Comparison of Neonatal Outcome with Meconium-Stained Amniotic Fluid in Normal Vaginal Delivery and Cesarean Section

ObjectiveTo analyze the maternal and fetal factors affecting emergency cesarean section (EmCS) and establish a risk scoring system to quantitatively predict the risk of EmCS.DesignA total of 10,295 pregnant women were enrolled in this study. The influence of maternal and fetal factors on the risk of EmCS was analyzed.Results991 (9.63%) cases of failed vaginal delivery received EmCS. The two main causes of EmCS were fetal distress (67.21%) and abnormal fetal position (14.93%). There were significant differences in 17 maternal and fetal factors between the normal vaginal delivery (NVD) and EmCS groups (p<0.05 for all). Univariate and multivariate regression analyses showed that nine maternal and infant factors were independent risk factors (p<0.05 for all). The major factors were abnormal quantity of amniotic fluid (OR 6.867, 95% CI 4.442 to 10.618), nulliparous (OR 4.336, 95% CI 3.074 to 6.115), induction of labor (OR 5.300, 95% CI 4.514 to 6.224) and abnormal characters of amniotic fluid (OR 3.126, 95% CI 2.708 to 3.608). A risk scoring system (six grades) was established based on those factors which showed high discriminative power. The rate of EmCS was 1.30%, 2.57%, 5.83%, 13.94%, 21.75% and 39.71% in grades 1, 2, 3, 4, 5 and 6, respectively. The area under the curve of the risk scoring system was 0.787, indicating that the regression model of the risk factors had a good predictive ability.ConclusionAn effective risk scoring system has been developed to quantitatively assess the risk of EmCS based on measurable maternal and fetal factors. The system is simple, easy to operate and has good repeatability in clinical practice.

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Perinatal and maternal outcome in meconium stained amnioticfluid (thin and thick) at dhiraj general hospital, a rural tertiary health centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20215102 ◽

2021 ◽

Vol 11 (1) ◽

pp. 192

Author(s):

Jitendra V. Shukla ◽

Arpana D. Patel ◽

Piyush Chandrayan

Keyword(s):

Amniotic Fluid ◽

Vaginal Delivery ◽

Perinatal Outcome ◽

Health Centre ◽

Birth Asphyxia ◽

Normal Vaginal Delivery ◽

Control Group ◽

P Value ◽

Continuous Variables ◽

Meconium Stained Amniotic Fluid

Background: To determine the perinatal outcome of with Meconium-stained amniotic fluid (MSAF) compared with clear amniotic fluid at Dhiraj Hospital.Methods: A prospective observational study was carried out in obstetrics and gynaecology department of Dhiraj Hospital, Sumandeep Vidyapeeth from March 2021 to August 2021. All patients fulfilling inclusion and exclusion criteria as mentioned above were taken for the study. All the categorial variables were analysed independently with the help of chi square test and fisher’s exact test and all the continuous variables were analysed with independent ‘t test’.Results: Out of 500 patients selected for the present study which had inclusion criteria, 13.6% were meconium stained out of which 50 (73.5%) cases had thin meconium and 18 (26.4%) cases had thick meconium. Fetal CTG abnormalities were more common in MSAF group and were noted in 38.2% of cases which is significantly increased compared to control group with CTG abnormalities in 8.3%. The difference was significant with p value of <0.001. 32(47.0%) patients with meconium-stained amniotic fluid had normal vaginal delivery, while in control group out of 432, 360 (83.3%) delivered normally. Incidence of LSCS and assisted vaginal delivery was more in meconium-stained amniotic fluid.Conclusions: Meconium-stained amniotic fluid is associated with more frequency of operative delivery, birth asphyxia, neonatal sepsis, and neonatal intensive care unit admissions compared to clear amniotic fluid. Better perinatal outcome in clear amniotic fluid compared to meconium stained liquor.

