scholarly journals Maternal and neonatal outcome in second stage cesarean section versus first stage: a comparative study

2018 ◽  
Vol 7 (11) ◽  
pp. 4640
Author(s):  
Anusha S. R. ◽  
Deepak A. V. ◽  
K. J. Jacob
Keyword(s):  
Cesarean Section ◽  
Neonatal Outcome ◽  
Cross Sectional Study ◽  
Fetal Head ◽  
Cross Sectional ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Adjacent Structures ◽  
Duration Of Surgery ◽  
Fetal Complications

Background: Cesarean Section is the most commonly performed abdominal operation in women all over the world. Variable rates of cesarean section are reported between and within countries. Cesarean section at full cervical dilatation with an impacted fetal head can be technically difficult and is associated with increased trauma to the lower uterine segment and adjacent structures, as well as increased hemorrhage and infection.Methods: This is a comparative cross-sectional study comparing maternal and neonatal outcome between first stage and second stage cesarean section performed at Govt Medical College Thrissur.Results: In present study out of 90 cesarean sections 30 were performed in second stage and 60 in first stage.74 % were primigravida in second stage cs group. Arrest due to malposition was major indication for second stage (76% of cases). The most important complication among second stage cs group was PPH (76.7%) and majority of them needed blood transfusion. These complications were less in first stage cs group. Other Complications like increased duration of surgery (mean=53.3 min), post op fever (36% post op Wound infection (13.3%) was seen in second stage group. Fetal complications like low APGAR scores were seen in 16.7% of cases compared to first stage group and most of them needed resuscitation.Conclusions: Women undergoing cesarean section in second stage of labour had increased maternal and fetal morbidity. They required special care and hence Operation should ideally perform and supervised by an experienced obstetrician. Timely decision for cesarean section should be made especially when risk factors for failure to progress are present.

scholarly journals Maternal and foetal outcome in second stage caesarean section: a prospective study

2021 ◽  
Vol 10 (4) ◽  
pp. 1644
Author(s):  
Shuchi Sharma ◽  
Poojan Dogra ◽  
Reena Sharma ◽  
Suraj Bhardwaj
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Cervical Dilatation ◽  
Bladder Injury ◽  
Fetal Head ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Adjacent Structures ◽  
A Prospective Study

Background: Caesarean section is the most commonly performed abdominal operation in women all over the world. Caesarean sections during the second stage labour accounts for approximately one fourth of all primary caesareans.  Caesarean section at full cervical dilatation is technically difficult and is associated with increased trauma to the lower uterine segment and adjacent structures, as well as increased haemorrhage and infection. Aims and objectives were to determine the indications, maternal and foetal morbidity associated with caesarean section in the second stage of labour.Methods: This prospective study included consecutive 50 cases of caesarean section deliveries conducted in second stage of labor for singleton live pregnancies at term. The data collected in the study was analyzed in terms of maternal demographics, indications of caesarean section, intra-operative and postoperative complications and neonatal outcomes.Results: In our series of 50 deliveries, arrest of descent of fetal head due to malposition was the most common indication of caesarean section accounting for 74% and average procedure time was 45-70 minutes. PPH (62%) was the most common complication. Bladder injury was found in 14% cases. Neonatal outcome variables like APGAR<3 at 5 minutes, respiratory distress and neonatal death were observed in 7, 26 and 2 deliveries respectively.Conclusions: Women undergoing cesarean section in second stage of labour are associated with increased maternal and fetal morbidity. They require special care and hence operation should ideally be performed and supervised by an experienced obstetrician. A proper judgement is required to take a decision for caesarean section at full cervical dilatation.

scholarly journals The three pathways to becoming a midwife: self-assessed confidence in selected competencies in intrapartum care from seven African countries

2021 ◽  
Vol 15 (1) ◽  
pp. 1-10
Author(s):  
Helena Lindgren ◽  
Ingegerd Hildingsson ◽  
Kyllike Christensson ◽  
Lena Bäck ◽  
Christina Mudokwenyu–Rawdon ◽  
...  
Keyword(s):  
Education Programme ◽  
Cross Sectional Study ◽  
Intrapartum Care ◽  
African Countries ◽  
Cross Sectional ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Midwifery Education ◽  
Third Stage ◽  
Sub Saharan

Background/Aims Globally, there are three pathways to become a midwife: midwifery post nursing, direct entry midwifery and integrated nursing and midwifery. There is limited knowledge on the effectiveness of pre-service midwifery education. The aim of this study was to describe and compare midwifery students' confidence in intrapartum skills and associated factors such as type and level of education. Methods A multi-country cross-sectional study was conducted, where midwifery students were approached in the final months of their education programme. Data were collected using a questionnaire, based on the basic skills by the International Confederation of Midwives. Intrapartum care comprised 40 skills. Results In total, 1407 midwifery students from seven sub-Saharan countries responded. The 40 skills were grouped into six domains; three related to care during the first and second stage of labour and three related to care during the third stage of labour. Sex and age were significantly associated with confidence, with female students and those 26–35 years old having higher levels of confidence. Students enrolled in a direct entry programme were more confident than other students in all three domains of care related to the first and second stage of labour. Conclusions Direct entry was found to result in higher confidence for midwifery students than post nursing programmes or integrated programmes. Further research is needed for evaluation of competence.

