scholarly journals Use of antenatal corticosteroids in Brazil: data analysis from the National Survey Nascer no Brasil

2022 ◽  
Vol 40 ◽  
Author(s):  
Antônio José Ledo Alves da Cunha ◽  
Karina Bilda de Castro Rezende ◽  
Maria Elisabeth Lopes Moreira ◽  
Silvana Granado Nogueira da Gama ◽  
Maria do Carmo Leal
Keyword(s):  
Data Analysis ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Maternal Education ◽  
Mode Of Delivery ◽  
Immune Deficiency Syndrome ◽  
Antenatal Corticosteroids ◽  
Maternal Complications ◽  
Mortality And Morbidity

ABSTRACT Objective: To estimate the rate of the use of antenatal corticosteroids (ANC) among pregnant women and to identify the conditions associated with their non-use in Brazil. Methods: Secondary data analysis from “Birth in Brazil”, a national hospital-based survey carried out in 2011–2012 on childbirth and birth. The sample was characterized regarding maternal age, marital status and maternal education, parity, mode of delivery and place of residence. The association of ANC use with gestational age and type of delivery was analyzed. The studied maternal complications were the presence of hypertension, pre-eclampsia/eclampsia, and pyelonephritis, infection by the HIV virus or acquired immune deficiency syndrome. Results: 2,623 pregnant women with less than 37 weeks of gestational age were identified, and, of these, 835 (31.8%) received ANC. The frequency of ANC use was higher among women with gestational ages between 26–34 weeks (481 cases; 48.73%). In pregnancies with less than 37 weeks, the use of ANC was 23.9% in spontaneous deliveries, 20.6% in induced deliveries and 43.8% among those who did not go into labor. The variables vaginal delivery (OR 2.5; 95%CI 1.8–3.4) and living in the countryside were associated with not using ANC, and the occurrence of pre-eclampsia/eclampsia (OR 1.8; 95%CI 1.2–2.9) was associated with the use of ANC. Conclusions: The use of ANC among Brazilian pregnant women was low. Interventions to increase its use are necessary and can contribute to reduce neonatal mortality and morbidity. ANC should be promoted in pregnancies of less than 37 weeks, especially in cases of vaginal delivery and for those living in the countryside.

scholarly journals Indicators for mode of delivery in pregnant women with uteruses scarred by prior caesarean section: a retrospective study of 679 pregnant women

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhifen Hua ◽  
Fadwa El Oualja
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Fetal Membrane ◽  
Delivery Mode ◽  
Maternal Preference

Abstract Background The delivery mode for pregnant women with uteruses scarred by prior caesarean section (CS) is a controversial issue, even though the CS rate has risen in the past 20 years. We performed this retrospective study to identify the factors associated with preference for CS or vaginal birth after CS (VBAC). Methods Pregnant women (n = 679) with scarred uteruses from Moulay Ali Cherif Provincial Hospital, Rashidiya, Morocco, were enrolled. Gestational age, comorbidity, fetal position, gravidity and parity, abnormal amniotic fluid, macrosomia, placenta previa or abruptio, abnormal fetal presentation, premature rupture of fetal membrane with labor failure, poor progression in delivery, and fetal outcomes were recorded. Results Out of 679 pregnant women ≥28 gestational weeks, 351 (51.69%) had a preference for CS. Pregnant women showed preference for CS if they were older (95% CI 1.010–1.097), had higher gestational age (95% CI 1.024–1.286), and a shorter period had passed since the last CS (95% CI 0.842–0.992). Prior gravidity (95% CI 0.638–1.166), parity (95% CI 0.453–1.235), vaginal delivery history (95% CI 0.717–1.818), and birth weight (95% CI 1.000–1.001) did not influence CS preference. In comparison with fetal preference, maternal preference was the prior indicator for CS. Correlation analysis showed that pregnant women with longer intervals since the last CS and history of gravidity, parity, and vaginal delivery showed good progress in the first and second stages of vaginal delivery. Conclusions We concluded that maternal and gestational age and interval since the last CS promoted CS preference among pregnant women with scarred uteruses.

scholarly journals Vaginal birth after caesarean section: why and how?

