Triplet and Higher-Order Births: What Is the Optimal Delivery Route?

1988 ◽  
Vol 37 (1) ◽  
pp. 89-98 ◽  
Author(s):  
M. Thiery ◽  
G. Kermans ◽  
R. Derom
Keyword(s):  
Antenatal Care ◽  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Neonatal Outcome ◽  
Higher Order ◽  
Delivery Rate ◽  
Delivery Route ◽  
Abdominal Delivery

AbstractData concerning 16 triplet and higher-order deliveries (resulting in a total of 56 infants) are reviewed. The vaginal delivery rate was 81%. Maternal morbidity was more serious after abdominal delivery. Prematurity (< 36 weeks gestation) rate amounted to 68%. Overall perinatal and neonatal mortalities for infants born after 28 weeks gestation and weighing at least 1000 g were 7% and 3%, respectively. We doubt that neonatal outcome could have been markedly improved by performing more cesareans. The importance of antenatal care is stressed.

scholarly journals Vaginal Delivery versus Elective Caesarean Section for Breech Presentation - Experience in Institute of Child and Mother Health (ICMH)

2019 ◽  
Vol 31 (1) ◽  
pp. 23-26
Author(s):  
Mahe Jabeen ◽  
Sabiha Shimul ◽  
Ummay Salma ◽  
Jebunnesa
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Neonatal Outcome ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Cost Of Care ◽  
Increased Risk

Introduction: Compared with a fetus with cephalic presentation, a breech fetus faces increased risk during labour and delivery of asphyxia from cord compression and of traumatic injury during delivery of the shoulders and head. Caesarean section avoids most of this risk. The purpose of this study was to evaluate the feasibility of vaginal delivery of uncomplicated singleton breech presentation by evaluating early neonatal morbidity and mortality as well as maternal morbidity following vaginal and caesarean delivery for breech presentation. Materials and Methods: This is a cross sectional comparative study.104 women with singleton breech presentation at term in labour were included consequetively in labour ward of Institute of Child and Mother Health (ICMH). Informed consent was taken from them. Neonatal and maternal outcome were recorded and statistical analysis was done using SPSS version 22. Results: APGAR at 5 min and Neonatal Intensive Care Unite (NICU) admission were not affected by mode of delivery. Long term neonatal outcome is similar in either mode of delivery. Maternal morbidity and duration of hospital stay is increased in caesarean births. Conclusion: Neonatal outcome did not depend on mode of delivery though maternal morbidity and cost of care is increased following Caesarean Section. Proper selection of cases and by improving skill & confidence in new generation obstetrician, vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to a woman in a tertiary care centre. Medicine Today 2019 Vol.31(1): 23-26

scholarly journals Feto-maternal Outcome of Vaginal Delivery and Caesarean Section in Eclamptic Patients

2016 ◽  
Vol 24 (2) ◽  
pp. 92-98
Author(s):  
Nazneen Begum ◽  
Shawkat Jahan ◽  
Shikha Ganguly ◽  
Begum Rokeya Anwar
Keyword(s):  
Caesarean Section ◽  
Antenatal Care ◽  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Emergency Situation ◽  
Contributing Factors ◽  
College Hospital ◽  
Socioeconomic Condition ◽  
Low Socioeconomic ◽  
Medical College

Eclampsia is a major cause of maternal morbidity and mortality. It is largely a preventable disease provided the pregnant women get regular antenatal care. It’s incidence in Bangladesh is still high. Lack of health education, low socioeconomic condition, lack of adequate facilities to deal with the emergency situation, inadequate referral and transfer system are important contributing factors of consideration. In many peripheral centers, facilities to deal with such a complicated patient are absent. This prospective study was conducted in the eclampsia ward in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, Dhaka, from July to December, 2004. Our aim was to identify the better mode of termination of pregnancy in eclamptic patients. Hundred antenatal eclamptic patients were purposively selected for the study. Eclampsia is a disease of relatively younger age group. Out of 100 patients, 53 percent were < 20 years of age, 42 percent patients were primigravida and 67 percent patients were from low socioeconomic condition. 72 percent patients of vaginal delivery group and 60 percent patients of caesarean section group had no antenatal care (ANC). Maternal morbidity was more in vaginal delivery group (56%) than in caesarean section group (36%). Maternal mortality rate was 4% in both the groups. Perinatal mortality was higher in vaginal delivery (36%) than in caesarean section group (22%).J Dhaka Medical College, Vol. 24, No.2, October, 2015, Page 92-98

scholarly journals Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110183
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Birth Asphyxia ◽  
Public Hospitals ◽  
Obstructed Labor ◽  
Eastern Ethiopia ◽  
Adverse Neonatal Outcome ◽  
Follow Up Study

