scholarly journals The Effect of Ethnic Variation on the Success of Induced Labour in Nulliparous Women with Postdates Pregnancies

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Dimitrios Papoutsis ◽  
Angeliki Antonakou ◽  
Chara Tzavara
Keyword(s):  
Caesarean Section ◽  
White Women ◽  
Total Sample ◽  
Ethnic Origin ◽  
Potential Effect ◽  
Primary Objective ◽  
Ethnic Variation ◽  
Nulliparous Women ◽  
Increased Risk ◽  
Observational Cohort

Objective. To identify the potential effect of ethnic variation on the success of induction of labour in nulliparous women with postdates pregnancies.Study Design. This was an observational cohort study of women being induced for postdates pregnancies (≥41 weeks) between 2007 and 2013. Women induced for stillbirths and with multiple pregnancies were excluded. The primary objective was to identify the effect of ethnicity on the caesarean section (CS) delivery rates in this cohort of women.Results. 1,636 nulliparous women were identified with a mean age of 27.2 years. 95.8% of the women were of White ethnic origin, 2.6% were Asian, and 1.6% were of Black ethnic origin. The CS delivery rate was 24.4% in the total sample. Women of Black ethnic origin had a 3.26 times greater likelihood for CS in comparison to White women, after adjusting for maternal age, BMI, smoking, presence of meconium, use of epidural analgesia, fetal gender, birth weight, and head circumference (adjusted OR = 3.26; 95% CI: 1.31–8.08,p= 0.011).Conclusion. We have found that nulliparous women of Black ethnicity demonstrate an almost threefold increased risk of caesarean section delivery when induced for postdates pregnancy.

scholarly journals A Prospective Study on the Relationship Between Cervical Dilatation at Initial Presentation in Labour and Subsequent Outcome in Nulliparous Women

2014 ◽  
Vol 13 (1) ◽  
pp. 39-41
Author(s):  
Smriti Kona Kabiraj ◽  
Juthi Bhowmik ◽  
Haradhan Deb Nath
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Fetal Distress ◽  
Cervical Dilatation ◽  
P Value ◽  
Nulliparous Women ◽  
Group I ◽  
Increased Risk ◽  
Group Ii

Background: The spontaneous birth of a live infant can convey a huge degree of both satisfaction and achievement for both the mother and her partner. Many factors influence the variation in rates of caesarean section among hospitals throughout the world. These included patients’ demographic characteristics, underlying medical and obstetric complication, hospital facilities, hospital practice and physician practice style. Objective: The present study was planned to determine how the outcome of women change with timing of admission either in active or latent phase of spontaneous labour.Methods: This was a prospective observational study, which was conducted at labour ward, department of Obstetrics and Gynaecology, BSMMU hospital and DMCH Dhaka, from February 1, 2008 to August 30, 2008, where data were collected prospectively. Patients with any medical or obstetric complications, rupture of membrane antenatally diagnosed fetal anomalies or death and with prior caesarean section were excluded from the study. Patients with cervical dilatation at less than 4cm were in group I. On the other hand, patients with cervical dilatation of 4 cm or more in active phase and these types of patients were allocated in group II.Results: Outcome differences were compared using chi-square(X2) test, fishers exact test, A ‘p’ value <0.05 considered significant. Main outcome variables were duration of labour, mode of delivery, indication for caesarean section, need for oxytocin, labour analgesia, Apgar score <7, maternal PPH and postpartum hospital stay. A total 500 patients were enrolled during the study period. Of them 308 patients were (61.6%) in group I and 192 patients (38.4%) in group II. Dystocia was the main indication for caesarean delivery in early admitted group which was 58.6% and fetal distress in late admitted group which was 37.5%. Second commonest indication for caesarean section was fetal distress which was 31.6% in group I and dystocia 50.0% in group II). Oxytocin for augmentation was used in 70.0% in group I and 30.0% in group II.Conclusion: It is shown that early admission to the hospital in low-risk women may negatively affect the outcome of labour and are at increased risk of prolonged labour, more oxytocin used, increased rate of caesarean section.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19417

scholarly journals Usefulness of Robson classification system to analyze caesarean section deliveries: a hospital based study

2020 ◽  
Vol 6 (1) ◽  
pp. 38-44
Author(s):  
Tshering Tamang ◽  
Jigme Dema ◽  
Sonam Pelden ◽  
Phuntsho Choden
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Primary Objective ◽  
Referral Hospital ◽  
World Health ◽  
Delivery Methods ◽  
Robson Classification ◽  
Increased Risk ◽  
Tertiary Hospitals ◽  
Health Organization

