Can Uterine Scar Dehiscence Affect Hospital's Labor Management for Future Births after Cesarean Delivery? Two Years Experience of Lithuanian Tertiary Hospital

2017 ◽  
Vol 7 (3) ◽  
Keyword(s):  
Cesarean Delivery ◽  
Tertiary Hospital ◽  
Labor Management ◽  
Uterine Scar

Influence of Estimated Fetal Weight on Labor Management

2019 ◽  
Vol 37 (03) ◽  
pp. 252-257
Author(s):  
Elisa T. Bushman ◽  
Norris Thompson ◽  
Meredith Gray ◽  
Robin Steele ◽  
Sheri M. Jenkins ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Secondary Analysis ◽  
Physical Exam ◽  
Fetal Weight ◽  
Secondary Outcome ◽  
Labor Management ◽  
Increased Risk ◽  
Tertiary Center ◽  
The Impact ◽  
Estimated Fetal Weight

Abstract Objective Prior studies suggest knowledge of estimated fetal weight (EFW), particularly by ultrasound (US), increases the risk for cesarean delivery. These same studies suggest that concern for macrosomia potentially alters labor management leading to increased rates of cesarean delivery. We aimed to assess if shortened labor management, as a result of suspected macrosomia (≥4,000 g), leads to an increased rate of cesarean delivery. Study Design This is a secondary analysis of a retrospective cohort study at a single tertiary center in 2015 of women with singleton pregnancies ≥36 weeks with documented EFW by US within 3 weeks or physical exam on admission. Women were excluded if an initial cervical exam was ≥6 cm or no attempt was made to labor. In addition, patients were excluded for the diagnosis of hypertension, diabetes, or prior cesarean delivery, as these comorbidities influence the use of US, labor management, and cesarean delivery independent of fetal weight. Patients were classified as EFW of ≥4,000 and <4,000 g. Secondary analysis examined the impact of US within 3 weeks of admission when compared with physical exam at the time of admission. The primary maternal outcomes were duration of labor and cesarean delivery. Duration of labor was evaluated as total time from 4 cm to delivery (with 4-cm dilation being a surrogate marker for active labor), length of time allowed from 4 cm until the first documented cervical change (or delivery), and time in second stage of labor (complete dilation to delivery). Cesarean delivery for arrest of labor was a secondary outcome. Student's t-test, Mann–Whitney U-test, chi-squared test, and Fisher's exact test were used for univariate data analysis as appropriate. Results Of 1,506 patients included, 54 (3.5%) had EFW of ≥4,000 g. Women with EFW of ≥4,000 g had a larger body mass index, higher fetal birth weight, were more likely to be undergoing induction of labor, had a more advanced gestational age, and were more likely to have had an US within 3 weeks of delivery. They were more likely to undergo cesarean delivery (29.6 vs. 9.3%, adjusted odds ratio [AOR]: 2.7, 95% confidence interval [CI]: 1.3–5.5) despite not having shortened labor times. When analyzing this population by method of obtaining EFW, those with EFW based on US rather than external palpation were more likely to undergo cesarean delivery (13.1 vs. 7.9%, AOR: 1.5, 95% CI: 1.01–2.12), again without having shortened labor times. Conclusion EFW of ≥4,000 g and use of US to estimate fetal weight do not appear to shorten labor management despite being associated with an increased risk of cesarean delivery.

Interventions to reduce the cesarean delivery rate in a tertiary hospital in China

2019 ◽  
pp. 1-9 ◽  
Author(s):  
Xiaoyan Sha ◽  
Huiping Hu ◽  
Jinying Yang ◽  
Dajun Fang ◽  
Weidong Li ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Tertiary Hospital ◽  
Delivery Rate ◽  
Cesarean Delivery Rate

scholarly journals New Labor Management Guidelines and Changes in Cesarean Delivery Patterns

2018 ◽  
Vol 73 (5) ◽  
pp. 255-256
Author(s):  
Joshua I. Rosenbloom ◽  
Molly J. Stout ◽  
Methodius G. Tuuli ◽  
Candice L. Woolfolk ◽  
Julia D. López ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Labor Management ◽  
Management Guidelines

