scholarly journals Maternal outcome in antepartum eclampsia caesarean versus vaginal delivery

2018 ◽  
Vol 7 (4) ◽  
pp. 1330
Author(s):  
Nihar Ranjan Behera ◽  
Jaiminkumar Patel
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Word Meaning ◽  
Maternal Outcome ◽  
Fetal Mortality ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Unfavorable Cervix ◽  
Early Decision ◽  
Developed World

Background: The term eclampsia is derived from a Greek word, meaning "like a flash of lightening". The onset of convulsions in a woman with pre-eclampsia that cannot be attributed to other causes is termed eclampsia. Eclampsia is an obstetric enigma. Though it has almost been eradicated from the developed world, it continues to be a major cause of maternal and fetal mortality and morbidity in the developing countries. The real challenge of eclampsia has not been met. In spite of considerable progress made in the field of obstetrics, the incidence of eclampsia and its consequent complications has not decreased significantly in our country over the past few decades. It is indeed sad that even today antenatal care is available only to a fraction of our rural population. However, the management of eclampsia still poses a fascinating challenge to the obstetrician, requiring the greatest skill, judgement and patience.Methods: This is an observational and prospective study of 200 cases admitted with eclampsia in MKCG medical college. The study was extended from October 2015 to September 2017. The inclusion criteria were antepartum eclampsia, primigravida and multigravida, duration of gestation>28 weeks. Patients with pregnancy & convulsion attributed to epilepsy or other causes were excluded from the study.Results: Of the 200 cases, caesarean section was done in 51.50% of the cases, while vaginal delivery was carried out in 48.5% of the cases. It was observed the caesarean section was having better maternal outcome than vaginal delivery.Conclusions: In antepartum eclampsia in primigravidas with more than 28 weeks gestation with unfavorable cervix on admission, an early decision for caesarean section either within 6 hours of admission or 12 hours of first fit whichever is earlier is paramount in improving the maternal outcome”. Prompt termination of pregnancy by caesarean section reduces maternal mortality, improves maternal outcome by reducing complications.

scholarly journals Vaginal birth after Cesarean section (VBAC)

2016 ◽  
Vol 10 (2) ◽  
Author(s):  
Javed Iqbal ◽  
Fouzia Nausheen ◽  
Fozia Ali Bhatti ◽  
Shahida Sheikh
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Placenta Previa ◽  
Multiple Pregnancy ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Normal Pregnancy ◽  
Fetal Mortality ◽  
Medical College ◽  
Vertex Presentation

Aims & Objective: To find out the rate of vaginal delivery after one caesarean section Study Design: Non-interventional, descriptive study Study Setting: Department of Obstetrics & Gynaecology, Allama Iqbal Medical College and Jinnah Hospital, Lahore. Materials and Methods: A trial of vaginal delivery was carried out on 100 patients with previous one caesarean section. Selection criteria were subjects with normal pregnancy, adequate maternal pelvic dimensions vertex presentation and spontaneous onset of labour with previous one uncomplicated LSCS. Patients with classical caesarean section, medical complications, multiple pregnancy, IUGR, placenta previa and extensive myomectomy were excluded from the study. Informed consent was taken from all patients; trail of scar was given with vigilance. Maternal and fetal monitoring was carried out with facility of operation theatre, anaesthesia and paediatrician. Results: Majority of patients was between 20-24 years of age. 58% of the patients were primipara. Successful vaginal delivery was achieved in 72% and rate of repeat section was 28%. Leading indications for repeat section were failure to progress, (50%), fetal distress (28.5%) and scar tenderness (21.43%). No maternal & fetal mortality occurred. Conclusion: Trial of scar after one LSCS should be encouraged with vigilant monitoring provided no obstetric contraindication exists.

scholarly journals A comparative evaluation of post placental intrauterine contraceptive device (IUCD) insertion between normal delivery and caesarean section

2018 ◽  
Vol 7 (9) ◽  
pp. 3826
Author(s):  
Sharmistha Sarkar ◽  
Dhruba Prasad Paul ◽  
Jayanta Ray
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Comparative Evaluation ◽  
P Value ◽  
Contraceptive Device ◽  
Government Medical College ◽  
Expulsion Rate ◽  
Medical College ◽  
Significant Difference ◽  
Post Placental

