scholarly journals Mode of delivery and outcome of breech presentation: a prospective observational study in a tertiary centre

2017 ◽  
Vol 6 (8) ◽  
pp. 3409
Author(s):  
Rashmi Kumar Karning ◽  
Bhanu B. T. ◽  
. Sarojini
Keyword(s):  
Observational Study ◽  
Cesarean Section ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Fetal Outcome ◽  
Short Term ◽  
Maternal Complications ◽  
Breech Delivery ◽  
Vaginal Breech Delivery

Background: Breech presentation is the commonest malpresentation with the incidence of 3-4% at term. This study was done with the objective of studying the mode of delivery in breech presentation and to compare the maternal and fetal outcome in patients delivered vaginally to those delivered by cesarean section.Methods: This prospective observational study was conducted in Vanivilas Hospital, affiliated to Bangalore Medical College and Research Institute, from June 2014 to May 2015. The study group included 509 patients with breech presentation who were studied with respect to their gestational age, birth weight, type of breech, mode of delivery, maternal and perinatal outcome.Results: The incidence of breech presentation was 2.92% (509) among 17454 total deliveries with the incidence of 3.17% in primi and 2.73% in multies. 193 (38%) patients had vaginal breech delivery and 316 (62%) delivered by LSCS. Apgar score of less than 7 at 1 minute was seen with 21.42% of vaginally delivered fetuses and 9.09% of fetuses delivered by cesarean section. The perinatal mortality was 1.6% (8 cases) in vaginal group 0.8% (4 cases) in LSCS group. The short term maternal complications in LSCS group was 7.62% and in vaginal delivery group was 3.09%.Conclusions: The short term maternal morbidity is higher in patients with cesarean section compared to those with vaginal breech delivery. Perinatal outcome is better in babies delivered by cesarean section. Still vaginal breech delivery can be an option for breech babies with proper selection and when conducted by a skilled obstetrician.

scholarly journals REVIVAL OF VAGINAL BREECH DELIVERY

1969 ◽  
Vol 5 (1) ◽  
pp. 597-602
Author(s):  
NASIM AKHTAR
Keyword(s):  
Cesarean Section ◽  
Neonatal Mortality ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
Maternal Complications ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Emergency Cesarean

BACKGROUND: Since the publication of term breech trail there had been a dramatic changeworldwide from selective to planned Cesarean Section for all women with breech presentation at term.This high cesarean section rate led to adverse consequences in subsequent pregnancy &on futurefertility. Choice of safest mode of delivery has always been a dilemma.OBJECTIVE: Prospective interventional study. This study was done to determine the safety of vaginalbreech birth in terms of neonatal & maternal complications, so that to encourage the trend of breechdelivery in carefully selected cases & to discourage the trend of routinely recommending cesareansection for all gravidas with fetus in breech presentation at term. The study was conducted atDepartment of Obstetrics & Gynae Mardan Medical Complex from January 2010 to December 2015.PATIENTS & METHOD: About 809 patients with singleton pregnancy with breech presentation wereincluded. Decision about mode of delivery was taken on the basis of clinical judgment and ultrasoundwhich was further reviewed in the light of rate of progress during labour .Delivery was conducted byexperienced obstetrician. Mother & infants were followed up to 6 wks post partum. The primaryoutcome was neonatal mortality, infant mortality & serious infant morbidity.RESULTS: out of 809 total patients with breech presentation, 714 were planned for vaginal delivery674 delivered (83%) while 40 pts (5%) had emergency Cesarean Sections.95 patients (12%) hadElective cesarean section. In the delivery group two (0.29%) neonates had serious neonatal morbidity. Inthe cesarean group there was no serious neonatal morbidity. Infection & blood loss was greater in thecesarean group. There were no serious maternal complications in the vaginal delivery group. Thedifference between neonatal morbidity, perinatal mortality &neonatal mortality between the two groupswas not significant.CONCLUSION: Vaginal breech delivery is still a safe option which better suits the clinical situation&problems of our patients .In our set up, Cesarean section should not be routinely advised to patientswith breech presentation no matter it may be the best management option in developed countries.Careful case selection & vigilant monitoring of progress of labour will save many patients fromunnecessary section without costing extra morbidity & mortality.KEY WORDS: Breech presentation, Breech Delivery, Cesarean section, Apgar score.

