scholarly journals Comparison of progress of labour and maternofetal outcome among induced versus spontaneous labour in nulliparous women using modified WHO partograph

2018 ◽  
Vol 7 (2) ◽  
pp. 415
Author(s):  
Anamika Singh ◽  
Smitha B. Rao ◽  
Bhavana Sherigar ◽  
Reena D’souza ◽  
Soumya R. ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Outcome Data ◽  
T Test ◽  
Safe Procedure ◽  
Nulliparous Women ◽  
Spontaneous Labour ◽  
The Mean

Background: Induced or spontaneous labour has implication on the eventual mode of delivery and neonatal outcome. The aim of study is to compare the progress and outcome of induced versus spontaneous labour among nulliparous women using the modified WHO partograph.Methods: Comparative study involving nulliparous women in active phase of labour with the cervix at least 4cm dilated. Those whose labours were induced were compared with those on spontaneous labour; both labouring women were monitored using modified WHO partograph. Outcome measures include the mean duration of labour, the eventual mode of delivery and the Maternofetal outcome. Data were managed using SPSS software. Chi-square t-test and student t-test were used in data analysis. Level of significance was placed at P<0.05.Results: 115 women were compared in each group. There was no difference in mean age group, gestational age at delivery, cervical dilatation on admission, and the level of head of fifth palpable on admission. More women had spontaneous vaginal delivery among those in spontaneous labour (72.1% versus 64.7%) P=0.0001. There were less caesarean section among those in spontaneous labour. The mean Apgar scores were significantly better among induced labour babies (P=0.0001).Conclusions: Induced labour may increase the chances of caesarean section, it does not adversely affect the neonatal outcome. Therefore, it is advised induced labour can be a safe procedure among nulliparous women if labour is partographically monitored.

scholarly journals Comparative study of induced and spontaneous labour in nulliparous women using modified WHO partograph

2020 ◽  
Vol 9 (5) ◽  
pp. 2014
Author(s):  
Kamlesh Yadav ◽  
Monika Ranga ◽  
Ankur Nama
Keyword(s):  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Safe Procedure ◽  
Maternal Complications ◽  
Second Stage Of Labour ◽  
Nulliparous Women ◽  
Spontaneous Labour ◽  
Group Rate ◽  
The Mean

Background: Induced or spontaneous labour has implication on the eventual mode of delivery and neonatal outcome. The aim of study is to compare mean duration of labour andmaterno-foetal outcome of induced versus spontaneous labour among nulliparous women using modified WHO partograph.Methods: The study was conducted in nulliparous women coming at term in active phase of labour (with cervical dilatation at least 4 cm) either spontaneous or induced, both labouring women were monitored using modified WHO partograph. Outcomes measures include requirement of augmentation of labour with oxytocin, mean duration of labour, eventual mode of delivery and the materno foetal outcome.Results: A total 100 women were compared in each group. There was no difference in mean age group, BMI, gestational age. More women had spontaneous vaginal delivery among those with spontaneous labour (76% versus 58%) (p=0.033). The mean duration of second stage of labour was significantly more in induced labour (16.25 minutes) than in spontaneous labour (14.60 minutes) (p=0.0212). The mean Apgar scores were comparable in two groups. Induced labour is comparable to spontaneous labour regarding fetomaternal outcomes but with increased rate of caesarean deliveries.Conclusions: Study concluded from our study that in spontaneous group mean duration of labour was less than induced group and most of the patient delivered vaginally. In induced group rate of caesarean was higher and requirement of oxytocin for labour augmentation was also more than spontaneous group. Maternal complications were also found more in induced group than spontaneous group whereas neonatal outcome was similar in both the groups. We observed in our study that induced labour can be a safe procedure among nulliparous women if labour is partographically monitored by WHO modified partograph.

scholarly journals Comparative study of labour progress and delivery outcome among induced versus spontaneous labour in nulliparous women using modified WHO partograph

