Analysis on the Outcome of Tubal Interstitial Pregnancy after Partial Cornual Resection

2021 ◽  
Vol 7 (5) ◽  
pp. 1865-1877
Author(s):  
Ye Wang ◽  
Beilei Ge

Objective: To investigate the safety of re-pregnancy after partial cornual resection for tubal interstitial pregnancy. Methods: The clinical data of 22 cases of re-pregnancy after partial cornual resection from November 20J 3 to June 20J 9 were retrospectively analyzed, the operation condition, re-pregnancy outcome and neonatal outcome were analyzed. Results: 18 of the 21 cases were tubal interstitial pregnancy, the re-pregnancy interval was 6-36 months, the median delivery time was 17.4 moths, the median delivery time was 36 weeks (28-41+2W), there was 2 cases of birth weight <2500 g. The remaining 4 cases were interstitial heterotopic pregnancy, the median delivery time was 36 weeks (32+4-38+2W), there was 1 case of birth weight <2500g. Of the 22 patients, 21 were delivered by cesarean section and 1 was vaginal delivery, all the newborns survived. There were no cases of rupture of uterus, adhesion or implantation of placenta at uterine horn. Conclusion: The patients with tubal interstitial pregnancy after standard partial cornual resection have a good outcome of re-pregnancy.

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110183
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa

The adverse neonatal outcome is defined as the presence of birth asphyxia, respiratory distress, birth trauma, hypothermia, meconium aspiration syndrome, neonatal intensive care admission, and neonatal death. It is a major concern in developing countries, including Ethiopia. This study tried to identify predictors of adverse neonatal outcomes at selected public hospitals in Eastern Ethiopia. A hospital-based prospective follow-up study was conducted in three public hospitals in Eastern Ethiopia from June to October 2020. A total of 2,246 laboring women and neonates born at the hospitals were enrolled in the study. Data were collected through interviews, observation checklists, and clinical chart review. Reports were presented in relative risks with 95% CIs. The overall magnitude of adverse neonatal outcome was 20.97% (95% CI: 19.33- 22.71%). It was 24.3% for babies born through cesarean section (95% CI: 21.3%, 27.5). The presence of meconium in the amniotic fluid increased the risk for neonates delivered via cesarean section (ARR, 1.52 95% CI; 1.04, 2.22). Among neonates born via vaginal delivery, the risk of adverse neonatal outcome was higher among nullipara women (ARR, 1.42 95% CI; 1.02, 1.99) and among women diagnosed with abnormal labor or pregnancy such as APH, pre-eclampsia, obstructed labor, fetal distress, and mal-presentation at admission (ARR, 1.30 95%CI; 1.01, 1.67). The risk of adverse neonatal outcome was higher among babies born through the cesarian section than those born via vaginal delivery. Abnormal labor or pregnancy and being primiparous increased the risk of adverse neonatal outcome in vaginal delivery.


2020 ◽  
Vol 80 (10) ◽  
pp. 1033-1040
Author(s):  
Anne Dathan-Stumpf ◽  
Katharina Winkel ◽  
Holger Stepan

Abstract Objective The appropriate delivery mode for twins is discussed controversially in the literature. The aim of this study was to investigate delivery modes and short-term neonatal outcomes of twin pregnancies delivered in University Hospital Leipzig. Material and Methods A total of 274 twin pregnancies (32.0 to 39.4 weeks of gestation) delivered between 2015 and 2017 were analyzed retrospectively with regard to the planned and final delivery mode as well as neonatal outcomes. The inclusion and exclusion criteria for vaginal delivery were comparable to those of the Twin Birth Study. Results The spontaneous birth rate for births planned as vaginal deliveries was 78.5%; the rate of secondary cesarean section was 19.4%. The final total cesarean rate was 58.8%, and the rate of vaginal deliveries was 41.2%. Vertex or non-vertex position of the second twin had no significant effect on neonatal outcome or mean delivery interval between the birth of the first and second twin. Chorionicity, neonatal weight and gender had no significant impact on delivery mode. However, successful vaginal delivery was associated with higher gestational age and both fetuses in vertex position. The combined neonatal outcome for both twins was significantly worse if they were delivered by cesarean section compared to spontaneous birth. In addition, the leading twin in monochorionic/diamniotic (MC/DA) pregnancies was intubated more frequently after cesarean delivery and had significantly lower Apgar scores. Conclusion Vaginal delivery in twin pregnancies is a practicable and safe option in specific defined conditions and when the appropriate infrastructure and clinical experience is available.


