal effort. In our study, common complication noted was extended episiotomy followed by perineal tear in forceps group and vice versa in vacuum group. Cephalhematoma was found to be more common in vacuum and scalp and instrumental injuries were more common in forceps assisted vaginal deliveries.Conclusions: Operative vaginal deliveries helps in improving both maternal and foetal outcomes and reduces the caesarean delivery rate and vacuum significantly reduces maternal trauma than forceps. No difference noted in neonatal outcome. 

Comparison of Melatonin Levels in the Colostrum between Vaginal Delivery and Cesarean Delivery

2017 ◽  
Vol 35 (05) ◽  
pp. 481-485 ◽  
Author(s):  
Ziya Kalem ◽  
Tuncay Yuce ◽  
Batuhan Bakırarar ◽  
Feride Söylemez ◽  
Müberra Namlı Kalem
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Elective Cesarean Section ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional ◽  
Emergency Cesarean ◽  
Study Results ◽  
Elective Cesarean

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.

scholarly journals Differences in Expulsion on Post-placenta Intrauterine Contraceptive Device between Mother with Vaginal and Cesarean Delivery

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Atika Zahria Arisanti ◽  
Tono Djuwantono ◽  
Sri Endah Rahayuningsih
Keyword(s):  
General Hospital ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Intrauterine Device ◽  
Sampling Technique ◽  
Sectio Caesarea ◽  
Contraceptive Device ◽  
Cross Sectional ◽  
Post Placental

Intrauterine device (IUD) is a long term, highly effective, and reversible contraception method. In Indonesia, the number of IUD acceptors is still lower than other methods. An effort to improve the long term contraception is using post-placental IUD that can be a choice for postpartum mother who has limited access to another contraception service. The purpose of this study was to compare the incidence of expulsion in post-placental IUD insertion between mother with vaginal delivery and cesarean delivery. This study design was a comparative cross-sectional method with a consecutive sampling technique conducted at Dr. Hasan Sadikin General Hospital Bandung and Dr. Kariadi General Hospital Semarang from November 2017 to February 2018. Subjects were postpartum mothers who received post-placental IUD insertion at vaginal delivery and cesarean delivery. Samples were 96 women, consisting of 48 women with IUD insertion in vaginal delivery and 48 women with IUD insertion in cesarean delivery. Data obtained from interviews and transvaginal ultrasonography examination. The result showed there was a difference in expulsions incidence between IUD’s insertion among vaginal delivery compared to cesarean delivery (p=0.041). It concluded that expulsion’s to post-placental IUD insertion is higher in vaginal delivery compared to cesarean delivery. PERBEDAAN KEJADIAN EKSPULSI PADA PEMASANGAN ALAT KONTRASEPSI DALAM RAHIM PASCAPLASENTA ANTARA IBU DENGAN PERSALINAN PER VAGINAM DAN PERSALINAN SECTIO CAESAREAAlat kontrasepsi dalam rahim (AKDR) merupakan kontrasepsi jangka panjang, efektif dan reversibel. Di Indonesia, jumlah akseptor AKDR masih lebih rendah daripada metode lainnya. Salah satu upaya untuk meningkatkan penggunaan kontrasepsi jangka panjang, yaitu dengan AKDR pascaplasenta yang dapat menjadi alternatif bagi ibu pascasalin yang mempunyai akses terbatas untuk mendapatkan pelayanan kontrasepsi. Penelitian ini bertujuan membandingkan kejadian ekspulsi pada pemasangan AKDR pascaplasenta antara ibu dengan persalinan per vaginam dan persalinan sectio caesarea. Desain penelitian ini adalah cross-sectional komparatif dengan teknik pengambilan sampel consecutive yang dilaksanakan di RSUP Dr. Hasan Sadikin Bandung dan RSUP Dr. Kariadi Semarang dari bulan November 2017 hingga Februari 2018. Subjek penelitian adalah ibu pascasalin yang mendapatkan insersi AKDR pascaplasenta pada persalinan per vaginam dan persalinan sesar. Jumlah sampel 96 ibu, terdiri atas 48 ibu yang bersalin per vaginam dan 48 ibu yang bersalin sesar. Data didapatkan melalui wawancara dan pemeriksaan ultrasonografi transvaginal. Hasil penelitian menunjukkan terdapat perbedaan kejadian ekspulsi pada pemasangan AKDR antara ibu dengan persalinan per vaginam dan persalinan sectio caesarea (p=0,041). Simpulan, kejadian ekspulsi pada pemasangan AKDR pascaplasenta lebih tinggi pada ibu dengan persalinan per vaginam dibanding dengan persalinan sectio caesarea.