The consequences of previous uterine scar dehiscence and cesarean delivery on subsequent births

2014 ◽  
Vol 126 (2) ◽  
pp. 120-122 ◽  
Author(s):  
Joel Baron ◽  
Adi Y. Weintraub ◽  
Tamar Eshkoli ◽  
Reli Hershkovitz ◽  
Eyal Sheiner
Keyword(s):  
Cesarean Delivery ◽  
Uterine Scar

The Consequences of Previous Uterine Scar Dehiscence and Cesarean Delivery on Subsequent Births

2014 ◽  
Vol 69 (11) ◽  
pp. 645-647
Author(s):  
Joel Baron ◽  
Adi Y. Weintraub ◽  
Tamar Eshkoli ◽  
Reli Hershkovitz ◽  
Eyal Sheiner
Keyword(s):  
Cesarean Delivery ◽  
Uterine Scar

scholarly journals Symptomatic Uterine Rupture: A Fifteen Year Review

Medicina ◽  
2020 ◽  
Vol 56 (11) ◽  
pp. 574
Author(s):  
Egle Savukyne ◽  
Raimonda Bykovaite-Stankeviciene ◽  
Egle Machtejeviene ◽  
Ruta Nadisauskiene ◽  
Regina Maciuleviciene
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Incidence Rate ◽  
Cesarean Delivery ◽  
Epidural Anaesthesia ◽  
Uterine Rupture ◽  
Acute Abdominal Pain ◽  
Significant Risk ◽  
Uterine Scar ◽  
Previous Cesarean

Background and objectives: To assess the incidence of complete and partial uterine rupture during childbirth in a single tertiary referral centre as well as the significant risk factors, symptoms and peripartum complications. Materials and Methods: A retrospective single-centre study involved all cases of uterine rupture at the Kaunas Perinatal Centre in 2004–2019. Data were from a local medical database complemented with written information from medical records. We included 45,893 women with an intact uterus and 5630 with uterine scars. Women (n = 5626) with scarred uterus’ after previous cesarean delivery. The diagnosis was defined by clinical symptoms, leading to an emergency cesarean delivery, when complete or partial uterine rupture (n = 35) was confirmed. Asymptomatic cases, when uterine rupture was found at elective cesarean section (n = 3), were excluded. The control group is represented by all births delivered in our department during the study period (n = 51,525). The outcome was complete (tearing of all uterine wall layers, including serosa and membranes) and partial uterine rupture (uterine muscle defect but intact serosa), common uterine rupture symptoms. Risk factors were parameters related to pregnancy and labour. Results: 51,525 deliveries occurred in Kaunas Perinatal Centre during the 15 years of the study period. A total number of 35 (0.06%) symptomatic uterine ruptures were recorded: 22 complete and 13 partial, leading to an incidence rate of 6.8 per 10,000 deliveries. The uterine rupture incidence rate after a single previous cesarean delivery is 44.4 per 10,000 births. 29 (83%) cases had a uterine scar after previous cesarean, 4 (11%) had a previous laparoscopic myomectomy, 2 (6%) had an unscarred uterus. The most significant risk factors of uterine rupture include uterine scarring and augmentation or epidural anaesthesia in patients with a uterine scar after cesarean delivery. The most common clinical sign was acute abdominal pain in labour 18 (51%). No maternal, six intrapartum perinatal deaths (17%) occurred, and one hysterectomy (2.8%) was performed due to uterine rupture. Neonatal mortality reached 22% among the complete ruptures. Average blood loss was 1415 mL, 4 (11%) patients required blood transfusion. Conclusions: The incidence rate of uterine rupture (complete and incomplete) at Kaunas Perinatal Centre is 6.8 per 10,000 deliveries. In cases with a scar of the uterus after a single cesarean, the incidence of uterine rupture is higher, exceeding 44 cases per 10,000 births. The most significant risk factors were uterine scar and augmentation or epidural anaesthesia in a previous cesarean delivery. Acute abdominal pain in labour is the most frequent symptom for uterine rupture.

