scholarly journals Effect of Intrapartum Fever Associated With Epidural Analgesia on Short-Term Maternal and Neonatal Outcomes in Nulliparous Women: A Case Control Study

2020 ◽  
Author(s):  
Huiqian Zeng ◽  
Baohua Lin ◽  
Huizhu Zhang ◽  
Kaimin Guo ◽  
Ping He ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Neonatal Outcomes ◽  
Short Term ◽  
Neonatal Asphyxia ◽  
Nulliparous Women ◽  
Vaginal Deliveries ◽  
Assisted Delivery ◽  
Maternal And Neonatal Outcomes

Abstract BackgroundThe effects of intrapartum fever associated with epidural analgesia in nulliparous women on the short-term maternal and neonatal outcomes are not well understood.Methods We included 2076 nulliparous women who received regular obstetric examination and gave birth at Guangzhou Women and Children’s Medical Center from January 1, 2020 to June 30, 2020. All cases were singleton full-term pregnancies, and all foetuses were in cephalic presentation. We allocated 817 women with temperature >38℃ during labour into the fever group and 1259 women with temperature ≤38℃ during labour to the non-fever group. The short-term maternal and neonatal outcomes in the two groups were compared. Results in the fever group, 8.3% of pregnant women converted to caesarean delivery. The conversion rate in the non-fever group was 5.2% (p = 0.004). The rates of mild neonatal asphyxia, severe neonatal asphyxia, and neonatal hospitalisation in the fever group were higher than those in the non-fever group (χ2 = 12.070, 6.325, and 6.821, respectively, all P<0.05). The 1194 pregnant women in the fever group who had vaginal deliveries spent 756.46 ± 256.43 minutes in the first stage of labour and 65.74 ± 47.63 minutes in the second stage, significantly longer than the 749 women who had vaginal deliveries in the non-fever group (P<0.001, P=0.001). The assisted delivery rate for vaginal delivery in the fever group was 49.0%, significantly higher than that in the non-fever group (2=49.738, P<0.001). The rates of mild neonatal asphyxia, severe neonatal asphyxia, neonatal acidosis, and neonatal hospitalisation with vaginal delivery in the fever group were higher than those in the non-fever group (2=15.375, 6.597, 22.265, and 7.322, respectively, and p<0.001, 0.010, <0.001, and 0.007, respectively).Conclusions Epidural analgesia-associated intrapartum fever in nulliparous women increased the rates of short-term adverse maternal and neonatal outcomes, indicating that efforts are needed to prevent incidence of intrapartum fever due to administration of epidural analgesia.

scholarly journals The Effects of Epidural Analgesia during Labor on Maternal and Neonatal Outcomes

2020 ◽  
Author(s):  
Jin-Hua Huang ◽  
Mei Yu ◽  
Di-Bao Zhang ◽  
Jun-Ping Pan ◽  
Xiao-Tan Zhao ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Apgar Score ◽  
Umbilical Artery ◽  
Umbilical Vein ◽  
Neonatal Outcomes ◽  
Epidural Group ◽  
Umbilical Blood ◽  
Vaginal Deliveries ◽  
Maternal And Neonatal Outcomes ◽  
The Impact

Abstract Background: The purpose of the study was to investigate the impact of epidural analgesia usage vs. non-epidural labor on maternal and neonatal outcomes. Methods: We included 129 parturients who had vaginal deliveries in our hospital since December 1, 2018. The women were grouped into the epidural analgesia group or the non-epidural group. In order to investigate the effect of epidural analgesia on mother and newborn outcomes, we evaluated the differences in labor duration, the Apgar score of the newborn, and the overall outcome of the mother and newborn. Results: Compared to the non-epidural group, the durations of the first and second stages of labor in the analgesia group were significantly longer. In terms of neonatal outcome, the epidural analgesia group had a higher lactate value in the umbilical artery blood and higher pCO2 of umbilical vein blood of the neonates. However, there were no significant differences in Apgar Score, umbilical blood pH, base excess, or other umbilical cord blood gas analyses (pO2, HGB, SO2, HCO3 -) between epidural analgesia and non-epidural labor groups.Conclusion: The epidural analgesia prolongs the duration of the first and second stages of labor and affects the level of lactate in umbilical artery blood and the partial pressure of carbon dioxide in umbilical vein blood. There was no significant effect on the basic characteristics of the mothers and neonates, suggesting that epidural analgesia delivery technology is safe, but it may have a particular short-term impact on neonatal outcomes.

scholarly journals Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study

2020 ◽  
Author(s):  
Na Li ◽  
Lefei Han ◽  
Min Peng ◽  
Yuxia Lv ◽  
Yin Ouyang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Respiratory Symptoms ◽  
Case Control Study ◽  
Case Control ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Neonatal Complications ◽  
Maternal And Neonatal Outcomes ◽  
Control Study

