Subpubic Arch Angle and Mode of Delivery in Low-Risk Nulliparous Women

Objective: To assess whether subpubic arch angle (SPA) measurement before labor onset can predict labor outcome among low-risk pregnant women. Methods: 3D ultrasound volume was transperineally acquired from a series of nulliparous women with uncomplicated pregnancy at term before the onset of labor. SPA was measured offline using Oblique View Extended Imaging (OVIX) on each volume performed by an investigator not involved in the clinical management. Labor outcome was prospectively investigated in the whole study group. Results: Overall, 145 women were enrolled in the study. Of these, 83 underwent spontaneous vaginal delivery, whereas obstetric intervention was performed in 62 cases (Cesarean section in 40 and vacuum extraction in 22). The SPA appeared to be significantly narrower in the women submitted to obstetric intervention compared with those undergoing spontaneous vaginal delivery (116.8 ± 10.3° vs. 123.7 ± 9.6°, p < 0.01). At multivariate analysis SPA and maternal age were identified as independent predictors of the mode of delivery. On the other hand, the duration of labor did not show a significant relationship with SPA. Conclusions: In low-risk nulliparous women at term gestation, SPA measurement obtained by 3D ultrasound before the onset of labor seems to predict the likelihood of an obstetric intervention but not the duration of labor.

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The impact of delivery mode on the risk of neonatal intracranial haemorrhage

Slovenian Nursing Review ◽

10.14528/snr.2019.53.3.751 ◽

2019 ◽

Vol 53 (3) ◽

Author(s):

Nika Buh ◽

Miha Lučovnik

Keyword(s):

Vaginal Delivery ◽

Intracranial Haemorrhage ◽

Caesarean Delivery ◽

Mode Of Delivery ◽

Vacuum Extraction ◽

Delivery Mode ◽

Spontaneous Vaginal Delivery ◽

Emergency Caesarean ◽

Vaginal Deliveries ◽

The Impact

Introduction: The objective of the study was to examine the association between the mode of delivery and the incidence of neonatal intracranial haemorrhage.Methods: Slovenian National Perinatal Information System (NPIS) data for the period 2002 through 2016 were analysed. Nulliparous women delivering singleton neonates in cephalic presentation weighting 2,500 to 4,000g were included. Incidence of neonatal intracranial haemorrhage in vacuum delivery vs. other modes of delivery was compared using the Chi-square test (p < 0.05 significant).Results: 125,393 deliveries were included: 5,438 (4 %) planned caesarean deliveries, 9,7764 (78 %) spontaneous vaginal deliveries, 15,577 (12 %) emergency caesarean deliveries, and 6,614 (5 %) vacuum extractions. 17 (0.14/1000) neonatal intracranial haemorrhages were recorded: 12 occurred in spontaneous vaginal deliveries, two in emergency caesarean deliveries, and three in vacuum extractions. In comparison to infants born by spontaneous vaginal delivery, those delivered by vacuum extraction had higher rates of intracranial haemorrhage (odds ratio (OR) 3.70; 95% confidence interval (CI) 1.04−13.10). Risk estimates did not reach statistical significance when comparing infants born by vacuum extraction and those born by emergency caesarean delivery (OR 3.54; 95% CI 0.59−21.16).Discussion and conclusion: Infants born by vacuum extraction have significantly higher rates of intracranial haemorrhage than those born by spontaneous vaginal delivery although the absolute risk is small. There are no significant differences in the rates of intracranial haemorrhage in vacuum extraction vs. emergency caesarean delivery.

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Angle of Progression on Ultrasound in the Second Stage of Labor and Spontaneous Vaginal Delivery

American Journal of Perinatology ◽

10.1055/s-0037-1608633 ◽

2017 ◽

Vol 35 (04) ◽

pp. 413-420 ◽

Cited By ~ 2

Author(s):

Caroline Rouse ◽

David Cantonwine ◽

Sarah Little ◽

Thomas McElrath ◽

Julian Robinson ◽

...

