Vaginal birth after cesarean (VBAC): fear it or dare it? An evaluation of potential risk factors

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Anastasia Lazarou ◽  
Magdalena Oestergaard ◽  
Johanna Netzl ◽  
Jan-Peter Siedentopf ◽  
Wolfgang Henrich
Keyword(s):  
Body Mass Index ◽  
Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Body Mass ◽  
Vaginal Birth ◽  
Vacuum Extraction ◽  
Vaginal Birth After Cesarean ◽  
Vaginal Deliveries ◽  
Spontaneous Delivery

Abstract Objectives The consultation of women aspiring a vaginal birth after caesarean may be improved by integrating the individual evaluation of factors that predict their chance of success. Retrospective analysis of correlating factors for all trials of labor after caesarean that were conducted at the Department of Obstetrics of Charité-Universitätsmedizin Berlin, Campus Virchow Clinic from 2014 to October 2017. Methods Of 2,151 pregnant women with previous caesarean, 408 (19%) attempted a vaginal birth after cesarean. A total of 348 women could be included in the evaluation of factors, 60 pregnant women were excluded because they had obstetric factors (for example preterm birth, intrauterine fetal death) that required a different management. Results Spontaneous delivery occurred in 180 (51.7%) women and 64 (18.4%) had a vacuum extraction. 104 (29.9%) of the women had a repeated caesarean delivery. The three groups showed significant differences in body mass index, the number of prior vaginal deliveries and the child’s birth weight at cesarean section. The indication for the previous cesarean section also represents a significant influencing factor. Other factors such as maternal age, gestational age, sex, birth weight and the head circumference of the child at trial of labor after caesarean showed no significant influence. Conclusions The clear majority (70.1%) of trials of labor after caesarean resulted in vaginal delivery. High body mass index, no previous spontaneous delivery, and fetal distress as a cesarean indication correlated negatively with a successful vaginal birth after cesarean. These factors should be used for the consultation of pregnant women.

The effect of prepregnancy body mass index on birth weight, preterm birth, cesarean section, and preeclampsia in pregnant women

2018 ◽  
Vol 32 (22) ◽  
pp. 3818-3823 ◽  
Author(s):  
Maryam Mohammadi ◽  
Saman Maroufizadeh ◽  
Reza Omani-Samani ◽  
Amir Almasi-Hashiani ◽  
Payam Amini
Keyword(s):  
Body Mass Index ◽  
Birth Weight ◽  
Preterm Birth ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Body Mass ◽  
Prepregnancy Body Mass Index

scholarly journals Relationship of Oxygen Saturation with Neonatal and Maternal factors in Vaginal and Cesarean Deliveries

2015 ◽  
Vol 53 (199) ◽  
Author(s):  
Shyam Kumar Mahato ◽  
Nagendra Chaudhary ◽  
Susana Lama ◽  
K N Agarwal ◽  
B D Bhatia
Keyword(s):  
Body Mass Index ◽  
Birth Weight ◽  
Cesarean Section ◽  
Body Mass ◽  
Apgar Score ◽  
Pulse Oximeter ◽  
Maternal Factors ◽  
Cesarean Deliveries ◽  
Vaginal Deliveries ◽  
Cesarean Births

Introduction: Hypoxemia is the major cause of neonatal morbidity and mortality. The study aims to determine the influence of birth weight, Apgar score, gestation age, body mass index and hemoglobin of mother on levels of SpO2 in healthy newborns born vaginally and through cesarean section. Methods: A hospital Based, observational study conducted in Department of Pediatrics, Universal College of Medical Sciences-Teaching Hospital, Bhairahawa, Lumbini, Nepal; on 49 vaginal and 49 cesarean deliveries with Apgar Score ≥ 6. SpO2 was estimated by pulse oximeter post-ductally between 1 to 30 minutes of birth. The observed SpO2 values were correlated with neonatal and maternal factors. Results: Vaginal and Cesarean deliveries SpO2 were comparable for birth weight, gestational age, Apgar score of neonates, body mass index and hemoglobin of the mother. Birth weight in vaginally delivered babies and Apgar score in cesarean births showed significant change in SpO2 (P<0.05). At all points of time the SpO2 values were higher in neonates, born by cesarean than those born out of spontaneous vaginal deliveries (P<0.001). Conclusions: SpO2 levels in neonates born through cesarean section were higher in comparison to thoseborn by vaginal route. Birth weight and Apgar score had correlation with SpO2 in vaginal and cesarean births, respectively.Keywords: Apgar score; birth weight; newborn; pulse oximeter; SpO2.