AbstractBackgroundThe ongoing epidemics of coronavirus disease 2019 (COVID-19) have caused serious concerns about its potential adverse effects on pregnancy. There are limited data on maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia.MethodsWe conducted a case-control study to compare clinical characteristics, maternal and neonatal outcomes of pregnant women with and without COVID-19 pneumonia.ResultsDuring January 24 to February 29, 2020, there were sixteen pregnant women with confirmed COVID-19 pneumonia and eighteen suspected cases who were admitted to labor in the third trimester. Two had vaginal delivery and the rest took cesarean section. Few patients presented respiratory symptoms (fever and cough) on admission, but most had typical chest CT images of COVID-19 pneumonia. Compared to the controls, COVID-19 pneumonia patients had lower counts of white blood cells (WBC), neutrophils, C-reactive protein (CRP), and alanine aminotransferase (ALT) on admission. Increased levels of WBC, neutrophils, eosinophils, and CRP were found in postpartum blood tests of pneumonia patients. There were three (18.8%) and two (10.5%) of the mothers with confirmed or suspected COVID-19 pneumonia had preterm delivery due to maternal complications, which were significantly higher than the control group. None experienced respiratory failure during hospital stay. COVID-19 infection was not found in the newborns and none developed severe neonatal complications.ConclusionSevere maternal and neonatal complications were not observed in pregnant women with COVID-19 pneumonia who had vaginal delivery or caesarean section. Mild respiratory symptoms of pregnant women with COVID-19 pneumonia highlight the need of effective screening on admission.

scholarly journals Vacuum Assisted Vaginal Delivery in Singleton Term Pregnancies: Short Term Maternal and Neonatal Outcome in a Tertiary Hospital of Nepal

2016 ◽  
Vol 4 (2) ◽  
pp. 104
Author(s):  
Buddhi Shrestha ◽  
Subha Shrestha ◽  
Babita Thapa
Keyword(s):  
Vaginal Delivery ◽  
Post Partum ◽  
Birth Asphyxia ◽  
College Teaching ◽  
Neonatal Morbidity ◽  
Short Term ◽  
Assisted Vaginal Delivery ◽  
Vaginal Deliveries ◽  
Skilled Operator ◽  
Assisted Delivery

Introduction: Other than cesarean delivery, assisted vaginal delivery is an alternative procedure for delivery in emergency obstetrics. Presently, vacuum delivery has gained more popularity than forceps for operative/ assisted vaginal delivery, when and where indicated, with success as well as lesser neonatal and maternal complications. This study was done to estimate the short term maternal and fetal morbidity/mortality due to vacuum assisted vaginal delivery.   Methods:  A prospective observational study was conducted at Lumbini Medical College Teaching Hospital from January 2015 to May 2016. One hundred and four pregnant women who had successful vacuum assisted vaginal deliveries were enrolled. Fetal and maternal outcome were assessed.   Results: One hundred and four successful vacuum deliveries (2.9%) were conducted among 3457 deliveries during our study period. Sixty seven (64.4%) were primigravida and most (n=59, 56.7%) parturients were of age group 20-30 years. The commonest (n=65, 62.5%) indication for vacuum application was prolonged second stage of labor. The maternal morbidity variables were: 6.7% (n=7) had genital tract injury, 3.8% (n=4) had primary post-partum hemorrhage, 3.8% (n=4) had urinary retention, 2.8% (n=3) needed blood transfusion. Among neonatal morbidity indicators, 19.2% (n=20) neonates had birth asphyxia, 4.8% (n=5) neonates had cephalohematoma, 0.96% (n=1) had brachial plexus injury. There was one early neonatal death due to meconium aspiration syndrome.   Conclusion: A successful vacuum assisted delivery can be achieved with lesser maternal and neonatal morbidity with timely assessment of labor, skilled operator, and availability of neonatal team.

scholarly journals Risk of Severe Adverse Maternal and Neonatal Outcomes in Deliveries with Repeated and Primary Cesarean Deliveries versus Vaginal Deliveries: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Kiattisak Kongwattanakul ◽  
Rungroj Thamprayoch ◽  
Chumnan Kietpeerakool ◽  
Pisake Lumbiganon
Keyword(s):  
Vaginal Delivery ◽  
Cross Sectional Study ◽  
Neonatal Outcomes ◽  
World Health ◽  
Maternal Outcomes ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vaginal Deliveries ◽  
Increased Risk ◽  
Maternal And Neonatal Outcomes

Objective. To determine risks of severe adverse maternal and neonatal outcomes in women with repeated cesarean delivery (CD) and primary CD compared with those with vaginal delivery (VD). Methods. Data of this cross-sectional study were extracted from 2,262 pregnant women who gave birth between August 2014 and December 2016, at Srinagarind Hospital, Khon Kaen University. Severe maternal outcomes were categorized based on the World Health Organization criteria. Adjusted odds ratio (aOR) and 95% confidence intervals (CI) were calculated to indicate the risk of severe adverse maternal and neonatal outcomes among women underwent CD compared with those who underwent VD. Results. There were no cases of maternal death in this study. CD significantly increased risk of severe adverse maternal outcomes (SMO) (aOR 10.59; 95% CI, 1.19-94.54 for primary CD and aOR 17.21; 95% CI, 1.97-150.51 for repeated CD) compared with women who delivered vaginally. When compared with vaginal delivery, the risks of neonatal near miss (NNM) and severe adverse neonatal outcomes (SNO) were significantly higher in primary CD group (aOR 1.71; 95% CI 1.17-2.51 and aOR 1.66; 95% CI 1.14-2.43), respectively. For repeated CD, the risks were borderline significant (aOR, 1.58; 95% CI, 0.98-2.56 for NNM and aOR, 1.61; 95% CI, 0.99-2.60 for SNO). Conclusion. Primary and repeated CD significantly increased the risk of SMO compared with VD. Risks of NNM and SNO were also significantly increased in women with primary CD. The risks of NNM and SNO for repeated CD trended toward a significant increase.

