scholarly journals Effectiveness of the fetal pillow to prevent adverse maternal and fetal outcomes at full dilatation cesarean section in routine practice

2020 ◽  
Author(s):  
Helen Sacre ◽  
Alice Bird ◽  
Mark Clement‐Jones ◽  
Andrew Sharp
Keyword(s):  
Cesarean Section ◽  
Routine Practice ◽  
Fetal Outcomes

The management of labour

2020 ◽  
pp. 331-338
Author(s):  
Devendra Kanagalingam
Keyword(s):  
Active Management ◽  
Cervical Dilatation ◽  
Routine Practice ◽  
Fetal Outcomes ◽  
Uterine Contractions ◽  
Best Management ◽  
Spontaneous Expulsion ◽  
Three Stages

Normal labour is a process of spontaneous expulsion of the fetus, placenta, and membranes at term. This process is initiated by complex endocrine mechanisms that cause uterine contractions which lead to effacement and dilatation of the cervix and descent of the fetus, resulting in delivery. About 10% of women go into labour in the preterm period. The progress is dependent on uterine contractions (power), the size and presentation of the fetus (passenger), and the size of the pelvis (passage). For ease of management, the observed labour is artificially divided into three stages. The partogram is used to manage labour and is where maternal and fetal observations can be plotted in addition to cervical dilatation and descent of the presenting part. The value of active management is still debated but has been adapted in routine practice. More research is needed to decide the best management of labour to optimize the maternal and fetal outcomes.

scholarly journals The Impact of Previous Cesarean Section on The Outcome in Patients With Non-Adherent Placenta Previa

2020 ◽  
Author(s):  
Amer Sindiani ◽  
Nail Obeidat ◽  
Omar Abu-Azzam ◽  
Heba Hijazi
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Organ Injury ◽  
P Value ◽  
Fetal Outcomes ◽  
Chi Square ◽  
Artery Ligation ◽  
Adherent Placenta ◽  
Lower Segment Cesarean Section ◽  
The Impact

Abstract Background: to evaluate the impact of lower segment cesarean section (LSCS) on the maternal and fetal outcomes of women with non-adherent placenta previa (PP). Methods: This is a retrospective study of all women who delivered at our hospital by LSCS with non-adherent PP over a period of 10 years. Data were obtained through hospital registry and medical records search. Data were analyzed using the Statistical Package for Social Sciences (SPSS, version 20). The differences in demographic and obstetric characteristics, peripartum complications, and fetal outcomes between women with no previous CS and those with previous CS were analyzed using t test or chi-square test wherever appropriate. A p-value of less than 0.05 was considered statistically significant. Results A total of 90 women with non-adherent placenta were included, 54 women with no previous CS and 36 women with previous CS. Women with previous CS were significantly more likely to experience organ injury (p-value <0.005), transfusion of ≥ 4 units of PRBC (p-value = 0.034), transfusion of FFP (p-value = 0.034), and hysterectomy or other procedure ( B Lynch, Uterine artery ligation) use (p-value <0.005)Conclusion: There is a significant increase in the incidence of maternal morbidities such as hysterectomy, blood transfusion and organ injury in patients with non-adherent PP with previous CS, with no difference in perinatal outcome in the same group of patients.

scholarly journals Does Immediate Removal of Urinary Catheter Prevent Urinary Morbidities Following Cesarean Section: A Prospective Randomized Study

2020 ◽  
Author(s):  
Upasana Maskey ◽  
Rita Marahatta ◽  
Biloni Vaidya
Keyword(s):  
Cesarean Section ◽  
Urinary Retention ◽  
Urinary Catheter ◽  
Randomized Study ◽  
Length Of Hospital Stay ◽  
Routine Practice ◽  
Early Group ◽  
Urinary Catheters ◽  
Removal Group ◽  
Delayed Removal

Objective: Urinary catheters are known cause of urinary morbidities. The longer the catheter is retained, the greater the risk for contamination and infection. An increasing body of literature suggests routine practice of catheterization and retaining it for 24 hours does not add any procedural advantage. Thus, we sought to study outcomes in relation to early vs. delayed removal of urinary catheters following cesarean section. Methods: We randomly assigned 116 patients into early and delayed removal of urinary catheter groups. In the early group, catheter was removed immediately after the procedure and in the delayed removal group, catheter was removed 24 hours later. Clinical outcomes were measured in terms of significant bacteriuria 72 hours postop, voiding difficulties, urinary retention, mobilization time, length of hospital stay, and patient satisfaction. Results: Study revealed higher incidence of bacteriuria in the delayed removal group (32.8% vs. 15.5%, P = 0.030). Urinary frequency was also higher (34.6% Vs. 8.6%, P=0.001). However, there were no difference between the two groups in other urinary complaints including dysuria and urgency (P = 0.103 &amp; P = 0.087). Urinary retention was more frequent in the early group, but difference was not significant (P = 0.080). Patients with immediate removal of the urinary catheter had early ambulation and early discharge from hospital (P = 0.001 and P = 0.040) and were generally satisfied with the procedure (P= 0.010). Conclusion: Our study showed that immediate removal of urinary catheter was associated with lower urinary complications, shorter length of hospitalization and associated cost.

