Neonatal outcome after trial of labor or elective cesarean section in relation to the indication for the previous cesarean delivery

Abstract Septum resection using hysterescopy is safe, rapid and efective, but some late complication of it may be seen as uterine rupture or dehiscence of uterine wall during pregnancy due to myometrial damage. We present a case of recurrent large uterine fundal dehiscence conscecutive to cesarean section in a patient who had previously undergone a uterine septum resection. The patient was a 35-year-old who presented at 39 weeks of gestation (Gravida 2, Parity 1) and was admitted for an elective cesarean section. Her reproductive history included a septum resection which resulted in uterine perforation, and one previous cesarean section in which a large fundal defect was found and repaired. Then the examination had shown an aproximately 5 cm large uterine fundus defect including all three layers of uterus which had been repaired. Perforation or excessively deep incision of uterine fundus during hysteroscopic metroplasty may cause chronic weakness of the uterine wall especially at fundal localization. Our case was an incidental uterine wall dehiscence during cesarean section. Patients with an uterine septum resection history should be followed up carefully for uterine rupture during pregnancy.

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Impact of Prophylactic Betamethasone Indication on the Neonatal Outcome in 38-Week Pregnancies Prior to Elective Cesarean Section

Open Journal of Obstetrics and Gynecology ◽

10.4236/ojog.2020.10100128 ◽

2020 ◽

Vol 10 (10) ◽

pp. 1396-1401

Author(s):

Enrique Valdés Rubio ◽

Pamela Socías ◽

Javiera Urquieta ◽

Enrique Valdés M ◽

Alvaro Sepúlveda-Martínez

Keyword(s):

Cesarean Section ◽

Neonatal Outcome ◽

Elective Cesarean Section ◽

Elective Cesarean

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

American Journal of Perinatology ◽

10.1055/s-0037-1608681 ◽

2017 ◽

Vol 35 (05) ◽

pp. 481-485 ◽

Cited By ~ 1

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.

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Management of stillbirths: an observational analysis at a rural tertiary care centre in Kerala, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20191222 ◽

2019 ◽

Vol 8 (4) ◽

pp. 1583

Author(s):

Ajini K. K. ◽

Reena R. P. ◽

Radha K. R.

Keyword(s):

Cesarean Section ◽

Fetal Death ◽

Tertiary Care ◽

Induction Of Labour ◽

Intrauterine Fetal Death ◽

Elective Cesarean Section ◽

Care Centre ◽

Tertiary Care Centre ◽

Elective Cesarean ◽

Previous Cesarean

Background: Stillbirth is a distressing event, both for the expecting mother and the obstetrician. Several maternal, social and circumstantial factors influence its occurrence. These women with intrauterine fetal death need to be treated in a considerate manner. Our aim was to analyse different methods of induction, management of labour and their outcomes in women with antepartum fetal demise.Methods: All women admitted to a tertiary care centre with intrauterine fetal death after 22 weeks during the study period of 24 months were recruited. Maternal sociodemographic characteristics and relevant investigations were studied. Induction of labour was achieved with mechanical and pharmacological methods. Stillborn babies, placentae and umbilical cord were examined after delivery.Results: There were 175 women with IUFD admitted during the study period. The stillbirth rate was 38.6 per1000 live births.148 women (84.57%) required induction of labour while16 women had spontaneous onset of labour. Among the 44 women with previous Cesarean section, 11 underwent elective Cesarean section. 19 women (57.6%) out of 33 cases of trial of labour after Cesarean had a successful vaginal delivery. There were 2 cases of rupture uterus and 10 women required ICU admissions. Intrauterine growth restriction was the leading cause of stillbirth (41.8%) followed by hypertensive disorders (27.7%).Conclusions: Present study has shown that vaginal birth can be achieved in most women with mechanical and pharmacological methods of induction within a reasonable period of time.

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Outcomes of induction in trial of labor after cesarean delivery

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190882 ◽

2019 ◽

Vol 8 (3) ◽

pp. 1076

Author(s):

Anubha Varshney ◽

Zehra Mohsin

Keyword(s):

