scholarly journals Duration of Operative Vaginal Delivery and Adverse Obstetric Outcomes

2019 ◽  
Vol 37 (05) ◽  
pp. 503-510
Author(s):  
Emily S. Miller ◽  
Yinglei Lai ◽  
Jennifer Bailit ◽  
Uma M. Reddy ◽  
Ronald J. Wapner ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Study Design ◽  
Neonatal Outcome ◽  
Secondary Analysis ◽  
Perinatal Outcomes ◽  
Obstetric Outcomes ◽  
Adverse Neonatal Outcome ◽  
Operative Vaginal Delivery ◽  
Adverse Neonatal Outcomes ◽  
Observational Cohort

Abstract Objective This study aimed to evaluate whether the number of vacuum pop-offs, the number of forceps pulls, or the duration of operative vaginal delivery (OVD) is associated with adverse maternal and perinatal outcomes. Study Design This is a secondary analysis of a multicenter observational cohort of women who underwent an attempted OVD. Women were stratified by the duration of OVD and the number of pop-offs (vacuum) or pulls (forceps) attempted. Severe perineal lacerations, failed OVD, and a composite adverse neonatal outcome were compared by the duration of OVD and number of pop-offs or pulls. Results Of the 115,502 women in the primary cohort, 5,325 (4.6%) underwent an attempt at OVD: 3,594 (67.5%) with vacuum and 1,731 (32.5%) with forceps. After adjusting for potential confounders, an increasing number of pop-offs was associated with an increased odds of the composite adverse neonatal outcome. However, an increasing duration of vacuum exhibited a stronger association with the composite adverse neonatal outcome. Similarly, the number of forceps pulls was less strongly associated with the composite adverse neonatal outcome compared with the duration of forceps application. Conclusion The duration of OVD may be more associated with adverse neonatal outcomes than the number of pop-offs or pulls.

Outcomes of Operative Vaginal Delivery during Trial of Labor after Cesarean Delivery

2017 ◽  
Vol 34 (08) ◽  
pp. 765-773 ◽  
Author(s):  
Clifton Brock ◽  
Shravya Govindappagari ◽  
Cynthia Gyamfi-Bannerman
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Secondary Analysis ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Logistic Regression Models ◽  
Trial Of Labor ◽  
Operative Vaginal Delivery ◽  
Uterine Scar

Objective The objective of this study is to determine the maternal and neonatal morbidity associated with attempting operative vaginal delivery (OVD) compared with the alternative of a laboring repeat cesarean delivery (LRCD) in women attempting a trial of labor after cesarean delivery (TOLAC). Methods This is a secondary analysis of a multicenter prospective study designed to assess perinatal outcomes of OVD in women with a prior uterine scar. The study includes women who attempted TOLAC and reached +2 station with a fully dilated cervix. Composites on neonatal and maternal morbidity were compared between women in whom OVD was attempted and those who underwent LRCD by fitting multivariate logistic regression models. Results In total, 6,489 women attempting TOLAC reached 2+ station with a fully dilated cervix. Of these, 5,640 (86.9%) had a spontaneous vaginal delivery, 762 (11.7%) underwent attempted OVD, and 87 (1.3%) had an LRCD. Compared with attempting OVD, LRCD was associated with greater neonatal morbidity (odds ratio [OR]: 2.41; 95% confidence interval [CI]: 1.13–5.15) and less maternal morbidity (OR: 0.28; 95% CI: 0.14–0.55). Maternal morbidity of OVD is driven by perineal injury. Conclusion In laboring women with a previous uterine scar, attempting OVD is associated with greater maternal and less neonatal morbidity than LRCD.

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 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. 

scholarly journals Risk factors for cesarean delivery and adverse neonatal outcome in twin pregnancies attempting vaginal delivery

2018 ◽  
Vol 97 (7) ◽  
pp. 845-851 ◽  
Author(s):  
Natali Schachter-Safrai ◽  
Gilad Karavani ◽  
Rani Haj-Yahya ◽  
Noa Ofek Shlomai ◽  
Shay Porat
Keyword(s):  
Risk Factors ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Adverse Neonatal Outcome ◽  
Twin Pregnancies

Maternal and fetal factors contributing to neonatal outcome in Al-Tibri Medical College and Hospital

2021 ◽  
Vol 15 (1) ◽  
pp. 18-22
Author(s):  
Erum Saboohi ◽  
Nighat Seema ◽  
Abdulah Hadi Hassan
Keyword(s):  
Risk Factors ◽  
Antenatal Care ◽  
Preterm Delivery ◽  
Neonatal Outcome ◽  
Neonatal Outcomes ◽  
P Value ◽  
Medical College ◽  
Adverse Neonatal Outcome ◽  
Adverse Neonatal Outcomes ◽  
Nicu Admission