1970 ◽  
Vol 3 (1) ◽  
pp. 24-28 ◽  
Author(s):  
Ernest O Orji ◽  
Taofeek O Olabode
Keyword(s):  
Comparative Study ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Outcome Data ◽  
T Test ◽  
Chi Square ◽  
Delivery Outcome ◽  
Nulliparous Women ◽  
Spontaneous Labour ◽  
The Mean

Aim: Induced or spontaneous labour has implication on the eventual mode of delivery and neonatal outcome. The objective of this study is to compare the progress and outcome of induced versus spontaneous labour among nulliparous women using the modified WHO partograph. Methods: Comparative study involving nulliparous women in active phase of labour with the cervix at least 4cm dilated. Those whose labours were induced were compared with those on spontaneous labour; both labouring women were monitored using modified WHO partograph. Outcome measures include the mean duration of labour, the eventual mode of delivery and the feto-material outcome. Data were managed using SPSS software. Chi-square t-test and student t-test were used in data analysis. Level of significance was placed at P < 0.05. Results: 136 women were compared in each group. There were no difference in mean age group, gestational age at delivery, cervical dilatation on admission, and the level of head of fifth palpable on admission. More women had spontaneous vaginal delivery among those in spontaneous labour (72.1% versus 64.7%) P=0.0001. There were less caesarean section among those in spontaneous labour (20.6% versus 35.3%). The mean Apgar scores were significantly better among induced labour babies (P=0.0001). While most induced labour cases reached or crossed action line compared to spontaneous labour (33.1% versus 16.9% P=0.002), there were more cases in spontaneous labour moving between alert and action line (27.9% versus 9.6%, P=0.000) Conclusion: Induced labour monitored with modified WHO partograph is comparative to spontaneous labour with no increased adverse feto maternal outcome. Key words: Induced versus spontaneous labour; modified WHO partograph, labour outcome.   doi:10.3126/njog.v3i1.1435 NJOG 2008 May-June; 3(1): 24 - 28

scholarly journals A Prospective Study on the Relationship Between Cervical Dilatation at Initial Presentation in Labour and Subsequent Outcome in Nulliparous Women

2014 ◽  
Vol 13 (1) ◽  
pp. 39-41
Author(s):  
Smriti Kona Kabiraj ◽  
Juthi Bhowmik ◽  
Haradhan Deb Nath
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Fetal Distress ◽  
Cervical Dilatation ◽  
P Value ◽  
Nulliparous Women ◽  
Group I ◽  
Increased Risk ◽  
Group Ii

Background: The spontaneous birth of a live infant can convey a huge degree of both satisfaction and achievement for both the mother and her partner. Many factors influence the variation in rates of caesarean section among hospitals throughout the world. These included patients’ demographic characteristics, underlying medical and obstetric complication, hospital facilities, hospital practice and physician practice style. Objective: The present study was planned to determine how the outcome of women change with timing of admission either in active or latent phase of spontaneous labour.Methods: This was a prospective observational study, which was conducted at labour ward, department of Obstetrics and Gynaecology, BSMMU hospital and DMCH Dhaka, from February 1, 2008 to August 30, 2008, where data were collected prospectively. Patients with any medical or obstetric complications, rupture of membrane antenatally diagnosed fetal anomalies or death and with prior caesarean section were excluded from the study. Patients with cervical dilatation at less than 4cm were in group I. On the other hand, patients with cervical dilatation of 4 cm or more in active phase and these types of patients were allocated in group II.Results: Outcome differences were compared using chi-square(X2) test, fishers exact test, A ‘p’ value <0.05 considered significant. Main outcome variables were duration of labour, mode of delivery, indication for caesarean section, need for oxytocin, labour analgesia, Apgar score <7, maternal PPH and postpartum hospital stay. A total 500 patients were enrolled during the study period. Of them 308 patients were (61.6%) in group I and 192 patients (38.4%) in group II. Dystocia was the main indication for caesarean delivery in early admitted group which was 58.6% and fetal distress in late admitted group which was 37.5%. Second commonest indication for caesarean section was fetal distress which was 31.6% in group I and dystocia 50.0% in group II). Oxytocin for augmentation was used in 70.0% in group I and 30.0% in group II.Conclusion: It is shown that early admission to the hospital in low-risk women may negatively affect the outcome of labour and are at increased risk of prolonged labour, more oxytocin used, increased rate of caesarean section.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19417

scholarly journals Sonographic assessment of fetal head deflexion using occiput: spine angle measured during first stage of labour and its role in predicting the mode of delivery among nulliparous women

