scholarly journals Factors affecting the fetal & maternal outcome in a trial of labour after previous one caesarean section

2019 ◽  
Vol 10 (2) ◽  
pp. 1110-1117
Author(s):  
Aseel Ghazi Rifat
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Safe Alternative ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Fetal Complications ◽  
History Of ◽  
Maternal Bmi

This study was designed to evaluate maternal and obstetrical factors associated with a successful trial of labour after one caesarean section (TOLAC) as well as evaluating the associated fetal and maternal outcomes and to determine the rate of vaginal delivery and repeated C/S. A prospective cross-sectional study was done on 237 women with previous one C/S then patients were selected for the trial of labour based on the department protocol. Those who were chosen for TOL were strictly monitored & observed for the progress of labour and the outcomes were recorded in terms of mode of delivery, maternal & fetal complications and were analysed and compared with those who had repeated C/S. Seventy-three (30.8%) patient was delivered by elective C/S without trial, 109 (46%) of the patients who were admitted to labour room delivered vaginally while 55 (23.2%) delivered by emergency C/S. It has been found that maternal BMI of (<25), history of vaginal birth after C/S (VBAC) and smaller gestational age were significantly associated with the success of TOL and can predict the outcome. Higher maternal & fetal complications rates were reported in cases delivered by emergency C/S compared to those who delivered vaginally or through elective C/S. The trial of labour after one caesarean section is a safe alternative to repeated C/S and decreases the associated morbidities with repeated C/S. The success rate of TOLAC reported in this study was (66.5%). A successful TOLAC is associated with normal maternal BMI, smaller gestational age and history of the previous VBAC.

scholarly journals HEMOGLOBIN STATUS OF FEMALE MEDICOS IN URBAN AREA AND FACTORS AFFECTING IT: AN OBSERVATIONAL CROSS-SECTIONAL STUDY

2017 ◽  
Vol 10 (3) ◽  
pp. 439
Author(s):  
Drpadmajauday Kumar ◽  
Varsha Kalyanpur
Keyword(s):  
Statistical Significance ◽  
Cross Sectional Study ◽  
Leafy Vegetables ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Green Leafy Vegetables ◽  
Nutritional Anemia ◽  
Mild Anemia ◽  
History Of

ABSTRACTObjectives: Estimating the hemoglobin (Hb) status in female medicos through prospective cross-sectional study and assessment of influencing ofcofactors were objectives.Methods: Women medicos who volunteered, consented and met selection criteria were enrolled. Hb level was estimated to diagnose anemia.Relationship with influencing factors was assessed statistically.Result: A total of 100 eligible students were enrolled. Mean age±standard deviation (SD) age of the participants’ was 20.9±3.1 years (17-25 years).Mean±SD Hb was 12.25±1.0189 g% (9.0-16.0 g%). 33 were anemic, and mild anemia (32%) was frequent. There was a history of worm infestation inthree students (3%), who were treated adequately. Nine were on iron supplements of which five were still anemic and were continuing the treatmentby the end of the study. 28 (84.84%) anemic students were not on any iron or hematinic treatment. There was no association between the anemiaand nature of diet, consumption of green leafy vegetables, consumption of coffee/tea after food, smoking/tobacco or alcohol consumption, mother’seducation, socioeconomic status, menstrual factors, and physical exercise. The prevalence of anemia was found to be higher in underweight andoverweight students in comparison to students with normal body mass index.Asymptomatic participants (n=78) outnumbered symptomatic ones(n=22), but without any statistical significance. Easy fatigability (14%), pallor (7%), breathlessness (6%), weakness (9%), and easy bruising (1%)were frequent complaints.Conclusion: Anemia is frequent among women medicos, often underdiagnosed, under-reported, many remaining asymptomatic. Negligence ofmedical students toward their anemic status despite the awareness of consequences of low Hb level is a serious cause of concern.Keywords: Awareness, Hemoglobin, Nutritional anemia, Women medical students.

