scholarly journals Outcome of Women with Previous Cesaerian Section At A Tertiary Care Hospital in Eastern Nepal

2015 ◽  
Vol 12 (1) ◽  
pp. 18-23
Author(s):  
Ajay Agrawal ◽  
S Chhetri ◽  
A Thakur ◽  
S Agrawal ◽  
P Basnet
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Caesarean Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Vaginal Birth ◽  
Care Hospital ◽  
Previous Caesarean Section ◽  
Vaginal Birth After Caesarean

Background: Pregnant women with previous caesarean section are increasing due to the liberal use of caesarean section in first pregnancy due to multifactorial reason. The risks, benefits, and relative safety of vaginal birth after caesarean (VBAC) have been subject of interest for well over 100 years. Thus mutual understanding between the treating obstetrician and patient herself is a core towards achieving good maternal and perinatal outcome considering all the risk and benefit in women with previous caesarean section. Objective: The aim was to analyze the maternal and perinatal outcome in pregnant women with previous caesarean section. Methods: In this prospective observational study, 300 women with singleton pregnancy in cephalic presentation with previous one lower segment caesarean section (LSCS) having inter pregnancy interval ≥ 18 months presenting at ≥ 37-41 week period of gestation admitted for delivery were enrolled and various maternal and perinatal outcome were noted. Results: Caesarean delivery rate during the study period was 26.95%. Eighty percent of eligible women opted for trial of labor. Successful vaginal birth after caesarean section was 29%. Elective repeat caesarean delivery was 19.66%. The rate of failed VBAC was 51%. Failed VBAC increased with increasing weight of baby. There was no difference in mean birth weight among patient who had successful VBAC, who refused VBAC and who had failed VBAC. Mode of delivery had no significant effect on the number of neonatal intensive care unit admission and number of still births.  DOI: http://dx.doi.org/10.3126/hren.v12i1.11980Health Renaissance 2014;12(1):18-23

scholarly journals Successful vaginal birth after caesarean section in patient with Ehler-Danlos syndrome type 2

2011 ◽  
Vol 4 (4) ◽  
pp. 164-165 ◽  
Author(s):  
Hemant Maraj ◽  
Michelle Mohajer ◽  
Deepannita Bhattacharjee
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Genetic Defect ◽  
Vaginal Birth ◽  
Previous Caesarean Section ◽  
Inherited Disorders ◽  
Vaginal Deliveries ◽  
Danlos Syndrome ◽  
Vaginal Birth After Caesarean

We present the case of a 31-year-old woman with Ehler-Danlos syndrome (EDS) type 2. She had a previous caesarean section and went on to have an uncomplicated vaginal birth in her last pregnancy. To our knowledge, this is the first case of a successful vaginal birth after caesarean section in a patient with EDS. EDS is a multisystem disorder involving a genetic defect in collagen and connective-tissue synthesis and structure. It is a heterogeneous group of 11 different inherited disorders. Obstetric complications in these patients include miscarriages, stillbirths, premature rupture of the membranes, preterm labour, uterine prolapse, uterine rupture and severe postpartum haemorrhage. There has been much controversy over the appropriate mode of delivery. Abdominal deliveries are complicated by delayed wound healing and increased perioperative blood loss. Vaginal deliveries may be complicated by tissue friability causing extensive perineal tears, pelvic floor and bladder lesions. Our case highlights that in specific, controlled situations it is possible to have a vaginal delivery even after previous caesarean section in patients with EDS.

scholarly journals Vaginal birth after caesarean section: why and how?

2017 ◽  
Vol 6 (12) ◽  
pp. 5554
Author(s):  
Vidyadhar B. Bangal ◽  
Satyajit Gavhane ◽  
Vishesha Yadav ◽  
Kunal Aher ◽  
Dhruval Bhavsar
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Section Rate ◽  
Mode Of Delivery ◽  
Vaginal Birth ◽  
Maternal Complications ◽  
History Of ◽  
Spontaneous Onset ◽  
Vaginal Birth After Caesarean

