Re: Is Caesarean section equal to vaginal birth as a mode of delivery?

Author(s):  
Takami INOUE
2018 ◽  
Vol 25 (10) ◽  
pp. 1537-1545
Author(s):  
Muhammad Ikram ◽  
Amna Javed ◽  
Shafqat Mukhtar

Introduction: The cardiotocography (CTG) is more commonly knows aselectronic fetal monitoring (EFM). A cardiotocography measures the fetal heart and the frequencyof uterine contractions. Using two separate disc shaped transducers. Objectives: The objectiveof this study is to co-relate the intrapartum cardiotocography monitoring with fetomaternaloutcome. Study Design: Cross sectional analytical study. Setting: Department of Obstetricsand Gynaecology, Shaikh Zayed Hospital, Lahore, Pakistan. Period: From September 2012 toMarch 2013 (Six Months). Patient & Method: Total 60 patients (pregnant females) fulfilling theinclusion criteria were selected for this study, who were admitted in labour room in early andactive labour. In group A normal CTG monitoring and in Group B women with abnormal CTGmonitoring. Maternal outcomes in terms of mode of delivery and fetal outcome (APGAR Score,neonatal seizures, admission to nursery and time of neonatal discharge were seen). Result: Themean age in group A was 26.13+3.90 years and in group B was 26.53+4.17 years. The meangestational age in group A was 38.40+1.50 weeks and in group B was 36.60+1.59 weeks. Ingroup A, 25 (83.3%) woman were delivered through spontaneous vaginal birth and 4(13.4%)women, who were delivered by caesarean section (for all indication except fetal distress), 1(3.3%) woman by assisted vaginal birth (for all other indications). In group B there were 7(23.8%)women who delivered through spontaneous vaginal birth. 3(10%) women by assisted vaginalbirth (for abnormal CTG monitoring) and 20(66.7%) women by caesarean section (for abnormalCTG). In group A, there were 7(23.3%) neonates who were admitted in nursery, while in groupB, there were 19(63.3%) neonates, who were admitted in nursery. Conclusion: Intrapartumexternal fetal cardiotocography is not a single indicator of fetal distress. An increased caesareansection rate in babies with a pathological cardiotocography stresses on the need for additionaltests to differentiate hypoxic fetuses from non-hypoxic.


2020 ◽  
Vol 11 (4) ◽  
pp. 5473-5480
Author(s):  
Poonam Kalburgi ◽  
Sanjaykumar Patil

Women after delivering her first baby by section have a choice about mode of delivery for her second baby. The study was planned to compare maternal and perinatal outcome between VBAC and repeat elective LSCS in patients with prior one LSCS and their complications. A prospective observational study was carried out in department of obstetrics and . Total 180 cases of previous LSCS who were eligible for vaginal delivery were recruited 90 in each group as per consent given by them. Group 1: Vaginal Birth after section Group 2: elective repeat section. It was observed that majority of the patients group 1(51.1%) and group 2 (47.8%) were in age group of 25 to 30 years. More than 25kg/m2 BMI was found in 18(20%) cases of VBAC group and 30(33.3%) cases of LSCS group pregnancy interval was significantly lower in LSCS group compared to VBAC group. Mean birth weight was 2.832 kg to 2.917kg in both group. with improved maternal care, close fetal monitoring and institutional delivery for a previous one section, VBAC is considered safer than repeat elective section in carefully selected patient.


2011 ◽  
Vol 4 (4) ◽  
pp. 164-165 ◽  
Author(s):  
Hemant Maraj ◽  
Michelle Mohajer ◽  
Deepannita Bhattacharjee

We present the case of a 31-year-old woman with Ehler-Danlos syndrome (EDS) type 2. She had a previous caesarean section and went on to have an uncomplicated vaginal birth in her last pregnancy. To our knowledge, this is the first case of a successful vaginal birth after caesarean section in a patient with EDS. EDS is a multisystem disorder involving a genetic defect in collagen and connective-tissue synthesis and structure. It is a heterogeneous group of 11 different inherited disorders. Obstetric complications in these patients include miscarriages, stillbirths, premature rupture of the membranes, preterm labour, uterine prolapse, uterine rupture and severe postpartum haemorrhage. There has been much controversy over the appropriate mode of delivery. Abdominal deliveries are complicated by delayed wound healing and increased perioperative blood loss. Vaginal deliveries may be complicated by tissue friability causing extensive perineal tears, pelvic floor and bladder lesions. Our case highlights that in specific, controlled situations it is possible to have a vaginal delivery even after previous caesarean section in patients with EDS.