CLINICAL AND SUBCLINICAL CHARACTERICTIS AND PREGNANCY OUTCOME OF FETAL MACROSOMIA AT OBSTETRIC DEPARTMENT AT HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2020 ◽  
pp. 78-84
Author(s):  
Giang Truong Thi Linh ◽  
Quang Mai Van
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Vaginal Birth ◽  
Fetal Macrosomia ◽  
Major Influence ◽  
Maternal Complications ◽  
Perineal Tear ◽  
History Of

Background: Fetal macrosomia has a major influence on maternal, neonatal and pregnancy outcomes.Objective: To describe the clinical and subclinical features and the management of fetal macrosomia on pregnancy outcomes. Subjects and methods: Study subjects including pregnant women and babies born ≥ 3500 g with nulliparous and over 4000 grams with primiparous or multiparous at Departement of Obstetrics and Gynecology in Hue University of Medicine and Pharmacy Hospital. The time of choosing subjects to enter the research group is that after birth, the weight is above 3500/4000 grams, then follow up the pregnancy result and retrospect the clinical and subclinical characteristics. Results: From May 2019 to April 2020, there were 223 pregnant women with the birth weight ≥ 3500 g in this study. The mean neonatal weight for macrosomia was 3869.96 ± 315.72 (g). The birth weight ≥ 4000 g, the rate of cesarean section was 91.5%, vaginal birth was 8.5%. The birth weight 3500 - under 4000 g, the rate of cesarean section was 76%, vaginal birth was 24%. 1.1% maternal complications was perineal tear. Conclusion:Factors related to fetal macrosomia: Maternal age, gender of fetus, parity, a history of fetal macrosomia, maternal height, pregnancy weight gain. Caesarean section is the majority. Key words: Fetal macrosomia, gestational diabetes mellitus, normal labor, caesarean section.

Primary cesarean section in term, low-risk multiparous women: a single clinic retrospective observational study

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Kimitoshi Imai MD
Keyword(s):  
Observational Study ◽  
Cesarean Section ◽  
Breech Presentation ◽  
Vaginal Birth ◽  
Low Risk ◽  
Retrospective Observational Study ◽  
Vacuum Extraction ◽  
Cesarean Sections ◽  
Vaginal Deliveries ◽  
Multiparous Women

Background: Multiparous women who have previously delivered vaginally are generally considered to be at low risk for cesarean section. We aimed to determine the incidence rate and indications for primary cesarean section and operative vaginal deliveries among multiparous women with previous vaginal births. Patients and methods: Multiparous women who had delivered their babies in our clinic between January 2004 and December 2019 were enrolled in this retrospective observational study. The inclusion criteria were as follows: delivery at 37 weeks of gestation or more, singleton pregnancy with a live fetus, had one or more past vaginal deliveries including instrumental vaginal birth, and no history of previous cesarean section. Women with placenta previa, abruptio placentae, severe pregnancy-induced hypertension, and uncontrolled medical diseases were referred to tertiary hospitals and excluded from this study. The frequency of occurrence and indications for cesarean section and vacuum extraction, duration of labor, and the effect of induction of labor on the cesarean section rates were analyzed. Results: A total of 3094 multiparous women were enrolled. Primary cesarean section was performed in 30 women (30/3094=0.97%). The indications for cesarean section included the following: breech presentation in 28 women, myomectomy after the first vaginal birth in one (of 29 elective cesarean sections), and failed vacuum extraction after a prolonged second stage in one (one emergency cesarean section). Vacuum extraction was performed in 61 women (61/3094=2.0%), the indications for which were non-reassuring fetal status (n=38), prolonged 2nd stage of labor (n=10), and narrow pelvic outlet (n=10). Vaginal breech delivery occurred in 11 women. Induction of labor (n=402) did not affect the cesarean section rate. Conclusion: In multiparous women, breech presentation was the main indication for primary cesarean sections, and the cesarean section rate was very low in women with cephalic presentation.

scholarly journals Intake of antioxidants nutrients by pregnant womem: Associated factors

2018 ◽  
Vol 31 (4) ◽  
pp. 353-362
Author(s):  
Luiz Gonzaga Ribeiro SILVA NETO ◽  
Marilene Brandão TENÓRIO ◽  
Raphaela Costa FERREIRA ◽  
Alane Cabral Menezes de OLIVEIRA
Keyword(s):  
Public Health ◽  
Body Mass Index ◽  
Birth Weight ◽  
Vitamin A ◽  
Health System ◽  
Pregnant Women ◽  
Body Mass ◽  
Associated Factors ◽  
Public Health System ◽  
Maternal Body Mass Index