scholarly journals Maternal and Perinatal Outcomes of Singleton Term Breech Vaginal Delivery at a Tertiary Care Center in Nepal: A Retrospective Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Tulasa Basnet ◽  
Baburam Dixit Thapa ◽  
Dipti Das ◽  
Ramesh Shrestha ◽  
Sarita Sitaula ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Care Hospital ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Emergency Cesarean

Background. Breech presentation is associated with increased rates of maternal and perinatal morbidity regardless of mode of delivery. After the results of Term Breech Trial, most of the countries adopted the protocol of cesarean section for term breech delivery because of which breech vaginal delivery is becoming rare. The aim of this study is to evaluate short-term maternal and perinatal outcomes of breech vaginal delivery at a tertiary care hospital in Nepal. Methods. A retrospective review of case records of all women who had vaginal breech delivery from April 13, 2016, to April 12, 2018, was conducted, over a period of two years. Available demographic variables, obstetric characteristics, details of labor, postpartum complications, and perinatal complications were recorded and analyzed. Results. Out of 21,768 cases of deliveries during the study period, the incidence of term breech deliveries was 528 (2.4%) among which the mode of only 84 (17.8%) deliveries was vaginal. Most of the deliveries were unplanned and were conducted because emergency cesarean section could not be performed. Three (3.6%) women had postpartum hemorrhage, and four (4.8%) had entrapment of aftercoming head, two of them requiring Dührssen incisions. Adverse perinatal outcomes were seen in 23.8% of such deliveries with <7 APGAR score at 5 minutes in 20.2%, neonatal admission in 17.7%, and perinatal mortality in 8.3%. The perinatal mortality was significantly associated with birthweight less than 2500 grams as compared to birthweight ≥2500 grams (21.1% versus 4.6%; P = 0.043 ). Conclusion. The perinatal outcomes for vaginal breech delivery are grave with our existing health facilities, especially when the deliveries are not well planned.

scholarly journals Outcome of breech delivery: caesarean section versus vaginal delivery at Patan Hospital, Patan Academy of Health Sciences

2016 ◽  
Vol 3 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Anagha Pradhan Malla ◽  
Laxmi RC ◽  
Alka Singh ◽  
Reena Shrestha ◽  
Padma Gurung ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Maternal Blood ◽  
Health Sciences ◽  
Term Infant ◽  
Critical Element ◽  
Intrauterine Death ◽  
Breech Delivery ◽  
Vaginal Breech Delivery

Introductions: Obstetricians have long debated the role of caesarean section as a potentially safer mode of delivery for the fetus with breech presentation. However, the experience of the health care provider remains a critical element in the decision to pursue a vaginal breech delivery, and it may still be a viable option. The aim of this study is to determine the incidence of breech delivery at Patan Hospital and compare maternal and neonatal outcomes subjected to either vaginal or caesarean section.Methods: This was a five-year retrospective study of breech deliveries covering the year 2010 to 2014. Patient’s charts were retrieved from the medical record section and reviewed.Results: There were 896 breech deliveries out of a total 44,842 deliveries giving an incidence of 1.99%. One hundred thirteen (12.61%) of breech deliveries were through vaginal route while 431 (48.10%) and 352 (39.28%) were through emergency and elective caesarean sections respectively. There were 154 (17.18%) preterm breech deliveries including 27 (17.5%) preterm intrauterine death. Among term pregnancy, there were 3 neonatal deaths not associated with mode of delivery. None of the term infant had neurological morbidity comprising neonatal seizures, brachial plexus injury, chephalohematoma. Maternal blood loss was significantly higher in caesarean section group. Conclusions: In well-selected cases, the neonatal outcome following assisted vaginal breech delivery and caesarean section may not be different.Journal of Patan Academy of Health Sciences, Vol. 3, No. 1, 2016. page: 4-9

scholarly journals Umbilical Cord Abnormalities and Maternal and Perinatal Outcome: A Prospective Observational Study