Author(s):  
Liyan Hu

Objective To investigate the effect of different methods of delivery on the outcome of twin pregnancies. Methods This is a retrospective cohort review of 627 twin pregnancies with delivery from January 2016 to December 2019. According to the clinical guidelines for cesarean section, the cesarean section and vaginal delivery groups were determined. Finally, the baseline information, delivery method, pregnancy outcome, and maternal and infant complications of the two groups were compared. Results For different delivery methods, the incidence of preeclampsia was significantly higher in the cesarean section group than in the vaginal delivery group (χ2 = 4.405, p < 0.05). There were 23 fetal growth ratios (FGR) in the cesarean section group, which were significantly higher than the vaginal delivery group (χ2 = 4.740, p < 0.05). However, the incidence of preterm premature rupture of membranes (PPROM) in the vaginal delivery group was significantly higher than in the cesarean section group (χ2 = 5.235, p < 0.05). In addition, the volume of postpartum bleeding in the vaginal delivery group was significantly higher than in the cesarean section group (t = 4.723, p < 0.001). The neonatal weights and 5-minute Apgar scores of the vaginal delivery group were lower than the cesarean section group, and the difference was statistically significant. In the vaginal delivery group, 48 and 26 neonates were transferred to the intensive care and neonatal units, respectively, which were significantly higher than in the cesarean section group (χ2 = 5.001, p < 0.05). Conclusion The major complications of a twin pregnancy are gestational diabetes mellitus and PPROM. Cesarean section can reduce the rate of neonatal asphyxia in twins and improve the pregnancy outcome. Key Points


Author(s):  
Pratibha Singh ◽  
Vibha Rani Pipal ◽  
Dharmendra Kumar Pipal ◽  
Navdeep Kaur Ghuman ◽  
Garima Yadav ◽  
...  

Background: The aim of this study was to compare the outcomes of pregnancies complicated by isolated oligohydramnios with the low risk pregnancies with normal amniotic fluid volume.Methods: The present study is a retrospective cohort study of singleton pregnancies diagnosed with Isolated oligohydramnios (AFI≤5) in their third trimester (N=35). Pregnancy outcome was compared with a matched control group of low risk pregnancies with amniotic fluid volume >5 (N=30).Results: The overall incidence of Isolated oligohydramnios was 0.7-0.8%. In oligohydramnios group, significant association were found in null-parity (60% vs 23.33%, p-value<0.005), Fetal growth retardation (25.71% vs 0% p-value<0.02), preterm delivery (22.85% vs 3.33%, p-value 0.025), rate of Induction of labor (40% vs 10%) and cesarean rate for non-reassuring fetal heart rate (20% vs 3.33%, p-value<0.001). Likewise, the incidence of low birth weight was (54.28% vs 13.33%, p-value<0.001) and NICU admissions was (20% vs 0%, p-value<0.01), but there was no difference in Apgar score finding. NICU stay was of short duration and all babies discharged in stable condition, there were no stillbirth or early neonatal death in both groups.Conclusions: Isolated oligohydramnios has an adverse influence on pregnancy and neonatal outcome in the form of FGR, preterm delivery, increased rate of Induction and cesarean section. Despite the high incidence of low birth weight and NICU admissions, the overall early neonatal outcome was similar to the other low risk pregnancies.


2021 ◽  
Vol 104 (4) ◽  
pp. 645-653

Background: Siriraj Hospital has seen remarkably high cesarean section rates during the last decade. A labor induction protocol has been established to reduce cesarean section rate from “failed induction”. Objective: To determine effectiveness of a sequential low dose misoprostol solution protocol for labor induction. Cervical ripening and vaginal delivery rates, pregnancy outcomes, and associated factors of successful vaginal delivery were determined. Materials and Methods: The present study was a retrospective observational study. Medical records of women with a term singleton pregnancy and with Bishop score of 6 or less who underwent labor induction were reviewed. The induction protocol started with series 1 which was 25 mL oral misoprostol solution (1 mcg/mL) every two hours for a maximum of 24 hours. If Bishop score was 6 or less by the end of series 1, then series 2 would follow, comprising 50 mL oral misoprostol solution (1 mcg/mL) every four hours for a maximum of 24 hours. Data of Bishop scores, delivery route by the end of each series, pregnancy outcomes, and possible associated factors were collected. Results: One hundred twenty-eight women were analyzed. The overall rate of cervical ripening, with a Bishop score of more than 6, was 92.2%, and at 88.3% with series 1 only. Successful vaginal delivery was achieved in 70 cases (54.7%), 53 of whom were delivered within 24 hours. Significantly associated factors with successful vaginal delivery were multiparity, and birth weight of 3,200 grams or less; adjusted OR 4.0 (95% CI 1.31 to 12.16, p=0.015) and 3.4 (95% CI 1.48 to 7.63, p=0.004), respectively. No serious adverse pregnancy outcomes were observed. Conclusion: With Siriraj induction protocol, success rates of cervical ripening and vaginal delivery were 92.2% and 54.7%, respectively, without serious adverse outcomes. Significant associated factors of successful vaginal delivery were multiparity and birth weight of 3,200 grams or less. Keywords: Oral misoprostol, Misoprostol solution, Low dose, Labor induction, Cervical ripenting, Vaginal delivery