scholarly journals Intrapartum interventions that affect maternal and neonatal outcomes for vaginal birth after cesarean section

2019 ◽  
Vol 48 (2) ◽  
pp. 030006051988280
Author(s):  
Shao-Wen Wu ◽  
He Dian ◽  
Wei-Yuan Zhang
Keyword(s):  
Cesarean Section ◽  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Mainland China ◽  
Vaginal Birth ◽  
Neonatal Outcomes ◽  
Vaginal Birth After Cesarean ◽  
Operative Vaginal Delivery ◽  
Maternal And Neonatal Outcomes ◽  
Total Labor

Objective To investigate maternal and neonatal outcomes after different intrapartum interventions for vaginal birth after cesarean section (VBAC) in mainland China. Methods A retrospective study was performed on 143 VBAC cases from Beijing Obstetrics and Gynecology Hospital between January 2015 and November 2016. These cases were divided into two groups on the basis of different intrapartum interventions. Maternal and neonatal outcomes were compared. Results The durations of the first stage and total labor after oxytocin were significantly longer than those before oxytocin use. The proportion of operative vaginal delivery with oxytocin was significantly higher than that without oxytocin (43.9% vs. 11.8%). The times of the first stage, second stage, and total labor with analgesia were significantly longer than those without analgesia (548.4±198.1 vs. 341.8±233.0 minutes, 52.0±38.9 vs. 36.0± 29.1 minutes, and 606.3±212.1 vs. 387.3±233.0 minutes, respectively). Postpartum hemorrhage and operative vaginal delivery occurred significantly more frequently in women with epidural analgesia than in those without epidural analgesia (29.7% vs. 12.3 and 35.1% vs. 16.0%, respectively). Conclusions Induction can increase the rate of operative vaginal delivery in VBAC. Oxytocin and epidural analgesia may increase the risk of operative vaginal delivery, and may be associated with a prolonged duration of labor.

Initial review of pregnancy and neonatal outcomes of pregnant women with COVID-19 infection

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Ifeoma Ogamba ◽  
Andrea Kliss ◽  
Nicole Rainville ◽  
Linus Chuang ◽  
Erin Panarelli ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Descriptive Analysis ◽  
Clinical Manifestations ◽  
Neonatal Outcomes ◽  
Limited Data ◽  
Repeated Testing ◽  
Cesarean Deliveries ◽  
Vaginal Deliveries ◽  
Maternal And Neonatal Outcomes ◽  
The Mean

AbstractObjectivesData regarding the pathogenesis and clinical manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to emerge, however, there’s limited data in regard to maternal and neonatal outcomes. Therefore, we conducted a retrospective analysis of all pregnant women who tested positive for SARS-CoV-2 within Nuvance Health system.Study designData were abstracted from the medical records of each patient and descriptive analysis was performed. Variables included demographics, COVID testing results, symptoms, management, labor course, neonatal information, and complications.ResultsTotal of 40 patients were identified. Average age was 29.6 years old, 35% were Hispanic, and approximately one in three patients had comorbidities. Of the patients who had repeated testing, the average number of days between first positive test and negative test was 36.8 days (+/− 19.9 days). Three out of four women reported symptoms. Of the 40 pregnant women who were positive for SARS-CoV-2, 25 of them delivered. About 84% of the women delivered after 37 weeks. Twelve percent of the women delivered under 33 and 6/7 weeks. Most patients had vaginal deliveries (68%) and the remaining had cesarean deliveries. Neonatal outcomes included: mean 1 and 5 min Apgar scores of 8 and 8.8, respectively and the mean birth weight was 3212 g. Twenty neonates were tested for SARS-CoV-2 and were all found to be negative.ConclusionOverall, with routine prenatal care and preventive measures, pregnant patients and neonates in our study had good outcomes. At this time, there appears to be no evidence of vertical transmission.

Epidural analgesia and vacuum-assisted delivery in primiparous women: maternal and neonatal outcomes

2021 ◽  
pp. 1-8
Author(s):  
Eyal Lang Ben Nun ◽  
Hen Y. Sela ◽  
Alexander Ioscovich ◽  
Reut Rotem ◽  
Sorina Grisaru-Granovsky ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Neonatal Outcomes ◽  
Assisted Delivery ◽  
Maternal And Neonatal Outcomes ◽  
Primiparous Women

Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maternal Age ◽  
Unwanted Pregnancy ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

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