2019 ◽  
Vol 8 (8) ◽  
pp. 3025
Author(s):  
Keerthi Somu ◽  
Sujatha B. S. ◽  
Shripad Hebbar ◽  
Shyamala G. ◽  
Muralidhar V. Pai
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Mean Value ◽  
Fetal Head ◽  
Nulliparous Women ◽  
Active Labour ◽  
Study Population ◽  
The Mean

Background: The attitude of the fetal head during labour significantly influences the progress and outcome of delivery and is mainly diagnosed by vaginal examination during labour. The aim of the study was to quantify the extent of deflexion of the fetal head by measuring the fetal occiput spine angle (OSA) through transabdominal ultrasonography in the first stage of labour and to determine whether the fetal OSA can predict the mode of delivery.Methods: We conducted a prospective observational study on 145 nulliparous uncomplicated singleton pregnant women without occiput-posterior position of the fetus during active labour. The OSA was measured as the angle between the two tangential lines to the occipital bone and the vertebral body of the first cervical spine, during active labour and monitored until delivery. Intra- and interobserver reproducibility of the OSA measurement and the correlation between the OSA and mode of delivery were also evaluated.Results: For the study population, the mean value of the OSA measured in the active phase of the first stage was 124.2±11.5⁰. The OSA measurement showed excellent intraobserver agreement (r = 0.82; 95% confidence interval [95% CI] 0.70-0.80) and fair-to-good interobserver agreement (r = 0.62; 95% CI 0.51-0.71).  The mean OSA was significantly less for the group of patients who required conversion to cesarean section due to labour arrest (n=32) as compared to those who had vaginal delivery (n=113) (116.25±9.2⁰ versus 126.53±11.1⁰, P<0.01). An OSA of ≥121° was associated with vaginal delivery in 80.5% (91/113) of women, whereas 87.5% (28/32) of the women who delivered by cesarean section had an OSA <121⁰.Conclusions: Measurement of the OSA, by sonography is feasible, reproducible and an objective tool to assess the degree of fetal head deflexion during labour and to predict the mode of delivery.

scholarly journals Postpartum femoral neuropathy: managing the next pregnancy

2019 ◽  
Vol 12 (12) ◽  
pp. e232967 ◽  
Author(s):  
Cathy Rowland ◽  
Daniel Kane ◽  
Maeve Eogan
Keyword(s):  
Caesarean Section ◽  
Motor Function ◽  
Lower Limb ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Primiparous Woman ◽  
Limb Weakness ◽  
Femoral Neuropathy ◽  
Lower Limb Weakness ◽  
Spontaneous Labour

A 34-year-old primiparous woman presented in spontaneous labour and had an unassisted vaginal birth of a 3.5 kg infant. Postnatally, the patient experienced lower limb weakness and was unable to mobilise unassisted. A diagnosis of postpartum femoral neuropathy was made. Full recovery of normal motor function was not achieved until 5 months postpartum. She returned in her next pregnancy, seeking advice on how to avoid this complication from reoccurring. It was decided that an elective caesarean section was an appropriate mode of delivery, which she underwent at 39 weeks without complication and without recurrence of the femoral neuropathy.

