Fetomaternal Outcome in Operative Vaginal Deliveries in a Tertiary Care Centre: A Descriptive Retrospective Study

2020 ◽  
Vol 3 (2) ◽  
pp. 23-27
Author(s):  
Rakshya Joshi ◽  
Sabita Shrestha ◽  
Jully Chaudhary ◽  
Upendra Pandit ◽  
Renuka Tamrakar
Keyword(s):  
Retrospective Study ◽  
Vaginal Delivery ◽  
Care Center ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Tertiary Care Centre ◽  
Fourth Degree ◽  
Operative Vaginal Delivery ◽  
Nulliparous Women ◽  
Vaginal Deliveries

Background: Operative vaginal delivery is safe and effctive when applied by well-trained personnel. However, it is an underutilized component of obstetric care. We aimed to estimate the frequency of operative vaginal delivery in a tertiary care center and evaluate the immediate maternal and fetal morbidities. Methods: This descriptive retrospective study was carried out in the Department of Obstetrics and Gynecology, Chitwan Medical College and Teaching Hospital. Medical records of all operative vaginal deliveries conducted from May 2019 to April 2020 were retrieved. Data regarding demography, delivery characteristics, maternal and fetal morbidity and mortality associated with operative vaginal deliveries were collected. Results: The frequency of operative vaginal delivery was found to be 2.3% among 3060 deliveries. It was more commonly used in nulliparous women (n = 54, 76.1%); the commonest age group being 20 to 35 years. The commonest indication was fetal distress (n = 32, 45.1%) followed by prolonged second stage of labor (n = 26, 36.6%). The associated maternal morbidities included postpartum hemorrhage (n = 12, 16.9%), need of blood transfusion (n = 9, 12.7%), fever (n = 6, 8.5%), cervical tear (n = 3, 4.2%) and third/fourth degree perineal tears (n = 3, 4.2%). One neonate had cephalhematoma and 14 neonates (19.7%) needed admission in neonatal intensive care unit. Conclusion: Operative vaginal delivery accounted for 2.3% of the total deliveries and was associated with a few maternal and fetal morbidities.

scholarly journals Risk factors for post-partum hemorrhage in patients who underwent operative vaginal delivery in a tertiary care center

2021 ◽  
Author(s):  
Gayatri Devi Sivasambu ◽  
Sujani B. Kempaiah ◽  
Urvashi Thukral
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Tertiary Care ◽  
Significant Risk ◽  
Post Partum Hemorrhage ◽  
Second Stage ◽  
Operative Vaginal Delivery ◽  
Vaginal Deliveries

Background: Operative vaginal delivery is a timely intervention to cut short second stage labor when imminent delivery is in the interests of mother, fetus, or both. It reduces second stage cesarean section morbidity and uterine scar and its influence on future obstetric career. The possible structural neonatal adverse outcomes due to operative vaginal delivery are well quantified. However, its effects on maternal outcome need to be understood better. In this paper, we study the effect of operative vaginal delivery on maternal post-partum hemorrhage (PPH) and the associated risk factors.Methods: It was a retrospective study carried out for the period July 2016 to July 2020 at Ramaiah Medical College, Bengaluru. Total number of vaginal deliveries in this period were 6318. Out of these, 1020 patients underwent assisted vaginal delivery using vacuum/ forceps/ sequential use of instrument. Blood loss greater than 500 ml is considered PPH for the purpose of this study. 15% of the study population was noted to have PPH. We employ a multivariate logistic regression to identify statistically significant risk factors for PPH in women undergoing operative vaginal delivery.Results: The logistic regression model identifies multiparity, maternal age, neonatal birth weight more than 3.5 kg, application of forceps in women with hypertensive disorders, III-degree tear, cervical tear to significantly increase the risk of PPH in our study population.Conclusions: Certain factors seem to increase the risk of PPH in operative vaginal delivery. The risks and benefits must be weighed properly before use of instruments.