scholarly journals Obstetric and Neonatal Outcome in Second-Pregnancy Patients with One Prior Cesarean Section at A Costarican Hospital 2006-2007

2011 ◽  
Vol 52 (1) ◽  
Author(s):  
Manrique Leal Mateos ◽  
Loretta Giacomin Carmiol ◽  
Rafael A Moya Sibaja
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Neonatal Resuscitation ◽  
Obstetric Complications ◽  
Obstetric Outcomes ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Neonatal Complications ◽  
Vaginal Deliveries ◽  
Prior Cesarean Section

Aim: To analyze neonatal and obstetric outcomes in second-pregnancy patients with 1 prior cesarean section.Materials and methods: This study is a cross-sectional observational study. We analyzed 306 medical records of patients treated at the Dr. Rafael A. Calderón Guardia Hospital (HCG), from January 1st 2006 to December 31st of 2007. Maternal variables associated to prenatal control were age and obstetrical indication of the previous cesarean delivery. Variables associated to delivery were gestational age, type of delivery, obstetric complications, and length of hospital stay. The neonatal variables were weight at birth, 5 minute Apgar score, neonatal complications, need for neonatal resuscitation or newborn hospitalization and length of hospital stay.Results: 59, 1% of the patients with 1 prior cesarean section had successful vaginal delivery. The percentage of maternal complications was significantly higher for those who underwent a cesarean section during labor.Uterine rupture occurred in 1,3% of the cases and no maternal or neonatal deaths were found as a consequence of such complication. The percentage of neonatal complications was similar for both groups. The need for neonatal resuscitation was significantly higher in the group that underwent an elective caesarean delivery.Conclusion: Our results show that at the HCG from January 1st 2006 to December 31st of 2007, a vaginal delivery in second-pregnancy patients with 1 prior caesarean delivery appears to be safe. The percentage of successful vaginal deliveries, obstetric complications and uterine rupture were similar to those reported in international literature. 

scholarly journals Assisted Vaginal Delivery - Preference of Vacuum or Forceps among Obstetricians

2021 ◽  
pp. 147-155
Author(s):  
Vijayalakshmi Gnanasekaran ◽  
Shantha Kanamma ◽  
Shanthi Dhinakaran ◽  
Jikki Kalaiselvi
Keyword(s):  
Vaginal Delivery ◽  
Entire Group ◽  
P Value ◽  
Significant Finding ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Assisted Vaginal Delivery ◽  
Choice Of Procedure ◽  
Vaginal Deliveries ◽  
Assisted Delivery

Objective: To determine the instrument preference among obstetricians practicing operative vaginal deliveries and to determine the prevalence and risks of vacuum or forceps Assisted Vaginal Delivery (AVD). Methods: This cross-sectional study was carried out in ACS Medical and Hospital, Chennai. A total of 520 obstetricians were included in the study. An online questionnaire was sent to all obstetricians in Chennai. The choice of procedure for specific circumstances, instrument preference [use of vacuum or forceps] and views on the complications encountered in both vacuum and forceps use at vaginal delivery were explored. For the replies, we computed means and percentages for the entire group and distinct subgroups. Risk assessment of outcome with exposure as suitable p-value was included in the statistical analysis. Results: Response rate for the questionnaire was 97% (504/520). The findings suggest that obstetricians preference was more towards vacuum due to their ease of usage.   Baseline characteristics were similar between the two groups. Failed vacuum due to slipping of the cup was the most common complication faced - 62%, followed by caput succedaneum 25%, both were statistically significant. The most significant finding was that maternal injuries in the vacuum group were only 2% which was way less than those who had forceps delivery (68%) with a p-value of < 0.001. Conclusion: In this research, physician instrument choice is a significant predictor of results that should be taken into account. Use of vacuum for delivery seemed to be the choice of majority of obstetricians [334 (66%)]. Vacuum extractor rather than forceps for assisted delivery appears to reduce maternal morbidity, whereas neonatal injuries were more common in newborns delivered by vacuum. The choice of instrument should be personalized based on the patient's condition and the obstetrician's experience and expertise.