The adverse neonatal outcome is defined as the presence of birth asphyxia, respiratory distress, birth trauma, hypothermia, meconium aspiration syndrome, neonatal intensive care admission, and neonatal death. It is a major concern in developing countries, including Ethiopia. This study tried to identify predictors of adverse neonatal outcomes at selected public hospitals in Eastern Ethiopia. A hospital-based prospective follow-up study was conducted in three public hospitals in Eastern Ethiopia from June to October 2020. A total of 2,246 laboring women and neonates born at the hospitals were enrolled in the study. Data were collected through interviews, observation checklists, and clinical chart review. Reports were presented in relative risks with 95% CIs. The overall magnitude of adverse neonatal outcome was 20.97% (95% CI: 19.33- 22.71%). It was 24.3% for babies born through cesarean section (95% CI: 21.3%, 27.5). The presence of meconium in the amniotic fluid increased the risk for neonates delivered via cesarean section (ARR, 1.52 95% CI; 1.04, 2.22). Among neonates born via vaginal delivery, the risk of adverse neonatal outcome was higher among nullipara women (ARR, 1.42 95% CI; 1.02, 1.99) and among women diagnosed with abnormal labor or pregnancy such as APH, pre-eclampsia, obstructed labor, fetal distress, and mal-presentation at admission (ARR, 1.30 95%CI; 1.01, 1.67). The risk of adverse neonatal outcome was higher among babies born through the cesarian section than those born via vaginal delivery. Abnormal labor or pregnancy and being primiparous increased the risk of adverse neonatal outcome in vaginal delivery.

scholarly journals Poor Antenatal care and Neonatal outcome: An experience of a Developing Nation

2021 ◽  
Vol 2022 (1) ◽  
Author(s):  
Sufia Athar ◽  
Manjusha Ramanunny ◽  
Rohini Puttegowda ◽  
Kamal Atta Mustafa Ahmed ◽  
Hiba Mahmoud Hassan Satti ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Neonatal Outcome ◽  
Developing Nation

scholarly journals Delivery of Twin Gestation (≥ 32.0 Weeks): The Vaginal Route as a Practicable and Safe Alternative to Cesarean Section

2020 ◽  
Vol 80 (10) ◽  
pp. 1033-1040
Author(s):  
Anne Dathan-Stumpf ◽  
Katharina Winkel ◽  
Holger Stepan
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Neonatal Outcomes ◽  
University Hospital ◽  
Delivery Mode ◽  
Safe Alternative ◽  
Vaginal Deliveries ◽  
Twin Pregnancies ◽  
Second Twin

Abstract Objective The appropriate delivery mode for twins is discussed controversially in the literature. The aim of this study was to investigate delivery modes and short-term neonatal outcomes of twin pregnancies delivered in University Hospital Leipzig. Material and Methods A total of 274 twin pregnancies (32.0 to 39.4 weeks of gestation) delivered between 2015 and 2017 were analyzed retrospectively with regard to the planned and final delivery mode as well as neonatal outcomes. The inclusion and exclusion criteria for vaginal delivery were comparable to those of the Twin Birth Study. Results The spontaneous birth rate for births planned as vaginal deliveries was 78.5%; the rate of secondary cesarean section was 19.4%. The final total cesarean rate was 58.8%, and the rate of vaginal deliveries was 41.2%. Vertex or non-vertex position of the second twin had no significant effect on neonatal outcome or mean delivery interval between the birth of the first and second twin. Chorionicity, neonatal weight and gender had no significant impact on delivery mode. However, successful vaginal delivery was associated with higher gestational age and both fetuses in vertex position. The combined neonatal outcome for both twins was significantly worse if they were delivered by cesarean section compared to spontaneous birth. In addition, the leading twin in monochorionic/diamniotic (MC/DA) pregnancies was intubated more frequently after cesarean delivery and had significantly lower Apgar scores. Conclusion Vaginal delivery in twin pregnancies is a practicable and safe option in specific defined conditions and when the appropriate infrastructure and clinical experience is available.