2017 ◽  
Vol 6 (12) ◽  
pp. 5554
Author(s):  
Vidyadhar B. Bangal ◽  
Satyajit Gavhane ◽  
Vishesha Yadav ◽  
Kunal Aher ◽  
Dhruval Bhavsar
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Section Rate ◽  
Mode Of Delivery ◽  
Vaginal Birth ◽  
Maternal Complications ◽  
History Of ◽  
Spontaneous Onset ◽  
Vaginal Birth After Caesarean

Background: With the significant rise in the incidence of primary caesarean section(CS) for various indications, an increasing proportion of the pregnant women coming for antenatal care, report with a history of a previous CS. This necessitates definite need to bring down the caesarean section rate, either by judicious selection of cases for primary caesarean section or by attempting vaginal delivery, following previous caesarean section (VBAC).Methods: A prospective observational study was conducted to find out the success of VBAC and the common predictive factors leading to successful VBAC. A total of 136 pregnant women with full term pregnancy, having history of previous one lower segment caesarean section and without any other medical and obstetrical complication were enrolled in the study.Results: Majority of the women (95.59%) had spontaneous onset of labor. The success of VBAC was 75 percent. The commonest maternal complications were fever (7.35%), scar dehiscence (3.68%), PPH (1.47%) and wound infection (2.21%).There was significantly higher number of women who had history of previous successful VBAC, had vaginal delivery (91.67%; p=0.038).It was observed that the rate of vaginal delivery was significantly high in women with Bishop’s score between 10 to 13 (94.64%) compared to 6 to 9 (61.25%) (p<0.001).The baby weight determined by ultrasound scan was significantly associated with mode of delivery (p=0.049).Conclusions: Vaginal Birth After Caesarean section is relatively safe, provided it is conducted in carefully selected cases, under constant supervision. Spontaneous onset of labour, good Bishops score and average baby weight were good predictors of successful VBAC.

scholarly journals Evaluation of Pregnancy Outcomes in Women with Hypertension Disorders of Pregnancy

2021 ◽  
Vol 15 (10) ◽  
pp. 3420-3422
Author(s):  
Kalsoom Essa Bhattani ◽  
Shumaila Khawaja Khail ◽  
Kashif Ali Samin ◽  
Zubaida Khanum Wazir ◽  
Mobashara Ghulam Muhammad ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Pregnant Women ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Postpartum Hemorrhage ◽  
Health Centre ◽  
Mode Of Delivery ◽  
Hypertensive Disorders Of Pregnancy ◽  
Maternal Complications ◽  
Hypertensive Disorders

Background and Aim: Globally, hypertension disorder is the most common disorder in pregnancy. It complicates 6–10% of pregnancies with a major contribution to the worldwide maternal mortality rate. The aim of the current study was to evaluate the pregnancy outcomes in women with Hypertension disorders. Materials and Methods: This cross-sectional study was carried out on women with hypertension disorders enrolled in the department of Gynecology, Mardan Women Hospital, Sheikh Maltoon Town, Mardan and Family Health Centre, Peshawar from March 2021 to August 2021. Demographic details such as age, gestational age, parity, intrapartum, early postpartum complications such as perinatal outcomes and mode of delivery, and antepartum were recorded from each individual. Chi-square test was used for comparing the composite adverse outcomes such as preterm birth, postpartum hemorrhage, abrupt placenta, and mortality rate. SPSS version 20 was used for data analysis. Results: Of the total 2357 pregnant women, about 146 (6.2%) women had hypertensive disorders of pregnancy. The mean age of 146 pregnant women was 29.45±4.67 years with an age range from 17 to 43 years. About 37 (25.3%) women had no perinatal and maternal complications. Out of 109 pregnant women, the prevalence of eclampsia, preeclampsia, and pregnancy-induced hypertension were 8 (7.3%), 44 (40.4%), and 57 (52.3%) respectively. Based on gestational age, preterm (24-36 weeks) and term (>37 weeks) were 35 (32.1%) and 74 (67.9%) respectively. Other maternal complications were Abruption Placentae, Postpartum hemorrhage (PPH), Renal Failure., Pulmonary Edema, Disseminated intravascular coagulation (DIC), and Maternal Death. Conclusion: Our study found hypertension disorders as a significant medical disorder in pregnant women. However, neonatal outcomes and pregnancy outcomes were significantly smooth in more than 50% of pregnant women. Keywords: Hypertensive disorders of pregnancy, Pre-eclampsia, Eclampsia.

scholarly journals Maternal factors affecting outcome of induction of labour

2019 ◽  
Vol 8 (12) ◽  
pp. 4705
Author(s):  
Shravani Devarasetty ◽  
S. Habeebullah
Keyword(s):  
Vaginal Delivery ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Single Agent ◽  
Fetal Distress ◽  
Induction Of Labour ◽  
Delivery Rate ◽  
Bishop Score ◽  
Maternal Complications ◽  
Common Procedure

