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 Assisted Vaginal Delivery - Preference of Vacuum or Forceps among Obstetricians

2021 ◽  
pp. 147-155
Author(s):  
Vijayalakshmi Gnanasekaran ◽  
Shantha Kanamma ◽  
Shanthi Dhinakaran ◽  
Jikki Kalaiselvi
Keyword(s):  
Vaginal Delivery ◽  
Entire Group ◽  
P Value ◽  
Significant Finding ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Assisted Vaginal Delivery ◽  
Choice Of Procedure ◽  
Vaginal Deliveries ◽  
Assisted Delivery

Objective: To determine the instrument preference among obstetricians practicing operative vaginal deliveries and to determine the prevalence and risks of vacuum or forceps Assisted Vaginal Delivery (AVD). Methods: This cross-sectional study was carried out in ACS Medical and Hospital, Chennai. A total of 520 obstetricians were included in the study. An online questionnaire was sent to all obstetricians in Chennai. The choice of procedure for specific circumstances, instrument preference [use of vacuum or forceps] and views on the complications encountered in both vacuum and forceps use at vaginal delivery were explored. For the replies, we computed means and percentages for the entire group and distinct subgroups. Risk assessment of outcome with exposure as suitable p-value was included in the statistical analysis. Results: Response rate for the questionnaire was 97% (504/520). The findings suggest that obstetricians preference was more towards vacuum due to their ease of usage.   Baseline characteristics were similar between the two groups. Failed vacuum due to slipping of the cup was the most common complication faced - 62%, followed by caput succedaneum 25%, both were statistically significant. The most significant finding was that maternal injuries in the vacuum group were only 2% which was way less than those who had forceps delivery (68%) with a p-value of < 0.001. Conclusion: In this research, physician instrument choice is a significant predictor of results that should be taken into account. Use of vacuum for delivery seemed to be the choice of majority of obstetricians [334 (66%)]. Vacuum extractor rather than forceps for assisted delivery appears to reduce maternal morbidity, whereas neonatal injuries were more common in newborns delivered by vacuum. The choice of instrument should be personalized based on the patient's condition and the obstetrician's experience and expertise.

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

Influence of Patient-Level Factors on Mode of Delivery among Operative Vaginal Delivery Candidates in Modern Practice

2017 ◽  
Vol 34 (10) ◽  
pp. 0974-0981 ◽  
Author(s):  
Christina Gonzalez ◽  
Amanda Allshouse ◽  
Erick Henry ◽  
Sean Esplin ◽  
Torri Metz
Keyword(s):  
Vaginal Delivery ◽  
Gestational Age ◽  
Maternal Age ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Second Stage ◽  
Patient Level ◽  
Operative Vaginal Delivery

Objective We aimed to evaluate which patient-level factors influence mode of delivery among candidates for operative vaginal delivery. Study Design Cross-sectional study of candidates for operative vaginal delivery from 18 hospitals over 8 years. Probabilities of mode of delivery were estimated using hierarchical logistic modeling adjusting for clustering within physician and hospital. Results Total 3,771 (64%) women delivered with forceps, 1,474 (25%) vacuums, and 665 (11%) cesareans. Odds of forceps versus vacuum were higher with induction (OR = 2.16, 95% CI: 1.76–2.65), nulliparity (OR = 2.06, 95% CI: 1.59–2.66), epidural (OR = 2.05, 95% CI: 1.19–3.56), maternal indication (OR = 1.53, 95% CI 1.16–2.02), older maternal age (OR 1.18, 95% CI 1.06–1.31 per 5 years), and longer second stage (OR = 1.10, 95% CI: 1.01–1.20 per hour).Odds of cesarean versus operative vaginal delivery were higher with maternal indication (OR = 9.0, 95% CI: 7.23–11.20), a perinatologist (OR = 2.51, 95% CI: 1.09–5.78), longer second stage (OR = 1.79, 95% CI: 1.65–1.93 per hour), older gestational age (OR = 1.10, 95% CI: 1.01–1.20 per week), and longer labor (OR = 1.02, 95% CI: 1.01–1.04 per hour). Conclusion Patient-level factors influence the decision to proceed with an operative vaginal delivery and the choice of instrument, thereby emphasizing the importance of maintaining availability of both forceps and vacuums.