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Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

Global Pediatric Health ◽

10.1177/2333794x211018350 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110183

Author(s):

Maleda Tefera ◽

Nega Assefa ◽

Kedir Teji Roba ◽

Letta Gedefa

Keyword(s):

Cesarean Section ◽

Vaginal Delivery ◽

Neonatal Outcome ◽

Birth Asphyxia ◽

Public Hospitals ◽

Obstructed Labor ◽

Eastern Ethiopia ◽

Adverse Neonatal Outcome ◽

Follow Up Study

The adverse neonatal outcome is defined as the presence of birth asphyxia, respiratory distress, birth trauma, hypothermia, meconium aspiration syndrome, neonatal intensive care admission, and neonatal death. It is a major concern in developing countries, including Ethiopia. This study tried to identify predictors of adverse neonatal outcomes at selected public hospitals in Eastern Ethiopia. A hospital-based prospective follow-up study was conducted in three public hospitals in Eastern Ethiopia from June to October 2020. A total of 2,246 laboring women and neonates born at the hospitals were enrolled in the study. Data were collected through interviews, observation checklists, and clinical chart review. Reports were presented in relative risks with 95% CIs. The overall magnitude of adverse neonatal outcome was 20.97% (95% CI: 19.33- 22.71%). It was 24.3% for babies born through cesarean section (95% CI: 21.3%, 27.5). The presence of meconium in the amniotic fluid increased the risk for neonates delivered via cesarean section (ARR, 1.52 95% CI; 1.04, 2.22). Among neonates born via vaginal delivery, the risk of adverse neonatal outcome was higher among nullipara women (ARR, 1.42 95% CI; 1.02, 1.99) and among women diagnosed with abnormal labor or pregnancy such as APH, pre-eclampsia, obstructed labor, fetal distress, and mal-presentation at admission (ARR, 1.30 95%CI; 1.01, 1.67). The risk of adverse neonatal outcome was higher among babies born through the cesarian section than those born via vaginal delivery. Abnormal labor or pregnancy and being primiparous increased the risk of adverse neonatal outcome in vaginal delivery.

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Meconium Stained Amniotic Fluid and Risk of Post Cesarean Section Surgical Site Infection

Strad Research ◽

10.37896/sr8.7/039 ◽

2021 ◽

Vol 8 (7) ◽

Keyword(s):

Cesarean Section ◽

Amniotic Fluid ◽

Surgical Site Infection ◽

Site Infection ◽

Meconium Stained Amniotic Fluid

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Effect of Perceived Social Support on Postnatal Depression in Females with Cesarean Section and Normal Vaginal Delivery

RADS Journal of Pharmacy and Pharmaceutical Sciences ◽

10.37962/jpps.v8i4.482 ◽

2021 ◽

Vol 8 (4) ◽

Author(s):

Muhammad Saleem Rana ◽

Mohammad Asif ◽

Asif Hanif ◽

Syed Amir Gilani ◽

Ume Habiba ◽

...

Keyword(s):

Social Support ◽

Cesarean Section ◽

Vaginal Delivery ◽

Postnatal Depression ◽

Perceived Social Support ◽

Significant Risk ◽

Depression Scale ◽

Sampling Technique ◽

Normal Vaginal Delivery ◽

Significant Other

Objectives: To assess the association of perceived social support with postnatal depression among puerperal women of Faisalabad, Pakistan. Methods: It was a case-control study carried out during a period of 18 months (1-1-2019 to 30-06-2020). By using purposive sampling technique 284 postpartum women were enrolled from Allied hospital and Children hospital Faisalabad. The postnatal depression was diagnosed with Edinburg Postnatal Depression Scale (EPDS).The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure the social support that was perceived by women. Results: According to cut-off score ≥13 on EPDS 37.3% women were found depressed while 62.7% women were found non-depressed. The mean EPDS score ± SD was 10.12 ± 6.27 (min score 0; max score 27). The perceived social support from significant other, family and friends was found as significant predictor of postnatal depression. With one-point increase in global perceived social support, the postnatal depression decreased by 0.1 points on EPDS scale (p = 0.03) among women in normal vaginal delivery group, by 0.2 points in cesarean section group (p <0.001) and the postnatal depression decreased by 0.2 points in total sample (p < 0.001). Conclusion: A poor perceived social support from significant other, family and friends is a significant risk factor for postnatal depression among puerperal women.

