scholarly journals Perspectives, Decision Making, and Final Mode of Delivery in Pregnant Women With a Previous C-Section in a General Hospital in Peru: Prospective Analysis

2017 ◽  
Vol 2 (2) ◽  
pp. 238146831772440 ◽  
Author(s):  
Maria Lazo-Porras ◽  
Angela M. Bayer ◽  
Ana Acuña-Villaorduña ◽  
Claudia Zeballos-Palacios ◽  
Deborah Cardenas-Montero ◽  
...  
2020 ◽  
Vol 1 (2) ◽  
pp. 59-67
Author(s):  
Dian Puspita Virdayanti ◽  
Khanisyah Erza Gumilar

Background: Maternal obesity is defined when BMI is above 30. It is now considered one of the most commonly occurring risk factors seen in obstetric practice and it increased risks of specific complications, and to medical, surgical and technical challenges in providing safe maternity care. Objectives: This study aims to review maternal dan neonatal outcomes and complications from pregnant women with obesity in Soetomo General Hospital on January - December 2017. Methods: Retrospective cross-sectional study by using medical record data of Dr. Soetomo General Hospital on January - December 2017. Results: There were 297 (21,5%) of maternal obesity from 1384 deliveries, in which the majority age range from 20-34 years old and multiparity. The most BMI category was BMI class 1 (61%). Caesarean section (77,4%) in this study became a major proportion in mode of delivery. In our study, the incidence of hypertension in pregnancy was high (45,4%), while the incidence of severe preeclampsia were 20,9%. The incidence of gestational diabetes were 7,1%, and pregestational diabetes were 3,4%. In our cases, there were 294 cases (94,2%) of livebirth, while there were four stillbirth cases. The incidence of intrauterine fetal death were four cases. There were 11 cases of macrosomia, 7 in 11 came from mother with obesity class III. Other neonatal complications are intrauterine growth restriction which were 26 cases and 18 cases congenital malformation. Conclusion: Most maternal complications in obese pregnant women are severe preeclampsia with mode of delivery by cesarean section. Gestational diabetes cases were found mostly in maternal obesity class I, while pregestational diabetes cases were found mostly in maternal obesity class II. Most neonatal Apgar score in our study were between 7-10, while most of congenital malformation was omphalocele


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatemeh Hadizadeh-Talasaz ◽  
Faezeh Ghoreyshi ◽  
Fatemeh Mohammadzadeh ◽  
Roghaieh Rahmani

Abstract Background The promotion of vaginal birth after cesarean section (VBAC) is the best method for the reduction of repeated cesarean sections. Nonetheless, the decisional conflict which often results from inadequate patient involvement in decision making, may lead to delayed decision making and regret about the choices that were made. The present study aimed to determine the effect of shared decision making on the mode of delivery and decisional conflict and regret in pregnant women with previous cesarean section. Methods This randomized clinical trial was conducted on 78 pregnant women with a previous cesarean section referring to community health centers in Torbat-e Jam, Iran, in 2019. They were randomly assigned to two groups of intervention and control. During weeks 24-30 of pregnancy, the Decisional Conflict Scale (DCS) was completed by pregnant mothers. Apart from the routine care, the experimental group received a counseling session which was held based on the three-talk model of shared decision making. This session was moderated by a midwife; moreover, a complementary counseling session was administered by a gynecologist. During weeks 35–37 of pregnancy, DCS was completed, and the Decision Regret Scale (DRS) was filled out for both groups at the 8th weeks postpartum and they were asked about the mode of delivery. Data were analyzed in SPSS software (version 19) using the Mann-Whitney, Chi-squared and Fisher’s exact tests. p-value less than 0.05 was considered statistically significant. Results After the intervention, the decisional conflict score was significantly lower in the shared decision making (SDM) group, compared to that in the control group (14.90 ± 9.65 vs. 25.41 ± 13.38; P < 0.001). Moreover, in the SDM group, the rate of vaginal birth was significantly higher than that in the control group (P < 0.001). Two month after the delivery, the mean score of decision regret was lower in the SDM group, in comparison to that in the control group (15.67 ± 23.37 vs. 27. 30± 26.75; P = 0.007). Conclusions Based on the results of the study, shared counseling can be effective in the reduction of decisional conflict and regret, as well as rate enhancement of VBAC. Therefore, it can be concluded that this counseling method can be used in prenatal care to reduce the rate of repeated cesarean section. Trial registration IRCT20190506043499N1; Name of the registry: Iranian Registry of Clinical Trials; Registered 10. August 2019. URL of registry: https://en.irct.ir/trial/39538. Date of enrolment of the first participant to the trial: August 2019.


