scholarly journals Analysis of intracranial hemorrhage grade in preterm singleton pregnancies delivered vaginally or by cesarean section

2013 ◽  
Vol 70 (3) ◽  
pp. 255-258 ◽  
Author(s):  
Sasa Ljustina ◽  
Ivana Berisavac ◽  
Milica Berisavac ◽  
Ljudmila Kovacevic-Vukolic ◽  
Vesna Velickovic-Aleksic ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Perinatal Outcome ◽  
Intraventricular Hemorrhage ◽  
Mode Of Delivery ◽  
Preterm Neonates ◽  
Delivery Methods ◽  
Premature Babies ◽  
Significant Difference ◽  
Vertex Presentation ◽  
Singleton Pregnancies

Background/Aim. Preterm birth is the leading cause of neonatal mortality. Periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH) remains a significant cause of both morbidity and mortality in infants prematurely born. The aim of the study was to evaluate the perinatal outcome regarding IVH of premature babies according to the mode of delivery. Methods. A total of 126 women in preterm singleton pregnancies with vertex presentation and 126 neonates weighted from 750 g to 1,500 g at birth were enrolled. The outcomes of 64 neonates born vaginally were compared to 62 neonates born by cesarean section. Results. There was no significant difference in the incidence of IVH among both groups. Conclusion. Our data is consistent with the hypothesis that the mode of delivery does not influence IVH and consenquently perinatal outcome in preterm neonates.

Effect of Delayed Cord Clamping Reduced Anemic Outcome in Preterm Neonate

2021 ◽  
Vol 104 (5) ◽  
pp. 695-700
Keyword(s):  
Intraventricular Hemorrhage ◽  
Preterm Neonate ◽  
Controlled Trial ◽  
Preterm Neonates ◽  
Maternal Outcomes ◽  
Delayed Cord Clamping ◽  
Randomized Controlled ◽  
Cord Clamping ◽  
Significant Difference ◽  
The Mean

Objective: To compare the effects of immediate versus delayed cord clamping on neonatal outcomes in preterm neonates of gestational age of 32 to 36⁺⁶ weeks, and maternal outcomes. Materials and Methods: A randomized controlled trial was conducted in the Obstetrics and Gynecology Department at Bhumibol Adulyadej Hospital, in Bangkok, Thailand. The study compared the effects of immediate to delayed cord clamping at 60 seconds among preterm neonates born between 32 weeks, 0 day and 36 weeks, 6 days of gestation between August and October 2018. Results: The mean age of the participants was 26 years old, and half of the cases were nulliparous. One hundred ten women were randomly separated into two equal groups (n=55). Delayed cord clamping at 60 seconds increased hematocrit levels (Hct) in both two (p=0.004) and 48 (p<0.001) hours after delivery compared to the immediate cord clamping group. There were no differences in exposing the neonate to hypothermia, hypoxemia, Apgar score at 1-minute, polycythemia, intraventricular hemorrhage, hyperbilirubinemia, length of stay in hospital, and affecting the process of resuscitation. There were no statistical differences between the two groups in maternal outcomes such as retained placenta and postpartum hemorrhage. Conclusion: Delayed cord clamping at 60 seconds increased Hct in the newborn at two to 48 hours after birth. There was no significant difference in adverse maternal and neonatal complications within both groups. Keywords: Delayed cord clamping, Hematocrit, Preterm

Cesarean delivery may increase the risk of multiple sclerosis

2011 ◽  
Vol 18 (4) ◽  
pp. 468-471 ◽  
Author(s):  
Amir-Hadi Maghzi ◽  
Masoud Etemadifar ◽  
Kiyan Heshmat-Ghahdarijani ◽  
Safieh Nonahal ◽  
Alireza Minagar ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cesarean Section ◽  
Birth Order ◽  
Vaginal Delivery ◽  
Conditional Logistic Regression ◽  
Mode Of Delivery ◽  
Age At Onset ◽  
Significant Risk ◽  
Significant Difference ◽  
Healthy Siblings