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.

scholarly journals 3096 Estimation of the Prevalence of Cesarean Delivery for the Extremely Preterm Fetus in Breech Presentation

2019 ◽  
Vol 3 (s1) ◽  
pp. 43-43
Author(s):  
Alissa Dangel ◽  
Janis L Breeze ◽  
Gordon Huggins ◽  
Michael House ◽  
Kumaran Kolandaivelu
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Breech Presentation ◽  
Vital Statistics ◽  
Target Range ◽  
Multiple Gestation ◽  
Cross Sectional ◽  
Cesarean Deliveries ◽  
Vaginal Deliveries ◽  
Extremely Preterm

OBJECTIVES/SPECIFIC AIMS: Cesarean delivery is typically performed in the extremely preterm period (23 to 28 weeks) when the fetus is in breech presentation to avoid the potential risk of head entrapment by an insufficiently dilated cervix during a vaginal delivery. Assessment of the prevalence of extremely preterm breech cesarean delivery would help to appropriately guide future clinical interventions designed to increase the feasibility of vaginal delivery for this sub-group of patients. METHODS/STUDY POPULATION: We performed a cross-sectional study of the 2106 U.S. National Vital Statistics birth certificate database to estimate the prevalence of cesarean deliveries performed during the period of gestation from 23 to 28 weeks with a fetus in breech presentation. RESULTS/ANTICIPATED RESULTS: An analysis of the total births in the 2016 registry (3,945,875) was performed. The gestational age was limited to the target range of 23 0/7 to 27 6/7 weeks. Multiple gestation deliveries were excluded. This yielded 16,092 births of which 4,849 were noted to have breech presentation. The proportion of cesarean deliveries performed for singleton breech fetuses at this gestational range was 87% (4,203/4,849). DISCUSSION/SIGNIFICANCE OF IMPACT: The probability of undergoing a cesarean delivery for an extremely preterm fetus in breech presentation is notably higher (87%) when compared to an overall cesarean delivery rate of 31.9%. Specific interventions to allow for vaginal delivery in this particular sub-group of the obstetric population would be useful to reduce maternal morbidity by increasing vaginal deliveries. Future work will attempt to address innovative solutions to prevent head entrapment by the cervix in this particular population and ultimately avoid cesarean delivery.

scholarly journals Maternal Complication Related To Instrumental Delivery At Felege Hiwot Specialized Hospital, Northwest Ethiopia. A Retrospective Cross-Sectional Study

2019 ◽  
Author(s):  
shimeles biru zewudie ◽  
Dagne Addisu sewyew ◽  
Simachew kassa limenh ◽  
Simachew animen bante
Keyword(s):  
Vaginal Delivery ◽  
Northwest Ethiopia ◽  
Instrumental Delivery ◽  
Maternal Complications ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Maternal Complication ◽  
Assisted Vaginal Delivery ◽  
Specialized Hospital ◽  
Assisted Delivery

Abstract ABSTRACT Objective: The study aimed to determine proportion and risk factors for maternal complication related to forceps and vacuum delivery among mother who gave birth at Felege Hiwot Comprehensive Specialized Hospital (FHCSH). Results: Records of 406 mothers managed with instrumental vaginal delivery were reviewed and 97% of the reviewed card had complete documentation. The proportion of maternal complications related to instrumental delivery was 12.1%. A major complication of forceps assisted delivery was 2nd-degree perineal tear (7.4%), 3rd-degree perineal tear (1.5%), cervical tear (1.5%) and episiotomy extension (1%). However, the complication of vacuum-assisted vaginal delivery was only cervical tear (0.5%) and episiotomy extension (0.5%). Episiotomy during instrumental delivery reduce maternal complication by 86% [AOR=0.14, 95%CI=0.07-0.3]. Forceps assisted vaginal delivery had 3.4 times more risk for maternal complication compared to vacuum-assisted vaginal delivery [AOR=3.4, 95%CI=1.08-10.67] and the same is true for primiparity that primipara women who gave birth by the help of instrument had 3.5 times more risk for maternal complication compared to a multipara women [AOR=3.5, 95%CI=1.26-9.98]. Keywords: maternal complication, instrumental delivery, northwest, Ethiopia