scholarly journals Frequency of Caesarean Section in Pregnancies with Borderline Amniotic Fluid Index at Term

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Natasha Bushra ◽  
Khaula Zeeshan ◽  
Sara Ejaz ◽  
Javeria Mushtaq ◽  
Khadija Waheed ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Induction Of Labour ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Increased Risk ◽  
Failed Induction ◽  
One Year

AbstractThe increased risk of caesarean section after induced labour is well documented. Rate of induction of labour has doubled in the past decade from 10 to 20%. Low Amniotic Fluid Index (AFI) as an isolated finding leads to increased obstetrical interventions but without any improvement in outcome.Objectives:  To determine the frequency of caesarean section due to failed induction in pregnancies at term with borderline AFI.Patients and Methods:  This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Unit-III, SIMS/Services Hospital, Lahore. The duration of study was one year from January, 2015 to December, 2015. A total of 150 patients were included in this study. AFI was measured by recent obstetric ultrasound. All patients with borderline AFI (5 – 8 cm) were included in the study. They were induced by glandin E2 gel. If induction of patients failed with two doses of glandin E2 gel, given vaginally 6 hours apart, patients were considered for cesarean section. The outcome measure was rate of caesarean section due to failed induction. All data were analyzed by SPSS version 20.Results:  Mean age of the patients was 30.34 ± 6.68 years. Mean gestational age was noted 38.34 ± 1.05 weeks. Out of 150 patients, 103 (68.7%) were para 1 – 3 and 47 patients (31.3%) were para 4 – 6. Caesarean section due to failed induction with borderline AFI was performed in 27 patients (18.0%). Stratification with regard to age, gestational age and parity was carried out and was found significant only for gestational age being > 39 weeks.Conclusion:  It is concluded that failed induction of labour at term in women with borderline AFI is not associated with increased risk of caesarean delivery.

scholarly journals Caesarean section at Koudougou regional hospital centre: indications and prognosis

2020 ◽  
Vol 9 (12) ◽  
pp. 4792
Author(s):  
Djiguemde Nebnomyidboumbou Norbert Wenceslas ◽  
Lankaonde Martin ◽  
Savadogo-Komboigo B. Eveline ◽  
S. I. B. Sansan Rodrigue ◽  
Ouedraogo Wendlassida Estelle ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Caesarean Section Rate ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Important Place ◽  
History Of ◽  
Group 3 ◽  
Group 5 ◽  
Uterine Scar

Background: Objective was to study the indications and the prognosis of cesarean section in the obstetrics and gynecology department of CHR Koudougou from August 1st to October 16th 2018.Methods: This was a cross-sectional study for descriptive purposes with prospective collection of data over the month and monitoring of parturients up to the 42nd day post caesarean section. The study covered the period from August 1 to October 16, 2018. Gestures received in the work room and those hospitalized for a scheduled cesarean were involved in this study.Results: This study involved 316 deliveries. The caesarean section rate was 34.8% (n=110). The average age was 26.75 years with extremes of 12 and 42 years. Term pregnancies represented 90.9%. History of cesarean section was observed in 47, 3%. The main groups contributing to the caesarean section rate represent: Groups 5 (9.5%), Group 1 (9.2%), Group 3 (5.1%), the scar uterus (17.3%) and suffering fetal (14.6%). The reported complications were 15.5% including 3.6% parietal suppuration and 0.8% stillbirth.Conclusions: The caesarean section occupies an important place in the maternity service of the RHC of Koudougou. Robson's group 5 was the largest contributor to the overall cesarean rate in our study. Measures should be taken in this group so that the uterine scar does not become an absolute indication for cesarean.

scholarly journals Prevalence of small for gestational age newborns and associated factors in a Brazilian Northeast capital