Background: Adverse maternal and perinatal outcomes are related to pregnancies spaced too closely together. Objective of present study was to compare the expulsion rate and complications between post placental IUCD insertion between caesarean section and vaginal delivery.Methods: This study was a prospective comparative study conducted in the department of Obstetrics and Gynecology, at Agartala Government Medical College over 1.5 Years (January 2016-June2017) All cases at term pregnancy delivering by caesarean section and vaginal delivery were divided into two different groups. Sample size of 105 in each group. Subjects recruited from-obstetrics OPD and casualty of Agartala Government Medical College (AGMC) and GB Pant Hospital expulsion rate and complications. Comparative evaluation of Expulsion rate and complications following post placental IUCD insertion between caesarean section and vaginal delivery at the end of six months, one year and one and half year.Results: There was no significant difference in either complications between the two groups (P value-.913) or outcomes (p value-.035). Expulsion rate 18.2% following vaginal delivery compared to those with intracaesarean insertion i.e 3.8%.Conclusions: The complications associated with postplacental Intrauterine device insertion is insignificant, still the awareness, acceptance and continuation are very low. Therefore Information, education Communication activity by the field workers must be enhanced to overcome this knowledge gap.

scholarly journals Feto-maternal Outcomes in Cesarean Section Compared to Vaginal Delivery in Eclamptic Patients in a Tertiary Level Hospital

2013 ◽  
Vol 3 (2) ◽  
pp. 77-83
Author(s):  
Sheuly Begum ◽  
Ferdousi Islam ◽  
Arifa Akter Jahan
Keyword(s):  
Cesarean Section ◽  
Maternal Mortality ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Birth Asphyxia ◽  
Maternal Outcome ◽  
Maternal Complications ◽  
Medical College ◽  
Group I ◽  
Significant Difference

Background: Over  half-a-million women die each year  from pregnancy-related  causes, and  99 percent of these occur in developing countries. In Bangladesh though maternal mortality  rate (MMR) declined  significantly  around 40% in  the  past  decade,  still  eclampsia  accounts  for 20% of maternal deaths. Eclampsia is uniquely a disease of pregnancy, and the only cure  is  delivery  regardless  of  gestational  age.  A  rational  therapy  for  general  management  of  hypertension and convulsion has been established in Bangladesh by the Eclampsia Working  Group.  But  controversy  still  exists  regarding  obstetric  management. Objective: To  evaluate  the  feto-maternal  outcome  in  cesarean  section  compared  to  vaginal  delivery  in  eclamptic  patients. Materials  and  Methods: This  prospective  cohort  study  was  conducted  in  the  department of Obstretics & Gynecology, Dhaka Medical College & Hospital (DMCH), from  January to December 2011. A total 100 eclamptic women with term pregnancy and live foetus  were purposively included in the study (Group I, 50 patients with vaginal delivery and Group  II, 50 with cesarean section). Results: Out  of these 100 patients 56% were aged <20 years,  71%  were  primigravida  and  77%  were  from  low  socioeconomic  status.  Sixteen  percent  patients from vaginal delivery group and 18% from cesarean section group had no antenatal  care. The mean gestational age was about 38 weeks in two groups. No significant difference  was found between the two groups regarding blood pressure, proteinuria, consciousness level  and convulsion. Recurrence of convulsion occurred in 30% patients of vaginal delivery group  compared  to  6%  in  cesarean  section  group.  Maternal  complications  such  as  postpartum  hemorrhage,  cerebrovascular  accident,  renal  failure,  obstetric  shock  and  abruptio  placenta  were  higher  among  vaginal  delivery  group  patients  (46%)  than  cesarean  section  patients  (16%).  Maternal  mortality  was 6% in  the  vaginal  delivery  group  and  none  in  the  cesarean  section  group.  Regarding  fetal  outcome,  stillbirth  was  20%  after  vaginal  delivery  and  6%  after cesarean section,  the result was statistically  significant.  Birth asphyxia was less  in  the  cesarean  section  group  (23.4%)  than  in  vaginal  delivery  group  (60%)  and  this  was  statistically  significant. Conclusions:  The  result  of  the  present  study  shows  a  better  feto- maternal outcome in the cesarean section group than in the vaginal delivery group. Journal of Enam Medical College; Vol 3 No 2 July 2013; Page 77-83 DOI: http://dx.doi.org/10.3329/jemc.v3i2.16128

scholarly journals Analysis of postpartum intrauterine contraceptive devices

2021 ◽  
Vol 10 (5) ◽  
pp. 1856
Author(s):  
Sandhya A. Shrigadhi ◽  
Prabhakar S. Gawandi
Keyword(s):  
Family Planning ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Planning Method ◽  
Family Planning Method ◽  
Expulsion Rate ◽  
Medical College ◽  
Contraceptive Devices ◽  
Group Rate ◽  
Long Acting