scholarly journals Maternal Complication Related To Instrumental Delivery At Felege Hiwot Specialized Hospital, Northwest Ethiopia. A Retrospective Cross-Sectional Study

2019 ◽  
Author(s):  
shimeles biru zewudie ◽  
Dagne Addisu sewyew ◽  
Simachew kassa limenh ◽  
Simachew animen bante
Keyword(s):  
Vaginal Delivery ◽  
Northwest Ethiopia ◽  
Instrumental Delivery ◽  
Maternal Complications ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Maternal Complication ◽  
Assisted Vaginal Delivery ◽  
Specialized Hospital ◽  
Assisted Delivery

Abstract ABSTRACT Objective: The study aimed to determine proportion and risk factors for maternal complication related to forceps and vacuum delivery among mother who gave birth at Felege Hiwot Comprehensive Specialized Hospital (FHCSH). Results: Records of 406 mothers managed with instrumental vaginal delivery were reviewed and 97% of the reviewed card had complete documentation. The proportion of maternal complications related to instrumental delivery was 12.1%. A major complication of forceps assisted delivery was 2nd-degree perineal tear (7.4%), 3rd-degree perineal tear (1.5%), cervical tear (1.5%) and episiotomy extension (1%). However, the complication of vacuum-assisted vaginal delivery was only cervical tear (0.5%) and episiotomy extension (0.5%). Episiotomy during instrumental delivery reduce maternal complication by 86% [AOR=0.14, 95%CI=0.07-0.3]. Forceps assisted vaginal delivery had 3.4 times more risk for maternal complication compared to vacuum-assisted vaginal delivery [AOR=3.4, 95%CI=1.08-10.67] and the same is true for primiparity that primipara women who gave birth by the help of instrument had 3.5 times more risk for maternal complication compared to a multipara women [AOR=3.5, 95%CI=1.26-9.98]. Keywords: maternal complication, instrumental delivery, northwest, Ethiopia

scholarly journals Hubungan Faktor Maternal terhadap Posisi pada Waktu Persalinan Kala II dengan Kejadian Ruptur Perineum

2020 ◽  
Vol 2 (1) ◽  
pp. 31-36
Author(s):  
Wa Ode Hajrah ◽  
Niken Purbowati ◽  
Novia Nuraini
Keyword(s):  
Maternal Age ◽  
Statistical Tests ◽  
Reproductive Organs ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Second Stage ◽  
Second Stage Labor ◽  
Relationship Of ◽  
The Relationship

erineal rupture needs attention because it can cause dysfunction of the female reproductive organs, as a source of bleeding, a source, or a way in and out of infection, then it can cause death due to bleeding or sepsis. About 85% of Women who delivery vaginally experience perineal rupture, in the age group 25-30 years 24%, while in maternal age 32-39 years by 62%. In Asia, perineal rupture is also a problem in society, 50 % of the world's occurrence is in Asia. The study aims to determine the relationship of maternal factors to the position of the second stage labor and perineal rupture occurrence. This research applied a descriptive-analytic method using a cross-sectional research design. The research sample was 102 respondents, accidental random sampling, which was all labor with perineal rupture in July to November 2018. Statistical tests used chi-square. The results of perineal rupture with maternal age was p-value 0.042 (p <0.05), perineal rupture with maternal parity was p-value 0.01 (p <0.05). Suggestions for various maternal positions in maternity and ANC classes to prevent perineal rupture.