Introduction: World Health Organization recommends using the Ten-group Robson classification as a standard for assessing and reducing caesarean section (CS) rates. Our study aimed at analyzing CS deliveries using this system with the primary objective of examining the driving factors of increased risk for caesarean delivery. Methods: A retrospective observational study was conducted in Mongar Regional Referral Hospital from 1st January 2016 to 31st December, 2018 recruiting all institutional deliveries and classifying each of them into 10 groups of Robson classification system based on six obstetric variables. Results: There were 2337 deliveries, of which 804 were CS, contributing to a rate of 34.4%. More than three fourth (78.9%) of caesarean deliveries occurred in Groups 5, 4, 2 and 1. Previous CS was the highest contributor of CS rate and the most common indication. Conclusion: Higher CS rate has been observed in our referral hospital, contributed largely by women with previous CS, induced labour and pre-labour CS. There is a need for implementation of Robson classification system in all tertiary hospitals.

scholarly journals Does the length of second stage of labour or second stage caesarean section in nulliparous women increase the risk of preterm birth in subsequent pregnancies?

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Cathy Z. Liu ◽  
Nicole Ho ◽  
Keisuke Tanaka ◽  
Christoph Lehner ◽  
Renuka Sekar ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Subsequent Pregnancy ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Index Pregnancy ◽  
Nulliparous Women ◽  
Increased Risk ◽  
Significant Difference

AbstractShort communicationThis study aimed to investigate the role of prolonged second stage of labour and second stage caesarean section on the risk of spontaneous preterm birth (sPTB) in a subsequent pregnancy.Objectives and MethodsThis was a retrospective cohort study of nulliparous women with two consecutive singleton deliveries between 2014 and 2017 at a tertiary centre. In the vaginal delivery cohort, subsequent pregnancy outcomes for women with a prolonged second stage (>2 h) were compared with those with a normal second stage (≤2 h). In the caesarean delivery cohort, women with a first stage or a second stage were compared with the vaginal delivery cohort. The primary outcome was subsequent sPTB.ResultsA total of 821 women met inclusion criteria, of which 74.8% (614/821) delivered vaginally and 25.2% (207/821) delivered by caesarean section. There was no association between a prolonged second stage in the index pregnancy and subsequent sPTB (aOR 0.70, 95% CI 0.13–3.83, p=0.7). The risk of subsequent sPTB was threefold for those with a second stage caesarean section; however this did not reach statistical significance.ConclusionsA prolonged second stage of labour in the index pregnancy is not associated with an increased risk of subsequent sPTB. A second stage caesarean section in the index pregnancy may be associated with an increased risk of subsequent sPTB, however there was no statistically significant difference. These findings are important for counseling and suggest that the effects of these factors are not clinically significant to justify additional interventions in the subsequent pregnancy.

scholarly journals Caesarean Section Analysis of the Rate According to Robson Ten Group Classification

2021 ◽  
Vol 8 (01) ◽  
pp. 37-42
Author(s):  
Srividhya R ◽  
Jhansi Rani K
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Placenta Previa ◽  
Caesarean Section Rate ◽  
Relative Size ◽  
Group Classification ◽  
Nulliparous Women ◽  
Increased Risk ◽  
Group 5 ◽  
Group 1

BACKGROUND In current and subsequent births, Caesarean sections bear their own risks for maternal and perinatal morbidity and mortality. In contrast with vaginal delivery, Caesarean section has increased risk of blood transfusion, hysterectomy and death and the risk of uterine rupture, placenta accreta and placenta previa in future pregnancies is also increased. We wanted to analyse the Caesarean section rate using Robson ten group classification system & identify the leading groups contributing to high caesarean section rates using Robson ten group classification system. METHODS This observational descriptive study enrolled 11,090 women who underwent delivery, of whom 5117 (46.14 %) women delivered vaginally and 5973 (53.86 %) women delivered through Caesarean section. RESULTS Overall caesarean section percentage was 53.86 %. Major contributors for the CSR were Group 5, 2 and 1 in that order. CS rate in Group 5 and 1 is relatively increased. Ratio of relative size of Group 1 and 2 is 1:2 indicating a greater number of prelabour caesarean sections in nulliparous women. Caesarean section rate in Group 1 and 2 was 15.7 % and 20.1 % respectively. The main indications for caesarean sections being fetal distress, non-progressive labour and severe oligohydramnios / anamnios. Relative size of Group 1 and 5 was 47.3 % stating that most of the obstetric population was in Group 1 and 5. Caesarean section rate in Group 3 and Group 4 was relatively higher than expected; this may be due to our institute being a referral center. Group 5 contributed 45.7 % to overall caesarean section rate. CONCLUSIONS Standardisation of indication of Caesarean deliveries, regular audits and definite protocols in hospital will aid in decreasing the Caesarean section rate in hospital. KEYWORDS Kidney Size, Ultrasound Assessment, Age Groups