Author(s):  
Vidyadhar B. Bangal ◽  
Satyajit Gavhane ◽  
Vishesha Yadav ◽  
Kunal Aher ◽  
Dhruval Bhavsar

Background: With the significant rise in the incidence of primary caesarean section(CS) for various indications, an increasing proportion of the pregnant women coming for antenatal care, report with a history of a previous CS. This necessitates definite need to bring down the caesarean section rate, either by judicious selection of cases for primary caesarean section or by attempting vaginal delivery, following previous caesarean section (VBAC).Methods: A prospective observational study was conducted to find out the success of VBAC and the common predictive factors leading to successful VBAC. A total of 136 pregnant women with full term pregnancy, having history of previous one lower segment caesarean section and without any other medical and obstetrical complication were enrolled in the study.Results: Majority of the women (95.59%) had spontaneous onset of labor. The success of VBAC was 75 percent. The commonest maternal complications were fever (7.35%), scar dehiscence (3.68%), PPH (1.47%) and wound infection (2.21%).There was significantly higher number of women who had history of previous successful VBAC, had vaginal delivery (91.67%; p=0.038).It was observed that the rate of vaginal delivery was significantly high in women with Bishop’s score between 10 to 13 (94.64%) compared to 6 to 9 (61.25%) (p<0.001).The baby weight determined by ultrasound scan was significantly associated with mode of delivery (p=0.049).Conclusions: Vaginal Birth After Caesarean section is relatively safe, provided it is conducted in carefully selected cases, under constant supervision. Spontaneous onset of labour, good Bishops score and average baby weight were good predictors of successful VBAC.


Author(s):  
Philip Hepp ◽  
Markus Fleisch ◽  
Kathrin Hasselbach ◽  
Tanja Fehm ◽  
Nora K. Schaal

Abstract Purpose Evidence abounds about the beneficial effects of music on patients and healthcare professionals for many medical indications. This study aimed to evaluate the dissemination and use of music in the obstetrical setting. Methods Invitations to an online survey were sent to physicians and midwives of all obstetrics departments in Germany. The survey gathered descriptive data as well as information about the personal relation to music and the use of it during vaginal birth (VB) and caesarean section (CS) and whether data about positive or negative effects of music were known to the participant. Results In total, there were 293 respondents. The 47% that had the means to play music during CS stated that music was played in 15% of the cases. Most respondents have the means to play music during VB (97%). Music is played in 38% of VB. Regardless of the mode of delivery, music was estimated to be positive for team communication and patient communication. It was also deemed calming and mood lifting on the respondents. Regarding the patient, music during CS and VB was rated as being positive on all scales. Listening to music was recommended more often during VB (66%) than CS (38%). Conclusions Although healthcare professionals are mostly aware of the beneficial effects of music in obstetrics, our study shows that music plays a more important role during VB than during CS in Germanys obstetrical wards. There is a lack of equipment to play music in operation theatres where CS take place.


2021 ◽  
Author(s):  
Carla Perrotta ◽  
Mariana Romero ◽  
Yanina Sguassero ◽  
Natalia Righetti ◽  
Celia Gialdini ◽  
...  

Abstract BackgroundThis paper reports on women's perspectives on the birth mode in five public maternity hospitals in Argentina. The study is a formative research study component aimed at tailoring interventions to reduce unnecessary caesarean section (CS) use. MethodsParticipants were postpartum women aged ≥15 years old in five hospitals in the provinces of Salta, Corrientes, Tucuman, Santa Fe and Buenos Aires City. Hospitals completed an institutional survey indicating the availability of obstetric services. The fieldwork was carried out from November 2018 to June 2019. Trained interviewers gathered data on obstetric history, companionship, mode of delivery preferences, and general opinion on vaginal and caesarean section births through semi-structured interviews. The interviews were coded and analysed with standard quantitative methods. ResultsThe five hospitals had a CS rate between 29.2 and 45.5. Four institutions indicated limited access to epidural and other pain management strategies and a restricted antenatal education schedule. The sample included 621 postpartum women with a mean age of 26 years (± SD 6). 60% of them had a vaginal birth (VB). More than 90% of women in three hospitals favoured VB, and in two, 67% (p<0001). CS preference was associated with giving birth in those two hospitals and the numbers of miscarriages adjusting by maternal age and previous pregnancies. The reasons for preferring a VB included faster recovery, feeling ready, and considering it more natural. Most women chose CS as the best mode of birth to avoid birth pain. CS disadvantages included post-procedure pain, dependence on others to take care of her or the baby afterwards, and prolonged time in the hospital. Six out of ten women would have liked to be asked by their providers about the MOB of choice. ConclusionsWomen giving birth in public maternity hospitals of Argentina preferred a vaginal delivery to a caesarean section. There is an ongoing need to improve access to pain management during labour and vaginal birth and include women's opinions along the decision-making process for selecting the mode of childbirth. Hospitals with a lower preference for VB will require additional efforts to understand women's needs and values. Trial registration: IS002316