scholarly journals Prediction of caesarean section for arrest of descent during the second stage of labour

2017 ◽  
Vol 6 (3) ◽  
pp. 963 ◽  
Author(s):  
Sunil Kumar Samal ◽  
Setu Rathod
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Public Awareness ◽  
Multivariable Analysis ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Multiparous Women ◽  
Fetal Complications ◽  
Independent Risk Factors

Background: Friedman described the normal progress of labor in different curves for nulliparous and multiparous women in 1954. Any deviation from these curves during the second stage of labor is considered as failure to progress in the second stage of labor. The aim of the study is to define obstetrical risk factors for arrest of descent during the second stage of labour.Methods: All singleton, vertex, term deliveries with an unscarred uterus, between December 2013 to November 2016 (3 years) were included. Univariable and multivariable analysis were performed to investigate independent risk factors associated with arrest of descent during the second stage of labor.Results: The study included 7260 deliveries, of these 163 (3.3%) were complicated with arrest of descent during the second stage of labor. Using a multivariable analysis, the following obstetric risk factors were found to be significantly associated with arrest of descent: primigravida (RR=7.8, 95% CI=6.9-8.7, p<0.001), obesity (RR=1.8, 95% CI=1.6-2.0, p<0.001), short stature (RR=2.3, 95% CI=1.9-2.8, p<0.001), hypertensive disorders(RR=1.5, 95% CI=1.3-1.8,p<0.001), gestational diabetes(RR=1.5, 95%  CI=1.2-1.8, p<0.001), free floating head before labour(RR=3.4, 95%CI=2.5-4.1, p<0.001), Occipito-posterior position(RR=3.3, 95% CI=2.1-4.5, p<0.002), Prelabour rupture of membrane (PROM) (RR=1.3, 95% CI=1.0-1.6, p<0.02), induction of labour (RR=2.2, 95% CI=1.0-3.4, p<0.03)  and birth weight>3.5 kg (RR=2.2, 95% CI=2.0-2.4, p<0.001). Deliveries complicated by arrest of descent resulted in cesarean section in 67% and 34% vaginal delivery.Conclusions: In this era of increased public awareness and medicolegal events it is very crucial to assess and evaluate every woman in labor and to identify in advance the possibility of arrest in advanced labor so that a timely obstetric intervention possibly Cesarean section can prevent unnecessary maternal- fetal complications.

Postpartum haemorrhage and associated factors among mothers who gave birth in South Gondar Zone public health facilities, Ethiopia: a cross-sectional study

2021 ◽  
pp. postgradmedj-2020-139382
Author(s):  
Asrat Hailu Dagne ◽  
Shimeles Biru Zewude
Keyword(s):  
Associated Factors ◽  
Postpartum Haemorrhage ◽  
Cross Sectional Study ◽  
Labour Induction ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Care Visit

BackgroundPostpartum haemorrhage is one of the direct and the leading causes of maternal morbidity and mortality. There are many risk factors of postpartum haemorrhage, which vary in different settings. Therefore, the purpose of this study was to assess postpartum haemorrhage and associated factors among mothers who gave birth in public health facilities.MethodsA cross-sectional study was employed from 17 November 2019 to 15 February 2020. The study participants were selected using a systematic sampling technique. The data were entered and cleaned using EpiData V.3.1 then exported to SPSS V.20 for analysis. Factors associated with postpartum haemorrhage were selected for multiple logistic regression at the probability value (p value) of less than 0.2 in the χ2 analysis. Statistically significant associated factors were identified at probability value (p value) less than 0.05 and adjusted OR (AOR) with a 95% CI.ResultsThe mean age of participants was 31.3 (SD ±5.7) years. This study found that the prevalence of postpartum haemorrhage was 13.6% (67). Age of participants (AOR 12.5, 95% CI 4.0 to 38.6), disrespectful maternity care (AOR 8.4, 95% CI 3.2 to 22.0), labour induction and augmentation (AOR 6.97, 95% CI 2.34 to 20.8), the prolonged second stage of labour (AOR 9.9, 95% CI 2.6 to 37.1) and no antenatal care visit (AOR 10.1, 95% CI 3.4 to 29.7) were statistically significant associated factors of postpartum haemorrhage.ConclusionsThe prevalence of postpartum haemorrhage is high. The age of the participants, disrespectful maternity care, labour induction and augmentation, the prolonged second stage of labour and no antenatal care visit were independent predictors of postpartum haemorrhage.

scholarly journals Correlation of Cardiotocography with Intraoperative findings and neonatal outcome in caesarean section for non-reassuring fetal status

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Arju Chand Singh ◽  
Ratna Khatri ◽  
Pradyuman Chauhan ◽  
Sumana Thapa
Keyword(s):  
Cesarean Section ◽  
Apgar Score ◽  
Neonatal Outcome ◽  
Admission Rate ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Emergency Cesarean ◽  
Nuchal Cord ◽  
Late Deceleration ◽  
Nicu Admission