Racial Disparities in Pregnancy-associated Intimate Partner Homicide

2021 ◽  
pp. 088626052199083
Author(s):  
Aaron J. Kivisto ◽  
Samantha Mills ◽  
Lisa S. Elwood
Keyword(s):  
Black Women ◽  
Ethnic Minority ◽  
Racial Disparities ◽  
White Women ◽  
The United States ◽  
Intimate Partner ◽  
Intimate Partner Homicide ◽  
Homicide Victimization ◽  
Increased Risk ◽  
Racial Ethnic

Pregnancy-associated femicide accounts for a mortality burden at least as high as any of the leading specific obstetric causes of maternal mortality, and intimate partners are the most common perpetrators of these homicides. This study examined pregnancy-associated and non-pregnancy-associated intimate partner homicide (IPH) victimization among racial/ethnic minority women relative to their non-minority counterparts using several sources of state-level data from 2003 through 2017. Data regarding partner homicide victimization came from the National Violent Death Reporting System, natality data were obtained from the Centers for Disease Control and Prevention’s National Center for Health Statistics, and relevant sociodemographic information was obtained from the U.S. Census Bureau. Findings indicated that pregnancy and racial/ethnic minority status were each associated with increased risk for partner homicide victimization. Although rates of non-pregnancy-associated IPH victimization were similar between Black and White women, significant differences emerged when limited to pregnancy-associated IPH such that Black women evidenced pregnancy-associated IPH rates more than threefold higher than that observed among White and Hispanic women. Relatedly, the largest intraracial discrepancies between pregnant and non-pregnant women emerged among Black women, who experienced pregnancy-associated IPH victimization at a rate 8.1 times greater than their non-pregnant peers. These findings indicate that the racial disparities in IPH victimization in the United States observed in prior research might be driven primarily by the pronounced differences among the pregnant subset of these populations.

scholarly journals The presence of lupus nephritis additionally increases the risk of preeclampsia among pregnant women with systemic lupus erythematosus

Lupus ◽  
2021 ◽  
pp. 096120332110047
Author(s):  
Katarina Bremme ◽  
Sonja Honkanen ◽  
Iva Gunnarsson ◽  
Roza Chaireti
Keyword(s):  
Caesarean Section ◽  
Lupus Nephritis ◽  
Pregnant Women ◽  
Lupus Erythematosus ◽  
Premature Birth ◽  
Renal Involvement ◽  
Significant Risk ◽  
Obstetric Outcomes ◽  
Increased Risk ◽  
Renal Lupus

Introduction Pregnant women with systematic lupus erythematosus (SLE) have an increased risk of obstetric complications, such as preeclampsia and premature births. Previous studies have suggested that renal involvement could further increase the risk for adverse obstetric outcomes. Aims: The aim of this study was to compare the obstetric outcomes in a Swedish cohort of patients with SLE with and without lupus nephritis (LN). Patients and methods The study was conducted as a retrospective observational study on 103 women with SLE, who gave birth at the Karolinska University Hospital between the years 2000-2017. Thirty-five women had previous or active LN and 68 women had non-renal lupus. Data was collected from digital medical records. The outcomes that were analysed included infants born small for gestational age (SGA), premature birth, preeclampsia, SLE- or nephritis flare and caesarean section. Results Women with LN, both with previous and with renal flare during pregnancy suffered from pre-eclampsia more often compared to women with non-renal lupus (25.7% vs 2.9%, p = 0.001) and this complication was associated with premature birth (p = 0.021) and caesarean section (p = 0.035). Conclusions Lupus nephritis is a significant risk factor for adverse obstetric outcomes in women with SLE, including preeclampsia. Those patients could benefit from more frequent antenatal controls and more vigorous follow-up.