2018 ◽  
Vol 18 (3) ◽  
pp. 539-547
Author(s):  
Micaely Cristina dos Santos Tenório ◽  
Marilene Brandão Tenório ◽  
Raphaela Costa Ferreira ◽  
Carolina Santos Mello ◽  
Alane Cabral Menezes de Oliveira
Keyword(s):  
Birth Weight ◽  
Hierarchical Model ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Associated Factors ◽  
Protective Factor ◽  
Mode Of Delivery ◽  
Low Frequency ◽  
Cross Sectional Study ◽  
Cross Sectional

Abstract Objectives: to analyze the factors associated with the birth of small for gestational age (SGA)infants, in a Northeastern Brazilian capital. Methods: a cross-sectional study was carried out with 331 pregnant women and their newborns attending the public health network in the city of Maceió, in 2014. Maternal antenatal data were collected (socioeconomic, lifestyle, clinical and nutritional) as well as data of the newborns (gestational age, mode of delivery, sex, birth weight and length), after delivery. Birth weight was classified according to the INTERGROWTH-21st curves, being considered SGA those below the 10th percentile according to gestational age and gender. The results were analyzed by Poisson regression using a hierarchical model and were expressed as prevalence ratios (PR) and their respective 95% confidence intervals (CI95%). Results: it was verified that 5.1% of the newborns were SGA. Regarding the associated factors, after adjustment of the hierarchical model, the variable working outside the home was associated with the endpoint studied [PR = 0.14; (CI95% = 0.02-0.75); p=0.022]. Conclusions: it was verified a low frequency of SGA infants in the evaluated population. The fact that the mother works outside the home proved to be a protective factor for this condition.

scholarly journals Pregnancy with previous caesarean section: an overview of adverse fetomaternal sequelae

2018 ◽  
Vol 7 (5) ◽  
pp. 1817 ◽  
Author(s):  
Joyita Bhowmik ◽  
Amit Kyal ◽  
Indrani Das ◽  
Vidhika Berwal ◽  
Pijush Kanti Das ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Previous History ◽  
Successful Outcome ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Medical College ◽  
Increased Risk ◽  
Fetal Complications ◽  
History Of

Background: The Caesarean section epidemic is a reason for immediate concern and deserves serious international attention. The purpose of this study was to evaluate adverse maternal and fetal complications associated with pregnancies with history of previous caesarean section.Methods: A cross-sectional, observational study carried out over a period of 1 year from 1st June 2016 to 31st July 2017 in Medical College Kolkata. 200 antenatal patients with previous history of 1 or more caesarean sections were included. In all cases thorough history, complete physical and obstetrical examination, routine and case specific investigations were carried out and patients were followed till delivery and for 7 days thereafter. All adverse maternal and fetal complications were noted.Results: Out of 200 women, 30 candidates were tried for VBAC, of them 20 (66.66%) had successful outcome. Most common antenatal complication was APH (5.5%) due to placenta praevia followed by scar dehiscence. There were 12 cases (6.66%) of PPH and 6 cases (3.33%) of scar dehiscence in the study group. 3 cases required urgent hysterectomy due to placenta accreta. 42 out of 196 babies required management in SNCU immediately or later after birth.Conclusions: Women with a prior cesarean are at increased risk for repeat cesarean section. Vigilance with respect to indication at primary cesarean delivery, proper counselling for trial of labor and proper antepartum and intrapartum monitoring of patients are key to reducing the cesarean section rates and maternal complications.

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 Practice of Eye Checks among Medical Doctors in South-East Nigeria

2021 ◽  
pp. 38-46
Author(s):  
Arinze Anthony Onwuegbuna ◽  
Akunne Ijeoma Apakama ◽  
Miriam-Benigna Chika Amobi ◽  
Emeka Akujuobi Chianakwalam ◽  
Chuka Michael Okosa ◽  
...  
Keyword(s):  
Family History ◽  
Visual Impairment ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Eye Diseases ◽  
Public Hospitals ◽  
Medical Doctors ◽  
Cross Sectional ◽  
Factors Affecting ◽  
History Of

