scholarly journals Risk factors for post-partum hemorrhage in patients who underwent operative vaginal delivery in a tertiary care center

2021 ◽  
Author(s):  
Gayatri Devi Sivasambu ◽  
Sujani B. Kempaiah ◽  
Urvashi Thukral
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Tertiary Care ◽  
Significant Risk ◽  
Post Partum Hemorrhage ◽  
Second Stage ◽  
Operative Vaginal Delivery ◽  
Vaginal Deliveries

Background: Operative vaginal delivery is a timely intervention to cut short second stage labor when imminent delivery is in the interests of mother, fetus, or both. It reduces second stage cesarean section morbidity and uterine scar and its influence on future obstetric career. The possible structural neonatal adverse outcomes due to operative vaginal delivery are well quantified. However, its effects on maternal outcome need to be understood better. In this paper, we study the effect of operative vaginal delivery on maternal post-partum hemorrhage (PPH) and the associated risk factors.Methods: It was a retrospective study carried out for the period July 2016 to July 2020 at Ramaiah Medical College, Bengaluru. Total number of vaginal deliveries in this period were 6318. Out of these, 1020 patients underwent assisted vaginal delivery using vacuum/ forceps/ sequential use of instrument. Blood loss greater than 500 ml is considered PPH for the purpose of this study. 15% of the study population was noted to have PPH. We employ a multivariate logistic regression to identify statistically significant risk factors for PPH in women undergoing operative vaginal delivery.Results: The logistic regression model identifies multiparity, maternal age, neonatal birth weight more than 3.5 kg, application of forceps in women with hypertensive disorders, III-degree tear, cervical tear to significantly increase the risk of PPH in our study population.Conclusions: Certain factors seem to increase the risk of PPH in operative vaginal delivery. The risks and benefits must be weighed properly before use of instruments.

Risk factors for post-partum hemorrhage following vacuum assisted vaginal delivery

2016 ◽  
Vol 295 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Liran Hiersch ◽  
Riki Bergel-Bson ◽  
Dorit Asher ◽  
Amir Aviram ◽  
Rinat Gabby-Benziv ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Assisted Vaginal Delivery ◽  
Post Partum Hemorrhage

Anal Sphincter Injury Associated with Vaginal Twin Delivery

2019 ◽  
Vol 37 (11) ◽  
pp. 1134-1139
Author(s):  
Bobby D. O'Leary ◽  
Tariq Bholah ◽  
Tamara Kalisse ◽  
Mark P. Hehir ◽  
Michael P. Geary
Keyword(s):  
Risk Factors ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Univariate Analysis ◽  
Mode Of Delivery ◽  
Significant Risk ◽  
Sphincter Injury ◽  
Anal Sphincter Injury ◽  
Vaginal Deliveries ◽  
Twin Pregnancies

Abstract Objective Obstetric anal sphincter injury remains the most common cause of fecal incontinence in women, and research in twin pregnancies is sparse. This study aimed to examine risk factors for sphincter injury in twin deliveries over a 10-year period. Study Design This was a retrospective study of twin vaginal deliveries in a tertiary-level hospital over 10 years. We examined the demographics of women who had a vaginal delivery of at least one twin. Logistic regression analysis was used to examine risk factors. Results There were 1,783 (2.1%) twin pregnancies, of which 556 (31%) had a vaginal delivery of at least one twin. Sphincter injury occurred in 1.1% (6/556) women with twins compared with 2.9% (1720/59,944) singleton vaginal deliveries. Women with sphincter injury had more instrumental deliveries (83.3 vs. 27.6%; p = 0.008). On univariate analysis, only instrumental delivery was a significant risk factor (odds ratio: 2.93; p = 0.019). Conclusion Sphincter injury occurs at a lower rate in vaginal twin pregnancies than in singletons. No twin-specific risk factors were identified. Discussion of the risk of sphincter injury should form part of patient counseling with regard to the mode of delivery.