2018 ◽  
Vol 46 (2) ◽  
pp. 191-195 ◽  
Author(s):  
Rashi Bhargava ◽  
Madhu Mathur ◽  
Jyoti Patodia

AbstractObjectives:To study the normal oxygen saturation trends and fetomaternal correlates in healthy term newborns within 30 min of life born by normal vaginal delivery (NVD) and elective cesarean section (CS).Materials and methods::A cross-sectional study was conducted on 200 healthy term newborns born by NVD and elective CS at a tertiary care centre. Routine care as per the Neonatal Resuscitation Program (NRP) 2015 (Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, et al. Part 13: neonatal resuscitation: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132:S543–60) protocol was given and pre-ductal arterial oxygen saturation was assessed by pulse oximetry at different intervals after birth.Results:The mean peripheral oxygen saturation (SpO2) was 85.4%, 90.8%, 94.1%, 95.7%, 96.7% and 97.4% at 5, 10, 15, 20, 25 and 30 min, respectively, after birth. Higher mean SpO2was observed in NVD compared to elective CS (P<0.005). The mean time for SpO2to reach >90% was 9.13 min in NVD and 12.31 min in elective CS (P<0.001). Maternal hemoglobin (Hb) (r=−0.15; P<0.01), birth weight (r=−0.125; P<0.05) and Apgar at 10 min (r=0.33; P<0.001) were significantly correlated with SpO2of newborns at 10 min of life.Conclusion:Our study defines normal SpO2levels in healthy term newborns in the first 30 min of life born by NVD and elective CS. Babies born by NVD had significantly higher SpO2levels and attained SpO2>90% faster than those born by elective CS. Maternal Hb, birth weight and Apgar at 10 min were significant factors affecting SpO2levels of newborns at 10 min of life.


2021 ◽  
Vol 8 (3) ◽  
pp. 339-345
Author(s):  
Sivajyothi Pilli ◽  
Kavitha Bakshi

Pregnancy induced Hypertension (PIH) is strongly associated with intrauterine fetal growth restriction (IUGR), low birth weight (LBW) and admission to NICU. PIH is not by itself an indication for caesarean delivery. However, the incidence of caesarean is high because of the development of complications in mother and the need to deliver prematurely. To compare the immediate morbidity and survival advantage of LBW vertex presenting babies with the mode of delivery in hypertensive disorders complicating pregnancies. This was a comparative cross-sectional study done on women admitted to the labour ward during the study period with PIH delivering a baby through either a vaginal delivery or a caesarean section with a birthweight of &#60;2.5kgs. A detailed history taking and clinical examination was done. Babies were followed up for one week following delivery to note down the early neonatal outcome. In this study, over all there was no statistically significant difference in neonatal outcome in both vaginal delivery and caesarean section groups. However, there was slight increased incidence of prematurity (68% vs 64%), Birth Asphyxia (14% vs 8%), Sepsis (8% vs 6%), IVH (6% vs 2%) and Hyperbilirubinemia (16% vs 14%) in vaginal delivery group. While, RDS (20% vs 14%) and NEC (4% vs 2%) had higher incidence in caesarean delivery group. Overall, prematurity and IUGR resulting in LBW, contributed to these neonatal complications. Caesarean delivery offers no short-term survival advantage compared with vaginal delivery for LBW vertex presenting foetuses in PIH patients. Neonatal outcomes are not worsened by spontaneous or induced vaginal delivery in women with hypertension with good control and also decreases morbidity due to caesarean section to the mother.


2000 ◽  
Vol 34 (6) ◽  
pp. 596-602 ◽  
Author(s):  
Marco A Barbieri ◽  
Antônio AM Silva ◽  
Heloisa Bettiol ◽  
Uilho A Gomes

OBJECTIVE: To identify risk factors for low birth weight (LBW) among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.


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