Background: Prenatal and perinatal factors are believed to contribute to the risk of developing multiple sclerosis (MS). Objective: This study was designed to evaluate whether mode of delivery (vaginal versus cesarean section), as a perinatal factor, affects susceptibility to MS. Methods: MS patients were recruited from the MS registry of Isfahan Multiple Sclerosis Society (IMSS) and were compared with their healthy siblings. Data regarding mode of delivery, birth order, and gestation week of birth were obtained through a specially designed questionnaire. Preterm or post term deliveries were excluded. We used conditional logistic regression statistics and adjusted for gender and birth order. Results: This study included 1349 participants (449 MS patients and 900 controls). Subjects who were born by cesarean section had significant risk of MS (odds ratio, OR = 2.51; 95% confidence interval, CI: 1.43–4.41; p = 0.001). There was significant MS risk for females who were born by cesarean section (OR = 2.69, 95% CI: 1.30–5.58; p = 0.008), but not for males (OR = 2.25, 95% CI: 0.90–5.63; p = 0.082). The mean age at onset was lower in MS patients born by cesarean section (24.58 ± 6.33) compared with that of patients born by vaginal delivery (27.59 ± 7.97; p = 0.041). There was no significant difference between the two groups for birth order ( p = 0.417). Conclusion: Our results suggest that those born by vaginal delivery are at a lower risk of subsequent MS. These preliminary findings will need to be addressed in a much larger and preferably prospective study.

scholarly journals Labour with low dose epidural analgesia: maternal perception and fetal outcome

2018 ◽  
Vol 7 (2) ◽  
pp. 689 ◽  
Author(s):  
Vasudha Sawant ◽  
Archana Kumbhar
Keyword(s):  
Epidural Analgesia ◽  
Apgar Score ◽  
Low Dose ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Natural Phenomenon ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Significant Difference ◽  
Vertex Presentation

Background: Experiencing labour pains and giving birth to infant is normal physiological process. Though it is a natural phenomenon, it produces severe pain which requires analgesia to relieve pain during labour. The objective of this study was to compare effects of low dose epidural analgesia verses no analgesia during labour on mother and fetus.Methods: Here in this study we have assessed effect of epidural analgesia on mother and fetus. Total we have taken 60 women in age group of 20-26 years with full term pregnancy (37-42 weeks). Those who have entered spontaneous labour with vertex presentation, without any previous uterine surgery, clinically adequate pelvis. We had divided these women in 2 groups, 30 were given epidural analgesia and 30 without any analgesia. Variables recorded were pain score during labour using VAS, duration of labour during each stage, mode of delivery, Apgar score of newborn at 1 minute and 5 minutes.Results: Present study shows that duration of first stage of labour in epidural and non-analgesia group are same. Second stage of labour is prolonged in epidural group than non-analgesia group. Both groups had normal APGAR score. Epidural analgesia is not associated with any change in mode of delivery. Visual analogue scale is good with epidural analgesia.Conclusions: There was no significant difference in first stage of labour in both group. Second stage of labour was slightly prolonged in EA group than control, but it was less than two hours. No harmful neonatal outcome in epidural analgesia.

scholarly journals Elective induction of labour at 39 weeks versus expectant management up to 41 weeks in a tertiary care centre

2020 ◽  
Vol 9 (2) ◽  
pp. 794
Author(s):  
Yogindra M. Kabadi ◽  
Sanjana Kumar
Keyword(s):  
Cesarean Section ◽  
Gestational Age ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Expectant Management ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Perinatal Deaths ◽  
Elective Induction ◽  
Singleton Pregnancies

Background: The timing of delivery and effective management of labour at term makes a huge difference in the obstetric and perinatal outcome. There have always been controversies between choosing the elective induction of labour at 39 weeks versus expectant management up to 41/42 weeks which can result in placental ageing, reduced liquor, non-assuring fetal heart tracings, meconium stained amniotic fluid and fetal macrosomia.  our objective was to perform a comparative effectiveness analysis of elective induction of labor at 39 weeks gestational age among nulliparous women with uncomplicated singleton pregnancies as compared to expectant management up to 41 weeks.Methods: 120 primigravidae with singleton pregnancies with fetus in cephalic presentation were recruited into the study and divided into 2 groups of 60 each A: Patients were induced electively using dinoprostone gel (maximum 3 doses 8 hours apart) B: They were managed expectantly up to 41 weeks allowing for spontaneous onset of labour, induction or cesarean section was done for obstetric indications between 39 and 41 weeks and pregnancy was  terminated by induction for those who continued up to 41 weeks. Their obstetric and perinatal outcome were noted.Results: The cesarean section rates were higher in the expectantly managed group (21%) when compared to the electively induced group (16%). The same was with instrumental delivery rates (15% versus 10%). The perinatal outcome was poorer for the expectantly managed group with 20% NICU admissions and 5% perinatal deaths compared to the electively induced group which had 12% NICU admissions and 3.3% perinatal deaths. The expectantly managed group also resulted in respiratory distress in a larger number of fetuses and resulted in problems due to reduced liquor.Conclusions: Elective induction at 39 weeks gestational age was found to be a better option compared to expectant management up to 41 weeks in terms of obstetric and perinatal outcomes.

