scholarly journals Perinatal impact of cesarean delivery on maternal request compared with vaginal delivery among low-risk pregnancies in a university hospital: a prospective observational study in Bogotá, Colombia

2017 ◽  
Vol 68 (1) ◽  
pp. 35
Author(s):  
Luis Andrés Sarmiento-Rodríguez ◽  
Carlos O. Mendivil Anaya ◽  
Alexandra Casasbuenas-Salcedo ◽  
Ana María Pérez-Zauner ◽  
Ana Milena Angarita-Africano
Keyword(s):  
Observational Study ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Prospective Observational Study ◽  
Low Risk ◽  
University Hospital ◽  
Maternal Request ◽  
Las Mujeres

Objetivo: existe evidencia insuficiente sobre el impacto de la cesárea por solicitud materna (CSM); este estudio evalúa el efecto de la CSM en los múltiples desenlaces maternos y neonatales comparando CSM con parto vaginal entre embarazos de bajo riesgo. Materiales y métodos: estudio observacional prospectivo que incluyó mujeres entre 18 y 45 años de edad, con un embarazo a término y de bajo riesgo, que tuvieron parto entre junio de 2008 y abril de 2012 en un hospital universitario en Bogotá, Colombia. Se comparó la ocurrencia de cualquiera de 5 eventos adversos maternos preespecificados, y de cualquiera de 17 eventos neonatales preespecificados, entre CSM y partos vaginales. Los partos vaginales inducidos fueron analizados separadamente. Todas las mujeres recibieron el mismo cuidado estandarizado. El efecto de variables confusoras se ajustó mediante regresión logística múltiple.Resultados: se incluyeron 214 mujeres con CSM, 341 con parto vaginal espontáneo (PVE) y 376 con parto vaginal inducido (PVI). Respecto al grupo PVE, el OR ajustado del desenlace materno fue 0,21 (IC 95 %: 0,05-0,97) en el grupo CSM y 0,93 (IC 95%: 0,42-2,06) en el grupo PVI. Los OR del desenlace neonatal fueron 0,59 (IC95%: 0,36-0,93) para CSM y 0,84 (IC95%: 0,59-1,21) para PVI. La frecuencia de hospitalización del neonato más baja fue en el grupo de CSM (10,3 % frente a 15,8 % para PVE, 16,2 % para PVI).Conclusiones: en pacientes con embarazo de bajo riesgo que ingresaron a un protocolo estándar de cuidado obstétrico, CSM se acompañó de una menor tasa de eventos adversos perinatales respecto al parto vaginal espontáneo. Sin embargo, se requieren estudios que evalúen la seguridad de CSM en el largo plazo.

Evaluation of measured postpartum blood loss after vaginal delivery using a collector bag in relation to postpartum hemorrhage management strategies: a prospective observational study

2016 ◽  
Vol 44 (4) ◽  
Author(s):  
Christian Bamberg ◽  
Katja Niepraschk-von Dollen ◽  
Laura Mickley ◽  
Anne Henkelmann ◽  
Larry Hinkson ◽  
...  
Keyword(s):  
Blood Loss ◽  
Observational Study ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Prospective Observational Study ◽  
Management Strategies ◽  
Population Based ◽  
University Hospital ◽  
Hemoglobin Content ◽  
Vaginal Deliveries

AbstractTo evaluate the incidence of postpartum hemorrhage (PPH) and severe PPH via routine use of a pelvic drape to objectively measure blood loss after vaginal delivery in connection with PPH management.This prospective observational study was undertaken at the obstetrical department of the Charité University Hospital from December 2011 to May 2013 and evaluated an unselected cohort of planned vaginal deliveries (n=1019 live singletons at term). A calibrated collecting drape was used to meassure blood loss in the third stage of labor. PPH and severe PPH were defined as blood loss ≥500 mL and ≥1000 mL, respectively. Maternal hemoglobin content was evaluated at admission to delivery and at the first day after childbirth.During the study period, 809 vaginal deliveries were analysed. Direct measurement revealed a median blood loss of 250 mL. The incidences of PPH and severe PPH were 15% and 3%, respectively. Mean maternal hemoglobin content at admission was 11.9±1.1 g/dL, with a mean decrease of 1.0±1.1 g/dL. Blood loss measured after vaginal delivery correlated significantly with maternal hemoglobin decrease.This study suggests that PPH incidence may be higher than indicated by population-based data. Underbuttocks drapes are simple, objective bedside tools to diagnose PPH. Blood loss should be quantified systematically if PPH is suspected.