2021 ◽  
Author(s):  
Kalpna Kulshrestha ◽  
Debbarma Sukla ◽  
Kalpana Verma
Keyword(s):  
Observational Study ◽  
Umbilical Cord ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Insertion Site ◽  
Circulatory System ◽  
P Value ◽  
Maternal Complications

Introduction: The umbilical cord is the vital extension of the fetal circulatory system which regulates blood flow in both directions, thus allowing mother-child communications viz., immunological, oxygenation, fetal nutrition, cardiac function. Umbilical cord abnormalities are associated with the adverse maternal and perinatal outcome.. Aim: To assess prevalence of various umbilical cord abnormalities and its association with maternal complications and perinatal outcome. Materials and Methods: This prospective observational study was conducted at Saraswathi Institute of Medical Sciences Pilkhuwa, Hapur, Uttar Pradesh, India from June 2019 till March 2020. The approval for the study was taken from the Institutional Ethical Committee. Total number of deliveries during this period were 1284. After satisfying exclusion criteria, total 600 deliveries of more than 37 weeks of gestation were included in the study at random. Examination of cord was done during delivery for presence of loops of cord around the neck or body, any knots, true or false. After the delivery, the cord was clamped 5 cm from the fetal end and the total length was measured from the cut end till the placental insertion site, and 5 cm added therein. Umbilical cord was examined for any abnormalities and numbers of coils recorded and Umbilical Coiling Index (UCI) measured. Apgar score and NICU admissions noted. Results: Out of 600 patients, umbilical cord abnormalities were seen in 194 (32.33%) patients, while in 406 (67.67%) no abnormality was detected. The mode of delivery was vaginal in 441 cases (73.5%) while 159 (26.5%) had Lower Segment Cesarian Section (LSCS). Out of 194 cases with umbilical cord abnormality, 89 (45.87%) had LSCS and out of 406 cases with no cord abnormality, only 70 cases (17.24%) had LSCS (p-value<0.0001). Mean UCI was 0.25±0.09. Total 269(44.83%) had maternal complications and 143 cases (53.16%) had umbilical cord abnormalities. While 126 (46.84%) cases with maternal complications did not show any cord abnormality. Apgar score of <7 at one minute was seen in 43 cases (22.16%) and 23 (11.86%) were admitted in Neonatal Intensive Care Unit (NICU) with umbilical cord abnormality. Conclusion: The umbilical cord abnormalities were associated with the adverse maternal and perinatal outcome and increased rate of LSCS (p-value <0.0001). The study shows the importance of knowledge of cord abnormalities. The cord abnormality should be looked for after each delivery, with the aim to reduce perinatal morbidity.

scholarly journals Study of maternal and fetal outcome in pregnancy beyond 40 weeks: a prospective observational study at a tertiary institute

2020 ◽  
Vol 9 (10) ◽  
pp. 3959
Author(s):  
Shreedevi Kori ◽  
Dayanand Biradar ◽  
Aruna Biradar ◽  
Rajasri Yaliwal ◽  
Subhashchandra R. Mudanur ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Fetal Monitoring ◽  
Fetal Outcome ◽  
Medical College ◽  
Study Results ◽  
Fetal Complications ◽  
Prolonged Pregnancy ◽  
Failure Of Induction

Background: Prolonged pregnancy is one that exceeds 42 0/7weeks. Management of prolonged pregnancy is very challenging in modern obstetrics.Methods: It is prospective observational study in department of Obstetrics and Gynecology, Shri B.M Patil medical college and Research center, deemed to be University, Vijayapur, North karnataka. Study period was from January 2018 to January 2019.Results: Total of 186 pregnant women were included in the study. Results in terms of age, gravidity, gestational age, time of induction, mode of delivery, neonatal outcome and maternal complications.Conclusion: Pregnancies beyond 40 weeks require early detection, effective fetal monitoring and proper planning of labour. In pregnancies beyond 40 weeks, decision of induction should be taken cautiously as early induction leads to failure of induction and increased rates of lower (uterine) segment Caesarean section (LSCS), while delayed induction leads to increased fetal complications.