A STUDY OF FETOMATERNAL OUTCOME OF INSTRUMENTAL VAGINAL DELIVERIES AT A RURAL TERTIARY CARE HOSPITAL IN MANDYA DISTRICT KARNATAKA

2021 ◽  
pp. 1-3
Author(s):  
Triza Kumar Lakshman ◽  
Ekta Chhabra ◽  
Ravindra S. Pukale
Keyword(s):  
Vaginal Delivery ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Care Hospital ◽  
Maternal Complications ◽  
Perineal Tear ◽  
Operative Vaginal Delivery ◽  
Vaginal Deliveries ◽  
Skilled Operator ◽  
Assisted Delivery

Introduction: Giving birth can be a long and painful process and is not always a perfect one. Instrumental vaginal delivery is an art and provides a 1 temporal advantage over cesarean delivery. It is also an alternative procedure for delivery in emergency obstetrics. Instrumental vaginal delivery is an integral part of Obstetrics care world wide. The present study was carried out to evaluate the maternal and neonatal outcome in operative/assisted vaginal delivery. Method: We performed a retrospective observational study of women with singleton term pregnancies who underwent operative vaginal delivery at Adichunchanagiri Institute of Medical Sciences. The study was conducted between August 2019 to August 2020 for the duration of 1 year and the data was accrued from patient database retrospectively and was entered in Microsoft Excel (Version 16.4) for Windows. Results: During the study period, 95 patients underwent Instrumental Vaginal Delivery, of which 74 were vacuum assisted and 21 were forceps nd delivery. The most common indication for Operative vaginal delivery was failure of maternal efforts followed by prolong 2 stage of labour in vacuum group and severe pre-eclampsia in forceps group. Vacuum was used more often than forceps for most of the deliveries. Maternal st nd complication like 1 and 2 degree perineal tear were seen more often with the use of forceps. Instrument marks and bruising were found in the neonates delivered by forceps and a greater incidence of cephalohaematomas and caput in the neonates delivered with vacuum. Conclusion: A successful instrumental vaginal delivery can be achieved with lesser maternal and neonatal morbidity with timely assessment of labour and skilled operator. The overall rate of perinatal and maternal morbidity and mortality vary by indication and operative instrument. Women who underwent forceps-assisted delivery had greater rates of maternal complications than those who underwent vacuum-assisted delivery

scholarly journals Fetomaternal outcome in operative vaginal delivery

2021 ◽  
Vol 10 (11) ◽  
pp. 4096
Author(s):  
Jeyamani B. ◽  
Nashreen Dhasleema A.
Keyword(s):  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Breech Presentation ◽  
P Value ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Second Stage ◽  
Operative Vaginal Delivery ◽  
Vaginal Deliveries ◽  
Assisted Delivery

Background: Operative vaginal deliveries (OVD) were performed with the help of vacuum or forceps in the second stage of labor when mother and foetus condition is threatening. A successful assisted vaginal delivery avoids caesarean section and its associated morbidity and implications for future pregnancy. The aim of the study was to assess the maternal and neonatal outcome of vacuum and forceps assisted vaginal deliveries.Methods: It was a retrospective comparative cross sectional study done in VMKVMCH, Salem in obstetrics and gynecology department, from the period of April to June 2021. All the mothers delivered by operative vaginal delivery were included. Mothers with multiple pregnancies, preterm and breech presentation were excluded. Data collected using patients information sheet and analysis was done using SPSS 23. P value <0.05 was considered significant.Results: The most common age group was 21-25 years of age in both groups and most commonly used in primigravida. The most common indication for forceps assisted delivery in our study was the prolonged second stage labour and in vacuum delivery was poor maternal effort. In our study, common complication noted was extended episiotomy followed by perineal tear in forceps group and vice versa in vacuum group. Cephalhematoma was found to be more common in vacuum and scalp and instrumental injuries were more common in forceps assisted vaginal deliveries.Conclusions: Operative vaginal deliveries helps in improving both maternal and foetal outcomes and reduces the caesarean delivery rate and vacuum significantly reduces maternal trauma than forceps. No difference noted in neonatal outcome. 

scholarly journals Perbandingan Kejadian Retensi Urin antara Persalinan dengan Vakum Ekstraksi dan Persalinan Normal