Keyword(s):

Vaginal Delivery ◽

Prospective Observational Study ◽

Mode Of Delivery ◽

Transperineal Ultrasound ◽

Survival Models ◽

Spontaneous Vaginal Delivery ◽

Second Stage Of Labor ◽

Second Stage ◽

Nulliparous Women ◽

Angle Of Progression

Objective The objective of this study was to assess the association between the angle of progression (AoP) measured by transperineal ultrasound and mode of delivery and duration of the second stage. Study Design This is a prospective observational study of nulliparous women with a singleton gestation at term in which serial transperineal ultrasound examinations were obtained during the second stage of labor. Multivariable logistic regression and adjusted survival models were used for the analysis. Results A total of 137 patients were included in the analysis and median AoP for the study group was 153 degrees. The adjusted odds ratio (aOR) of requiring an operative delivery was 2.6 times higher for those patients who had an AoP < 153 degrees and the aOR of requiring a cesarean delivery was almost six times higher when compared with those patients who had an AoP ≥ 153 degrees (95% confidence interval [CI]: 1.0, 6.2; p = 0.04; aOR: 5.8, 95% CI: 1.2–28.3; p = 0.03, respectively). Those patients with an AoP < 153 degrees were at a higher hazard of staying pregnant longer (adjusted hazard ratio: 1.8, 95% CI: 1.2–2.8, p = 0.005). Conclusion The AoP has the potential to predict spontaneous vaginal delivery and the duration of the second stage of labor which may be useful in counseling patients and managing their labor.

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OC07.06: The subupic angle measured by a novel 3D ultrasound technique and the mode of delivery in low-risk nulliparous women

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.13508 ◽

2014 ◽

Vol 44 (S1) ◽

pp. 17-17

Author(s):

A. Youssef ◽

F. Martelli ◽

E. Montaguti ◽

G. Salsi ◽

G. Pilu ◽

...

Keyword(s):

Mode Of Delivery ◽

3D Ultrasound ◽

Low Risk ◽

Ultrasound Technique ◽

Nulliparous Women

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Effect of Immediate vs Delayed Pushing on Rates of Spontaneous Vaginal Delivery Among Nulliparous Women Receiving Neuraxial Analgesia

Obstetrical & Gynecological Survey ◽

10.1097/01.ogx.0000553984.98807.a6 ◽

2019 ◽

Vol 74 (3) ◽

pp. 131-133

Author(s):

Alison G. Cahill ◽

Sindhu K. Srinivas ◽

Alan T. N. Tita ◽

Aaron B. Caughey ◽

Holly E. Richter ◽

...

Keyword(s):

Vaginal Delivery ◽

Spontaneous Vaginal Delivery ◽

Neuraxial Analgesia ◽

Nulliparous Women

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Association between mode of delivery and postpartum depression: A systematic review and network meta-analysis

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867420954284 ◽

2020 ◽

pp. 000486742095428

Author(s):

Lei Sun ◽

Su Wang ◽

Xi-Qian Li

Keyword(s):

Postpartum Depression ◽

Confidence Interval ◽

Cesarean Section ◽

Vaginal Delivery ◽

Odds Ratio ◽

Meta Analysis ◽

Mode Of Delivery ◽

Spontaneous Vaginal Delivery ◽

Emergency Cesarean Section ◽

Emergency Cesarean

Background: Postpartum depression is one of the most common postpartum diseases, which has an important impact on the interaction between mother, infant, partner and family, as well as the long-term emotional and cognitive development of infants. However, there are still great disagreements on whether the delivery mode will affect the risk of postpartum depression. The purpose of this study is to explore whether the mode of delivery will affect the risk of postpartum depression through the comprehensive network meta-analysis of elective cesarean section, emergency cesarean section, instrumental vaginal delivery and spontaneous vaginal delivery. Methods: We searched in three electronic databases: PubMed, EMBASE and Cochrane Library. Results: This paper included 43 studies with a total sample size of 1,827,456 participants. Direct meta-analysis showed that the odds ratio of postpartum depression risk was 1.33 (95% confidence interval = [1.21, 1.46]) between cesarean section and vaginal delivery. The odds ratios of high Edinburgh Postpartum Depression Scale score between cesarean section and vaginal delivery in the three postpartum periods (within 2 weeks, within half a year and over half a year) were basically the same. There was no difference between cesarean section and vaginal delivery in the risk of severe postpartum depression at the Edinburgh Postpartum Depression Scale cut-off point ⩾13 (odds ratio = 1.07; 95% confidence interval = [0.99, 1.16]). Network meta-analysis showed that the risk of postpartum depression in the pairwise comparisons emergency cesarean section vs spontaneous vaginal delivery and elective cesarean section vs spontaneous vaginal delivery was odds ratio = 1.53 (95% confidence interval = [1.22, 1.91]) and 1.47 (95% confidence interval = [1.16, 1.86]). Conclusion: The mode of delivery has a significant effect on the occurrence of mild postpartum depression. Women who give birth by cesarean section, especially who give birth by emergency cesarean section, are at a higher risk of mild postpartum depression. We should carefully monitor the progress of postpartum mental disorders in women who delivered by cesarean section and make it possible for women to have a quick access to mental healthcare.