Background: Induction of labour is a common procedure in modern obstetrics and accounts for 20% among all deliveries. This study aims to assess the factors associated with success/failure of induction of labour.Methods: This is a cohort study involving 220 women who underwent induction of labour in the department of obstetrics and gynaecology, MGMCRI from December 2016 to May 2018. After obtaining informed consent, patients were recruited into the study. Maternal parameters like age, parity, gestational age, BMI, Bishop score, indication of induction, method of induction, mode of delivery, maternal complications and neonatal parameters like Apgar score, birth weight and NICU admission were analyzed. Association of all parameters with mode of delivery was done by chi square test or Fisher exact test.Results: Out of 220 women who were induced, vaginal delivery rate was 56.4%. Vaginal delivery rate was high in young women of age 20-25 years (65.2%), multiparous women (65.1%), gestational age of > 40-42 weeks (64.7%), with normal BMI (67.7%), with Bishop score ≥ 5(94.6%), induced for PROM and postdates (68.6%) and induced with single agent (74%). Most common indication of caesarean section was fetal distress (43.7%) followed by meconium stained liquor (30.2%). There were no adverse perinatal outcomes.Conclusions: Women of age 20-25 years, normal BMI and induced with single agent showed statistically significant successful induction of labour.

scholarly journals On demand caesarean section: What’s women’s attitude?

1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
University Teaching ◽  
Normal Vaginal Delivery ◽  
On Demand ◽  
Assisted Delivery ◽  
The Right

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15

scholarly journals Maternal Attitude and Knowledge towards Modes of Delivery

2018 ◽  
Vol 16 (2) ◽  
pp. 209-214
Author(s):  
Anshumala Joshi ◽  
Meeta Thapa ◽  
Om Biju Panta
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
College Teaching ◽  
Cross Sectional ◽  
Medical College ◽  
Acceptable Method

Background: Whether a mother should be allowed to choose between the modes of delivery is a matter of concern among practicing obstetricians. This study aims to explore the knowledge of the Nepalese women attending a tertiary care center about the benefits and complications of vaginal and caesarean delivery and their attitude and preference for the method of delivery.Methods: The study was a hospital based cross sectional questionnaire survey conducted in Nepal Medical College teaching Hospital, Jorpati from 1stShrawan 2074 to 31st Ashoj 2074. All pregnant women who were 36 weeks or more in gestation attending the clinic during the study period were included in the study. A questionnaire was made of 10 questions for knowledge assessment regarding mode of delivery consisting of the indications, the possible complications and advantages of vaginal and caesarean delivery. Results: A total of 256 pregnant women participated in the study. The knowledge of the mode of delivery, their benefit and complications was medium to good in approximately 90% of the mothers attending the antenatal OPD. Overall attitude for vaginal delivery was positive in 93% of women and negative or neutral in 6.6%.Overall attitude for caesarean delivery was positive in 24% and negative or neutral in 75.8%.Conclusions: Women in our setup agree that vaginal delivery is a natural and acceptable method of delivery and would prefer to have a vaginal delivery. Keywords: Attitude; knowledge; modes of delivery; women.

Vaginal Delivery and Low Gestational Age are Key Risk Factors for Hypernatremia in Neonates < 32 Weeks

2021 ◽  
Author(s):  
Nadia S. Eugster ◽  
Florence Corminboeuf ◽  
Gilbert Koch ◽  
Julia E. Vogt ◽  
Thomas Sutter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Preterm Neonates ◽  
Multiple Birth ◽  
Plasma Sodium ◽  
Delivery Mode ◽  
Antenatal Corticosteroids ◽  
Clinical Complications

Abstract Background Preterm neonates frequently experience hypernatremia (plasma sodium concentrations >145 mmol/l), which is associated with clinical complications, such as intraventricular hemorrhage. Study design In this single center retrospective observational study, the following 7 risk factors for hypernatremia were analyzed in very low gestational age (VLGA, below 32 weeks) neonates: gestational age (GA), delivery mode (DM; vaginal or caesarian section), sex, birth weight, small for GA, multiple birth, and antenatal corticosteroids. Machine learning (ML) approaches were applied to obtain probabilities for hypernatremia. Results 824 VLGA neonates were included (median GA 29.4 weeks, median birth weight 1170 g, caesarean section 83%). 38% of neonates experienced hypernatremia. Maximal sodium concentration of 144 mmol/l (interquartile range 142–147) was observed 52 hours (41–65) after birth. ML identified vaginal delivery and GA as key risk factors for hypernatremia. The risk of hypernatremia increased with lower GA from 22% for GA ≥ 31–32 weeks to 46% for GA < 31 weeks and 60% for GA < 27 weeks. A linear relationship between maximal sodium concentrations and GA was found, showing decreases of 0.29 mmol/l per increasing week GA in neonates with vaginal delivery and 0.49 mmol/l/week after cesarean section. Sex, multiple birth and antenatal corticosteroids were not associated hypernatremia. Conclusion VLGA neonates with vaginal delivery and low GA have the highest risk for hypernatremia. Early identification of neonates at risk and early intervention may prevent extreme sodium excursions and associated clinical complications.