2016 ◽  
Vol 3 (3) ◽  
pp. 188
Author(s):  
Nurul Hikmah Petrana ◽  
Ova Emilia ◽  
Heru Pradjatmo
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Urinary Retention ◽  
Vaginal Delivery ◽  
Significant Risk ◽  
Normal Vaginal Delivery ◽  
Chi Square ◽  
Related Factors ◽  
Normal Delivery ◽  
Chi Square Test

Background: Urinary retention after vaginal delivery is a common problem with incidence 1.7% - 17.9%. Assissted vaginal delivery is one risk factor for the occurence of urinary retention.Objective: to compare urinary retention between normal vaginal delivery and assissted vaginal delivery using extraction vacum, and evaluate factors related to urinary retention.Method: The study was prospective cohort design, conducted in 3 hospitals and 2 primary health centres during 6 month period since September 2013- February 2014. Subjects were divided into two groups i.e. normal delivery and assissted delivery using extraction vacum, each 118 subjects. Events of urinary retention was assessed and also related factors were identified. Analysis used Chi-Square test, Fisher test and also logistic regression analysis.Result and Discussion: In total 236 subjects were involved, there was no difference in age and parity among the subjects. Incidence of urinary retention among extraction vacum delivery group was higher (32.2%) compare to normal delivery (11.9%). Multivariate analysis using logistic regression showed that extraction vacum (p=0.074; OR 2.71; 95% CI 1.55-4.73), baby weight (p= 0.230; OR 1.95; 95% CI 0.655.84) and perineal injury (p= 0.614; OR 1.35; 95% CI 0.41-4.36) were not significant risk factors for urinary retention. Length of labour (p=0.003; OR 3.71; 95% CI 1.55-8.86) and parity (p= 0.023; OR 2.29; 95% CI 1.2-4.66) were significant risk factors for urinary retention.Conclusion: Urinary retention is higher among vaginal delivery with extraction vacum compare to normal delivery. Length of labour and parity are external factors related to urinary retention. Keywords: Assissted vaginal delivery, extraction vacum, normal delivery, urinary retention, postpartum

scholarly journals Factors influencing the likelihood of vacuum delivery success

2017 ◽  
Vol 6 (9) ◽  
pp. 3818
Author(s):  
Kunaal K. Shinde ◽  
Anand Karale ◽  
Gulabsingh Shekhawat
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Care Center ◽  
Tertiary Care ◽  
Term Infants ◽  
Medical College ◽  
Second Stage ◽  
Single Term ◽  
Vaginal Deliveries ◽  
Vacuum Delivery

Background: Instrumental or assisted vaginal birth is commonly used to expedite birth, for the benefit of either mother, baby or both. Objective of present study was to evaluate risk factors for unsuccessful vacuum delivery when variability between individual accoucheurs is taken into account.Methods: We conducted a retrospective cohort study of attempted 687 vacuum deliveries over a 10-year period (2008–2017 inclusive) in a tertiary care center at Smt. Kashibai Navale Medical College and General Hospital, Narhe to account for inter-accoucheur variability, we matched unsuccessful deliveries (cases) with successful deliveries (controls) by the same operators. Multivariate logistic regression was used to compare successful and unsuccessful vacuum deliveries.Results: During the study period of 10 years, there were 29861 deliveries, of which 19831 (66.4%) were vaginal deliveries. 8802 (29.47%) were cesarean deliveries and 1228 (4.1%) were instrumental deliveries. Among instrumental deliveries, 687 (56%) were vacuum deliveries and 541 (44%) were forceps deliveries. Six hundred and eighty-seven ventouse deliveries of vertex presenting, single, term infants were attempted, of which 38 were unsuccessful (5.5%). Increased birth weight (OR=1.11 p<0.001), second-stage duration (OR=1.01 p<0.001), rotational delivery (OR=1.52 p<0.05) and use of ventouse versus forceps (OR=1.33 p<0.05) were associated with unsuccessful outcome. When inter-accoucheur variability was controlled for, instrument selection and decision to rotate were no longer associated with vacuum delivery success. More senior accoucheurs had higher rates of unsuccessful deliveries (12% v. 5%, p<0.05), but undertook more complicated cases. Cesarean delivery in the second stage without prior attempt at ventouse delivery was associated with higher birth weight (OR=1.07 p<0.001), increased maternal age (OR=1.03 p<0.01), and epidural analgesia (OR=1.46 p<0.001).Conclusions: Careful selection of cases and adequate training of post graduate students during residency under direct supervision of senior experienced obstetrician can reduce the rate of failed vacuum delivery and related complications Results suggest that birth weight and head position are the most important factors in successful vacuum delivery, whereas the influence of patient selection and rotational delivery appear to be operator-dependent. Risk factors for lack of vacuum delivery success are distinct from risk factors for requiring vacuum delivery, and these should not be conflated in clinical practice.

