scholarly journals Changing Trend of Instrumental Vaginal Deliveries at Patan Hospital

2016 ◽  
Vol 10 (2) ◽  
pp. 33-35
Author(s):  
B Lamichhane ◽  
A Singh
Keyword(s):  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Forceps Delivery ◽  
Normal Delivery ◽  
Progressive Decline ◽  
Vaginal Deliveries ◽  
Increasing Trend ◽  
Vacuum Delivery ◽  
Changing Trend ◽  
The Mean

Aims: The aim of the study was to evaluate the changing trend of the instrumental vaginal deliveries at Patan hospital over the last 10 years.Methods: This was a retrospective study done at Patan hospital. The study included data of 10 years duration (July 15th, 2004 – July 14th, 2014). The data included total normal delivery, caesarean section, vacuum delivery, forceps delivery and total delivery of the respective years.Results: Out of 80,149 deliveries over 10 years, 1635 (2.03%) were instrumental vaginal delivery (IVD). The study revealed progressive decline in overall trend of instrumental vaginal delivery.  The highest percentage of IVD in the year 2005 was 265 (16.02%) and tangential dropped to 49 (2.9%) by 2014.  The study revealed markedly decreased trend in vacuum delivery from 2005 to 2010, but a positive deflection was noticed till 2013, and abrupt fall in the year 2014.Regarding forceps delivery, a gradual fall in trend was noticed over the years. Over the last 10 years the mean percentile value of vacuum delivery was 78.47% while that of forceps was 21.52 %.Conclusions: The trend of instrumental vaginal delivery has markedly declined. On the other hand, it has shown increasing trend in caesarean delivery.

scholarly journals Outcome of Instrumental Vaginal Delivery at Patan Hospital

2018 ◽  
Vol 13 (3) ◽  
pp. 10-12
Author(s):  
Basant Lamichhane
Keyword(s):  
Vaginal Delivery ◽  
Apgar Score ◽  
Post Partum ◽  
Forceps Delivery ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Vaginal Deliveries ◽  
Vacuum Delivery ◽  
The Mean ◽  
Minute Apgar Score

Aim: To estimate the severity of neonatal and maternal morbidity associated with instrumental vaginal delivery (IVD). Methods: Record based cross-sectional retrospective study of 80 instrumental vaginal deliveries during two years from 2013 to 2015 were performed. Variables studied were neonatal and maternal complications. Results: Out of 80 IVD, 19(23.8%) were forceps deliveries and 61(76.2%) were vacuum deliveries. The mean one minute Apgar score was 6 and 7 for forceps and vacuum delivery respectively. The five minute Apgar score for the both IVD was 8. Regarding maternal complications 7(8.75%) cases had extended episiotomy with deep vaginal tears. In forceps delivery 5 had deep vaginal tear and one each for primary post-partum hemorrhage and urinary retention but among the vacuum deliveries two had deep vaginal tear only. Regarding neonatal complications, one had subgaleal bleed in forceps delivery and one had cephalhematoma with Erbs palsy in vacuum delivery. Conclusions: The neonatal and maternal complications between both types of IVD were comparable. Forceps and repeated vacuum application resulted in low one minute Apgar score; and extended episiotomy and deep vaginal tear were associated with use of forceps.

scholarly journals Frequency of Caesarean Delivery on maternal request in a private teaching hospital

2020 ◽  
Vol 24 (2) ◽  
pp. 139-143
Author(s):  
Fozia Umber Quraishi ◽  
Saima Jabeen ◽  
Wajiha Alvi
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Teaching Hospital ◽  
Caesarean Delivery ◽  
Caesarean Section Rate ◽  
Normal Vaginal Delivery ◽  
Maternal Request ◽  
Normal Delivery ◽  
Vaginal Deliveries ◽  
Private Teaching