Influence of Various Modes of Delivery on Mother-infant Bonding: A Prospective Observational Study

2019 ◽  
Vol 15 (4) ◽  
pp. 295-300
Author(s):  
Vidyashree Ganesh Poojari ◽  
Akhila Vasudeva ◽  
Vidya Sudha
Keyword(s):  
Observational Study ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Postpartum Period ◽  
Prospective Observational Study ◽  
Post Partum ◽  
Elective Cesarean Delivery ◽  
Emergency Cesarean ◽  
Bonding Failure ◽  
Elective Cesarean

Background: Mother-infant bonding has tremendous implications for the child's future development. The difficulties that some mothers have in establishing an emotional bond with their newborns often referred to as impaired bonding or bonding failure are an essential focus in the postpartum period. Therefore, it is important to identify predictive factors for bonding failure and to intervene at an early stage for the better mental health care of mothers as well as infant. Objective: To determine the effect of various modes of delivery on the mother-infant bonding. Methods: Prospective observational study performed on low-risk singleton pregnancy who delivered at term. Mother-to-Infant Bonding Scale (MIBS; Taylor et al., 2005), a validated self-report test was used to measure mother's feelings towards her baby within three days of delivery and at the end of six weeks postpartum period. Total score ranges from 0 to 24. A total MIBS score of ≥ 2 is established as cut-off indicating “poor bonding”. MIBS score of 0 and 1 is considered as “good bonding”. The mean bonding score among the 3 groups was compared. Results: Elective cesarean delivery group had 112 participants, 115 were Emergency cesarean group and 107 were vaginal delivery group. Immediately after the delivery (MIBS 1), the proportion of women with poor bonding among Emergency cesarean group was 34.8% when compared to proportion of women with poor bonding among Elective cesarean (11.6%) and Vaginal delivery (13%). This was statistically significant (p-value 0.01). When we followed up these mothers at 6 weeks post-partum checkup, the MIBS scoring (MIBS-2) consistently improved among the three groups. However, proportion of women with poor bonding still remained high at 16.5% among the Emergency cesarean group. Conclusion: Mode of delivery has a significant impact on MIBS. In this study, unplanned cesarean delivery was associated with a high incidence of poor mother to infant bonding. Poor bonding was commoner in this group even at 6 weeks post-partum, compared to those undergoing a successful vaginal delivery and a planned elective cesarean delivery.

scholarly journals The Incidence, Risk Factors, Predictors, and Prognoses of Cytomegalovirus Reactivation in Immunocompetent Mechanical Ventilation Patients: A Prospective Observational Study

2021 ◽  
Author(s):  
Zhihui Zhang ◽  
Xuesong Liu ◽  
Ling Sang ◽  
Sibei Chen ◽  
Zhan Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Area Under The Curve ◽  
University Hospital ◽  
Laboratory Findings ◽  
Cytomegalovirus Reactivation ◽  
Cmv Reactivation ◽  
Immunocompetent Patients

Abstract Background: Cytomegalovirus (CMV) reactivation can seriously affect the clinical prognoses of critically ill patients. However, the epidemiology and predictors of CMV in immunocompetent patients with mechanical ventilation are not very clear. Methods: A single-center, prospective observational study (conducted from June 30, 2017 to July 01, 2018) with a follow-up of 90 days (September 29, 2018) that included 71 CMV-seropositive immunocompetent patients with mechanical ventilation at a 37-bed university hospital general intensive care unit (ICU) in China. Routine detection of CMV DNAemia was performed once a week until 28 days (Day1, 7, 14, 21, 28) and serology, laboratory findings, and clinical data were obtained at admission.Results: Among 71 patients, 13 (18.3%) showed CMV reactivation within ICU 28-day admission. The median time to reactivation was 7 days. CMV reactivation was related to various factors, including body weight, body mass index (BMI), sepsis, NT-proBNP, BUN, and Hb levels (P< 0.05). In the multivariate regression model, BMI, Hb level, and sepsis were associated with CMV reactivation patients (P< 0.05). Moreover, the area under the curve (AUC) of BMI, Hb and BMI combined Hb was 0.69, 0.70, 0.76, respectively. The rate of complications, duration of mechanical ventilation, hospitalization expense, length of ICU stay, and 90-day all-cause mortality rate in patients with CMV reactivation was significantly higher than in those without CMV reactivation (P< 0.05).Conclusions: Among immunocompetent patients with mechanical ventilation, the incidence of CMV reactivation was high. CMV reactivation can lead to various adverse prognoses. BMI, Hb, and sepsis were independent risk factors for CMV reactivation. BMI and Hb may predict CMV reactivation.