Cesarean Section ◽

Cesarean Delivery ◽

Mode Of Delivery ◽

Neonatal Morbidity ◽

Induction Of Labor ◽

Control Group ◽

Study Group ◽

Previous Cesarean Section ◽

Trial Of Labor ◽

Previous Cesarean

Background: The objective of this study is to evaluate the outcomes of induction of labor in women attempting trial of labor after cesarean delivery and to compare maternal and neonatal morbidity and mortality in women who were induced to those delivering spontaneously.Methods: The prospective study was carried out in the Department of Obstetrics and Gynecology in collaboration with the Neonatal Section, Department of Pediatrics at J.N. Medical College and Hospital, AMU Aligarh. The sample included 280 women with one previous cesarean section, of whom 130 women underwent induction of labor (study group) and 150 were admitted with spontaneous onset of labor. Prostaglandin gel and intracervical Foley’s were used for cervical ripening in the study group. Indication of cesarean section, mode of delivery, maternal and neonatal outcome were studied in between groups.Results: Overall rate of vaginal delivery after cesarean section was 45.3% and 56% in both study and control group respectively. The rate of cesarean section were higher in women who were induced and having unfavorable cervix. Maternal and neonatal morbidity were not significantly higher as compared in both groups, however one case of scar rupture was found in study group.Conclusions: Induction of labor in women with previous cesarean section had higher rates of cesarean section however it does not adversely affect neonatal and maternal morbidity. Overall vaginal birth is safe and effective in women with previous cesarean section by prostaglandin gel or intracervical Foley’s. Authors cautiously suggest, induction of labor should be considered in preselected patient with strict monitoring.

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Report of a Case of Annular Pancreas of the Newborn in Two Consecutive Siblings

PEDIATRICS ◽

10.1542/peds.48.1.148 ◽

1971 ◽

Vol 48 (1) ◽

pp. 148-150

Author(s):

R. C. Montgomery ◽

M. H. Poindexter ◽

G. H. Hall ◽

John E. Leigh

Keyword(s):

Cesarean Section ◽

Intestinal Obstruction ◽

Duodenal Obstruction ◽

Case Reports ◽

Annular Pancreas ◽

Elective Cesarean Section ◽

Cesarean Sections ◽

Elective Cesarean ◽

Previous Cesarean ◽

High Intestinal Obstruction

Annular pancreas presenting as high intestinal obstruction in the newborn has been reported on numerous occasions.14 The purpose of this paper is to report the occurrence of annular pancreas causing duodenal obstruction in the newborn in two consecutive siblings. Case Reports Case 1, D.B., a male, was born August 31, 1966. The mother was gravida III, para II. Her expected date of confinement was September 12, 1966. The pregnancy had been uneventful except that she had minimal polyhydramnios. The mother had been on no medications during her pregnancy except a prenatal vitamin and iron. On August 31, 1966 the mother underwent an elective cesarean section because of previous cesarean sections which were performed for cephalo-pelvic disproportion.

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Trial of labor after previous cesarean delivery (TOLAC) and association of BMI and previous vaginal delivery with frequency of VBAC

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v15i4.21687 ◽

2016 ◽

Vol 15 (4) ◽

pp. 546-550 ◽

Cited By ~ 1

Author(s):

Huma Tasleem ◽

Haider Ghazanfar

Keyword(s):

Cesarean Section ◽

Success Rate ◽

Cesarean Delivery ◽

Vaginal Delivery ◽

Health Centre ◽

Tertiary Care ◽

Vaginal Birth ◽

Trial Of Labor ◽

Emergency Cesarean ◽

Previous Cesarean

Objectives: To determine the frequency of successful Vaginal Birth after One Cesarean Section in our tertiary care institution and to determine the causes of its failure.Material and Methods: This study was conducted in department of Obstetrics and Gynecology of Shifa International Hospital and Shifa Foundation Community Health Centre Islamabad Pakistan from Feb 2011 to Dec 2014. This study included 592 patients who presented in labor room emergency reception of Obs/Gynae department at term with previous one scar having fulfilled the laid down inclusion criteria for VBAC during ante-natal care. The patients were admitted in hospital and were allowed to proceed for spontaneous labor under vigilant monitoring on complications of trial of scar. Immediate emergency cesarean sections were performed, where indicated.Results: Out of 592 patients 70.7% were delivered vaginally after previous one cesarean section and 29.3% had emergency cesarean section. Leading indications for repeat cesarean section was fetal distress, failure to progress and scar tenderness. No maternal and fetal complication occurred in our study. The success rate of Trial of labor after one previous cesarean delivery was lower in obese (64.38%) as compared to non-obese women (82.06%) (p<0.001). Women with previous successful vaginal delivery had a success rate of 88.2% compared with 62.25% in women without such a history (OR 4.4; 95% CI 2.7-7.2 p <0.001).Conclusion: Vaginal birth after one lower segment cesarean section should be encouraged with vigilant monitoring provided no obstetric contra-indication to vaginal birth exists.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.546-550

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