Introduction: Caesarean section rates are increasing worldwide. There are many reasons for this increasing caesarean section rate one of them is increasing requests by women for caesarean section in the absence of medical indications. Most women think that elective caesarean section is safe both for women and babies. Some clinician also considered caesarean section safe. An increasing rate of caesarean section is alarming in developed as well as underdeveloped countries. Objective: To investigate the frequency of caesarean section on maternal request and factors leading to it in a private teaching hospital. Materials and Methods: This was a cross-sectional descriptive study carried out at Shalamar hospital from 1st May 2018 to 30th April 2019. Women of all ages who were pregnant and were going to have caesarean delivery during the study period at Shalamar hospital. Results: There were 3438 total births during the study period. There were 2380(69%) caesarean section and 1058(31%) were normal vaginal deliveries. Caesarean section rate was 69%. Caesarean sections performed on maternal request were 167(7%) out of 2380 caesarean. Out of these 167 Seventy-two, 43.1% of women were those who already have a previous caesarean section for different non-recurrent indications and now they don’t want the trial of labour and requested for caesarean section. Forty, 24% of women requested for a caesarean section because of fear of labour pains and eighteen, 10.8% were those who had a bad experience of the previous child-birth. Twelve, 7.2% of women had fear of failed vaginal delivery and eight women had fear of trauma to baby and three, 1.8% had fear of perineal trauma during the trial of normal vaginal delivery. Six, 3.6% of women had some social reasons for caesarean section and six, 3.6% had some bad experience of normal delivery of their relatives or friends and two, 1.2% were those who were requesting caesarean section because of their family members preferences. Conclusion: Most of the women requesting for caesarean section were those who had previously trial of labour. We can control the caesarean section rate by proper counselling of pregnant women.

scholarly journals A prospective study on effectiveness of drotaverine in acceleration of labor

2019 ◽  
Vol 2 (3) ◽  
pp. 137-141
Author(s):  
Padma Raj Dhungana ◽  
Rajesh Adhikari ◽  
Prem Raj Pageni ◽  
Apsara Koirala ◽  
Anand Nepal
Keyword(s):  
Prospective Study ◽  
Drug Administration ◽  
Active Phase ◽  
Delivery Mode ◽  
Normal Delivery ◽  
Group I ◽  
Vacuum Delivery ◽  
Drotaverine Hydrochloride ◽  
The Mean ◽  
Group Ii

Background: Labor is a naturally occurring physiological process associated with uterine contractions, effacement, dilatation of cervix and descent of presenting part. Drotaverine hydrochloride is a non-anticholinergic isoquinoline derivative which acts by elevating intracellular cyclic Adenosine Mono Phosphate (cAMP) and cyclic Guanosine Mono Phosphate (cGMP) promoting smooth muscle relaxation. Materials and Method: This was a hospital based prospective study on effectiveness of Drotaverine Hydrochloride on enhancing dilatation of cervix and acceleration of active phase of labor. The sample size was 100. Fifty cases of women in active phase of labor received injection drotaverine hydrochloride 40 mg (group i) and fifty cases of women did not receive any drug (group ii) among those at term with singleton pregnancy and vertex presentation. Variables like maternal age, interval between administration of drug and delivery, mode of delivery, apgar score at 5 minutes, NCU (Neonatal Care Unit) admission and neonatal outcomes were recorded. Data analysis was done with the help of SPSS program. Results: The mean interval between drug administration to delivery in primipara and multipara in group i was 3.05 hours and 2.31 hours while in group ii was 4.5 hours and 3.75 hours respectively. The mean interval between drug administration and delivery was shorter in both groups of multipara. In group i, 96% had normal delivery and 4 % had vacuum delivery and in group ii 90% and 10% had normal delivery and vacuum delivery respectively. None of the participants had caeserian section. There were no perinatal mortalities. Conclusion: The administration of drug Drotaverine Hydrochloride is effective in shortening duration of labor with favorable feto-maternal outcome.  