Visual impairment greatly affects one’s quality of life. The number of persons with visual impairment and blindness in the world is on the increase. Eye screening allows for early detection of sight-threatening diseases and timely intervention could be sight-saving.  Aim: To determine the practice of eye checks and identify the factors that affect periodic eye checks among medical doctors in south-east Nigeria. Methodology: This study was a descriptive, cross-sectional study conducted among practicing medical doctors in private and public hospitals in Anambra State Nigeria, using a self-administered semi-structured questionnaire. Information obtained from the participants included the sociodemographics data, type and duration of practice, presence of any medical and/or ocular condition, family history of eye diseases, history of use of spectacles, practice of eye check and interval of eye check, factors affecting the practice of eye check, and ways of promoting regular eye check. Data obtained were analysed using the Statistical Package for the Social Sciences version 23. Statistical significance was set at p˂0.05.  Results: One hundred and eighty-seven practicing  medical doctors were interviewed. There were 123 (65.8%) males and 64 (34.2%) females. Their ages ranged from 24 to 80 years, with a mean age of 44.81 ± 12.73 years. The mean duration of professional practice was 18.16 ± 11.9 years. Majority, 124 (66.3%) works in government-owned hospitals. Among the study participants, 93(49.7%) doctors had been diagnosed with different ocular diseases; 99(52.9%) had a family history of ocular problems; 94(50.3%) had used prescription lenses; and 51(27.3%) had medical conditions. One hundred and twelve (59.9%) had undergone at least  eye examinations once, of which 54(48.2%) had their last eye examination over 5 years ago. The prevalence of eye check was 59.9% (95%CI: 52.9 – 66.9%). Eye checks were significantly associated with medical practice of over 20 years (P=0.030), working in a private practice (P=0.001), having eye diseases such as cataract (P=0.006), refractive error (P˂0.001), presbyopia (P˂0.001), and use of prescription spectacles (P˂0.001). ‘Belief of not having eye problems’ and ‘No time’ which accounted for 58.7% and 24.0% respectively were the commonest reasons for not regularly  having eye examinations.  Conclusion: Poor attitude to periodic eye examinations was seen in medical doctors in south east Nigeria. 

scholarly journals A study on peripartum hysterectomy in a tertiary referral government hospital

2019 ◽  
Vol 8 (12) ◽  
pp. 4971
Author(s):  
Chaithra M. ◽  
Tejeswini K. K. ◽  
Savitha C.
Keyword(s):  
Caesarean Section ◽  
Postpartum Haemorrhage ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Peripartum Hysterectomy ◽  
Obstetrics And Gynaecology ◽  
Vaginal Deliveries ◽  
Life Threatening ◽  
Emergency Peripartum Hysterectomy

Background: Emergency peripartum hysterectomy (EPH) is a major surgical venture invariably performed in the setting of life-threatening haemorrhage during or immediately after abdominal and vaginal deliveries. Aim of the study was to study the frequency and indications for peripartum hysterectomy and to assess the maternal outcome of peripartum hysterectomy.Methods: Cross sectional study was done in the department of obstetrics and gynaecology, Vanivilas hospital, Bangalore from September 2018 to august 2019. This study consists of 24 cases of emergency peripartum hysterectomy within 24 hours of delivery, operated at Vanivilas hospital.Results: The frequency of peripartum hysterectomy was 1.102/1000 deliveries and following caesarean section and vaginal deliveries are 3.544/1000 deliveries and 0.248/1000 deliveries respectively. Among 24 cases who had peripartum hysterectomy, 16 cases were delivered by caesarean section and 4 cases delivered by vaginal route while another 4 cases delivered by laparotomy for rupture uterus. 22 cases (91.67%) survived with major number of cases having morbidities and there were 2 (8.33%) maternal death.Conclusions: The most common mode of delivery before peripartum hysterectomy was Caesarean section. The most common indication was atonic postpartum haemorrhage. Better protocols for induction and augmentation of labour will decrease the necessity of peripartum hysterectomies.