scholarly journals Cesarean Section Among all Deliveries in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (241) ◽  
pp. 839-843
Author(s):  
Renuka Tamrakar ◽  
Sachin Sapkota ◽  
Deekshanta Sitaula ◽  
Rohit Thapa ◽  
Bandana Pokharel ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cesarean Deliveries

Introduction: Worldwide there is a tremendous increase in cesarean section rate over the last decades which has been a global public health issue. This study aimed to find out the prevalence of cesarean delivery in a tertiary care center of Nepal. Methods: A descriptive cross-sectional study was conducted among pregnant women at tertiary care centre from 15th September 2019 to 15th October 2020. Ethical clearance was taken from the Institutional Review Committee (Ref: CMC-IRC/077/078-200). Convenience sampling was done to reach the sample size. Basic demographic data, clinical indications and neonatal outcomes were noted. Data entry was done using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 3193 total deliveries, cesarean deliveries were 1412 (44.22%) at 95% Confidence Interval (42.49-45.94). Among caesarean deliveries 1086 (76.9%) were emergency cesarean sections. Most common indication for cesarean section was fetal distress (24.9%). Among 1437 newborns, 1428 (99.4%) were live births, 1387 (98.2%) were singleton and 801 (55.7%) were male. Nearly one third 418 (29.1%) neonates required neonatal intensive care unit admission and transient tachypnoea of newborns (44.28% in emergency and 60.46% in elective cesarean delivery) was the most common indication for admission. Conclusions: The prevalence of cesarean delivery was found to be higher than that recommended by the World Health Organisation. Fetal distress was the leading indication for cesarean deliveries.

Antibiotics for 3rd and 4th Degree Vaginal Lacerations, Uterine Tamponade, and Manual Placental Extraction

2019 ◽  
Vol 37 (01) ◽  
pp. 092-103
Author(s):  
Conrad N. Stern-Ascher ◽  
Yongmei Huang ◽  
Cassandra R. Duffy ◽  
Maria Andrikopoulou ◽  
Jason D. Wright ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Antibiotic Use ◽  
The United States ◽  
Sensitivity Analyses ◽  
Antibiotic Administration ◽  
Cross Sectional ◽  
Adjusted Risk ◽  
Clinical Scenarios ◽  
Vaginal Deliveries ◽  
Log Linear

Abstract Objective Trends in use of antibiotics during delivery hospitalizations complicated by (1) 3rd/4th degree vaginal lacerations, (2) manual placenta extraction, and (3) uterine tamponade are not well characterized. The objective of this study was to analyze trends in antibiotic use during vaginal delivery hospitalizations complicated by these three clinical scenarios. Study Design An administrative inpatient database was used to perform a serial cross-sectional analysis of antibiotic administration during delivery hospitalizations in the United States from January 2006 to March 2015. The primary outcome was receipt of antibiotics during vaginal delivery hospitalizations complicated by (1) 3rd and 4th degree vaginal lacerations, (2) manual placenta extraction, and (3) uterine tamponade. Patients with other indications for antibiotics were excluded. The Cochran–Armitage test was used to assess trends. Adjusted log linear regression analyses including demographic, hospital, and obstetric factors were performed to analyze factors associated with antibiotic receipt for each of these three clinical scenarios in both primary and sensitivity analyses. Results From 2006 to 2015 the rate of antibiotic administration during delivery hospitalizations decreased from 43.1% in 2006 to 25.5% for 3rd and 4th degree lacerations and from 59.6% to 49.2% for manual extraction (p < 0.01). Administration of antibiotics in the setting of uterine tamponade decreased from 48.6% in 2006 to 27.6% in 2009 before rising to 62.5% in the first quarter of 2015. In adjusted analyses, comparing the first quarter of 2015 to 2006 adjusted risk ratios for antibiotic administration were 0.61 (95% confidence interval [CI] 0.56–0.66) for 3rd and 4th degree vaginal lacerations, 0.76 (95% CI 0.53–1.09) for manual placental extraction, and 0.83 (95% CI 0.76–0.92) for uterine tamponade. Conclusion Antibiotics are not used consistently during vaginal deliveries complicated by 3rd/4th degree lacerations, manual placenta extraction, and uterine tamponade. These findings support that a significant opportunity exists for comparative effectiveness research to assist in characterizing best practices.