scholarly journals A prospective observational study for the evaluation of maternal and fetal outcome in patient with eclampsia

2017 ◽  
Vol 5 (5) ◽  
pp. 1785 ◽  
Author(s):  
Santosh Kumar Dora ◽  
Lalmohan Nayak ◽  
Benudhar Pande ◽  
Atal Bihari Dandapat
Keyword(s):  
Blood Pressure ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Fetal Outcome ◽  
Maternal Complications ◽  
Medical College ◽  
Labour Room

Background: Eclampsia continues to be a measure health issue in developing country. In order to get a comprehensive data on eclamptic patients we conduct a prospective observational study to address the maternal and fetal complication during pregnancy.Methods: It is a prospective observational study conducted in a tertiary care medical college between the periods September 2016 to February 2017. During the period all patients with eclampsia admitted to the labour room were taken. Any patients with known epilepsy were excluded from the study.Results: During the period 3780 women were admitted to the labour room, out of which 56 women had eclampsia with an incidence of 1.48%. Out this antenatal eclampsia was most common with an incidence of 91.08% followed by intra partum 4 (7.14%) and postpartum eclampsia 1 (1.78%). Majority of patients 54 (96.43%) were unbooked or inadequately supervised. Most of the patient had normalization of blood pressure after oral nifedipine 46 (82.14%), only 10 (17.86%) patient required additional injection labetalol for control of blood pressure. The maternal complications were placental abruption 8 (14.28%), HELLP 6 (10.71%), pulmonary edema 1 (1.78%), acute renal failure 1 (1.78%), DIC 1 (1.78%) and maternal death 2 (3.57%). Out of fifty six babies delivered 42 (75%) had live birth and 14 (25%) had still birth. A total of 17 (40.42%) had IUGR, 17 (40.47%) require SNCU admission post-delivery.Conclusions:Eclampsia still remains the major cause of maternal and fetal morbidity. In low resource countries improvement in health care facility, adequate antenatal supervision, and timely referral will reduce the maternal and fetal complication. 

scholarly journals A prospective observational study of role of epidural in trial of labour after cesarean section in view of maternal and neonatal outcome in a tertiary care hospital

2020 ◽  
Vol 9 (6) ◽  
pp. 2415
Author(s):  
Jothi Sundaram ◽  
Divya Vinoth ◽  
Malathi Sriram
Keyword(s):  
Observational Study ◽  
Cesarean Section ◽  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Tamil Nadu ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Previous History ◽  
Care Hospital

Background: In a well-equipped hospital, trial of vaginal delivery is done in selected cases of previous C-section (CS). Epidural analgesia administration has been proved to be good adjunct in trial of labor after caesarean (TOLAC).Methods: This study is a prospective observational study done in a tertiary care institution in Tamil Nadu from May 2019 to July 2019. 50 cases with previous history of one CS were selected. Single ton pregnancy, previous transverse lower segment cesarean section admitted cases with adequate pelvis with no other co-morbidities were selected. Epidural analgesia was administered once mother was in established labor. TOLAC was continued till satisfactory progress and emergency repeat caesarean was taken in case of Suspected scar dehiscence (SSD) or abnormal fetal heart rate tracings. Quantitative data was expressed in mean and standard deviation. For qualitative data percentage was used.Results: In 50 cases observed the mean age of the cases was 26±3.64 years. TOLAC was successful in 41 (82%) mothers out of 50. The mode of delivery in 41 TOLAC mothers was found to be forceps in 18 cases (36%) and ventouse delivery 18 cases (36%). Only 9 cases had needed emergency CS (18%). The major indication for CS in TOLAC was found to be fetal distress in 4 number of cases (8%). 43 babies delivered were healthy, 6 babies (12%) admitted in NICU.Conclusions: With the application of epidural analgesia on attempted vaginal delivery in previous cesarean, vaginal delivery was 82% cases.