SARS-CoV-2 in pregnancy: maternal and perinatal outcome data of 34 pregnant women hospitalised between May and October 2020

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Mirijam Hall ◽  
David Endress ◽  
Susanne Hölbfer ◽  
Barbara Maier
Keyword(s):  
Critical Care ◽  
Pregnant Women ◽  
Critical Care Unit ◽  
Birth Rate ◽  
Total Population ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Outcome Data ◽  
High Risk Population ◽  
Retrospective Data Collection

AbstractObjectivesTo report clinical data on maternal outcome, mode of delivery and immediate neonatal outcome in women infected with COVID-19.MethodsRetrospective data collection.ResultsA total of 8.6% of the total population of hospitalised SARS-CoV-2 positive pregnant women were admitted to a critical care unit. The premature birth rate for births before 34+0 weeks of gestation among pregnant women who tested positive for SARS-CoV-2 was 7.1%. One newborn (3.6%) tested positive for SARS-CoV-2 two days after birth and showed symptoms.ConclusionsPregnant women with COVID-19 seem to be at higher risk of invasive ventilation, admission to a critical care unit and preterm birth, and should therefore be considered a high-risk-population.

scholarly journals Perinatal outcome in meconium-stained amniotic fluid at term: a single center prospective study

2020 ◽  
Vol 10 (1) ◽  
pp. 107
Author(s):  
Vandana Mohapatra ◽  
Sujata Misra ◽  
Tapas Ranjan Behera
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Control Group ◽  
Study Group ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background: The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor. Methods: A prospective observational, study was conducted in the department of obstetrics and gynecology, VIMSAR, Burla from January, 2013 to June, 2013. Pregnant women with singleton pregnancy, cephalic presentation at term were included in the study. Total 135 cases of MSAF (study group) were compared with 165 randomly selected controls with clear liquor. Outcome measures were fetal heart rate (FHR) abnormality, mode of delivery, Apgar score, neonatal intensive care unit (NICU) admission, diagnosis of meconium aspiration syndrome (MAS), birth asphyxia and neonatal death. Statistical analysis was done by using the mean and Chi-square test with or without Yates’ correction.  Results: The mean gestational age for meconium staining in the present study was 40.31±0.48 weeks. Caesarean section was the most common mode of delivery in MSAF group whereas vaginal delivery was most common in control group. Significantly higher number of babies in the study group required NICU admissions. The incidence of MAS and birth asphyxia too was statistically higher among babies born to study group as compared to control group.Conclusions: MSAF has significant adverse effect on the perinatal outcome, as it increases the caesarean section rates, NICU admissions, MAS and birth asphyxia.

scholarly journals Vaginal Delivery versus Elective Caesarean Section for Breech Presentation - Experience in Institute of Child and Mother Health (ICMH)

2019 ◽  
Vol 31 (1) ◽  
pp. 23-26
Author(s):  
Mahe Jabeen ◽  
Sabiha Shimul ◽  
Ummay Salma ◽  
Jebunnesa
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Neonatal Outcome ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Cost Of Care ◽  
Increased Risk

Introduction: Compared with a fetus with cephalic presentation, a breech fetus faces increased risk during labour and delivery of asphyxia from cord compression and of traumatic injury during delivery of the shoulders and head. Caesarean section avoids most of this risk. The purpose of this study was to evaluate the feasibility of vaginal delivery of uncomplicated singleton breech presentation by evaluating early neonatal morbidity and mortality as well as maternal morbidity following vaginal and caesarean delivery for breech presentation. Materials and Methods: This is a cross sectional comparative study.104 women with singleton breech presentation at term in labour were included consequetively in labour ward of Institute of Child and Mother Health (ICMH). Informed consent was taken from them. Neonatal and maternal outcome were recorded and statistical analysis was done using SPSS version 22. Results: APGAR at 5 min and Neonatal Intensive Care Unite (NICU) admission were not affected by mode of delivery. Long term neonatal outcome is similar in either mode of delivery. Maternal morbidity and duration of hospital stay is increased in caesarean births. Conclusion: Neonatal outcome did not depend on mode of delivery though maternal morbidity and cost of care is increased following Caesarean Section. Proper selection of cases and by improving skill & confidence in new generation obstetrician, vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to a woman in a tertiary care centre. Medicine Today 2019 Vol.31(1): 23-26

scholarly journals Caesarean myomectomy - a safe procedure: A retrospective case controlled study