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Satisfaction and maternal postnatal adjustments following different modes of delivery

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200351 ◽

2020 ◽

Vol 9 (2) ◽

pp. 640

Author(s):

Manorama Eti ◽

Sunitha C. ◽

Sarojamma C. ◽

Sai Lakshmi M. P. A.

Keyword(s):

Caesarean Section ◽

Vaginal Delivery ◽

Health Care Professionals ◽

Psychological Symptoms ◽

Mode Of Delivery ◽

Postnatal Period ◽

P Value ◽

Spontaneous Vaginal Delivery ◽

Good Communication ◽

Initiation Of Breastfeeding

Background: Childbirth has a profound influence in a women’s life. One factor that has been more consistently identified as influencing the women’s physical and psychological symptoms following childbirth is the mode of birth. This study aims at figuring out on women’s satisfaction with their mode of delivery and what difficulties they faced in the immediate postnatal period accordingly.Methods: All women who delivered between the period 1st July 2019 to 1st August 2019 were interviewed with a pretested semi structured questionnaire on postnatal day two. Patient was asked how much they were satisfied with their mode of delivery, immediate postnatal adjustments like ambulation, holding the baby first time, initiation of breastfeeding and pain score following different modes of delivery. The data was analysed to find out which mode of delivery made women more comfortable in the immediate postnatal period.Results: A total 97.1% women were satisfied with the support they got from health care professionals during labour. But when compared, spontaneous vaginal delivery group were satisfied with their mode of delivery (P-value-0.0005 highly significant) than the rest. Women who had vaginal delivery were ahead of caesarean group in terms of ambulation, holding the baby, initiation of breastfeeding and were well adjusted in their postnatal period.Conclusions: Authors conclude that women in our study were more satisfied with spontaneous vaginal delivery than caesarean section which was reflected in their immediate postnatal adjustments. As obstetricians’ authors need to understand the empowering effects of the psychological experience of vaginal delivery. The benefits of this process can be maximized through good communication skills and emotional support for women, enhancing their confidence to deliver normally so that caesarean section is done only when really indicated.

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Comment on “Impact of Mode of Delivery on Female Postpartum Sexual Functioning: Spontaneous Vaginal Delivery and Operative Vaginal Delivery vs Cesarean Section”

Journal of Sexual Medicine ◽

10.1016/j.jsxm.2016.03.373 ◽

2016 ◽

Vol 13 (7) ◽

pp. 1142-1143 ◽

Cited By ~ 1

Author(s):

Antonio Simone Laganà ◽

Alessio Platania ◽

Salvatore Butticè ◽

Salvatore Giovanni Vitale

Keyword(s):

Cesarean Section ◽

Vaginal Delivery ◽

Sexual Functioning ◽

Mode Of Delivery ◽

Spontaneous Vaginal Delivery ◽

Operative Vaginal Delivery

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Cesarean delivery among women with prolonged labor induction

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0357 ◽

2016 ◽

Vol 44 (7) ◽

Cited By ~ 3

Author(s):

Louise L. Highley ◽

Rebecca A. Previs ◽

Sarah K. Dotters-Katz ◽

Leo R. Brancazio ◽

Chad A. Grotegut

Keyword(s):