Aims: To demonstrate the correlation of cardiotocography with intraoperative findings and neonatal outcome undergoing emergency cesarean section for non-reassuring fetal status. Methods: It is a hospital based cross sectional study at maternity ward of Shree Birendra Hospital in Kathmandu with non-reassuring CTG who underwent cesarean section in a period of one year. Their CTG were correlated with their intraoperative findings and neonatal outcome such as meconium stained liquor, nuchal cord, Apgar score at birth, NICU admission, perinatal mortality and stillbirth. Results: Fifty four patients were recruited. Most common operative finding was meconium stained liquor (35.2%); and cardiotocographic abnormality was variable Deceleration (37%). Variable deceleration and late deceleration had significant correlation with meconium stain liquor and nuchal cord. Apgar score ≤ 7 at 5 minute was 7.4%. NICU admission was 13% with common abnormality as late Deceleration. Conclusion: CTG pattern of variable and late deceleration had correlated with the meconium stained liquor and nuchal cord only. There was no relation with neonatal outcome in terms of Apgar score and admission rate.

The Comparison of Intrapartum Sonographic Signs and Digital Examination in Fetus with Cephalic Presentation

2020 ◽  
Vol 103 (11) ◽  
pp. 1178-1184
Keyword(s):  
Pregnant Women ◽  
Cross Sectional Study ◽  
Head Position ◽  
Vaginal Examination ◽  
Fetal Head ◽  
Cross Sectional ◽  
Percent Agreement ◽  
Anterior Position ◽  
Fetal Head Position ◽  
Digital Vaginal Examination

Objective: The agreement of fetal head position examined by digital vaginal examination (DVE) and intrapartum sonographic signs (ISS) in pregnant women during labor. Materials and Methods: A cross-sectional study was conducted. Two hundred eight-term singleton pregnant women attending labor at Ramathibodi Hospital, Thailand with the fetal cephalic presentation, cervical dilatation of 4 to 8 cm, station –2 or below and no contraindication for DVE were enrolled. The DVE evaluating fetal head position was performed by the third-year obstetrical residents. After DVE, ISS via transabdominal ultrasound for determining fetal head position was obtained immediately by the first researcher. The DVE report and the ultrasonographic images of ISS were recorded separately. The fetal head position based on ISS was designated by the second researcher blinded to the DVE result. The agreement of DVE and ISS for determining fetal head position was analyzed. Results: Two hundred eight pregnant women were analyzed. The fetal head position detected by DVE was consistent with that of ISS at 41.3% (p<0.001). The most percent agreement was observed in the fetus with left occiput anterior position at 72.7% (p<0.001). The lowest percent agreement was found in the direct occiput posterior at 14.3% (p=0.243). Parity, gestational age, current body mass index, epidural analgesia, cervical effacement, caput succedaneum, molding, and station did not significantly affect the discrepancy between DVE and ISS. Conclusion: The agreement between DVE and ISS for evaluating the fetal head position was low. The ISS might be considered for evaluating the fetal head position. Keywords: Fetal head position, Intrapartum sonographic sign, Digital vaginal examination

scholarly journals Timely Initiation of Breast Feeding and Associated Factors among Caesarian Section Delivered Mothers in Health Facilities of Dessie City Administration, North Eastern Ethiopia

2020 ◽  
Vol 13 (1) ◽  
pp. 1-8
Author(s):  
Roza Shiferaw ◽  
Sisay Eshete Tadesse ◽  
Tefera Chane Mekonnen ◽  
Aregash Abebayehu Zerga
Keyword(s):  
Cesarean Section ◽  
Breast Feeding ◽  
Associated Factors ◽  
Statistical Significance ◽  
Data Entry ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Timely Initiation ◽  
Eastern Ethiopia

Objective: To assess the magnitude and associated factors of timely initiation of breastfeeding among cesarean section delivered mothers. Methods: A health facility-based cross-sectional study was employed among 421 systematically selected mothers from February to June, 2017. Data were collected by a structured questionnaire. Data entry and analysis was done using Epi Data and SPSS version 24. Binary logistic regression was computed to identify factors. Adjusted odds ratio with a 95% confidence interval was used to declare statistical significance. Result: The magnitude of timely initiation of breast feeding (among mothers who gave birth by cesarean section was 57%. Counseling during antenatal care (AOR = 3.32; 95% CI: 1.80, 6.13), facility where cesarean section (CS) was performed (AOR = 2.55; 95% CI: 1.57, 4.14), and post-CS counseling (AOR = 6.93; 95% CI: 3.99, 12.02) were factors that contributed for the practice of timely initiation among cesarean section delivered mothers. Conclusions: The magnitude of TIBF was good. Counseling during ANC, the facility where CS was performed and post-natal advice were factors associated with TIBF. Implementation of baby-friendly hospital initiatives should be strengthened in order to promote timely initiation of breast feeding.

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