scholarly journals Incidence And Risk Factors Of Maternal And Fetal Outcomes Among Patients Of Placenta Previa With And Without Placenta Accreta

2018 ◽  
Vol 09 (01) ◽  
pp. 57-61
Author(s):  
Samina Naseem Khattak ◽  
Umbreen Akram ◽  
Erum Pervaiz ◽  
Maria Anayat ◽  
Tahir Ahmad Munir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Military Hospital ◽  
Fetal Outcomes ◽  
Maternal Risk ◽  
Neonatal Deaths ◽  
The Mean

Objective: The aim of the study was to evaluate maternal and fetal outcomes among patients of placenta previa (PP) with and without placenta accreta (PA). Methodology: All patients who underwent cesarean section for PP and PA were analyzed retrospectively at a tertiary care Combined Military Hospital Kharian, Pakistan, from February 2015 to March 2018. Maternal and neonatal data were obtained from medical records and the hospital database system. Results: PA was found in 37 patients from 111 patients of PP and 74 were without PA with the rate of approximately 2/1000 and 4/1000 respectively were included in the study. The mean age was 31.16±2.65 (range 22–37) years, mean gravidity of 3.69 ±1.40 (range 1 - 9), mean parity 2.57±1.01 (range 1–5), mean number of cesarean sections 2.10±0.66, (range 1-3) and a mean gestational age at the time of cesarean section was 35.65±2.46 (range 28–41) weeks. The maternal risk factors revealed marked differences between placenta previa with accreta and without accrete. The mean intraoperative blood loss in PA was 3,000ml, with a loss of 2,000ml occurring in 60%, and 3,000 ml in 21% of the PA cases. The mean pRBC transfusion was 4 units, while 17% received 6 units. Fetal growth restriction was not seen. A total of 12 neonates were admitted in NICU, with 03 neonatal deaths. There was no maternal death. Neonates born to women with placenta accreta had significantly lower birth weight, Apgar scores at 1 min and 12% required admission to NICU with 3 neonatal deaths. Conclusion: The advanced maternal age, past cesarean or uterine surgery, high parity as well as multiple gravidity were the risk factors for adverse fetal and maternal outcomes.

scholarly journals Role of Perineal Length Estimation in The Prediction of Maternal and Fetal Outcomes

2020 ◽  
Vol 2 (1) ◽  
pp. 11
Author(s):  
Sabah R. H. Ahmed ◽  
Hala A. Ali
Keyword(s):  
Cesarean Section ◽  
Apgar Score ◽  
Normal Vaginal Delivery ◽  
P Value ◽  
Fetal Outcomes ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Significant Difference ◽  
The Mean

Context: Female perineum is a significant part of females because perineal tears and episiotomy habitually happen in childbirth with first-time deliveries. Aim: This study aimed to explore the role of perineal length (PL) estimation in the prediction of maternal and fetal outcomes. Methods: A prospective cohort observational design used to collect data from the Department of Obstetrics and Gynecology, Laboring room, Kafrelsheikh General Hospital, Kafrelsheikh City, Egypt. A purposive sample of 139 parturient women recruited during the period from the first of December 2018 to the end of August 2019. Six tools used to conduct this study. Maternal and newborn characteristics questionnaire, disposable standardized paper tape for measuring PL in centimeters, a standardized scale for measuring maternal height by meters, and body weight in kilograms to calculate Body Mass Index (BMI) (k/m2), REEDA scale, partograph for labor process and Apgar score. Results: There were statistically significant differences regarding the mean age, previous episiotomy and cesarean section of both studied groups (PL less than or equal to 4 cm and more than 4 cm) at p-value <0.001. Out of 139 parturient women, the two groups of PL less than or more than 4 cm had 16.7% versus 56.9%, respectively had normal vaginal delivery, with a statistically significant difference between both groups, while 46.7% versus 6.3% respectively had an episiotomy. However, the mean duration of the second stage of labor had statistically significant differences between both studied groups, with 116.7 ± 44.3 versus 85.1 ± 42.0, respectively. Additionally; Mean birth weight/grams, cephalohematoma, caput succedaneum, and mean APGAR score after 5 minutes had a statistically significant difference between the two groups. Conclusions: Short perineum accompanied by increased duration of the second stage of labor. Cesarean section delivery and perineal trauma are associated with primigravida with short perineum. Regarding the mean APGAR score after 5 minutes, there were statistically significant differences between both studied groups. Maternity and newborn health nursing need to improve the illustration of the risk factors that can lead to undesirable consequences

scholarly journals Maternal and fetal outcomes following unplanned conversion to general anesthetic at elective cesarean section

