Maternal and neonatal morbidity in relation to the instrument used for mid-cavity rotational operative vaginal delivery: a prospective cohort study

Background: Mothers are encouraged to exclusively breastfeed for the first 6 months. However, cesarean delivery rates have increased worldwide, which may affect breastfeeding. Research aim: This study aimed to determine the potential effects of cesarean delivery on breastfeeding practices and breastfeeding duration. Methods: This was a 6-month cohort study extracted from a 24-month prospective cohort study of mother–infant pairs in three communities in Hunan, China. Data about participants’ characteristics, delivery methods, breastfeeding initiation, use of formula in the hospital, exclusive breastfeeding, and any breastfeeding were collected at 1, 3, and 6 months following each infant’s birth. The chi-square test, logistic regression model, and Cox proportional hazard regression model were used to examine the relationship between breastfeeding practices and cesarean delivery. Results: The number of women who had a cesarean delivery was 387 (40.6%), and 567 (59.4%) women had a vaginal delivery. The exclusive breastfeeding rates at 1, 3, and 6 months were 80.2%, 67.4%, and 21.5%, respectively. Women who had a cesarean delivery showed a lower rate of exclusive breastfeeding and any breastfeeding than those who had a vaginal delivery ( p < .05). In addition, cesarean delivery was related with using formula in the hospital and delayed breastfeeding initiation. Cesarean delivery also shortened the breastfeeding duration (hazard ratio = 1.40, 95% confidence interval [1.06, 1.84]). Conclusion: Healthcare professionals should provide more breastfeeding skills to women who have a cesarean delivery and warn mothers about the dangers of elective cesarean section for breastfeeding practices.

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Ability of shock index and heart rate to predict the percentage of body blood volume lost after vaginal delivery as an indicator of severity: results from a prospective cohort study

Journal of Global Health ◽

10.7189/jogh.09.020432 ◽

2019 ◽

Vol 9 (2) ◽

Author(s):

Anderson Borovac-Pinheiro ◽

José Guilherme Cecatti ◽

Rodolfo de Carvalho Pacagnella

Keyword(s):

Heart Rate ◽

Cohort Study ◽

Vaginal Delivery ◽

Blood Volume ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Shock Index

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Obstetric perineal tears, sexual function and dyspareunia among primiparous women 12 months postpartum: a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2019-032368 ◽

2019 ◽

Vol 9 (12) ◽

pp. e032368 ◽

Cited By ~ 2

Author(s):

Ditte Gommesen ◽

Ellen Nøhr ◽

Niels Qvist ◽

Vibeke Rasch

Keyword(s):

Cohort Study ◽

Sexual Health ◽

Sexual Function ◽

Vaginal Delivery ◽

Prospective Cohort Study ◽

Clinical Examination ◽

Prospective Cohort ◽

Fourth Degree ◽

Primiparous Women ◽

Second Degree

ObjectiveSexuality is an important aspect of human identity and contributes significantly to the quality of life in women as well as in men. Impairment in sexual health after vaginal delivery is a major concern for many women. We aimed to examine the association between degree of perineal tear and sexual function 12 months postpartum.DesignA prospective cohort studySettingFour Danish hospitals between July 2015 and January 2019ParticipantsA total of 554 primiparous women: 191 with no/labia/first-degree tears, 189 with second-degree tears and 174 with third-degree/fourth-degree tears. Baseline data were obtained 2 weeks postpartum by a questionnaire and a clinical examination. Sexual function was evaluated 12 months postpartum by an electronic questionnaire (Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12)) and a clinical examination.Primary outcome measuresTotal PISQ-12 score and dyspareuniaResultsEpisiotomy was performed in 54 cases and 95 women had an operative vaginal delivery. The proportion of women with dyspareunia was 25%, 38% and 53% of women with no/labia/first-degree, second-degree or third-degree/fourth-degree tears, respectively.Compared with women with no/labia/first-degree tears, women with second-degree or third-degree/fourth-degree tears had a higher risk of dyspareunia (adjusted relative risk (aRR) 2.05; 95% CI 1.51 to 2.78 and aRR 2.09; 95% CI 1.55 to 2.81, respectively). Women with third-degree/fourth-degree tears had a higher mean PISQ-12 score (12.2) than women with no/labia/first-degree tears (10.4).ConclusionsImpairment of sexual health is common among primiparous women after vaginal delivery. At 12 months postpartum, more than half of the women with a third-degree/fourth-degree tear experienced dyspareunia. Women delivering with no/labia/first-degree tears reported the best outcomes overall. Thus, it is important to minimise the extent of perineal trauma and to counsel about sexuality during and after pregnancy.

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Evaluating Fundal Dominant Contractions on Spatiotemporal Electrohysterography as a Marker for Effective Labor Contractions

American Journal of Perinatology ◽

10.1055/s-0038-1675621 ◽

2018 ◽

Vol 36 (09) ◽

pp. 924-929 ◽

Cited By ~ 2

Author(s):

Rodney K. Edwards ◽

Neil R. Euliano ◽

Savyasachi Singh ◽

Rachel C. LeDuke ◽

William W. Andrews ◽

...

Keyword(s):

Cohort Study ◽

Vaginal Delivery ◽

Prospective Cohort Study ◽

Study Design ◽

Prospective Cohort ◽

Cervical Dilation ◽

Labor Dystocia ◽

Nulliparous Women ◽

Vaginal Deliveries

Objective To evaluate if fundal (F) dominance of the electrohysterogram is associated with vaginal delivery and lack of F dominance is associated with cesarean for labor dystocia. Study Design We conducted a prospective cohort study of nulliparous women in spontaneous labor at ≥36 weeks. Clinicians were blinded to electrohysterography data which were in addition to standard cardiotocography. All contractions in the hour preceding diagnosis of complete cervical dilation (for women delivering vaginally) or the hour preceding the decision for cesarean were analyzed. Results Of 224 patients, 167 had evaluable data. The proportion of F dominant contractions was not different for women undergoing cesarean for labor dystocia (n = 11) compared with all others (n = 156)—88.7 ± 10.2 versus 86.0 ± 11.4%; p = 0.44. Results were similar when comparing the cesarean for labor dystocia group to those undergoing cesarean for other indications (n = 10) and vaginal deliveries (n = 146)—88.7 ± 10.2 versus 86.5 ± 10.0 versus 85.9 ± 11.5%; p = 0.74. Conclusion We were unable to confirm our earlier finding that F dominance of the electrohysterogram is associated with vaginal delivery and lack of F dominance is associated with cesarean for dystocia.

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