Background: With the significant rise in the incidence of primary caesarean section(CS) for various indications, an increasing proportion of the pregnant women coming for antenatal care, report with a history of a previous CS. This necessitates definite need to bring down the caesarean section rate, either by judicious selection of cases for primary caesarean section or by attempting vaginal delivery, following previous caesarean section (VBAC).Methods: A prospective observational study was conducted to find out the success of VBAC and the common predictive factors leading to successful VBAC. A total of 136 pregnant women with full term pregnancy, having history of previous one lower segment caesarean section and without any other medical and obstetrical complication were enrolled in the study.Results: Majority of the women (95.59%) had spontaneous onset of labor. The success of VBAC was 75 percent. The commonest maternal complications were fever (7.35%), scar dehiscence (3.68%), PPH (1.47%) and wound infection (2.21%).There was significantly higher number of women who had history of previous successful VBAC, had vaginal delivery (91.67%; p=0.038).It was observed that the rate of vaginal delivery was significantly high in women with Bishop’s score between 10 to 13 (94.64%) compared to 6 to 9 (61.25%) (p<0.001).The baby weight determined by ultrasound scan was significantly associated with mode of delivery (p=0.049).Conclusions: Vaginal Birth After Caesarean section is relatively safe, provided it is conducted in carefully selected cases, under constant supervision. Spontaneous onset of labour, good Bishops score and average baby weight were good predictors of successful VBAC.

scholarly journals The Outcome of Vaginal Birth After Caesarean Section (VBAC): A Descriptive Study

2013 ◽  
Vol 25 (1) ◽  
pp. 14-17
Author(s):  
R Rahman ◽  
NN Khanam ◽  
N Islam ◽  
KF Begum ◽  
HH Pervin ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Vaginal Birth ◽  
Care Hospital ◽  
Lower Segment Cesarean Section ◽  
Medicine Today ◽  
Vaginal Birth After Caesarean

The study, conducted in the tertiary care hospital of Dhaka Bangladesh, describes the outcome of vaginal birth after caesarean section (VBAC) in women with a previous caesarean. A prospective study was carried out from 1st January 2007 to 31st December, 2007 on 126 women with one prior lower segment cesarean section (LSCS) for a nonrecurrent cause. All unbooked women and those with estimated fetal weight more than 3.5 kg, breech presentation, history of postoperative wound infection after previous LSCS, anemia (Hb < 10 gm%), pregnancy induced hypertension, diabetes, heart disease, renal disease, cephalopevic disproportion abnormal presentation and placenta praevia were excluded from the study. An informed consent was taken for allowing a trial of vaginal delivery. Spontaneous onset of labor was awaited up to 41 weeks. Induction of labor was considered only in highly selected cases. Labor was constantly supervised by competent staff and meticulously monitored by cardiotocography (CTG). Out of the 126 women enrolled for the study, 26 had to leave the station leaving a total of 100 patients; 72 patients underwent elective repeat C/S, 28 patients (28%) of these underwent trial of labour, among them 15 had successful vaginal delivery (53.57) but 13 patients failed the attempt and had to undergo emergency caesarean section. To assist in the 2nd stage of labour, 6 had ventouse application. In total 85 cases needed repeat caesarean section. Among the cases there was one case of scar dehiscence (6.6%), one case of cervical tear (6.6%), two cases of manual removal of placenta (13.3%), one case of post partum hemorrhage (6.6) and one case of puerperal pyrexia (6.6).Perinatal morbidity was comparable with the elective repeat C/S group. VBAC should be considered in cases of previous one cesarean delivery for nonrecurrent indication. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.15902 Medicine Today 2013 Vol.25(1): 14-17

scholarly journals Vaginal birth after previous caesarean section in women at Al-Wahda hospital Derna, Libya

2021 ◽  
Vol 10 (12) ◽  
pp. 4337
Author(s):  
Soad Ajroud ◽  
Raga A. Elzahaf ◽  
Fawzia A. G. Arhaiam
Keyword(s):  
Decision Making ◽  
Caesarean Section ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Vaginal Birth ◽  
Previous Caesarean Section ◽  
Trial Of Labor ◽  
High Chance ◽  
Vaginal Birth After Caesarean