Nocturnal enuresis among children in Morogoro region in Tanzania: A cross-sectional survey

2020 ◽  
Vol 31 (1) ◽  
pp. 16-29
Author(s):  
Nehemia Kilongo ◽  
Francis F. Furia
Keyword(s):  
Family History ◽  
Demographic Data ◽  
Positive Family History ◽  
Cross Sectional Study ◽  
African Region ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Childhood Disorders ◽  
Factors Affecting ◽  
History Of

Background: Enuresis is common childhood disorders which affecting quality of life of children and causing significant psychosocial disturbances to children and their families. This condition has been widely reported globally with increasing data from sub-Saharan African region. In Tanzania there is no reports on its magnitude and therefore this study was carried out with the aim of determine the prevalence of this condition among children in Tanzania.Methods: This was a community based cross-sectional study conducted among children aged between 5 and 14 years recruited from 12 streets in Morogoro Municipality in Tanzania. Standardized Swahili questionnaire was used to collect data including socio-demographic details of parents,  children and presence of enuresis. Socio-demographic data included age of the child, sex, level of education of the parents, education of the child, presence of bed wetting, history of enuresis in the family.Results: Five hundred and ten children were recruited into this study out of which 271 (53.1%) were females and mean age of study participants was 9±2.8 years. Enuresis was noted in 19% (97/510) of children, 68% (66/97) and 32% (31/97) had primary and secondary enuresis respectively. Significantly higher prevalence rates of enuresis were noted for children aged below 8 years 26.4% (43/162) and those with family history of enuresis 47% (18/38) with p values of 0.01 and < 0.001 respectively. Forty-one (42.3%) out of 97 respondents whose children had enuresis reported to have punished their children and only 21.4% (20/97) reported to have sought treatment for their children.Conclusions: Enuresis is common among children in Tanzania particularly those with positive family history. Punishment to children with enuresis was noted in this study and only one in five parents/guardians sought treatment for their affected children. Therefore, there is a need for initiatives for raising community awareness about enuresis in Tanzania Key words: Enuresis in children, prevalence of enuresis in Tanzania, factors affecting enuresis in children.

Amniocentesis Complications in Yazd Baghaeipour Polyclinic: A Cross-Sectional Study

2020 ◽  
Author(s):  
Nasim Shirgholami ◽  
Fatemeh Abdi ◽  
Mahta Mazaheri ◽  
Razieh Sadat Tabatabaee
Keyword(s):  
Gestational Age ◽  
Fetal Death ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Second Stage ◽  
History Of ◽  
The Mean ◽  
Pass Through ◽  
Type Of Delivery

Background: Amniocentesis, like other invasive methods, has complications such as abortion, premature rupture - second pregnancy and at 29 weeks of membranes, infection, bleeding, etc. Here, we aimed to study the complications of amniocentesis in pregnant women. Methods: This descriptive cross-sectional study was included 409 women with positive first and second stage screening or required amniocentesis referred to Baghaeipour Clinic in 2017. Data was collected by a pre-prepared questionnaire. Results: The mean age of the patients and gestational age was 33.49 ± 6.51 years and 17.39 ± 1.36  weeks, respectively. 132 patients (32.2%) had a history of abortion. Regarding the frequency of needle passage through the placenta, the results showed that in 369 people (90.2%) the needle did not pass through the placenta and in 40 people (9.8%). The needle has passed through the pair. Regarding the frequency distribution of amniocentesis complications, fetal death in (2.4%), bleeding in (2.2%) and PROM (1.7%) were observed in patients and no case of infection and abortion was observed. In terms of age, gestational age, gestational number, placental location, needle passage, aspirated fluid color, history of abortion and type of delivery, there were no significant differences. Conclusion: In this study the most common complication of amniocentesis was fetal death (2.4%), followed by bleeding and Spotting (2.2%), PROM (1.7%), infection and abortion, respectively.

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