scholarly journals VAGINAL BIRTH AFTER CAESAREAN SECTION;

2013 ◽  
Vol 20 (05) ◽  
pp. 759-764
Author(s):  
SANA ZAHIRUDDIN ◽  
SUMERA RAUF QURESHI ◽  
UMER FAROOQ
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Vaginal Delivery ◽  
Breech Presentation ◽  
Vaginal Birth ◽  
University Hospital ◽  
Cross Sectional ◽  
Study Results ◽  
Previous Cesarean ◽  
Vaginal Birth After Caesarean

Background: Cesarean section is the commonest obstetrical procedure, associated with increase in maternal morbidity,the cesarean section rate is steadily on the rise in our country which can give rise to a number of complications. Objective: To determinethe factors associated with successful vaginal delivery after previous cesarean section. Study Design: Cross sectional study. Period:May 2009 to October 2009. Setting: Liaquat university hospital, Hyderabad. Material and Methods: a total of 96 women which fulfilledthe selection criteria were included in the study. Results: The women included in the study had a mean age of+SD(range),29.94+4.41successful vaginal birth was observed in 57(59.5%) women and 39(40.6%) had an emergency repeat cesareandelivery. The factors favoring successful vaginal delivery were history of previous vaginal delivery and previous cesarean due to fetaldistress or breech presentation, and patients having cesarean due to non progress of labor and no prior vaginal delivery were less likely tohave a successful vaginal birth after having previous cesarean delivery. Conclusions: vaginal birth after caesarean section can berecommended in patients having prior vaginal delivery and previous caesarean due to fetal distress and breech presentation.

scholarly journals Timely initiation of breastfeeding and associated factors among mothers with vaginal and cesarean deliveries in public hospitals of Addis Ababa

2021 ◽  
Author(s):  
Adane Mekonnen ◽  
Zewdu Shewangizaw
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Associated Factors ◽  
Addis Ababa ◽  
Public Hospitals ◽  
Breastfeeding Initiation ◽  
Timely Initiation ◽  
Vaginal Deliveries ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding

Abstract Background WHO and UNICEF recommend breastfeeding to be initiated within the first hour of birth. It is possible to initiate breastfeeding within an hour of birth regardless of the method of delivery. Despite this, the practice of timely initiation of breastfeeding remains low in Ethiopia with both delivery modalities. Therefore, this study aims to compare timely initiation of breastfeeding and associated factors with cesarean and vaginal deliveries in public hospitals of Addis Ababa, 2021. Methods and materials: Comparative cross-sectional study was conducted from January 2021 to February 2021 in public hospitals of Addis Ababa. 322 mothers within three days of delivery at the postnatal ward of the respective public hospitals were selected. A multi-stage sampling method was employed with the final participants being recruited by systematic random sampling. Data was entered to Epi data Version 4.6 and analysis was performed by SPSS Version 26. A Binary and multivariate logistic regression statistical model was used. Adjusted odds ratio with 95% CI was computed to see the strength of association. Result Timely breastfeeding initiation was 79 (51.2%) and 123 (80%) for cesarean and vaginal deliveries. With a vaginal delivery, pre-lacteal feeding (AOR= 5.50, 95% CI:1.83-16.57) was significantly associated with timely initiation of breastfeeding. Multiparty (AOR= 2.14, 95% CI: 1.02-4.50), support from health care worker (AOR= 2.602, 95% CI: 1.16-5.82), and pre-lacteal feeding (AOR= 2.55, 95% CI: 1.13-5.75) were significantly associated with timely initiation of breastfeeding with cesarean delivery. Conclusion The rate of timely initiation of breastfeeding differs according to the mode of delivery. Cesarean delivery, as compared to vaginal delivery, was associated with a higher mean and median time for initiation of breastfeeding.

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