Background: PPIUCDs are the only postpartum family planning  method for couples requesting a highly effective and reversible, yet long acting, family planning method that can be initiated during the immediate postpartum in lactating women. The public health benefits from PPIUCDs stemmed from the women’s increased accessibility to PPIUCDs following facility births, as PPIUCDs could be offered at health facilities after childbirth. It is an attempt to reduce unmet family planning need. The specific aims of this study were to assess the acceptability, feasibility expulsion rate and complications of PPIUCD insertion among women delivering at term in our institute who were eligible and counselled for PPIUCD.Methods: Prospective study undertaken at Dr. Vaishampayan memorial government medical college, Solapur, Maharashtra conducted from September 2015 to August 2017. All women undergoing delivery at term in this institute and not having any contraindications for postpartum IUCD insertion were counseled for PPIUCD.Results: A total 3032 were eligible for PPIUCD insertion and were counseled for the same. 1.97% women accepted PPIUCD insertion while 98.03% of them declined insertion. 1124 underwent caesarean section while 1908 had vaginal delivery. Among vaginal delivery group rate of acceptance was 1.20% while that in caesarean section group was 3.29%.Conclusions: The present study concluded that overall acceptance of PPIUCD in our institute is 1.97 %. Considering fear of complications related to IUCD and partner refusal as major causes of refusal for PPIUCD in our study, emphasis on this aspect during counseling can improve acceptance.

scholarly journals Pregnancy Outcome in Women with One Previous Caesarean Delivery - A Prospective Longitudinal Study in a Peripheral Medical College of West Bengal

2021 ◽  
Vol 8 (21) ◽  
pp. 1608-1613
Author(s):  
Saheli Chandra ◽  
Anjan Dasgupta ◽  
Pradip Kumar Saha ◽  
Kamal Kumar Dash ◽  
Abirbhab Pal ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
West Bengal ◽  
Vaginal Birth ◽  
Safe Procedure ◽  
Prospective Longitudinal Study ◽  
Medical College ◽  
Prospective Longitudinal ◽  
Vaginal Birth After Caesarean

BACKGROUND Pregnancy with one prior Caesarean section (CS) constitutes a high-risk group with associated medical and legal implications. The dictum ‘once a Caesarean always a Caesarean’ has now judiciously been replaced with ‘once a Caesarean, trial of labour after selection’ because low transverse uterine incision has much lesser chance of scar rupture. Though vaginal birth after Caesarean (VBAC) or trial of scar (TOS) brings a significant change in modern obstetric practice in terms of lower maternal and perinatal morbidities, apprehension of accidental scar rupture during trial of labour with its undesirable consequences still prevents a good number of obstetricians adopting this process. The purpose of the study was to determine the outcome of pregnancy in relation to mode of delivery, i.e., either elective repeat Caesarean section (ERCS) or vaginal birth after Caesarean (VBAC) with maternal and perinatal complications in each mode. METHODS A hospital based prospective, longitudinal, and observational study of 300 pregnant women with previous one Caesarean delivery attended labour emergency or out-patient department (OPD) at Midnapore Medical College of West Bengal, was carried out, approved by the institutional ethical committee. Gestational age < 37 weeks and > 42 weeks and h\o previous uterine surgery like myomectomy, hysterotomy, classical CS were excluded from the study. Data collected was analysed using statistical package for the social sciences (SPSS) software version 20. Descriptive statistics were used to analyse the continuous and categorical data and expressed in the form of mean and percentage whereas proportions were analysed using chi-square test. A P - value ≤ 0.05 was considered statistically significant. RESULTS Out of 300 pregnancies, 140 subjects were given trial of labour (TOL). Of which 89 subjects (63.6 %) had successful VBAC and 51 subjects (36.4 %) had repeat Caesarean sections. Among 211 subjects of repeat Caesarean section, 53 subjects (25.12 %) had indicated for scar tenderness and 73 subjects (34.59 %) had elective repeat Caesarean section (ERCS) due to protracted or arrested cervical dilatation. Those having previous vaginal delivery (VD), had more incidences of VBAC in present pregnancy than those who had no previous VD (P ≤ 0.005); Maternal morbidity (33.65 % ERCS versus 10.11 % VD group, P ≤ 0.05) and neonatal morbidity (12.3 % ERCS versus 2.46% VD group, P ≤ 0.05) was significantly higher in ERCS group. CONCLUSIONS Trial of labour (TOL) should be given in well-equipped hospital. In carefully selected cases, it is a safe procedure and often rewarding, thus incidence of repeat CS can be reduced. Those who had a history of vaginal delivery, VBAC often successful. KEYWORDS VBAC, Trial of Scar, Elective Repeat Caesarean Section, Trial of Labour