Background: The study was done to identify the maternal and fetal factors contributing to neonatal outcome and to evaluate the correlation between risk factors and adverse neonatal outcome. Subjects and methods: This prospective observational study was conducted on 126 mothers and their neonates fulfilling the selection criteria at Al-Tibri Medical College and Hospital. A self-designed Performa was used to enter data of subjects. Sick neonates were referred to neonatal intensive care unit for admission and management. The results were analyzed by using SPSS version 22. A p-values <0.05 was considered as significant. Results: Out of 126 enrolled subjects, 81% mothers were multigravidas, 31% were unbooked, 13.5% had gestational comorbidities, 15% were drug addict, 2% were Hepatitis B positive. 22.2% underwent emergency LSCS while 31.7% delivered babies by elective LSCS. Regarding fetal factors contributing to sick babies, IUGR (20%), twin fetuses (15.4%), prematurity (47.7%) were significant. 65 were sick babies. Adverse neonatal outcomes observed were prematurity in 25.4%, IUGR in 11.1%, NICU admission in 33.3%, and neonatal death in 2%. Risk factors associated with adverse neonatal outcomes were positive maternal drug addiction (p-value = 0.028), preterm delivery (p-value<0.001), NICU admission (p-value<0.001) and low birth weight (p-value <0.001). Conclusion: Compromised maternal antenatal care has profound deleterious effect on fetus and neonate. Obstetricians, perinatologists and neonatologists need to work in concord to improve maternal antenatal care hence improving neonatal outcome. In our study adverse neonatal outcome was associated with unbooked cases, delivery by EmLSCS, addicted mother, preterm delivery, LBW and neonates requiring NICU admission.

scholarly journals Gastroschisis: Antenatal Sonographic Predictors of Adverse Neonatal Outcome

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Rachael Page ◽  
Zachary Michael Ferraro ◽  
Felipe Moretti ◽  
Karen Fung Kee Fung
Keyword(s):  
Neonatal Outcome ◽  
Adverse Outcomes ◽  
Abdominal Circumference ◽  
Future Research ◽  
Adverse Neonatal Outcome ◽  
Not Otherwise Specified ◽  
Adverse Neonatal Outcomes ◽  
Clinically Significant ◽  
Key Terms ◽  
Bowel Dilatation

Objectives. The aim of this review was to identify clinically significant ultrasound predictors of adverse neonatal outcome in fetal gastroschisis.Methods. A quasi-systematic review was conducted in PubMed and Ovid using the key terms “gastroschisis,” “predictors,” “outcome,” and “ultrasound.”Results. A total of 18 papers were included. The most common sonographic predictors were intra-abdominal bowel dilatation (IABD), intrauterine growth restriction (IUGR), and bowel dilatation not otherwise specified (NOS). Three ultrasound markers were consistently found to be statistically insignificant with respect to predicting adverse outcome including abdominal circumference, stomach herniation and dilatation, and extra-abdominal bowel dilatation (EABD).Conclusions. Gastroschisis is associated with several comorbidities, yet there is much discrepancy in the literature regarding which specific ultrasound markers best predict adverse neonatal outcomes. Future research should include prospective trials with larger sample sizes and use well-defined and consistent definitions of the adverse outcomes investigated with consideration given to IABD.

Is There a Benefit of Antenatal Corticosteroid When Given < 48 Hours Before Delivery?

2021 ◽  
Author(s):  
Yoav Siegler ◽  
Naphtali Justman ◽  
Gal Bachar ◽  
Roy Lauterbach ◽  
Yaniv Zipori ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Neonatal Outcome ◽  
Neonatal Morbidity ◽  
Time Interval ◽  
Outcome Study ◽  
Antenatal Corticosteroid ◽  
Time Intervals ◽  
Corticosteroid Administration ◽  
Adverse Neonatal Outcome ◽  
Adverse Neonatal Outcomes

Abstract Objective We assessed the association between a short Antenatal Corticosteroid Administration-to-Birth Interval and neonatal outcome. Study design: A retrospective study between 2010- 2020. Eligible cases were singleton preterm live-born neonates born between 24 0/7 and 33 6/7 weeks of gestation and were initiated an ACS course of Betamethasone. We divided the first 48 hours following 1st ACS administration to four-time intervals and compared each time interval to those born more than 48 hours following ACS administration. The primary outcome was a composite of adverse neonatal outcome, including neonatal mortality or any major neonatal morbidity. Results A total of 200 women gave birth less than 48 hours from receiving the first betamethasone injection, and 172 women gave birth within 2-7 days (48-168 hours) from ACS administration. Composite adverse neonatal outcome was higher for neonates born less than 12 hours from initial ACS administration compared to neonates born 2-7 days from first betamethasone injection (55.45% vs. 29.07%, OR 3.45 95% CI [2.02-5.89], p.value<0.0001). However, there was no difference in composite adverse neonatal outcomes between neonates born 12-48 hours following ACS administration and those born after 2-7 days. That was also true after adjusting for confounders. Conclusions 12-24 hours following ACS Administration may be sufficient in reducing the same risk of neonatal morbidities as > 48 hours following ACS administration. It may raise the question regarding the utility of the second dose of ACS.

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