scholarly journals Evaluation of induction of labour in a tertiary care hospital

2020 ◽  
Vol 9 (4) ◽  
pp. 1361
Author(s):  
Janupalli Kiran Poornima ◽  
Vijayalakshmi K. ◽  
Anuradha C. R. ◽  
Famida . ◽  
Sai Latha R.
Keyword(s):  
Vaginal Delivery ◽  
Apgar Score ◽  
Induction Of Labour ◽  
Delivery Rate ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Normal Delivery ◽  
Operative Vaginal Delivery ◽  
Misoprostol Group ◽  
Oxytocin Augmentation

Background: The objective is to evaluate the preferred methods for labor induction, including incidence of caesarean section, operative and normal vaginal delivery rate, need for oxytocin augmentation, and Apgar score at 1 and 5 min.Methods: This was a hospital-based study carried out in 110 inductions of labour during the study period. misoprostol 50 mcg was inserted in posterior fornix of vaginal in cases with PROM and intracervical 0.5 mg Dinoprostone for other causes in whom induction was decided. Maternal and neonatal outcomes were observed. collected data were analyzed using SPSS and MS excel.Results: Most preferred methods of induction of labour were observed to be Dinoprostone and Misoprostol, augmentation was done by oxytocin. normal delivery rate was 54% in Dinoprostone gel and 58.3% in misoprostol group. Caesarean and operative vaginal delivery rates were 42.8%, 3% in Dinoprostone gel group and 33.3%, 8.3% respectively in misoprostol group. Mean Apgar scores were observed to be similar in both methods of induction at 1st and 5th minutes.Conclusions: It was found that misoprostol had higher percentage of normal and operative vaginal delivery and need for oxytocin augmentation than Dinoprostone. Neonatal outcome as predicted by Apgar score were similar in both groups.

scholarly journals Perinatal and maternal morbidity and mortality after attempted operative vaginal delivery at midpelvic station

2017 ◽  
Vol 189 (22) ◽  
pp. E764-E772 ◽  
Author(s):  
Giulia M. Muraca ◽  
Yasser Sabr ◽  
Sarka Lisonkova ◽  
Amanda Skoll ◽  
Rollin Brant ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Morbidity And Mortality ◽  
Operative Vaginal Delivery ◽  
Maternal Morbidity And Mortality

scholarly journals Mifepristone as pre-induction cervical ripening agent: a review article

2019 ◽  
Vol 8 (11) ◽  
pp. 4636
Author(s):  
Nikita . ◽  
Seetesh Ghose ◽  
Setu Rathod
Keyword(s):  
Adverse Effects ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Review Article ◽  
Induction Of Labour ◽  
Present Review ◽  
Cervical Ripening ◽  
Successful Induction

Induction of labour after the period of viability by any methods medical, surgical or combined, for the purpose of vaginal delivery. The success of induction, to a great extent, depend upon pre-induction cervical status i.e. cervical ripening. So, ripening of cervix prior to induction i.e. pre-induction cervical ripening is one of the important steps for successful induction of labour. There are different methods for cervical ripening like prostaglandins (PGE). However, use of prostaglandins (PGE) and oxytocin as labour inducing agent has its own adverse effects on maternal and perinatal outcome. So, constant efforts are made for the less use of uterotonins. The present review aims to study the efficacy of oral Mifepristone for improvement in Bishop’s score, requirement of additional uterotonics, induction delivery interval, mode of delivery and neonatal outcome. Electronic databases were searched by using keywords ‘Mifepristone, RU486, PGE2 gel, Cervical ripening, Bishop’s score and Induction of labour’ and eleven articles were found from 2009 to 2018 which fulfils our study criteria and thus they were taken for review. Based on all the studies, Mifepristone appears to be effective cervical ripening in comparison to other agents with significant improvement in Bishop’s score, higher vaginal delivery rate, shorter induction delivery interval and good neonatal outcome.

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