DIAGNOSIS AND MANAGEMENT OF ITP DURING THE PERINATAL PERIOD

1987 ◽  
Author(s):  
G C M L Christiaens
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Randomized Study ◽  
Elective Caesarean Section ◽  
Corticosteroid Treatment ◽  
Perinatal Period ◽  
Current Data ◽  
Mortality And Morbidity ◽  
Breech Delivery ◽  
Platelet Counts

Although maternal and perinatal mortality and morbidity in pregnant patients with ITP are lower than previously assumed, they are not negligable. Significant postpartum hemorrhage occurs in 7% of the mothers with ITP. Thrombocytopenia is found in 51% of the newborns born from mothers with ITP and 6% of these have serious bleeding problems. Tests which predict which fetuses are at risk, are not yet available. Thrombocyte counts in a fetal blood sample are falsely low in 40% of cases.A prospective controlled randomized study done in the Netherlands failed to show an effect of antenatal corticosteroid treatment on neonatal platelet counts. Elective caesarean section has not been shown to protect against intracranial bleeding in thrombocytopenic newborns. The choice between vaginal delivery and caesarean section in ITP patients should be made on obstetric grounds with one exception: no other assisted vaginal delivery than the easy outlet forceps should be done. All cases of slow progress of the second stage of labour with insufficient descent should be terminated by caesarean section as well as breech delivery with suboptimal progress. Newborn thrombocyte counts should be done daily during the first week of life, since lowest platelet counts are often found between the 3rd and 5th postpartum day. Newborn thrombocytopenia is transient and does not warrant splenectomy, but can necessitate treatment with corticosteroids and/or high doses of immunoglobulin 6. Current data do not justify to dissuade breastfeeding.The recurrence of neonatal thrombocytopenia in subsequent patients is unknown.

scholarly journals Spontaneous Vaginal Delivery after Three Previous Caesarean Sections

2018 ◽  
Vol 1 (1) ◽  
pp. 120-124
Author(s):  
Hani Shams Eldin ◽  
Nicholas Oligbo
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Uterine Rupture ◽  
Elective Caesarean Section ◽  
Vaginal Birth ◽  
Spontaneous Vaginal Delivery ◽  
Mortality And Morbidity ◽  
Risk Increase ◽  
Wheel Chair ◽  
Uterine Scar

Women with one previous caesarean section have 0.05% risk of uterine rupture, with two caesarean sections the risk increase to 1.36%. We could not find data on the risk of uterine rupture after three caesarean sections. Elective caesarean section is therefore offered to these women by their clinical professionals to eliminate the risk. However, we report a case of spontaneous vaginal delivery with an intact uterine scar in a woman with a previous three caesarean sections to show the possibility of vaginal birth in patients with repeated caesarean section. A 32-year-old female in her 4th pregnancy with previous three caesarean section 1st two emergencies and 3rd elective (Gravida 4, para 3) presented to the delivery suite in spontaneous labour at 39 weeks and 3 days with vaginal bleeding. Emergency call gone off and patient was transferred immediately to theatre, during transfer she pushed down while she was on the wheel chair and the baby head found to be delivered vaginally. A live healthy baby girl weighing 2590 g was delivered. The patient had Postpartum bleeding of 500 ml and 2nd degree perineal and labial tears; the patient was discharged home fit and well on day one postpartum. Repeated caesarean section increases maternal mortality and morbidity. Vaginal birth after repeated previous caesarean sections could still be an option in selected cases as safe vaginal delivery has been reported.