Perinatal outcome associated with oligohydramnios in term pregnancies

2018 ◽  
Vol 1 (01) ◽  
pp. 25-30
Author(s):  
Deepa Chudal ◽  
Keshang Diki Bista ◽  
Neelam Pradhan
Keyword(s):  
Cesarean Section ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Well Being ◽  
Fetal Outcome ◽  
University Teaching ◽  
Amniotic Fluid Index ◽  
Prelabor Rupture Of Membranes

Introduction: Amniotic fluid is a complex substance essential to fetal well-beingand dynamic milieu that changes as pregnancy progresses andsurrounds developing fetus providing an ideal environment for normal fetal growth and development. Amniotic fluid volume is fetal well being which varies with gestational age and depends on a dynamic interaction between placenta, fetus and maternal components. Methods: This was a hospital based descriptive study conducted at Tribhuvan University Teaching Hospital, from 14th April 2013 to 13th April 2014(2070) which consisted of singleton, term (37-42weeks) pregnancies admitted with ultrasonographicfinding of Amniotic Fluid Index≤ 5 with delivery within one week of ultrasonographicfinding. A prefixed questionnaire was used to fill maternal and fetal outcome parameters like age, parity, period of gestation, Amniotic Fluid Index, associated maternal conditions, mode of delivery, indication of Cesarean section, color of liquor and perinatal outcomes. Results: Total 115 cases of oligohydramnioswere noted accounting for an incidence of 2.4%. 92 women were term, giving incidence of term oligohydramnios to be 2%. Out of 92 cases, 77(83.6%) underwent emergency caesarean section and 15 (16.3%) were delivered vaginally. Low birth weight of < 2.5 kg was noted in 14 (15.2%) babies and meconium stained liquor was present in 12 (13%) of oligohydramnios cases. APGAR score of < 7 at 1 minute and 5 minute was seen in 13 (14.13%) and 3 (3.26%) cases respectively. . Among 92 cases, 44 (47.8%) were associated with Prelabor Rupture of Membranes followed by post dated pregnancies and Intrauterine Growth Retardation accounting for 12 (13.1%) cases in each group Conclusion: Prelabor Rupture of Membranes was  most common cause of term oligohydramnios resulting in high risk of caesarean delivery in oligohydramnios cases. Cesarean Section for oligohydramnios has been associated with good perinatal outcome.

scholarly journals Maternal and perinatal outcome in Rh negative mothers

2018 ◽  
Vol 7 (8) ◽  
pp. 3141
Author(s):  
Rashmi Tripathi ◽  
Neelam Singh
Keyword(s):  
Congenital Anomaly ◽  
Cesarean Section ◽  
Blood Group ◽  
Antibody Titre ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Study Group ◽  
Forceps Delivery ◽  
New Born ◽  
Group Distribution