scholarly journals Trends in cesarean delivery rates in primipara and the associated factors

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Guoqiang Sun ◽  
Ying Lin ◽  
Honglian Lu ◽  
Wenjing He ◽  
Ruyan Li ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Associated Factors ◽  
Tertiary Hospital ◽  
Joinpoint Regression ◽  
Upward Trend ◽  
Chi Square ◽  
Child Policy ◽  
Binomial Regression ◽  
The One ◽  
Social And Cultural Factors

Abstract Background Few studies have focused on cesarean delivery (CD) trends among primipara under the one-child and the two-child policies. This study aimed to explore the trends in CD rates among primipara during 1995–2019 and the associated factors with CD risk. Methods This study obtained clinical data on primiparous mothers and newborns from 1995 to 2019 at a large tertiary hospital in Wuhan, China. Trends in CD rates were calculated using the joinpoint regression analysis. The Chi-square tests and log-binomial regression analyses were used to evaluate the associations between primary variables and CD risk. Results CD rates showed a significant upward trend with an average annual percentage change (APC) of 2.2% (95% CI: 0.6, 3.8%) during the study period. In 1995–2006, the CD rates continued to increase with an APC of 7.8% (95% CI: 4.8, 10.9%). After 2006, the CD rates started to decline by an APC of − 4.1% (95% CI: − 5.5, − 2.6%). The CD rates non-significantly increased from 36.2% in 2016 to 43.2% in 2019. Moreover, the highest CD rate during 2015–2019 was observed on August 30 (59.2%) and the lowest on September 1 (29.7%). Primipara of older age and those with >3pregnancies had higher risks of CD. Furthermore, primipara who gave birth to newborns with low birth weight and macrosomia had higher risks of CD. Conclusions Maternal and fetal as well as social and cultural factors may contribute to the rising trend of CD rates. Effective measures should be taken to control CD under the two-child policy, especially for primipara.

Impact of Recommended Changes in Labor Management for Prevention of the Primary Cesarean Delivery

2018 ◽  
Vol 38 (4) ◽  
pp. 215-216
Author(s):  
C. Thuillier ◽  
S. Roy ◽  
V. Peyronnet ◽  
T. Quibel ◽  
A. Nlandu ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Labor Management ◽  
Primary Cesarean Delivery

scholarly journals Analytical study on indications of primary cesarean section in tertiary care hospital

2019 ◽  
Vol 8 (8) ◽  
pp. 3179
Author(s):  
Arpitha S. Ballu ◽  
Asha M. B.
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Tertiary Care ◽  
Previous History ◽  
Fetal Distress ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Failed Induction

Background: Cesarean delivery is a commonest obstetric surgical procedure performed. WHO stated that regional cesarean section rate should not exceed 10 to 15%. However in many countries cesarean delivery has increased steadily over years. Hence present study is conducted to analyze various indications of primary cesarean section in a tertiary hospital, with an aim to reduce cesarean section rate.Methods: This is a retrospective study conducted in Cheluvamba hospital, Mysore Medical College Research Institute, Mysore, which is a tertiary care centre. For a period of 6months from 1st June 2018 to 31st November 2018Inclusion criteria: All primary cesarean section done at Cheluvamba hospital during study period were included.Exclusion criteria: Previous cesarean section, patients with previous history of laparotomy done for any obstetric or gynecological cause were excluded.Results: During the study period there was 3799 number of cesarean section. Amongst these 983 cases were primary cesarean section done for varying indications. Hence the rate of cesarean section in our hospital is 25.87%. There were 40.3% cases of fetal distress, failed induction (13.6%), breech (10%), CPD (8%), IUGR with poor BPP (1.8%) Ante partum haemorrhage (3%), DTA (3.5%).Conclusions: From our study, we would conclude that rising trend in cesarean section is an alarming issue. Measures need to be taken to reduce cesarean delivery like Regular use of partograph, Judicious use of amniotomy, oxytocin with inducing agents, Expertization of skills to conduct instrumental vaginal delivery, which is a lost art in modern obstetrics.

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