scholarly journals Prospective study on outcome of post-partum intrauterine contraceptive device insertion at tertiary level rural health institute of Gujarat, India

2019 ◽  
Vol 8 (6) ◽  
pp. 2275
Author(s):  
Shilpa N. Ninama ◽  
Tejas A. Shah ◽  
Mayur R. Gandhi
Keyword(s):  
Prospective Study ◽  
Post Partum ◽  
Public Awareness ◽  
Tertiary Care ◽  
Significant Risk ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Vaginal Route ◽  
Vaginal Deliveries ◽  
Intrauterine Contraceptive

Background: This study was conducted to evaluate the acceptance, safety, efficacy, complications and expulsion rate of post-partum intrauterine contraceptive device (PPIUCD) insertion among post-partum pregnant women in a rural tertiary care center. Objective of this study was assessment of the efficacy and safety of post-partum IUCD insertion. Comparing the complications and client satisfaction in both groups (intra caesarean insertion versus vaginal route of insertion).Methods: This is a prospective study conducted at one of the rural tertiary care teaching institution. A total of 150 patients with caesarean or vaginal deliveries had PPIUCD insertions and they were followed up for a period of one year. The outcome measures analyzed were menstrual irregularities, vaginal discharge, pelvic infection and perforation and efficacy measures - failure, expulsion and removal. Data are expressed in frequency and percentage. Chi square test was used for comparison and P value <0.05 was considered significant.Results: The study shows that PPIUCD is an effective intervention in both caesarean and vaginal delivery with non-significant differences in safety and efficacy depending on the route of insertion. There was no case of perforation and no significant risk of infection in either caesareans or delivery. Spontaneous expulsion occurred in two cases inserted by vaginal route. Missing string incidence is high in the caesarean group compared to vaginal insertion.Conclusions: PPIUCD is a safe, effective and long term reversible method of contraception and should be encouraged by public awareness and community acceptance.

Fetomaternal Outcome in Operative Vaginal Deliveries in a Tertiary Care Centre: A Descriptive Retrospective Study

2020 ◽  
Vol 3 (2) ◽  
pp. 23-27
Author(s):  
Rakshya Joshi ◽  
Sabita Shrestha ◽  
Jully Chaudhary ◽  
Upendra Pandit ◽  
Renuka Tamrakar
Keyword(s):  
Retrospective Study ◽  
Vaginal Delivery ◽  
Care Center ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Tertiary Care Centre ◽  
Fourth Degree ◽  
Operative Vaginal Delivery ◽  
Nulliparous Women ◽  
Vaginal Deliveries

Background: Operative vaginal delivery is safe and effctive when applied by well-trained personnel. However, it is an underutilized component of obstetric care. We aimed to estimate the frequency of operative vaginal delivery in a tertiary care center and evaluate the immediate maternal and fetal morbidities. Methods: This descriptive retrospective study was carried out in the Department of Obstetrics and Gynecology, Chitwan Medical College and Teaching Hospital. Medical records of all operative vaginal deliveries conducted from May 2019 to April 2020 were retrieved. Data regarding demography, delivery characteristics, maternal and fetal morbidity and mortality associated with operative vaginal deliveries were collected. Results: The frequency of operative vaginal delivery was found to be 2.3% among 3060 deliveries. It was more commonly used in nulliparous women (n = 54, 76.1%); the commonest age group being 20 to 35 years. The commonest indication was fetal distress (n = 32, 45.1%) followed by prolonged second stage of labor (n = 26, 36.6%). The associated maternal morbidities included postpartum hemorrhage (n = 12, 16.9%), need of blood transfusion (n = 9, 12.7%), fever (n = 6, 8.5%), cervical tear (n = 3, 4.2%) and third/fourth degree perineal tears (n = 3, 4.2%). One neonate had cephalhematoma and 14 neonates (19.7%) needed admission in neonatal intensive care unit. Conclusion: Operative vaginal delivery accounted for 2.3% of the total deliveries and was associated with a few maternal and fetal morbidities.