A STUDY OF FETOMATERNAL OUTCOME OF INSTRUMENTAL VAGINAL DELIVERIES AT A RURAL TERTIARY CARE HOSPITAL IN MANDYA DISTRICT KARNATAKA

2021 ◽  
pp. 1-3
Author(s):  
Triza Kumar Lakshman ◽  
Ekta Chhabra ◽  
Ravindra S. Pukale
Keyword(s):  
Vaginal Delivery ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Care Hospital ◽  
Maternal Complications ◽  
Perineal Tear ◽  
Operative Vaginal Delivery ◽  
Vaginal Deliveries ◽  
Skilled Operator ◽  
Assisted Delivery

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

scholarly journals Outcome of Assisted Vaginal Deliveries in a Tertiary Care Centre in Bengaluru

2021 ◽  
Vol 10 (40) ◽  
pp. 3538-3542
Author(s):  
Sivasambu Gayatri ◽  
Sujani B. K. ◽  
Urvashi Urvashi ◽  
Priyanka Sinha
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Assisted Vaginal Delivery ◽  
Safe Delivery ◽  
Vaginal Deliveries

BACKGROUND The lower segment caesarean section (LSCS) audit shows an increase in caesarean section rates worldwide. Assisted vaginal delivery and, if needed, emergency caesarean section are options available to the obstetrician to handle challenges in the second stage when spontaneous and safe delivery is not imminent. Judicious use of the instrument as well as continuing medical education in the art of assisted vaginal delivery is a must to achieve the twin goal of containing the surging caesarean section rate as well as bring about a successful and safe assisted vaginal delivery. The objective of this study was to quantify the various morbidities associated with assisted vaginal deliveries among patients in a tertiary care teaching hospital in Bengaluru. METHODS It is a retrospective study carried for four years between July 2016 and June 2020 at Ramaiah Medical College at Bengaluru. The total number of vaginal deliveries was 6318 out of which 1020 had a successful assisted vaginal delivery and were studied in terms of outcomes, maternal and foetal indications and morbidity. RESULTS Out of 1020 assisted vaginal deliveries, 86.96 % were vacuum-assisted, 3.9 % were forceps assisted and 9.11 % were both vacuum and forceps assisted. The success rate of forceps deliveries was more compared to vacuum. No significant maternal and neonatal mortality and morbidity were observed in our study. CONCLUSIONS In this study, vacuum was the most used method of assisted vaginal delivery and was safer for mothers and babies. It is also easier to teach and learn. Forceps delivery was more used in preterm delivery. KEY WORDS Assisted Vaginal Delivery, Vacuum, Forceps, Sequential use of Instruments, Maternal and Neonatal Morbidity.

scholarly journals Detection and Enumeration of the Commonest Stool Parasites Seen in a Tertiary Care Center in South India

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Vani Chandrashekar
Keyword(s):  
Entamoeba Histolytica ◽  
South India ◽  
Care Center ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Center ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Stool Samples

The aim of this study was to identify common stool parasites in patients attending a tertiary care centre in South India. We evaluated 2355 stool samples and parasites were detected in 7.9% of samples. 41.1% of our patients were in the 45–58-year age group. Protozoal infections were the commonest seen in 7.8% of samples. Entamoeba histolytica was the commonest protozoa (4.6%) followed by Entamoeba coli (1.2%) and Giardia (0.8%). Entamoeba histolytica and Entamoeba coli were together seen in 0.63%, and they were the commonest organisms seen in samples with multiple-organism infection. Both were equally detected in diarrheal samples.

ANALYSIS AND INTERPRETATION OF SPIROMETRY OF PATIENTS ATTENDING RESPIRATORY MEDICINE OPD IN A TERTIARY CARE CENTER: A RETROSPECTIVE STUDY

2021 ◽  
pp. 39-41
Author(s):  
Vidhi Jobanputra ◽  
Hafiz Deshmukh ◽  
Ashish Deshmukh ◽  
Sunil Jadhav ◽  
Shivprasad Kasat ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bronchial Asthma ◽  
Lung Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
Respiratory Medicine ◽  
Smoking History ◽  
Tertiary Care Center ◽  
Operative Evaluation ◽  
History Of

OBJECTIVE: To study the various spirometry ndings and look for its association with smoking history and use of biomass fuels. METHODS: Spirometry ndings of 375 patients who attend Respiratory medicine OPD from year 2017- 2019 were studied. RESULTS: Out of 375 patients, 95 patients were diagnosed as COPD, 62 as bronchial asthma, 149 had normal spirometry and 69 had restriction. CONCLUSION: In this study we concluded that spirometry plays an intergral role in the diagnosis of bronchial asthma, COPD and restrictive lung diseases. It gives an overview of the decline of lung function with increasing age, smokers, occupational lung exposures, family history of bronchial asthma. Restrictive patterns were most commonly seen in patients who came for pre operative evaluation.

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