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Delivery of Twin Gestation (≥ 32.0 Weeks): The Vaginal Route as a Practicable and Safe Alternative to Cesarean Section

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-1181-8737 ◽

2020 ◽

Vol 80 (10) ◽

pp. 1033-1040

Author(s):

Anne Dathan-Stumpf ◽

Katharina Winkel ◽

Holger Stepan

Keyword(s):

Cesarean Section ◽

Vaginal Delivery ◽

Neonatal Outcome ◽

Neonatal Outcomes ◽

University Hospital ◽

Delivery Mode ◽

Safe Alternative ◽

Vaginal Deliveries ◽

Twin Pregnancies ◽

Second Twin

Abstract Objective The appropriate delivery mode for twins is discussed controversially in the literature. The aim of this study was to investigate delivery modes and short-term neonatal outcomes of twin pregnancies delivered in University Hospital Leipzig. Material and Methods A total of 274 twin pregnancies (32.0 to 39.4 weeks of gestation) delivered between 2015 and 2017 were analyzed retrospectively with regard to the planned and final delivery mode as well as neonatal outcomes. The inclusion and exclusion criteria for vaginal delivery were comparable to those of the Twin Birth Study. Results The spontaneous birth rate for births planned as vaginal deliveries was 78.5%; the rate of secondary cesarean section was 19.4%. The final total cesarean rate was 58.8%, and the rate of vaginal deliveries was 41.2%. Vertex or non-vertex position of the second twin had no significant effect on neonatal outcome or mean delivery interval between the birth of the first and second twin. Chorionicity, neonatal weight and gender had no significant impact on delivery mode. However, successful vaginal delivery was associated with higher gestational age and both fetuses in vertex position. The combined neonatal outcome for both twins was significantly worse if they were delivered by cesarean section compared to spontaneous birth. In addition, the leading twin in monochorionic/diamniotic (MC/DA) pregnancies was intubated more frequently after cesarean delivery and had significantly lower Apgar scores. Conclusion Vaginal delivery in twin pregnancies is a practicable and safe option in specific defined conditions and when the appropriate infrastructure and clinical experience is available.

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Amniotic fluid index versus maximum vertical pocket measurement in predicting perinatal outcome at 40 weeks or beyond

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184934 ◽

2018 ◽

Vol 7 (12) ◽

pp. 4887

Author(s):

Nasreen Noor ◽

Seema Amjad Raza ◽

Shazia Parveen ◽

Mohammad Khalid ◽

Syed Manazir Ali

Keyword(s):

Amniotic Fluid ◽

Vaginal Delivery ◽

Perinatal Outcome ◽

Prospective Observational Study ◽

Fetal Distress ◽

Normal Vaginal Delivery ◽

Amniotic Fluid Index ◽

Institutional Ethics ◽

Significant Difference ◽

Baseline Demographic

Background: The aim of this study is to compare the use of amniotic fluid index with maximum vertical pocket for predicting perinatal outcomes.Methods: The present study was a prospective observational study and includes 140 The study include normal antenatal women at gestational age 40 weeks or beyond (by last menstrual period/1st trimester scan) referred from antenatal between 20 to 40 years were enrolled in this study from 2015 to 2017. After Institutional Ethics Committee approval all recruited women was assessed at the 3rd trimester visit for baseline demographic and obstetric data. After taking a detailed history and examination the women were subjected to ultrasonography for Amniotic Fluid index (AFI) and Maximum vertical pocket (MVP). The women were divided into 2 groups based on measurement of AFI and MVP ultrasonologically. The correlation of Amniotic fluid index and Maximum vertical pocket with perinatal outcome were computed for the 2 groups: Group Ia - women having normal AFI and normal MVP; Group Ib - women having decreased AFI and normal MVP.Results: In Group Ia, 31(34.44%) women were induced and in Group Ib 59 (65.56%) women were induced for oligohydramnios. 65 women (72.22%) had normal vaginal delivery versus 25women (27.28%) had undergone LSCS in Group Ia, while in Group Ib, 32 women (64%) versus 18 women (36%) had vaginal delivery and LSCS respectively. Higher rate of LSCS was observed in Group Ib. There was no significant difference in the rate of LSCS for fetal distress between Group Ia and Ib for fetal distress.Conclusions: Amniotic fluid index (AFI) compared with the maximum vertical pocket (MVP) excessively characterizes patients as having oligohydramnios, leading to an increase in obstetric interventions, without any documented improvement in perinatal morbidity and mortality. Thus, authors cannot find any objective reason to favour AFI over MVP.

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