scholarly journals EFEKTIVITAS POSISI TANGAN PENOLONG DALAM PENCEGAHAN RUPTUR PERINEUM PADA PERSALINAN NORMAL

2017 ◽  
Vol 9 (01) ◽  
pp. 68
Author(s):  
Mulyati Priyantini ◽  
Yuli Trisnawati
Keyword(s):  
Maternal Morbidity ◽  
P Value ◽  
Cross Sectional ◽  
Second Stage Of Labor ◽  
Whitney Test ◽  
Second Stage ◽  
Mann Whitney Test ◽  
Significant Difference ◽  
U Value ◽  
Quota Sampling

ABSTRAKFokus utama asuhan persalinan adalah pencegahan komplikasi untuk mengurangi angka kesakitan dan kematian ibu. Salah satu upaya adalah mencegah terjadinya ruptur perineum. Posisi tangan yang dipakai penolong persalinan kala II untuk mencegah ruptur perineum antara lain posisi tangan APN dan Varney. Penelitian ini bertujuan untuk mengetahui efektivitas antara posisi tangan penolong menurut APN dan menurut Varney dalam mencegah ruptur perineum spontan pada kala II persalinan di RSIA ‘Bunda arif’ Purwokerto. Penelitian ini merupakan penelitian observasional analitik, menggunakan pendekatan cross sectional dengan populasi seluruh persalinan spontan di RSIA ‘Bunda arif’ Purwokerto. Sampel yang digunakan adalah quota sampling  sebanyak 30 sampel yang memenuhi kriteria inklusi. Metode analisis data menggunakan uji U Mann-Whitney. Hasil penelitian ini adalah Kejadian ruptur perineum pada posisi tangan menurut APN sebanyak 93,3%, sedangkan menurut Varney sebanyak 86,7%. Hasil analisa statistik uji U Mann-Whitney didapatkan p value = 0,550 (p>0,005) sedangkan U value  = 33,000 (Uh < U t ), artinya tidak ada perbedaan bermakna, tetapi posisi tangan Varney lebih baik dengan selisih ruptur 6,6%. Posisi tangan penolong menurut Varney lebih efektif daripada posisi tangan menurut APN dalam pencegahan ruptur perineum spontan pada kala II persalinan, tetapi keduanya tidak memberikan perbedaan yang bermakna terhadap kejadian ruptur perineum. Penolong persalinan dapat menemukan metode yang paling tepat dalam meminimalisir kejadian ruptur perineum spontan untuk menurunkan angka kesakitan dan kematian ibu.Keyword : Posisi tangan penolong, ruptur perineumEFFECTIVENESS OF HANDLING POSITION IN PREVENTION OF PERINEUM RUPTURE IN NORMAL LABORABSTRACTMain focus of delivery care is preventing the complication to reduce the maternal morbidity and mortality. One of the efforts to prevent the occurance of perineal rupture. The position hand which is used birth attendant in the second stage of labor to prevent perineal rupture among others APN and Varney hands position. The goal of this reasearch is to know the effectiveness between APN and Varney hands position to prevent spontanoeus perineal rupture in the second stage of labor in RSIA ‘Bunda arif’ Purwokerto. This reasearch was observational analytic by approachment cross sectional with population of this reasearch was all of spontaneous delivery in RSIA ‘Bunda arif’ Purwokerto and the sample used quota sampling, it’s about 30 sample can be a inclusion criteria. The analyze method data used U Mann-Whitney test. The result of this experiment are precentage of spontaneous perineal rupture by  APN hands position is 93,3%, while by Varney is 86,7%. Result of statistic analysis used U Mann-Whitney test is p value = 0,550 (p>0.005) and U value  = 33,000 (Uh < U t). It means, not significant difference, but Varney hands position better by a margin of 6.6%. the conclusion are varney hands position is more effective than APN hands position in  prevention spontaneous perineal rupture in the second stage of labor, but both not significant for perinel rupture. Suggestion : Birth attendants can find the most appopriate method to minimize perineal ruptured to reduce maternal morbidity and mortalityKeyword : APN & Varney hands position, and perineal rupture.

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