PRIMIGRAVIDAS;

2017 ◽  
Vol 24 (02) ◽  
pp. 258-262
Author(s):  
Sarwat Memon ◽  
Sumaira Rauf

Objectives: To determine frequency of different mode of deliveries andassociated maternal complications in primigravidas in tertiary care setup. Study Design: Caseseries study. Setting: Department of Obstetrics and Gynaecology (Liaquat University Hospital)Hyderabad, Sindh, Pakistan. Period: 6 months from Jan 2009 till June 2009. Methodology: Allthe primigravidas underwent delivery by any means i-e emergency\elective caesarean sectionor spontaneous vaginal delivery\instrumental vaginal delivery and developed postpartumcomplications up till 7 days after delivery were included. Data was analyzed on pre- designedprofoma and was analyzed through software program SPSS version 10. Results: In this studymost frequent mode of delivery were found to be spontaneous vaginal delivery 46(36.8%)and emergency caesarean section 29(23.2%) while forceps 8.8%, vacuum 20% and electivecaesarean section 1.2%. Complications associated with mode of deliveries included postpartumhemorrhage were reported to be 51.2%, abdominal wound infection 11.2%, perineal woundinfection 17.6%, retained products of conception 28% and puerperal sepsis 16.8%. Conclusion:Deliveries in our setup are mostly conducted by dais (birth attendants) without any asepticmeasures and without assessing the abnormalities that will leads to emergency caesareansection or instrumental vaginal deliveries and in the consequence of these entire patientsdevelop postpartum complications.

Author(s):  
Priti Kumari ◽  
Sipra Singh ◽  
Salma Khatun ◽  
. Shashikar

Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.


2016 ◽  
Vol 3 (3) ◽  
pp. 179
Author(s):  
Nuring Pangastuti

Background: Vaginal delivery is the most preffered mode of delivery by all women, and the birth attendants. The vaginal delivery assistance was conducted by various health professionals such as midwives, physicians, and obstetricians. Various complaints of pelvic floor dysfunction and complaints related to the perineum as a result of vaginal perineal laceration during childbirth can affect the quality of life of a woman.Objective: To identify and conduct an analysis of maternal factors (maternal age, parity, gestational age), fetal factor (birth weight), and the labor factor (duration of 2nd stage of labor), with the occurrence of perineal rupture in vaginal delivery at the 5 Midwife’s Private Clinic (MPC), Yogyakarta, Indonesia.Method: Retrospective medical record searching, from January 2014 until December 2016.Result and Discussion: There were 1595 obtained samples of data that met the criteria for inclusion and exclusion. Number of perineal laceration reached 1201 (75.3%), with 1.9% of them are grade 3. Perineal rupture occurred in 80.55% of vaginal deliveries at young age, 69.14% in more than 35 years old women, and 85.05% primiparas. There was significant negative correlation (0.186) between parity and perineal rupture (p=0.000). The less the parity, the higher the incidence of perineal rupture (p=0.002). There was significant correlation between baby’s weight less than 2500 gram and perineal rupture but not for the baby’s weight more than 4000grams (p=0.304). The correlation was positive which meant that the heavier the baby’s weight the higher the incidence of perineal rupture. There was significant positive correlation (p=0,018) for the duration of 2nd stage of labor between 30-60 minutes and perineal rupture(0.061). The correlation was positive as well (0.092) for the duration of 2nd stage of labor more than 60 minutes and perineal rupture( p=0.002). The longer the duration of the 2nd stage of labor the higher the incidence of perineal rupture.Conclusion: There was significant relationship between parity, and duration of the 2nd stage of labor and perineal rupture in vaginal delivery. Keywords: perineal rupture, vaginal delivery, parity, duration of the 2nd stage of labor