The ratio of circulating endothelin-1 to endothelin-3 associated with TIMI risk and dynamic TIMI risk score in ST elevation acute myocardial infarction

2020 ◽  
Vol 98 (9) ◽  
pp. 637-643 ◽  
Author(s):  
Anggoro Budi Hartopo ◽  
Ira Puspitawati ◽  
Hasanah Mumpuni
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Score ◽  
Multivariable Analysis ◽  
Primary Objective ◽  
St Segment Elevation ◽  
Timi Score ◽  
Increased Risk ◽  
Timi Risk Score ◽  
Elevation Acute Myocardial Infarction

In ST segment elevation acute myocardial infarction (STEMI), the endothelin (ET) system imbalance, reflected by the circulating ET-1:ET-3 ratio has not been investigated. This study’s primary objective was to measure the circulating ET-1:ET-3 ratio and correlate it with the risk stratification for 1 year mortality of STEMI based on TIMI score. On admission, the TIMI risk score and at discharge, the dynamic TIMI risk score were calculated in 68 consecutive subjects with STEMI. Subjects with high TIMI risk score were associated with higher mean ET-1 level and ET-1:ET-3 ratio. The ET-1:ET-3 ratio more accurately predicted the high on admission TIMI risk score than the ET-1 level. Subjects with high dynamic TIMI risk score were associated with higher mean ET-1 level and ET-1:ET-3 ratio. The ET-1:ET-3 ratio more accurately predicted the high at discharge dynamic TIMI risk score than ET-1 level. From multivariable analysis, the ET-1:ET-3 ratio was not independently associated with high on admission TIMI risk score but independently predicted high at discharge dynamic TIMI risk score (odds ratio = 9.186, p = 0.018). In conclusion, combining the ET-1 and ET-3 levels into the ET-1:ET-3 ratio provided a prognostic value by independently predicting the increased risk to 1 year mortality as indicated by at discharge dynamic TIMI risk score in patients with STEMI.

scholarly journals Ethnic Disparities in the Development of Sight-Threatening Diabetic Retinopathy in a UK Multi-Ethnic Population with Diabetes: An Observational Cohort Study

2021 ◽  
Vol 11 (8) ◽  
pp. 740
Author(s):  
Manjula D. Nugawela ◽  
Sarega Gurudas ◽  
Andrew Toby Prevost ◽  
Rohini Mathur ◽  
John Robson ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Ethnic Differences ◽  
Minority Groups ◽  
Treatment Options ◽  
Ethnic Disparities ◽  
Ethnic Minority Groups ◽  
The United Kingdom ◽  
Increased Risk ◽  
Observational Cohort ◽  
General Practices

There is little data on ethnic differences in incidence of DR and sight threatening DR (STDR) in the United Kingdom. We aimed to determine ethnic differences in the development of DR and STDR and to identify risk factors of DR and STDR in people with incident or prevalent type II diabetes (T2DM). We used electronic primary care medical records of people registered with 134 general practices in East London during the period from January 2007–January 2017. There were 58,216 people with T2DM eligible to be included in the study. Among people with newly diagnosed T2DM, Indian, Pakistani and African ethnic groups showed an increased risk of DR with Africans having highest risk of STDR compared to White ethnic groups (HR: 1.36 95% CI 1.02–1.83). Among those with prevalent T2DM, Indian, Pakistani, Bangladeshi and Caribbean ethnic groups showed increased risk of DR and STDR with Indian having the highest risk of any DR (HR: 1.24 95% CI 1.16–1.32) and STDR (HR: 1.38 95% CI 1.17–1.63) compared with Whites after adjusting for all covariates considered. It is important to optimise prevention, screening and treatment options in these ethnic minority groups to avoid health inequalities in diabetes eye care.

scholarly journals Hypertension in the United States Fire Service

2021 ◽  
Vol 18 (10) ◽  
pp. 5432
Author(s):  
Saeed U. Khaja ◽  
Kevin C. Mathias ◽  
Emilie D. Bode ◽  
Donald F. Stewart ◽  
Kepra Jack ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Population ◽  
Age Groups ◽  
Total Sample ◽  
The United States ◽  
Fire Service ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cardiac Events ◽  
Antihypertensive Medications ◽  
Increased Risk

Hypertension is a major risk factor for atherosclerotic cardiovascular disease and cardiac remodeling and is associated with an increased risk of sudden cardiac events, the leading cause of duty-related death in the fire service. We assessed systemic blood pressures and prevalence of hypertension among US firefighters by decade of life. Medical records of career firefighters (5063 males and 274 females) from four geographically diverse occupational health clinics were assessed. Hypertension was defined as systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg, or taking antihypertensive medication. Results from the firefighter sample were compared to the US general population (2015–2016 and 2017–2018 National Health and Nutrition Examination Surveys). Among the total sample, 69% of firefighters met the criteria for hypertension and 17% were taking antihypertensive medications. Percentages of hypertensive male and female firefighters were 45% and 11% among 20–29 years old, respectively, and increased to 78% and 79% among 50–59 years old, respectively. Compared to the general population, male firefighters had a higher prevalence of hypertension (p < 0.05) across all age groups (11–16% higher). In order to improve firefighter health and protect against sudden incapacitation in this public safety occupational group, increased efforts are necessary to screen for and manage high blood pressure.

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