1970 ◽  
Vol 2 (2) ◽  
pp. 59-62 ◽  
Author(s):  
Alexander T Owolabi ◽  
Oluwafemi Kuti ◽  
Olabisi M Loto ◽  
Oluwafemiwa N Makinde ◽  
Adebanjo B Adeyemi
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Post Partum ◽  
Uterine Fibroids ◽  
Controlled Study ◽  
Control Group ◽  
High Dose ◽  
Safe Procedure ◽  
The Mean ◽  
Duration Of Operation

Objective(s): The aim of the study is to determine whether myomectomy at the time of caesarean section leads to increase incidence of intrapartum and postpartum complications. Methods: Fourteen women, with uterine fibroids in pregnancy who were treated by caesarean myomectomy between January 2001 and June 2007, were compared retrospectively with fourteen women, without uterine fibroids who had routine caesarean section during the same period. Myomectomy for all types of myoma was performed at caesarean section after the delivery of the baby. Haemorrhage was controlled with the use of Foleys catheter tourniquet and high dose oxytocin infusion. The cases and control were analysed for age of the patient, parity, pre and post-operative haematocrit levels, duration of operation, blood loss, blood transfusions, and incidence of postpartum fever. Results: Caesarean myomectomy resulted in the mean blood loss of 589 ml (range 300-1300 ml) compared with 518 ml (range 350-850 ml) in the control group (p=0.376). The mean duration of operation was longer in the cases of caesarean myomectomy (66.8 mins) than those of the controls (56.4 mins). There were no significant differences between the two groups in the incidence of intraoperative haemorrhage, the need for blood transfusion, post partum fever, and length of hospital stay. Conclusions: This study shows that myomectomy during caesarean section is a safe procedure in experienced hands and is not as dangerous as generations of obstetricians have been trained to believe. Further research is necessary to establish the cost effectiveness of the procedure. Key words: myomectomy, cesarean section, hemorrhage      doi:10.3126/njog.v2i2.1457 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 59 - 62

Predicting the Mode of Delivery by Angle of Progression (AOP) before the Onset of Labor by Transperineal Ultrasound in Nulliparous Women

2020 ◽  
Vol 16 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Priyanka Shankerappa Minajagi ◽  
Sujatha Bagepalli Srinivas ◽  
Shripad Hebbar
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Antenatal Clinic ◽  
Transperineal Ultrasound ◽  
Multivariable Logistic Regression Analysis ◽  
Fetal Head ◽  
Labor Dystocia ◽  
Nulliparous Women ◽  
Fetal Position ◽  
Angle Of Progression

Background: Prediction of the mode of delivery is crucial for better labour outcome. Recent studies suggest that the angle of progression (AOP), measured using transperineal ultrasound, can substantially aid the assessment of fetal head descent during labor, thereby predicting the mode of delivery. Objective: To assess the ability of the AOP measured by transperineal ultrasound to predict the mode of delivery in nulliparous women before the onset of labor. Methods: A prospective observational study was conducted at our hospital, of nulliparous women who had presented to the antenatal clinic at ≥ 38 weeks of gestation but not in labor. AOP was measured using transperineal ultrasonography and compared among the women having Caesarean section (CS) due to labor dystocia and vaginal delivery (VD). Various other confounding factors which increase the risk of caesarean section were analyzed. Results: Among total 120 nulliparous women, the mean AOP was narrower in patients undergoing CS (n = 28) compared to those with VD (n = 92) (91.6 ± 6.1° vs. 100.7 ± 6.9°; P < 0.01). Multivariable logistic regression analysis revealed that narrow AOP values (OR 3.66; P < 0.001; 95% CI 1.7- 14.5) and occiput-posterior fetal position (OR 1.63; P = 0.04; 95% CI 1.0-7.5) were the independent risk factors for CS. An AOP ≥ 96° (calculated from the ROC curve) was associated with VD in 95% (76/80) of women and an AOP < 96° was observed among 60% (24/40) of women who underwent CS. Conclusion: Narrow AOP (< 96°) and occiput-posterior fetal position are at higher risk for CS due to labor dystocia. AOP measured at the antenatal period could accurately predict the mode of delivery, thereby modifying labor outcome.

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