Transoral Dermoid Cyst Excision: A Multicenter Prospective Observational Study

2018 ◽  
Vol 159 (6) ◽  
pp. 981-986 ◽  
Author(s):  
Jin Pyeong Kim ◽  
Dong Kun Lee ◽  
Jeong Hwan Moon ◽  
Jung Je Park ◽  
Seung Hoon Woo
Keyword(s):  
Observational Study ◽  
Oral Cavity ◽  
Dermoid Cyst ◽  
Prospective Observational Study ◽  
University Hospital ◽  
Secondary Outcome ◽  
Transoral Surgery ◽  
Cyst Excision ◽  
Surgery Group ◽  
Multicenter Prospective Observational Study

Objective Transoral surgery is becoming a preferred technique because it does not leave any scar after surgery. However, transoral surgery for a dermoid cyst of the oral cavity is not standardized yet, due to the anatomic complexity of this region. The aim of this study was to evaluate the safety and efficacy of a transoral dermoid cyst excision. Study Design Multicenter prospective observational study. Setting University hospital. Subjects and Methods This study was designed as a 4-year prospective multicenter evaluation of dermoid cyst excisions within the floor of mouth. Clinical outcomes and complications related to procedures were evaluated among patients. The primary outcome was the efficacy of the procedure, and the secondary outcome was cosmetic satisfaction of each procedure. Results Twenty-one patients underwent transoral dermoid cyst excisions, and 22 underwent transcervical excisions. In the transoral surgery group, the mean size of the dermoid cyst was 5.35 cm (95% CI, 4.79-5.91), and in the transcervical surgery group, it was 6.19 cm (95% CI, 5.67-6.71). There was no significant differences with respect to overall demographic characteristics between the groups. However, the duration of the operation was shorter with the transoral group than with the transcervical group ( P = .001), and cosmetic satisfaction was much better in the transoral group ( P < .001). Conclusion Transoral dermoid cyst excision is a potentially safe and effective method that can lead to easy and quick removal of an oral cavity dermoid cyst, with excellent cosmetic outcomes.

Neonatal outcomes of two‐step delivery in low‐risk pregnancy: A prospective observational study

2020 ◽  
Vol 46 (7) ◽  
pp. 1090-1097
Author(s):  
Kenji Hishikawa ◽  
Takeshi Kusaka ◽  
Takanori Fukuda ◽  
Yutaka Kohata ◽  
Hiromi Inoue
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Low Risk ◽  
Neonatal Outcomes ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy

scholarly journals Factors associated with weaning practices in term infants: a prospective observational study in Ireland

2010 ◽  
Vol 104 (10) ◽  
pp. 1544-1554 ◽  
Author(s):  
Roslyn C. Tarrant ◽  
Katherine M. Younger ◽  
Margaret Sheridan-Pereira ◽  
Martin J. White ◽  
John M. Kearney
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
University Hospital ◽  
Term Infants ◽  
Professional Advice ◽  
Dietary History ◽  
Targeted Interventions ◽  
Improve Compliance ◽  
History Of ◽  
Usual Diet

The WHO (2001) recommends exclusive breast-feeding and delaying the introduction of solid foods to an infant's diet until 6 months postpartum. However, in many countries, this recommendation is followed by few mothers, and earlier weaning onto solids is a commonly reported global practice. Therefore, this prospective, observational study aimed to assess compliance with the WHO recommendation and examine weaning practices, including the timing of weaning of infants, and to investigate the factors that predict weaning at ≤ 12 weeks. From an initial sample of 539 pregnant women recruited from the Coombe Women and Infants University Hospital, Dublin, 401 eligible mothers were followed up at 6 weeks and 6 months postpartum. Quantitative data were obtained on mothers’ weaning practices using semi-structured questionnaires and a short dietary history of the infant's usual diet at 6 months. Only one mother (0·2 %) complied with the WHO recommendation to exclusively breastfeed up to 6 months. Ninety-one (22·6 %) infants were prematurely weaned onto solids at ≤ 12 weeks with predictive factors after adjustment, including mothers’ antenatal reporting that infants should be weaned onto solids at ≤ 12 weeks, formula feeding at 12 weeks and mothers’ reporting of the maternal grandmother as the principal source of advice on infant feeding. Mothers who weaned their infants at ≤ 12 weeks were more likely to engage in other sub-optimal weaning practices, including the addition of non-recommended condiments to their infants’ foods. Provision of professional advice and exploring antenatal maternal misperceptions are potential areas for targeted interventions to improve compliance with the recommended weaning practices.

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