2015 ◽  
Vol 35 (9) ◽  
pp. 695-699 ◽  
Author(s):  
C E Aiken ◽  
A R Aiken ◽  
J C Cole ◽  
J C Brockelsby ◽  
J H Bamber
Keyword(s):  
Cesarean Section ◽  
Elective Cesarean Section ◽  
General Anesthetic ◽  
Fetal Outcomes ◽  
Elective Cesarean

scholarly journals Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial

2015 ◽  
Vol 133 (3) ◽  
pp. 227-234 ◽  
Author(s):  
Anıl İçel Saygı ◽  
Özkan Özdamar ◽  
İsmet Gün ◽  
Hakan Emirkadı ◽  
Ercüment Müngen ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Apgar Score ◽  
Urine Volume ◽  
Fetal Distress ◽  
Controlled Clinical Trial ◽  
Fetal Outcomes ◽  
General Anesthesia Group

CONTEXT AND OBJECTIVE: As the rates of cesarean births have increased, the type of cesarean anesthesia has gained importance. Here, we aimed to compare the effects of general and spinal anesthesia on maternal and fetal outcomes in term singleton cases undergoing elective cesarean section.DESIGN AND SETTING: Prospective randomized controlled clinical trial in a tertiary-level public hospital.METHODS: Our study was conducted on 100 patients who underwent cesarean section due to elective indications. The patients were randomly divided into general anesthesia (n = 50) and spinal anesthesia (n = 50) groups. The maternal pre and postoperative hematological results, intra and postoperative hemodynamic parameters and perinatal results were compared between the groups.RESULTS: Mean bowel sounds (P = 0.036) and gas discharge time (P = 0.049) were significantly greater and 24th hour hemoglobin difference values (P = 0.001) were higher in the general anesthesia group. The mean hematocrit and hemoglobin values at the 24th hour (P = 0.004 and P < 0.001, respectively), urine volume at the first postoperative hour (P < 0.001) and median Apgar score at the first minute (P < 0.0005) were significantly higher, and the time that elapsed until the first requirement for analgesia was significantly longer (P = 0.042), in the spinal anesthesia group.CONCLUSION: In elective cases, spinal anesthesia is superior to general anesthesia in terms of postoperative comfort. In pregnancies with a risk of fetal distress, it would be appropriate to prefer spinal anesthesia by taking the first minute Apgar score into account.

Comparison of Maternal and Neonatal Outcomes in Case of Primary Cesarean Section Done During Late vs. Early Labor

2020 ◽  
Vol 7 (3) ◽  
pp. 244-253
Author(s):  
Heena Anuff ◽  
Zeinah Rahman ◽  
Rajani Dube ◽  
Shatha Taher Salman Al-Zuheiri
Keyword(s):  
Cesarean Section ◽  
Early Stage ◽  
Fetal Distress ◽  
Fetal Outcomes ◽  
Second Stage Of Labor ◽  
Labor Ward ◽  
Fetal Complications ◽  
Study Population ◽  
Maternal And Neonatal Outcomes ◽  
Prolonged Labor

Background: Cesarean section (CS) done before the onset of labor is called an elective and done during labor is called an emergency CS. During labor, CS may be needed in early(1st) or late(2nd) stages. Earlier studies have shown more maternal and fetal complications when a cesarean is done for the first time in the late stages. Objective: Our objective was to find out whether the maternal and fetal outcomes differ when primary CS is done in the first stage of labor compared to the second stage of labor for various indications and how. Methods: This was a retrospective observational study on women who underwent primary CS during active labor and to link the maternal and fetal outcomes related to the stages of labor. The study population was patients admitted to the Labor ward of Saqr hospital, Ras Al Khaimah, UAE, between 1st January 2017 till 31st December 2017, but had to undergo primary CS during labor for various indications at 1st and 2nd stages of labor. Data was collected from maternal and neonatal electronic case records. Results: A total of 135 case records were studied. Most cesarean sections were in the early stage of labor. The most common indications were fetal distress and prolonged labor. The maternal and fetal complications were higher in 2nd stage of labor than in 1st stage which includes uterine atonia (p=.001), postpartum hemorrhage (p=.006), postoperative hematuria(RR=3.46), problems with breastfeeding (p=0.001) and fetal injuries (p<.001). Conclusion: Primary CS in late labor is associated with increased maternal and neonatal complications compared to CS in early labor.

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