scholarly journals Neonatal inflammation, stress and growth factors after vaginal delivery, pre-labour, and in-labour caesarean section: a retrospective cohort study

2020 ◽  
Author(s):  
Pia Kiilerich ◽  
Rikke Cortes ◽  
Ulrik LAUSTEN THOMSEN ◽  
Nis BORBYE LORENZEN ◽  
Kristin Skogstrand
Keyword(s):  
Cohort Study ◽  
Growth Factors ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort

scholarly journals Planned caesarean section versus planned vaginal delivery among women without formal medical indication for planned caesarean section: A retrospective cohort study of short-term complications

2021 ◽  
Author(s):  
Karin Dahlquist ◽  
Andrea Stuart ◽  
Kärin Kallén
Keyword(s):  
Cohort Study ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Short Term ◽  
Adjusted Risk ◽  
Medical Indication ◽  
Increased Risk ◽  
Tract Infections

Objective: To study complications, within six weeks postpartum, after planned caesarean section (CS) compared with planned vaginal delivery, among women without formal indication for caesarean section. Design: Retrospective cohort study. Setting: Swedish national registries. Population: 714 326 deliveries, 2008-2017. Methods: The risks of complications were compared between planned caesarean section and planned vaginal delivery among women without formal medical indication for planned CS. Adjusted Risk Ratios (ARR) were obtained using modified Poisson-regression models adjusting for; maternal age, parity, body mass index, smoking, country of birth, and county. Main outcome measure: infections, haemorrhage and thromboembolism. Results:. In the planned CS group (n=22 855), 15% had a postpartum infection compared with 10% in the planned vaginal group (n=691 471) (ARR=1.6; 95%CI 1.5-1.6), 8.4% vs 0.6% had haemorrhage >1 litre (ARR=13.4; 95%CI 12.7-14.2), and 0.08% vs 0.05% had a postpartum pulmonary embolism (ARR=1.7; 95%CI 1.0-2.6). The obtained risk estimates correspond to a Number-Needed-to-Harm estimate of 17, 14, and 3448, respectively. When dividing the infections into subgroups, an increased risk of endometritis (ARR 1.2; 95%CI 1.1-1.3), wound infection (ARR 2.7 95%CI 2.4-3.0), urinary tract infections (ARR 1.5 95%CI 1.3-1.7), and mastitis (ARR 2.0; 1.9-2.2) was found after planned CS. Conclusion: The risks of short-term maternal complications were higher in women delivered by planned CS compared with planned vaginal delivery among women without formal medical indication for planned CS. Funding: Gorthon Foundation. Key words: caesarean section, puerperal infection, haemorrhage, thromboembolism.

scholarly journals Evaluation of the risk of umbilical cord prolapse in the second twin during vaginal delivery: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046616
Author(s):  
Rokuhiro Asahina ◽  
Hiroyuki Tsuda ◽  
Yuki Nishiko ◽  
Kazuya Fuma ◽  
Momoko Kuribayashi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vaginal Delivery ◽  
Umbilical Cord ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Cord Prolapse ◽  
Umbilical Cord Insertion ◽  
Umbilical Cord Prolapse ◽  
Second Twin

ObjectiveThis study aimed to evaluate the success rate of vaginal delivery, the reasons for unplanned caesarean delivery, the rate of umbilical cord prolapse and the risk of umbilical cord prolapse in twin deliveries.DesignRetrospective cohort study.SettingSingle institution.ParticipantsThis study included 455 women pregnant with twins (307 dichorionic and 148 monochorionic) who attempted vaginal delivery from January 2009 to August 2018. The following criteria were considered for vaginal delivery: diamniotic twins, cephalic presentation of the first twin, no history of uterine scar, no other indications for caesarean delivery, no major structural abnormality in either twin and no fetal aneuploidy.ResultsThe rate of vaginal delivery of both twins was 89.5% (407 of 455), caesarean delivery of both twins was 7.7% (35 of 455) and caesarean delivery of only the second twin was 2.9% (13 of 455). The major reasons for unplanned caesarean delivery were arrest of labour and non-reassuring fetal heart rate pattern. The rate of umbilical cord prolapse in the second twin was 1.8% (8 of 455). Multivariate analysis revealed that abnormal umbilical cord insertion in the second twin (velamentous or marginal) was the only significant factor for umbilical cord prolapse in the second twin (OR, 5.05, 95% CI 1.139 to 22.472, p=0.033).ConclusionsAbnormal umbilical cord insertion in the second twin (velamentous or marginal) was a significant factor for umbilical cord prolapse during delivery. Antenatal assessment of the second twin’s umbilical cord insertion using ultrasonography would be beneficial.

Predictive Factors for Successful Vaginal Delivery after a Trial of External Cephalic Version: A Retrospective Cohort Study of 946 Women

2021 ◽  
Author(s):  
Asaf Bilgory ◽  
Olena Minich ◽  
Maria Shvaikovsky ◽  
Genady Gurevich ◽  
Joseph B. Lessing ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vaginal Delivery ◽  
Predictive Factors ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Goodness Of Fit ◽  
External Cephalic Version ◽  
Nulliparous Women ◽  
Tertiary Center ◽  
Vertex Presentation

Objective Our aim was to find the factors which predict a vertex presentation of vaginal delivery (VD) in women who are admitted for a trial of external cephalic version (ECV). Study Design This is a retrospective cohort study of women who underwent a trial of ECV and delivered between November 2011 and December 2018 in a single tertiary center. The main outcome measure was successful VD of a fetus in the vertex presentation. Women who achieved VD in the vertex presentation or underwent cesarean delivery were compared on the basis of variety of predictive factors. Adverse neonatal and maternal outcomes were reported. Logistic regression was used for the multivariate analysis. Results A total of 946 women were included; 717 (75.8%) women had a successful ECV and 663 (70.1%) women had a VD in the vertex presentation. Parous women had 79.3% VD rate (570/719) and nulliparous women had 41.0% VD rate (93/227). Women with an amniotic fluid index (AFI) of 50 to 79, 80 to 200, and >200 mm had 34.8, 71.0, and 83.1% VD rate, respectively. Parous versus nulliparous women had an adjusted odds ratio (aOR) of 5.42 (95% confidence interval [CI] 3.90–7.52, p < 0.001), women with AFI 50 to 79 mm compared with AFI 80 to 200 mm had an aOR of 0.21 (95% CI 0.12–0.37, p < 0.001), and women with an AFI >200 mm compared with AFI 80 to 200 mm had an aOR of 1.74 (95% CI 1.03–2.92, p = 0.037) to achieve VD. The final prediction model for the chances of a VD based on data on admission for ECV was reported. The Hosmer-Lemeshow test was used to evaluate the goodness of fit of the model (p = 0.836). Conclusion Being parous and having an AFI >200 mm are positive independent predictive factors for achieving VD of a vertex presenting fetus after ECV. Whereas AFI 50 to 79 mm is a negative independent predictive factor. Key Points

Sign in / Sign up

Export Citation Format

Share Document