Author(s):  
Ashenafi Habte Woyessa ◽  
Jote Markos Caffo ◽  
Thanasekaran Palanichamy

<p><strong>Objective</strong>: In Ethiopia very little or probably nothing is known about the significance of obstetric emergencies. This study was therefore aimed at assessing magnitude, characteristics, and outcomes of obstetric emergencies in western Ethiopia.</p><p><strong>Study Design:</strong> Institution based prospective cohort study was employed from January to June 2017. To select the hospitals, area sampling technique was used. Total of 567 pregnant women with obstetric emergencies presented and treated in respective hospitals during the study periods and met the inclusion criteria were consecutively included.</p><p><strong>Results:</strong> Majority (91.7%) of the identified obstetric emergencies have led to termination of pregnancy. Significant proportions of pregnant women (11%) who reached health facility died of obstetric emergencies. Pregnant women with obstetric emergencies traveled to facility carried by people were found to have died about 8 times more likely as compared to those who were transported by ambulance. While 29.21% of women gave birth to normal life births, stillbirth and neonatal death were 8.02% and 7.4% respectively. Higher number of neonatal death was also observed among mothers in whom final mode of delivery was a cesarean section (AOR: 0.19(0.05, 0.62)) compared to spontaneous vaginal delivery.</p><p><strong>Conclusion:</strong> This study has revealed that obstetric emergencies are responsible for the significant number of maternal and perinatal death. If the women have been accessed early and received optimum emergency care, many cases of the occurred death would have been prevented. Better outcome can be achieved through maximum utilization of quality and comprehensive antenatal care and organized pre-hospital obstetric emergency services.</p>


Author(s):  
Enrico Ferrazzi ◽  
Luigi Frigerio ◽  
Valeria Savasi ◽  
Patrizia Vergani ◽  
Federico Prefumo ◽  
...  

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Mirijam Hall ◽  
David Endress ◽  
Susanne Hölbfer ◽  
Barbara Maier

AbstractObjectivesTo report clinical data on maternal outcome, mode of delivery and immediate neonatal outcome in women infected with COVID-19.MethodsRetrospective data collection.ResultsA total of 8.6% of the total population of hospitalised SARS-CoV-2 positive pregnant women were admitted to a critical care unit. The premature birth rate for births before 34+0 weeks of gestation among pregnant women who tested positive for SARS-CoV-2 was 7.1%. One newborn (3.6%) tested positive for SARS-CoV-2 two days after birth and showed symptoms.ConclusionsPregnant women with COVID-19 seem to be at higher risk of invasive ventilation, admission to a critical care unit and preterm birth, and should therefore be considered a high-risk-population.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Koech Irene ◽  
Poli Philippe Amubuomombe ◽  
Richard Mogeni ◽  
Cheruiyot Andrew ◽  
Ann Mwangi ◽  
...  

Abstract Background Eclampsia, considered as serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital. Methods This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5. Results During the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0–40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1–2.0). Conclusion There is no benefit of emergency caesarean section for women with eclampsia. This study showed that induction of labour and vaginal delivery can be successfully achieved in pregnant women with eclampsia. Maternal and perinatal mortality from eclampsia can be prevented through prompt and effective care.


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