2019 ◽  
Vol 53 (3) ◽  
Author(s):  
Nika Buh ◽  
Miha Lučovnik

Introduction: The objective of the study was to examine the association between the mode of delivery and the incidence of neonatal intracranial haemorrhage.Methods: Slovenian National Perinatal Information System (NPIS) data for the period 2002 through 2016 were analysed. Nulliparous women delivering singleton neonates in cephalic presentation weighting 2,500 to 4,000g were included. Incidence of neonatal intracranial haemorrhage in vacuum delivery vs. other modes of delivery was compared using the Chi-square test (p < 0.05 significant).Results: 125,393 deliveries were included: 5,438 (4 %) planned caesarean deliveries, 9,7764 (78 %) spontaneous vaginal deliveries, 15,577 (12 %) emergency caesarean deliveries, and 6,614 (5 %) vacuum extractions. 17 (0.14/1000) neonatal intracranial haemorrhages were recorded: 12 occurred in spontaneous vaginal deliveries, two in emergency caesarean deliveries, and three in vacuum extractions. In comparison to infants born by spontaneous vaginal delivery, those delivered by vacuum extraction had higher rates of intracranial haemorrhage (odds ratio (OR) 3.70; 95% confidence interval (CI) 1.04−13.10). Risk estimates did not reach statistical significance when comparing infants born by vacuum extraction and those born by emergency caesarean delivery (OR 3.54; 95% CI 0.59−21.16).Discussion and conclusion: Infants born by vacuum extraction have significantly higher rates of intracranial haemorrhage than those born by spontaneous vaginal delivery although the absolute risk is small. There are no significant differences in the rates of intracranial haemorrhage in vacuum extraction vs. emergency caesarean delivery.


2019 ◽  
Vol 14 (2) ◽  
pp. 54-56
Author(s):  
Dhan Bahadur Shrestha ◽  
Rosy Malla ◽  
Reeta Manandhar ◽  
Ratna Khatri ◽  
Cimona Shrestha ◽  
...  

Aim: To study the prevalence of induction of labor and obstetric and neonatal outcome among delivery cases in the maternity unit of a tertiary care center. Methods: This is a prospective cross-sectional study conducted on pregnant ladies presenting to maternity unit of Shree Birendra Hospital, Chhauni over a period of six months from March to August 2017. All pregnant ladies in labor during the study period were enrolled. Induction of labor, mode of delivery, perinatal outcome (gestational age at delivery, birth weight), and maternal complications if any were recorded. Results: Among 497 deliveries in the study period, induction of labor was performed in 117 (23.5%) cases with post-date pregnancy being the most common indication. Induction was successful with vaginal deliveries in 82(70.1%) cases, while in the rest, IOL failed. Among the induced cases, 17 (14.5%) neonates had poor APGAR at 5 minutes and there was significant association of IOL with low APGAR. There was normal post-natal recovery in 108 (92.3%) induced cases while 9 (7.7%) cases developed some maternal complications. IOL has no significant association with maternal and neonatal complications or perineal injury (p>0.05). Conclusions: The prevalence of induction in this center is slightly higher than other centers. The IOL has significant association with low APGAR at 5 minutes but no significant association with the neonatal and maternal complications.


2021 ◽  
pp. 1-3
Author(s):  
Triza Kumar Lakshman ◽  
Ekta Chhabra ◽  
Ravindra S. Pukale