scholarly journals Maternal Outcome among the Misoprostol Induced Term Pregnant Women

2017 ◽  
Vol 7 (1) ◽  
pp. 6-9
Author(s):  
Aftabun Nahar ◽  
Afroza Ghani ◽  
Serajoom Munira ◽  
Ashia Khatun ◽  
Rifat Sultana ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Maternal Outcome ◽  
Induction Of Labour ◽  
Singleton Pregnancy ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Study Population ◽  
Selection Of

Background: Use of misoprostol in term pregnancy can give some maternal adverse events.Objective: The purpose of the present study was to see the maternal outcome among the term pregnant women.Methodology: This descriptive, prospective cohort study was carried out in the Department of Obstetrics and Gynaecology at Sir Salimullah Medical College and Mitford Hospital during the period from September 2005 to February 2006. Primi or second gravida patients with the gestational age between 37 weeks to 42 weeks in singleton pregnancy with cephalic presentation and not in labour who came for delivery purposes during the study period at any age were selected as study population. After proper selection of the cases, induction of labour (IOL) was done by applying tablet Misoprostol 5omcg in the posterior vaginal fomix. Purpose of induction of labour was successful when vaginal delivery occurred Without any untoward side effects and Without any surgical interference.Result: A total number of 60 pregnant women were recruited in this study of which 60% patients were within 23-30 years of age. Out of 43 cases of vaginal delivery 22 cases needed 1 dose of Misoprostol 21 cases needed more than 1 dose. 60% of study population who were primigravide had vaginal delivery in 67% cases and caesarean section in 33% cases and among 40% 2nd gravida cases vaginal delivery was 79% and caesarean delivery was 21%.Conclusion: In the conclusion, the use of Misoprostol results in a shorter induction to delivery time, a reduction in the rate of caesarean delivery and also did not appear to produce miserable adverse effects on the method of delivery or the foetus.J Shaheed Suhrawardy Med Coll, 2015; 7(1):6-9

scholarly journals Emergency Obstetric Hysterectomies at a Tertiary Referral Shri Vasantrao Naik Government Medical College and Hospital of Tribal of Yavatmal District (Maharashtra): Retrospective Critical Analysis (6 Years Study)

2015 ◽  
Vol 7 (2) ◽  
pp. 55-60
Author(s):  
Archana D Rathod ◽  
Sandhya P Pajai
Keyword(s):  
High Risk ◽  
Antenatal Care ◽  
Critical Analysis ◽  
Fetal Mortality ◽  
Government Medical College ◽  
Tertiary Referral ◽  
Mortality And Morbidity ◽  
Tertiary Referral Center ◽  
Medical College ◽  
High Risk Factors

ABSTRACT Objective To evaluate the demographic profile, high-risk factors, fetomaternal outcome, causes and incidence of emergency peripartum hysterectomies at tertiary referral center Government Medical College and Hospital at Yavatmal. Study design Retrospective analysis. Methodology Review of 14 case records of patient who undergone emergency peripartum hysterectomies during the year January 2007 to December 2012. Results During the study period, there were 39,612 deliveries, out of which 14 patients had undergone emergency peripartum hysterectomy (EPH), having an incidence of 0.35/1000 births. There was 1 (7.14%) maternal death and 5 (35.71%) perinatal deaths. The commonest indications noted were atonic PPH 7 (50%), morbidly adherent placenta 5 (35.71%) and rupture uterus 2 (14.28%). Five (35.71%) of these patients had not received antenatal care prior to their hospitalization. Lack of antenatal care and health education indeed a preventable factor that needs to be addressed to reduce maternal and fetal mortality and morbidity. Identification of high-risk patients, institutional deliveries by expert of risk group and early referral from peripheral health infrastructures are utmost importance in avoiding EPH and reduce maternal and fetal morbidity and mortality. Emergency obstetric hysterectomy still remains as life saving procedure which every obstetrician must be familiar with it. How to cite this article Rathod AD, Pajai SP. Emergency Obstetric Hysterectomies at a Tertiary Referral Shri Vasantrao Naik Government Medical College and Hospital of Tribal of Yavatmal District (Maharashtra): Retrospective Critical Analysis (6 Years Study). J South Asian Feder Obst Gynae 2015;7(2): 55-60.

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