scholarly journals Prenatal lead exposure and cord blood DNA methylation in PROGRESS: an epigenome-wide association study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Jonathan A Heiss ◽  
Martha M Téllez-Rojo ◽  
Guadalupe Estrada-Gutiérrez ◽  
Lourdes Schnaas ◽  
Chitra Amarasiriwardena ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Cord Blood ◽  
Gestational Age ◽  
Lead Exposure ◽  
Inductively Coupled Plasma ◽  
Maternal Education ◽  
Association Studies ◽  
Mode Of Delivery ◽  
Underlying Mechanisms ◽  
Prenatal Lead Exposure

Abstract The effects of prenatal lead exposure on child development include impaired growth and cognitive function. DNA methylation might be involved in the underlying mechanisms and previous epigenome-wide association studies reported associations between lead exposure during pregnancy and cord blood methylation levels. However, it is unclear during which developmental stage lead exposure is most harmful. Cord blood methylation levels were assayed in 420 children from a Mexican pre-birth cohort using the Illumina Infinium MethylationEPIC microarray. Lead concentrations were measured in umbilical cord blood as well as in blood samples from the mothers collected at 2nd and 3rd trimester and delivery using inductively coupled plasma-mass spectrometry. In addition, maternal bone lead levels were measured in tibia and patella using X-ray fluorescence. Comprehensive quality control and preprocessing of microarray data was followed by an unbiased restriction to methylation sites with substantial variance. Methylation levels at 202 111 cytosine-phosphate-guanine sites were regressed on each exposure adjusting for child sex, leukocyte composition, batch variables, gestational age, birthweight-for-gestational-age, maternal age, maternal education and mode of delivery. We find no association between prenatal lead exposure and cord blood methylation. This null result is strengthened by a sensitivity analysis showing that in the same dataset known biomarkers for birthweight-for-gestational-age can be recovered and the fact that phenotypic associations with lead exposure have been described in the same cohort.

scholarly journals Comparative study of vaginal delivery and caesarean section in antepartum eclampsia at tertiary care hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 457 ◽  
Author(s):  
Priti Kumari ◽  
Sipra Singh ◽  
Salma Khatun ◽  
. Shashikar
Keyword(s):  
Caesarean Section ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Fetal Outcome ◽  
Sudden Onset ◽  
Care Hospital ◽  
Maternal Complications

Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.

scholarly journals Mode of Delivery in Drug-Dependent Pregnant Women: A Case Control Study

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Ana Raquel Neves ◽  
Fabiane Neves ◽  
Isabel Santos Silva ◽  
Maria do Céu Almeida ◽  
Pitorra Monteiro
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Case Control Study ◽  
Mode Of Delivery ◽  
Case Control ◽  
Control Group ◽  
Maternal Characteristics ◽  
Drug Dependent ◽  
Route Of Delivery ◽  
Control Study

Objective. To determine the contribution of drug use during pregnancy to the route of delivery.Methods. A case-control study was conducted at a hospital in Coimbra, Portugal, between 2001 and 2014. Drug-dependent pregnant women (n=236) were compared with a control group of low risk women (n=228) in terms of maternal characteristics, obstetric history, pregnancy complications, and labor details. Factors that influenced the mode of delivery were determined. Statistical analysis was performed with SPSS v. 23.0 (IBM Corp.).pvalues < 0.05 were considered statistically significant.Results. Drug-dependent women presented a lower rate of cesarean delivery (18.2 versus 28.9%,p=0.006). After adjusting for the factors that were significantly related to the mode of delivery, drug dependency influenced the rate of cesarean section (β=0.567; 95% CI = 0.328–0.980). Within the drug-dependent group, the mode of delivery was significantly related to previous cesarean or vaginal delivery (p=0.008andp<0.001, resp.) and fetal presentation (p<0.001), but not with the type of drug, route of administration, or substitution maintenance therapy.Conclusions. The drug-dependent group presented a significantly higher rate of vaginal delivery. However, this was not associated with the behavioral factors analyzed. We hypothesize that other social and psychological factors might explain this difference.

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