Introduction: Giving birth can be a long and painful process and is not always a perfect one. Instrumental vaginal delivery is an art and provides a 1 temporal advantage over cesarean delivery. It is also an alternative procedure for delivery in emergency obstetrics. Instrumental vaginal delivery is an integral part of Obstetrics care world wide. The present study was carried out to evaluate the maternal and neonatal outcome in operative/assisted vaginal delivery. Method: We performed a retrospective observational study of women with singleton term pregnancies who underwent operative vaginal delivery at Adichunchanagiri Institute of Medical Sciences. The study was conducted between August 2019 to August 2020 for the duration of 1 year and the data was accrued from patient database retrospectively and was entered in Microsoft Excel (Version 16.4) for Windows. Results: During the study period, 95 patients underwent Instrumental Vaginal Delivery, of which 74 were vacuum assisted and 21 were forceps nd delivery. The most common indication for Operative vaginal delivery was failure of maternal efforts followed by prolong 2 stage of labour in vacuum group and severe pre-eclampsia in forceps group. Vacuum was used more often than forceps for most of the deliveries. Maternal st nd complication like 1 and 2 degree perineal tear were seen more often with the use of forceps. Instrument marks and bruising were found in the neonates delivered by forceps and a greater incidence of cephalohaematomas and caput in the neonates delivered with vacuum. Conclusion: A successful instrumental vaginal delivery can be achieved with lesser maternal and neonatal morbidity with timely assessment of labour and skilled operator. The overall rate of perinatal and maternal morbidity and mortality vary by indication and operative instrument. Women who underwent forceps-assisted delivery had greater rates of maternal complications than those who underwent vacuum-assisted delivery


2020 ◽  
Vol 10 (1) ◽  
pp. 32-38
Author(s):  
Aisha Khan Jadoon ◽  
Arzu Jadoon ◽  
Sarosh Khan Jadoon ◽  
Shahina Ishtiaq

Background: Postpartum Depression is a serious issue that can lead to irreversible disasters if not timely recognized and diagnosed. There are various modes of delivery; which may contribute towards physical and mental trauma. Methods: It was a prospective descriptive cross- sectional study carried out to evaluate the alliance of postnatal depression with different modes of delivery i.e. vaginal or lower segment caesarean section. The study was conducted at Ziauddin University Hospital. A sample size of 200 was taken. It was carried out from June 2019 to December 2019. A Performa was designed that questioned about different socio-demographic characteristics and risk factors for post-natal depression (PND). Edinburg Post-Natal Depression Scale (EPNDS) was used for authenticated identification of women with depression in purpeurium. Results: Out of the total sample of 200 women, 100 were taken from the spontaneous vaginal delivery group and 100 from cesarean section group. Mean age was 21-34 years. It was noticed that 60% women who underwent cesarean section became a victim of depression and 40% women who had a normal vaginal delivery were identified to have post natal depression. Conclusion: The study identifies cesarean section to be one of the culprits of postnatal depression as compared to woman undergoing spontaneous vaginal delivery.  There is an exponential rise in the frequency of performing unexplained cesarean sections that would also boost up the graphs of postnatal depression; hence there is a dire need to instruct women to follow up postnatal so that they can be evaluated for post partum depression.


Author(s):  
Patel Yogeshkumar Pransukhbhai ◽  
Poonam Londhe

Background: Fetal, neonatal and maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study was conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: This was a prospective cross-sectional study of 70 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital B. J. Medical College, Ahmedabad, Gujarat, India.Results: Out of 70 patients, majority of the subjects belongs to 26-30 years of age (50%). The gestational age of 90% of patients were between 40-42 weeks. About 42-44% of the foetus had a birth weight of 2.5-3.5 kgs. Maximum patients underwent vaginal deliveries in spontaneous group (57%) and 64% underwent LSCS in induced group. Mode of delivery is significantly associated with presence of adequate liquor.Conclusions: With regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up.


2020 ◽  
Vol 16 ◽  
Author(s):  
Mounica Lella ◽  
Jyothi Shetty ◽  
Keerti Kyalakond ◽  
Murlidhar V Pai