Background: The objective of this study is to find out the incidence and foetomaternal outcome of Rh negative women during pregnancy.Methods: In the study group, the labor was monitored carefully and the mode of delivery and the outcome of labor was studied in detail. Baby was thoroughly examined for any obvious congenital anomaly, weight, sex and condition was also noted particularly for hydrops. If neonate was Rh positive, then the mother was given postpartum immunoprophylaxis within 24 hours of delivery. The new born were followed for 3 days and were watched for the development of Jaundice. Mothers were advised to attend postnatal clinic for check-up after 6 weeks of delivery.Results: Blood group distribution of newborn: 37 were Rh positive and 18 were Rh negative. Raised Rh antibody titre was not found in any of the 55 cases. Maximum cases 47 delivered at 38-40 weeks, 2 cases delivered after 40 weeks and 6 patients delivered between 30-38 weeks. Maximum cases 37 delivered normally, 12 required cesarean section and 2 had forceps delivery. The babies who developed NNHB were managed either by sunrays exposure only or by phototherapy. The babies who had anemia immediately after birth were carefully monitored and considered for exchange transfusion.Conclusions: Tremendous advances in the medical services and technology during the last few decades have revolutionized the treatment of Rh disease. Various studies have been conducted and several are going on the in this field to achieve zero incidence of this disease.

scholarly journals Caesarean section and neonatal survival and neurodevelopmental impairments in preterm singleton neonates

2019 ◽  
Vol 25 (2) ◽  
pp. 93-101
Author(s):  
Abhay Lodha ◽  
Krystyna Ediger ◽  
Dianne Creighton ◽  
Selphee Tang ◽  
Arijit Lodha ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Best Practice ◽  
Mode Of Delivery ◽  
Matched Pair ◽  
Preterm Neonates ◽  
Composite Outcome ◽  
Neurodevelopmental Outcomes ◽  
Cognitive Delay ◽  
Significant Difference

Abstract Introduction Evidence is lacking regarding the benefit of caesarean section (CS) for long-term neurodevelopmental outcomes in singleton preterm neonates. Therefore, uncertainty remains regarding obstetrical best practice in the delivery of premature neonates. Objective Our objective was to determine the association between the mode of delivery and neurodevelopmental outcomes in preterm singleton neonates who were delivered by vaginal route (VR), CS with labour (CS-L), or CS without labour (CS-NL). Methods Singleton neonates of less than 29 weeks’ gestation born January 1995 through December 2010 and admitted to our NICU and then assessed at neonatal follow-up clinic were studied. The primary outcome was neurodevelopmental impairment (NDI) defined as cerebral palsy, cognitive delay, major or minor visual impairment, or hearing impairment or deafness at 36 months’ corrected age. Results In this retrospective cohort study of 1,452 neonates, 1,000 were eligible for the study and 881 (88.1%) were available for follow-up. There was no significant difference in mortality between VR group, CS-L group, and CS-NL group. At 3 years, there was no significant difference between the three groups in terms of NDI. The odds of composite outcome of mortality or NDI for neonates born via CS-NL versus VR, and CS–L versus VR were 0.90 (95% confidence interval [CI]: 0.59 to 1.37) and 1.08 (95% CI: 0.72 to 1.61), respectively. Propensity score-based matched-pair analyses did not show a significant association between the composite outcome and CS with or without labour. Conclusions CS was not associated with increased survival or decreased risk of NDI in premature singleton neonates born at less than 29 weeks’ gestation.

scholarly journals Postpartum Depression: Is Mode of Delivery a Risk Factor?

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Asli Goker ◽  
Emre Yanikkerem ◽  
M. Murat Demet ◽  
Serife Dikayak ◽  
Yasemin Yildirim ◽  
...  
Keyword(s):  
Postpartum Depression ◽  
Cesarean Section ◽  
Mode Of Delivery ◽  
Healthcare Providers ◽  
Depression Scale ◽  
Family Type ◽  
Elective Cesarean Section ◽  
Emergency Cesarean ◽  
Significant Difference ◽  
History Of

There are various factors related to postpartum depression. In this study we have aimed to determine the effect of mode of delivery on the risk of postpartum depression. A total of 318 women who applied for delivery were included in the study. Previously diagnosed fetal anomalies, preterm deliveries, stillbirths, and patients with need of intensive care unit were excluded from the study. Data about the patients were obtained during hospital stay. During the postpartum sixth week visit Edinburgh postnatal depression scale (EPDS) was applied. There was no significant difference between EPDS scores when compared according to age, education, gravidity, wanting the pregnancy, fear about birth, gender, family type, and income level (). Those who had experienced emesis during their pregnancy, had a history of depression, and were housewives had significantly higher EPDS scores (). Delivering by spontaneous vaginal birth, elective Cesarean section, or emergency Cesarean section had no effect on EPDS scores. In conclusion healthcare providers should be aware of postpartum depression risk in nonworking women with a history of emesis and depression and apply the EPDS to them for early detection of postpartum depression.