Decreased Rates of Nosocomial Endometritis and Urinary Tract Infection After Vaginal Delivery in a French Surveillance Network, 1997–2003

2008 ◽  
Vol 29 (6) ◽  
pp. 487-495 ◽  
Author(s):  
Louis Ayzac ◽  
Emmanuelle Caillat-Vallet ◽  
Raphaële Girard ◽  
Catherine Chapuis ◽  
Florence Depaix ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Vaginal Delivery ◽  
Significant Risk ◽  
Maternity Unit ◽  
Surveillance Network ◽  
Routine Surveillance ◽  
Vaginal Deliveries

Objectives.To identify independent risk factors for endometritis and urinary tract infection (UTI) after vaginal delivery, and to monitor changes in nosocomial infection rates and derive benchmarks for prevention.Design.Prospective study.Methods.We analyzed routine surveillance data for all vaginal deliveries between January 1997 and December 2003 at 66 maternity units participating in the Mater Sud-Est surveillance network. Adjusted odds ratios for risk of endometritis or UTI were obtained using a logistic regression model.Results.The overall incidence rates were 0.5% for endometritis and 0.3% for UTI. There was a significant decrease in the incidence and risk of endometritis but not of UTI during the 7-year period. Significant risk factors for endometritis were fever during labor, parity of 1, and instrumental delivery and/or manual removal of the placenta. Significant risk factors for UTI were urinary infection on admission, premature rupture of membranes (more than 12 hours before admission), blood loss of more than 800 mL, parity of 1, instrumental delivery, and receipt of more than 5 vaginal digital examinations. Each maternity unit received a poster showing graphs of the number of expected and observed cases of UTI and endometritis associated with vaginal deliveries, which enabled each maternity unit to determine their rank within the network and to initiate prevention programs.Conclusions.Although routine surveillance means additional work for maternity units, our results demonstrate the usefulness of regular targeted monitoring of risk factors and of the most common nosocomial infections in obstetrics. Most of the information needed for monitoring is already present in the patients' records.

scholarly journals Predictors of mortality in children hospitalized with severe acute malnutrition

2020 ◽  
Vol 7 (5) ◽  
pp. 1088
Author(s):  
Vinnamangalam Mani Baskaran ◽  
Sridevi A. Naaraayan ◽  
Dorairaj Priyadharishini
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Severe Acute Malnutrition ◽  
Care Center ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Significant Risk ◽  
Acute Malnutrition ◽  
World Health ◽  
Prognostic Features

Background: Severe acute malnutrition (SAM) is a leading cause of morbidity and mortality in children worldwide. Identification of factors contributing to mortality is crucial to decrease the mortality due to SAM. This study aims at identification of factors affecting mortality in hospitalized SAM children.Methods: This study was done in general pediatric wards of a Government tertiary care center from July 2015 to June 2016. Total 200 children admitted to the hospital with Severe Acute Malnutrition (SAM) as per World Health Organization (WHO) criteria were enrolled. Demographic and clinical data were recorded in structured proforma. These children were followed up till death or discharge and their progress and outcome were noted. The risk factors considered were younger age (infancy), female sex and presence of systemic illness, sepsis, retroviral positivity, severe anaemia, pneumonia and diarrhea and these were compared between those who died and survivors.  Univariate analysis and logistic regression analysis were performed to determine the significant risk factors.Results: The mortality rate was 10.5%. Presence of systemic illness, sepsis and retroviral positivity were significant risk factors at the end of univariate analysis and multivariate logistic regression, while the others were insignificant.Conclusions: Systemic diseases, sepsis and retroviral disease are poor prognostic features and are risk factors of mortality in hospitalized SAM children.

Sign in / Sign up

Export Citation Format

Share Document