Background: Vaginal birth after caesarean section is one strategy that has been developed to decrease the rate of caesarean section.Methods: The prospective observational study was carried out over a period of 01 January 2017 to 31 December 2018 years. VBAC was routinely offered at Al-Wahda hospital Derna to women fulfilling the criteria for trial of scar, according to the hospital protocol.Results: A total of 5018 deliveries took place in the study duration, there were 1039 (20.7%) had previous one caesarean section, out of which 319 (30.7%) were the number of underwent repeat caesarean section and 720 (69.3%) were the number of VBAC. The indications for emergency repeat caesarean section at Al-Wahda hospital was (29.3%) malpresentation, (24.45%) FD, (13.47) postdate, (11.59) obstracted lab and abruptiopl (5.95%). Anemia and difficult intubation were observed in repeated caesarean section.Conclusions: This study concluded that there is a high chance of success in a trial of labor. These findings might help clinicians and women in the decision-making for the mode of delivery when it comes to pregnancy with a previous caesarean section. Women are explained about the option of trial of scar and told about the risk associated with a repeat CS, so many CSs can be avoided.  

scholarly journals Maternal and neonatal outcome in pregnancy with previous lower segment caesarean section undergoing trial of scar

2021 ◽  
Vol 10 (9) ◽  
pp. 3434
Author(s):  
Monika Dalal ◽  
Smiti Nanda ◽  
Jagjit S. Dalal ◽  
Samiksha Kaushik ◽  
Meenakshi Chauhan ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
P Value ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Emergency Caesarean ◽  
Vaginal Birth After Caesarean

Background: Women with previous LSCS often have to make a decision about mode of delivery of their second baby. As the rate of caesarean section is continuously increasing, vaginal birth after caesarean section (VBAC) is a good strategy to decrease caesarean rate. The present study was planned to assess the fetomaternal outcome in pregnancies with previous lower segment caesarean section undergoing trial of scar and to identify the factors, which can influence the outcome of trial of scar.Methods: This was a prospective observational study on 100 patients at a tertiary care institute. Pregnant women with previous LSCS were selected randomly for the study on the basis of the inclusion and exclusion criteria. Each labor monitored closely using a partogram. Decision for repeat emergency caesarean was taken by consultant. All women included in the study were followed through delivery and till discharge.Results: Out of 100 pregnant women 49 % cases had successful VBAC, 50% had emergency caesarean and one patient had laparotomy for rupture uterus. In women, who also had a prior vaginal delivery, 72% delivered vaginally, as compared to 40% of the women who did not undergo prior vaginal delivery (p value=0.003). Women who were in spontaneous labor, 59.21% delivered vaginally, whereas women who were induced, 16.6% delivered vaginally. The rate of perinatal complication was more in the patients who required an emergency CS after a failed trial. Conclusions: Our findings may encourage obstetricians to encourage VBAC in the properly screened ANC patients and decrease the rate of recommending caesarean section.

Maternal and neonatal outcome in pregnancy bbeyond 41 Weeks of Gestation: Observational study

2021 ◽  
Vol 8 (2) ◽  
pp. 53-57
Author(s):  
Dr. Asmita Misal ◽  
Dr. Urmila Gavali ◽  
Dr. Gautam S. Aher
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Labour Induction ◽  
Care Hospital ◽  
Perinatal Complications ◽  
Perineal Tear ◽  
Meconium Stained Amniotic Fluid

Background: Pregnancy beyond term is associated with adverse maternal and perinatal outcome. The aim of the study the maternal and perinatal outcome in pregnancies at and beyond 41 week of gestation. Methods: This is a prospective study of 140 patients with pregnancy beyond 41 weeks fulfilling the eligibility criteria and admitted and delivered in department of obstetrics and gynaecology at a tertiary care hospital. We examined its association with following outcomes: age, parity, genetic factors, bishop’s score at admission, mode of delivery, induction rate, meconium stained amniotic fluid, oligohydramnios, Perinatal and neonatal morbidity, Perineal tear, postpartum haemorrhage, maternal morbidity and mortality etc. Results: Out of 140 patients, majority in the age group of 21-25 years, 68 (48.6%) patients were primigravida while 72 (51.4%) patients were multigravida. Maximum patients 65% were not in labour whereas 35% were in labour. In 51 (36.4%) patients mode of delivery was caesarean section, in which most common indication being foetal distress in 25.5% followed by meconium stained amniotic fluid in 17.6%. In present study perinatal morbidity like stillbirth, RDS were 2.86% & 25.8% respectively. Maternal morbidity like PPH, tear and wound infection were 4.31%, 6.4%, 0.7%respectively. Conclusions: With Regular antenatal check-up, incidence of post term pregnancy can be decreased and Labour induction should be considered at 41weeks to prevent lot of maternal and perinatal complications.