ABSTRACT Objective To evaluate the intake of antioxidant nutrients by pregnant women being cared for in the Brazilian public health system and associated factors. Methods A cross-sectional study was carried out with pregnant women cared for in the public health system in the city of Maceió, Brazil, in 2014, including 385 pregnant women and their newborns, and the collection of maternal information (socioeconomic, personal, prenatal, dietary and anthropometric data), and after the babies’ birth (gestational age, birth weight and length). Food intake was assessed by two 24-hour dietary reminders per pregnant woman with subsequent adjustments by the Estimated Average Requirement method. Data were processed and Pearson’s correlation was used to evaluate associations, considering p<0.05 as significant. Results A total of 388 pregnant women with a mean age of 24.06±5.92 years were studied, with inadequate intake and high variation of the following antioxidants: vitamin A (83.2%/62.7%), vitamin C (50.5%/75.7%), vitamin E (76.5%/60.2%), Selenium (60.8%/50.3%), Copper (98.5%/42.8%) and Zinc (79.6%/43.4%), respectively. Additionally, the following associations were observed: the intake of vitamin A (p=0.02), Copper (p=0.01), and Selenium (p=0.01) with the maternal Body Mass Index; the intake of vitamin A (0.04) and Selenium (p=0.02) with the birth weight; and between vitamin A (p=0.04) with the birth length. Conclusion The low intake of antioxidant nutrients by pregnant women is a reality, being associated to the maternal Body Mass Index and the birth weight and length of the newborn.

scholarly journals The effects of body mass index, smoking and anemia on fetal birth weight

2021 ◽  
Vol 29 ◽  
Author(s):  
Ersin Çintesun ◽  
Feyza Nur İncesu Çintesun ◽  
Meltem Aydoğdu ◽  
Emine Taşkın ◽  
Mete Can Ateş ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Birth Weight ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Body Mass ◽  
Fetal Weight ◽  
Important Indicator ◽  
Significant Difference ◽  
Fetal Birth Weight ◽  
Smoking Group

Objective: Fetal growth is an important indicator of fetal health. Low birth weight (LBW) is also associated with increased perinatal morbidity and mortality. Numerous factors that affect fetal weight have been identified. In this study, we aimed to investigate the effect of body mass index, smoking, and anemia on fetal birth weight on term pregnant women who had vaginal delivery in our clinic. Methods: This study is a retrospective cross-sectional study. This study included patients who had a spontaneous vaginal delivery at our hospital between January 1st, 2018, and June 15th, 2020. Measurements of hemoglobin (Hb) and hematocrit (Hct) levels during birth supported the diagnosis of anemia. Hb levels were compared in three categories in this study: (1) Hb<10 g/dL; (2) ≥10<11 g/dL; and (3) Hb ≥11 g/dL. Anemia was defined as having a Hb level <11 mg/dL. Birth weight was categorized as LBW <2500 g; normal birth weight (NBW) as ≥2500–3999 g, and macrosomia as ≥4000 g. Results: Analysis was performed on 1428 pregnant women. There was a statistically significant difference for the Hct and Hb subgroups between the groups (p<0.05). Fetal birth weight was found higher in the non-smoking group than in the smoking group (3302.1± 381.5 g vs. 2839.7±491.5 g; p<0.001). Body mass index (BMI) and Hb levels positively predicted fetal birth weight (β=0.134; p<0.001 and β=0.051; p=0.046), smoking was negatively predicted fetal birth weight (β=-0.245; p<0.001). Conclusion: BMI, Hb levels, and smoking status during mothers’ delivery are effective on fetal weight. Smoking was the strongest predictor of fetal birth weight compared with the other variables.

scholarly journals Nutritional status of pregnant women - effects on the course and pregnancy outcome

2021 ◽  
Vol 74 (1-2) ◽  
pp. 15-19
Author(s):  
Isidora Djozic ◽  
Edita Stokic ◽  
Jelena Nikolic
Keyword(s):  
Body Mass Index ◽  
Gestational Diabetes ◽  
Cesarean Section ◽  
Nutritional Status ◽  
Arterial Hypertension ◽  
Pregnant Women ◽  
Body Mass ◽  
Apgar Score ◽  
Statistical Significance ◽  
The Impact

Introduction. In recent decades, obesity has taken on epidemic proportions and is becoming one of the most significant public health problems today. The results of clinical and epidemiological studies show that obese pregnant women can be considered a high risk group, given the increased risk of maternal and fetal complications. The aim of this study was to examine the relationship between pregnant women?s nutritional status and the development of arterial hypertension, gestational diabetes and obstetric cholestasis during pregnancy, as well as the impact of pregnant women?s nutritional status on newborn birth weight and vital parameters at birth, assessed by Apgar score. Material and Methods. This retrospective study included 71 pregnant women who were divided into two groups, depending on the nutritional status. The first group included 28 pregnant women with a body mass index < 25 kg/m? or less, whereas the second group included obese pregnant women with a body mass index > 30 kg/m? or more. Birth protocol data were used for the newborns. Results. In obese pregnant women, the termination of pregnancy by cesarean section was statistically significant more frequent (p < 0.05). Newborns of obese mothers had a statistically lower Apgar score at 5 minutes, while higher body weight of newborns and a lower Apgar score at 1 minute were at the limit of statistical significance (p = 0.068). Arterial hypertension was more common in obese pregnant women (p = 0.014), while gestational diabetes (p = 0.42) and obstetric cholestasis (p = 0.51) were more common in obese pregnant women, but without statistical significance. Conclusion. Obesity in pregnancy is a risk factor for the development of hypertension, a higher incidence of cesarean section, and a lower Apgar score of newborns.

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