Cesarean Delivery ◽

Vaginal Delivery ◽

Mode Of Delivery ◽

Labor Induction ◽

University Hospital ◽

Delivery Rate ◽

Multivariate Logistic Regression Model ◽

Nulliparous Women ◽

Prolonged Labor ◽

Cesarean Delivery Rate

AbstractObjective:The objective of this study was to determine characteristics associated with cesarean delivery among women with labor induction lasting over 24 h.Study design:Women with live singleton pregnancies without prior cesarean delivery undergoing a labor induction lasting >24 h between September 2006 and March 2009 at Duke University Hospital were identified. Collected variables were compared between subjects by mode of delivery. A multivariate logistic regression model for the outcome cesarean delivery was constructed separately for nulliparous and parous women.Results:There were 303 women who met inclusion criteria. The overall cesarean delivery rate was 57% (n=172) and remained constant with time (P=0.15, test-for-trend). Nulliparous women having a cesarean delivery were more likely to be obese [adjusted OR (aOR) 2.00; 95% CI 1.05, 3.80] and have a larger fetus [aOR 1.11 (aOR for every 100 g increase in birthweight), 95% CI 1.03, 1.20] compared to those having a vaginal delivery.Conclusion:Increasing BMI and birthweight were independent predictors of cesarean delivery among nulliparous women with prolonged labor induction. Despite this, after 24 h of labor induction, the overall mean cesarean delivery rate remained constant at 57%, and did not change with time. Among women having a vaginal delivery following a prolonged labor induction, we saw high rates of shoulder dystocia, operative vaginal delivery and severe perineal laceration.

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Personal Preference of Mode of Delivery. What do Urogynaecologists choose? Preliminary Results of the DECISION Study

Geburtshilfe und Frauenheilkunde ◽

10.1055/s-0043-120919 ◽

2017 ◽

Vol 77 (11) ◽

pp. 1182-1188 ◽

Cited By ~ 4

Author(s):

Julia Bihler ◽

Ralf Tunn ◽

Christl Reisenauer ◽

Jan Pauluschke-Fröhlich ◽

Philipp Wagner ◽

...

Keyword(s):

Caesarean Section ◽

Risk Stratification ◽

Pelvic Floor ◽

Vaginal Delivery ◽

Elective Caesarean Section ◽

Mode Of Delivery ◽

Online Questionnaire ◽

Personal Attitude ◽

Uncomplicated Pregnancy ◽

Study Participants

Abstract Introduction Currently, almost every third child in Germany is delivered by caesarean section. Apart from straightforward and clear indications for caesarean section which account for approx. 10%, the large proportion of relative indications in particular needs to be critically reviewed if the current C-section rate is to be effectively lowered. It is more than doubtful, however, whether this can be a realistic goal in Germany, especially in the context of international developments. All studies on this topic demonstrate that the personal attitude of the obstetric team has a considerable influence on the pregnant womanʼs personally preferred mode of delivery. Therefore, in the first part of the DECISION study, the personal preferences of urogynaecologists were evaluated regarding the best suitable mode of delivery. Material and Methods All 432 delegates at the 9th German Urogynaecology Congress in Stuttgart in April 2017 were invited to participate in an online questionnaire study. The questionnaire was developed especially for this study. Results Of the 432 registered delegates, 189 (43.8%) participated in the survey. 84.7% (n = 160) of the study participants would prefer a vaginal delivery, in an otherwise uncomplicated pregnancy. Only 12.2% (n = 23) opted for an elective caesarean section. The main reasons stated for this decision were concerns about incontinence (87.5%) and pelvic floor trauma (79.2%). Amongst the study participants, 83.6% would like to be part of a risk stratification system presented in the questionnaire which, with the aid of specific parameters, is intended to allow early identification of a population with a high risk of developing pelvic floor disorders. There was also great interest in postpartum pelvic floor recovery (97.8%) and an associated optional pessary therapy (64.4%). The type of delivery already experienced (vaginal delivery vs. primary caesarean section) and parity also reveals to have a significant influence on the personal preferred mode of delivery as well. Conclusions Urogynaecologists prefer vaginal delivery for themselves. There is a great interest to participate in a risk stratification process in order to approach childbirth in an individualized and risk-adapted manner.

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