Author(s):  
Soad Ajroud ◽  
Raga A. Elzahaf ◽  
Fawzia A. G. Arhaiam

Background: Vaginal birth after caesarean section is one strategy that has been developed to decrease the rate of caesarean section.Methods: The prospective observational study was carried out over a period of 01 January 2017 to 31 December 2018 years. VBAC was routinely offered at Al-Wahda hospital Derna to women fulfilling the criteria for trial of scar, according to the hospital protocol.Results: A total of 5018 deliveries took place in the study duration, there were 1039 (20.7%) had previous one caesarean section, out of which 319 (30.7%) were the number of underwent repeat caesarean section and 720 (69.3%) were the number of VBAC. The indications for emergency repeat caesarean section at Al-Wahda hospital was (29.3%) malpresentation, (24.45%) FD, (13.47) postdate, (11.59) obstracted lab and abruptiopl (5.95%). Anemia and difficult intubation were observed in repeated caesarean section.Conclusions: This study concluded that there is a high chance of success in a trial of labor. These findings might help clinicians and women in the decision-making for the mode of delivery when it comes to pregnancy with a previous caesarean section. Women are explained about the option of trial of scar and told about the risk associated with a repeat CS, so many CSs can be avoided.  


Author(s):  
Sheenam Jakhar ◽  
Veena Ganju Malla

Background: Vaginal birth after previous caesarean section is challenging for obstetricians due to increased risk of uterine rupture. Common methods for labour induction in post caesarean pregnancies are membrane sweeping, balloon catheters, prostaglandins (PGE2), and oxytocin. As currently available data is limited, the evidence of safest method of induction is lacking. The present study aimed to assess the effectiveness of intra-cervical Foley catheter for pre-induction cervical ripening in women planned for vaginal birth after caesarean section.Methods: This prospective cross-sectional study included 24 pregnant women with a history of previous caesarean section, admitted for induction of labour. Induction was performed in patients with unfavourable modified Bishop Score by intra-cervical Foley catheter. The change in modified Bishop Score, oxytocin requirement, induction-delivery interval, mode of delivery, maternal complications and neonatal outcome were observed.Results: There was significant improvement in modified BS noted at the end of trans-cervical Foley catheter induction and this improvement in mean of modified BS was observed to be statistically significant (p<0.0001). The vaginal delivery rate was 29.2% while 70.8% of patients underwent caesarean section. No significant maternal or foetal complications were observed with Foley catheter induction except for one case of vaginal bleeding. There was no case of intrapartum or postpartum maternal infection.Conclusions: Foley catheter may be a cheap and effective method for pre-induction cervical ripening and induction of labour in patients with previous caesarean section.


2015 ◽  
Vol 12 (1) ◽  
pp. 18-23
Author(s):  
Ajay Agrawal ◽  
S Chhetri ◽  
A Thakur ◽  
S Agrawal ◽  
P Basnet

Background: Pregnant women with previous caesarean section are increasing due to the liberal use of caesarean section in first pregnancy due to multifactorial reason. The risks, benefits, and relative safety of vaginal birth after caesarean (VBAC) have been subject of interest for well over 100 years. Thus mutual understanding between the treating obstetrician and patient herself is a core towards achieving good maternal and perinatal outcome considering all the risk and benefit in women with previous caesarean section. Objective: The aim was to analyze the maternal and perinatal outcome in pregnant women with previous caesarean section. Methods: In this prospective observational study, 300 women with singleton pregnancy in cephalic presentation with previous one lower segment caesarean section (LSCS) having inter pregnancy interval ≥ 18 months presenting at ≥ 37-41 week period of gestation admitted for delivery were enrolled and various maternal and perinatal outcome were noted. Results: Caesarean delivery rate during the study period was 26.95%. Eighty percent of eligible women opted for trial of labor. Successful vaginal birth after caesarean section was 29%. Elective repeat caesarean delivery was 19.66%. The rate of failed VBAC was 51%. Failed VBAC increased with increasing weight of baby. There was no difference in mean birth weight among patient who had successful VBAC, who refused VBAC and who had failed VBAC. Mode of delivery had no significant effect on the number of neonatal intensive care unit admission and number of still births.  DOI: http://dx.doi.org/10.3126/hren.v12i1.11980Health Renaissance 2014;12(1):18-23


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