Objective: To study the outcomes of membrane sweep done during induction of labor with sublingual misoprostol at term pregnancy such as the mode of delivery and the induction delivery interval. Methods: This prospective descriptive study was conducted in 305 term women (237 primigravida and 68 multigravida) who received sublingual misoprostol followed by membrane sweep (single or double sweep based on the progress of labor). Main outcome measures included mode of delivery, induction to delivery interval, duration of labor, neonatal outcomes and maternal complications. Results: Among 237 primigravida, 108 (45.5%) women delivered after a single sweep and 129 (54.4%) women needed a second sweep. Among 68 multigravida, 47 (69.1%) delivered after a single sweep and only 21 (30.8%) required a second sweep. Maximum number (75.5%) of primigravida had pre-induction Bishop score of 2 while maximum number (67.6%) of multigravida had pre-induction Bishop score of 3. Vaginal deliveries (including instrumental delivery) were more in both primigravida (55.6%) and multigravida (88.2%) who received membrane sweep in conjunction with induction of labor. The mean time from the first dose of sublingual misoprostol to the onset of contraction was 6.9 hours in primigravida and 4.2 hours in multigravida while the meantime from the onset of contractions till vaginal delivery (duration of labor) was 11.2 hours in primigravida and 5.8 hours in multigravida. The mean interval from induction to the vaginal delivery was 18.8 hours in primigravida and 14.4 hours in multigravida. Conclusion: Sublingual misoprostol, along with membrane sweep at the initiation of labor induction is an effective intervention despite its association with increased rate of cesarian section among primigravida as compared to the literature.


2018 ◽  
Vol 16 (2) ◽  
pp. 209-214
Author(s):  
Anshumala Joshi ◽  
Meeta Thapa ◽  
Om Biju Panta

Background: Whether a mother should be allowed to choose between the modes of delivery is a matter of concern among practicing obstetricians. This study aims to explore the knowledge of the Nepalese women attending a tertiary care center about the benefits and complications of vaginal and caesarean delivery and their attitude and preference for the method of delivery.Methods: The study was a hospital based cross sectional questionnaire survey conducted in Nepal Medical College teaching Hospital, Jorpati from 1stShrawan 2074 to 31st Ashoj 2074. All pregnant women who were 36 weeks or more in gestation attending the clinic during the study period were included in the study. A questionnaire was made of 10 questions for knowledge assessment regarding mode of delivery consisting of the indications, the possible complications and advantages of vaginal and caesarean delivery. Results: A total of 256 pregnant women participated in the study. The knowledge of the mode of delivery, their benefit and complications was medium to good in approximately 90% of the mothers attending the antenatal OPD. Overall attitude for vaginal delivery was positive in 93% of women and negative or neutral in 6.6%.Overall attitude for caesarean delivery was positive in 24% and negative or neutral in 75.8%.Conclusions: Women in our setup agree that vaginal delivery is a natural and acceptable method of delivery and would prefer to have a vaginal delivery. Keywords: Attitude; knowledge; modes of delivery; women.


2016 ◽  
Vol 23 (09) ◽  
Author(s):  
Muhammad Iqbal ◽  
Adnan Ahmed ◽  
Muhammad Rafique Hingoro

Objectives: To determine incidence of steatosis in non-responder casesof chronic HCV. Study Design: Cross-sectional study. Setting: Tertiary Care Sanatorium inMedicine Department of LIAQUAT University Hospital Hyderabad/Jamshoro. Period: 26-9-2011to 25 August 2012. Material & Methods: Total 144 non-responders cases of Hepatitis C wereintegrated. Both gender, age 18 to 50 yrs, chronic HCV non-responder cases as well as cases fitfor hepatic biopsy were integrated in study. Grading of Inflammation was carried out as indicatedby histopathological measures. Results: Mean age was 48.5 + 5.2years. Uppermost prevalenceof chronic HCV disease was 65(45.13%) at 41 to 50 years age interval whereas 42(29.1%) caseswere noticed in 31 to 40 yrs age group and 25(17.3%) cases were observed in 20 to 30 yearsof young age group. In this study hepatic steatosis occurrence was observed in 103 (71.5%)cases and these were categories as: grade 1, grade 2, grade 3, as (<33%) 45/103(43.68%), (33to 66%) 35/103(33.98%), (>66%) 23/103(22.33%) respectively. Conclusion: Hepatic steatosisis a important risk factor the cases of HCV to decreased response to antiviral therapy and forprogression toward fibrosis as observed in cases related to metabolic steatosis.


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