scholarly journals Mode of delivery and neurosonographic findings in premature infants

2007 ◽  
Vol 60 (1-2) ◽  
pp. 7-11
Author(s):  
Gordana Velisavljev-Filipovic
Keyword(s):  
Cesarean Section ◽  
Premature Infants ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Brain Scans ◽  
Premature Babies ◽  
Functional Immaturity ◽  
Grade Ii ◽  
Intraventricular Bleeding ◽  
Novi Sad

Introduction Fetal and preterm infant brain is especially vulnerable to hemorrhagic and ischemic damage at the end of the second and at the beginning of the third trimester. This is due to vascular, cellular and anatomic characteristics of the brain during development. In premature babies, there is a physiological instability and limited autoregulation of cerebral circulation. Hemorrhagic and ischemic damages often occur together, though pathophysiological processes leading to lesions are different. Material and methods The paper deals with a detailed analysis of 860 ultrasound brain scans of prematurely born children. The examinations were performed at the Ultrasound Department of the Institute of Child and Youth Health Care in Novi Sad. 707 vaginally born premature infants and 153 premature infants born by Cesarean section were examined. The bleeding was graded according to the Papile classification. Results and Discussion Out of 384 children with diagnosed grade I hemorrhage, 75 premature infants (19.5%) were born by Cesarean section. In the group of children with grade II hemorrhage, operative deliveries account for 14.7%. From the total of 85 children with grade III hemorrhage, (intraventricular bleeding with chamber dilatation), only 6 premature infants were born by Cesarean section (7%). Intra-parenchymal bleeding was diagnosed in a very small number of premature infants; 0.32% of all diagnosed hemorrhages were grade IV hemorrhages. In this group there were no children born by Cesarean section. The increase of hemorrhage grade is accompanied by a greater rate of pelvic presentation and manual assistance by Bracht. There were 240 prematurely born children with no echosonographically diagnosed hemorrhage, 38% of all examined premature infants. From this number, 13.3% of neonates were born by Cesarean section. Conclusion In the etiology of neonatal intracranial hemorrhage, especially prematurely born ones, apart from the trauma, which plays a major role, other factors are also important, above all fetal distress, perinatal hypoxia and functional immaturity of all organs.

THE ADVERSE IMPACT OF MATERNAL OBESITY ON MATERNALAND PERINATAL OUTCOME

2021 ◽  
pp. 83-86
Author(s):  
Jayshree Chimrani ◽  
Uma Jain ◽  
Richa Bittharia
Keyword(s):  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Perineal Trauma ◽  
Reproductive Age ◽  
Age Group ◽  
Apgar Scores ◽  
Increased Risk ◽  
Reproductive Age Group

Introduction: Rapidly increased global prevalence of overweight and obesity has also affected women of reproductive age group. Pregnant women who are obese at booking have an increased risk for complications, both for themselves and their babies during pregnancy and childbirth. Women who are obese are at risk for gestational diabetes, miscarriage, preeclampsia, increased incidence of cesarean section, anesthetic complication, postpartum hemorrhage, thromboembolism, perineal trauma, and wound infection. There is an increased risk of stillbirth, congenital anomalies, prematurity, macrosomia, poor APGAR scores, and neonatal death in babies of obese mothers. This study investigated the effect of Maternal BMI on the mode of delivery and perinatal outcome. Methods: This is a prospective cohort study of 100 primigravidas of the reproductive age group done at Shivpuri District Hospital over a period of a year. We categorized them on the basis of their BMI at booking and studied the mode of delivery and perinatal outcome. Results: Elective cesarean and emergency cesarean were more common with obese women whereas most of the normal weighted and underweight women underwent spontaneous labor and induced labor. Maternal and fetal complications were more pronounced in the overweight and obese groups. Babies also had an increased risk of poor APGAR scores with the increasing BMI of the mother. Conclusion: Input of skilled birth attendants is essential to improve intrapartum outcomes. Obstetricians need to be acutely aware that obese patients form a high-risk population with an increased incidence of cesarean section, postpartum hemorrhage, and perineal trauma.

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