scholarly journals Singleton Vaginal Breech Delivery at Term: Maternal and Perinatal Outcome

2017 ◽  
Vol 23 (1) ◽  
Author(s):  
Tayyiba Wasim ◽  
Ahmad Zunair Wasim ◽  
Muhammad Ashraf Majrooh
Keyword(s):  
Wound Infection ◽  
Vaginal Delivery ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Birth Asphyxia ◽  
Breech Presentation ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Breech Delivery ◽  
Vaginal Breech Delivery

<p><strong>Objectives:</strong><strong> </strong>To determine fetomaternal outcome in patients undergoing planned vaginal breech delivery at term.</p><p><strong>Methods:</strong><strong> </strong>It was a descriptive cross sectional study conducted at Lady Aitchison hospital, Lahore for one and a half year from July 2012 to December 2013. All patients presenting with term breech presentation were included. Fetomaternal outcome in terms of successful vaginal delivery, maternal complications of operative delivery, PPH, wound infection and fetal complications of apgar score of less than five minutes, nursery admission, trauma during delivery (bone fracture, intra cranial hemorrhage) and perinatal mortality was studied.</p><p><strong>Results:</strong>  375 patients delivered as breech presentation during the study period. Out of 375 patients, 155 patients were selected for vaginal birth. Out of these, 65% had successful vaginal delivery, rest had emergency caesarean section due to fetal distress, cord prolapse dysfunctional labour. 6.4% patients had wound infection and 3.2% had PPH. Booking status was significantly important in patients who had successful vaginal delivery as 80% were booked (p = 0.001). There was no maternal mortality in these patients. Perinatal outcome was good in 87% of patients. 20 fetuses had Apgar score less than 7/min and required nursery admission. Two babies expired due to birth asphyxia and rest were discharged home in satisfactory condition.</p><p><strong>Conclusion:</strong><strong>  </strong>Although delivery of breech remains a dilemma, the plan of delivery should be individualized. Proper selection of cases with proper antenatal and intrapartum care can result in successful breech vaginal delivery without compromising feto maternal wellbeing and curtailing the percentage of caesarean being done for this malpresentation.<strong></strong></p>

scholarly journals Comparison of Perinatal Outcome of Breech Presentation between Vaginal Delivery and Cesarean Section

2016 ◽  
Vol 4 (1) ◽  
pp. 4 ◽  
Author(s):  
Buddhi Kumar Shrestha ◽  
Subha Shrestha
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
College Teaching ◽  
Breech Presentation ◽  
Morbidity And Mortality ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Vaginal Deliveries ◽  
Significant Difference

Introduction: Many times, parturient opt for labour and vaginal breech delivery even after informing increased perinatal risks. Vaginal breech deliveries are undertaken with the reasons like avoidance of cesarean section in next pregnancy, null risk of operative and anesthetic hazards, ability to resume early all household works after vaginal birth, etc. The purpose of this study is to compare the perinatal outcome of breech deliveries in singleton breech presentation between vaginal breech delivery and cesarean section.   Methods: A retrospective study was done in Lumbini Medical College Teaching Hospital for the duration of one year (December 2014 to November 2015). Data of perinatal outcome of breech deliveries were collected from the hospital records. The records of neonatal examination were also collected. The primary outcomes included were neonatal morbidity and mortality.   Results: Out of 80 selected women with breech presentation, 42 of them had vaginal deliveries and 38 women had undergone caesarean section. The perinatal mortality was 4.8% and morbidity was 2% in vaginal breech deliveries. There was no significant difference of APGAR score in the two groups at any time. Similarly, there was no significant difference in perinatal morbidity and mortality in the two groups. Nulliparous women were more likely to deliver by Cesarean section.   Conclusion:  In places where planned vaginal delivery is a common practice and when strict criteria are met before and during labour, planned vaginal breech delivery of singleton fetus in breech presentation remains a safe option that can be offered to women.

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