MATERNOFETAL OUTCOME IN MECONIUM STAINED LIQUOR AT TERTIARY CARE HOSPITAL

2021 ◽  
pp. 48-50
Author(s):  
Neha Agarwal ◽  
Samta Bali Rathore ◽  
Shivani Baberwal-
Keyword(s):  
Caesarean Section ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Meconium Aspiration ◽  
Induced Hypertension

BACKGROUND: Occurance of meconium-stained amniotic uid (MSAF) during labour may be considered as a measure for prediction of poor fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia ,resulting in perinatal as well as neonatal morbidity and mortality. It constitutes about 5% of deliveries with meconium stained amniotic uid and death results in about 12% of infants with MAS. METHODS: 40 cases of meconium stained liquor detected after spontaneous or artical rupture of membranes taken during labour from june 2020 to december 2020 and their outcome in terms of mode of delivery(whether vaginal delivery or lower segment caesarean section) and fetal outcome and associated maternal high risk were studied RESULT: Anemia was co existant in around 15%, pregnancy induced hypertension(PIH) in 25%and premature rupture of membrane in 10%.Pregnancies complicated with Pregnancy induced hypertension had signicant higher rate of meconium stained liquor among all cases. Caesarean Section was commonly performed in meconium stained amniotic uid cases and accounted for about 65%of all cases. CONCLUSIONS: Meconium Stained amniotic uid increases the chances of caesarean rates,leading to birth asphyxia ,Meconium Aspiration Syndrome and hence increases the chances of neonatal intensive unit admission.

scholarly journals MODE OF DELIVERY AND ITS IMPACT ON NEONATAL OUTCOMES IN PRETERM INFANTS

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e27-e27
Author(s):  
Sarah McKnight ◽  
Bishal Gautam ◽  
Michael Miller ◽  
Bryan S Richardson ◽  
Orlando da Silva
Keyword(s):  
Caesarean Section ◽  
Preterm Infants ◽  
Periventricular Leukomalacia ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Outcomes ◽  
Care Hospital ◽  
Significant Difference

Abstract BACKGROUND The optimal mode of delivery for preterm infants remains controversial, and routine Caesarean sections (C/S) are not recommended, except for maternal indications. Nonetheless, many preterm infants are delivered by C/S, particularly those in breech presentation, and recent retrospective data have suggested that these infants may have improved outcomes. OBJECTIVES To examine whether C/S as the mode of preterm delivery is associated with decreased mortality and improved short term outcomes. DESIGN/METHODS This retrospective, population-based cohort study examined infants with a gestational age between 23 0/7 weeks and 32 6/7 weeks, born between January 1, 2007 and December 31, 2016, and admitted to the Neonatal Intensive Care Unit at a single Canadian Tertiary Care hospital. Infants with major congenital anomalies were excluded. Data were abstracted from the local Neonatal-Perinatal database for all infants. Two groups, those delivered vaginally and those delivered by C/S, were compared for major neonatal outcomes including the primary outcomes of death and severe intraventricular hemorrhage (IVH), defined as grade 3 or higher. RESULTS A total of 1442 infants met inclusion criteria (784 born by C/S and 658 vaginally). There was no significant difference in neonatal mortality (7.0% vs 7.1%, p=0.925) or severe IVH (6.1% vs 7.4%, p=0.317). There was, however, a significant difference in the incidence of IVH, any grade (19.9% vs 27.5%, p=0.001), which remained after controlling for other significant predictors. There were no other significant differences in the secondary outcomes examined including need for extensive resuscitation, respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, periventricular leukomalacia, or retinopathy of prematurity. CONCLUSION Caesarean section was not associated with decreased mortality in preterm infants, relative to vaginal births. Caesarean section was associated with a reduced rate of IVH (any grade) and there was a trend towards decreased severe IVH which may warrant further study.

scholarly journals On demand caesarean section: What’s women’s attitude?

1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
University Teaching ◽  
Normal Vaginal Delivery ◽  
On Demand ◽  
Assisted Delivery ◽  
The Right

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15

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