A STUDY OF POSTPARTUM INTRAUTERINE CONTRACEPTIVE DEVICE INSERTIONS IN CAESAREAN SECTIONS AND FOLLOWING VAGINAL DELIVERIES

2021 ◽  
pp. 1-3
Author(s):  
Shweta Pathak ◽  
Manaswita Samanta ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Clinical Outcomes ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Contraceptive Device ◽  
Obstetrics And Gynaecology ◽  
Vaginal Deliveries ◽  
Intrauterine Contraceptive

Aim: To study clinical outcomes of immediate postpartum IUCD insertion and to compare immediate postpartum IUCD insertion as a factor of route of insertion (caesarean vs. vaginal). Material and methods: This prospective study was conducted in a Department of Obstetrics and Gynaecology, College of medicine and JNM Hospital, Kalyani, Nadia. Duration of the study was one and half years [ 15 months inclusion, 3 months follow up]. Total 100 cases are included [50 vaginal and 50 caesarean]. Women who were attending or referred to OPD or ER of Dept. of Obst and Gynae, College of medicine and JNM Hospital and delivering either vaginally or by caesarean section, have received counseling for postoperative contraception and have consented to PPIUCD insertion Result:It was found that in Caesarean, 26(52.0%) patients had bleeding P/V 6 weeks. In Vaiginal, 28(56.0%) patients had bleeding P/V 6 weeks. Association of bleeding P/V 6 weeks vs. group was not statistically signicant (p=0.61968). In Caesarean, 11(22.0%) patients had bleeding P/V 3 weeks. In Vaiginal, 13(26.0%) patients had bleeding P/V 3 weeks. Association of bleeding P/V 3 weeks vs. group was not statistically signicant (p=0.6395). Conclusion:Infection was not statistically signicant in two groups at 6 week and 3 month.Missing thread was signicantly higher caesarean delivery compared to vaginal delivery.It was also found that refusal/ continuation was more common in vaginal delivery compared to caesarean delivery, which was not statistically signicant.

scholarly journals Temporal trends in severe maternal and neonatal trauma during childbirth: a population-based observational study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020578 ◽  
Author(s):  
Qi Wen ◽  
Giulia M Muraca ◽  
Joseph Ting ◽  
Sarah Coad ◽  
Kenneth I Lim ◽  
...  
Keyword(s):  
Observational Study ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Temporal Trends ◽  
Birth Trauma ◽  
Forceps Delivery ◽  
Fourth Degree ◽  
Spontaneous Vaginal Delivery ◽  
Live Births ◽  
Obstetric Trauma

ObjectiveInstrumental vaginal delivery is associated with birth trauma to infant and obstetric trauma to mother. As caesarean delivery rates increased during the past decades, the rate of instrumental vaginal delivery declined. We examined concomitant temporal changes in the rates of severe birth trauma and maternal obstetric trauma.DesignA retrospective observational study.Settings and participantsAll hospital singleton live births in Washington State, USA, 2004–2013, excluding breech delivery. Severe birth trauma (brain, nerve injury, fractures and other severe birth trauma) and obstetric trauma (third/fourth degree perineal lacerations, cervical/high vaginal lacerations) were identified from hospitalisation data. Pregnancy and delivery characteristics were obtained from birth certificates. Temporal trends were assessed by the Cochran-Armitage test. Logistic regression was used to obtain adjusted ORs (AORs) and 95% CI.ResultsOverall, 732 818 live births were included. The rate of severe birth trauma declined from 5.3 in 2004 to 4.5 per 1000 live births in 2013 (P<0.001). The decline was observed only in spontaneous vaginal delivery, the rates of fractures and other severe birth trauma declined by 5% and 4% per year, respectively (AOR: 0.95, 95% CI 0.94 to 0.97 and AOR: 0.96, 95% CI 0.93 to 0.99; respectively). The rate of third/fourth degree lacerations declined in spontaneous vaginal delivery from 3.5% to 2.3% (AOR: 0.95; 95% CI 0.94 to 0.95) and in vacuum delivery from 17.3% to 14.5% (AOR: 0.97, 95% CI 0.96 to 0.98). Among women with forceps delivery, these rates declined from 29.8% to 23.4% (AOR: 0.98, 95% CI 0.96 to 1.00).ConclusionWhile the rates of fractures and other birth trauma declined among infants delivered by spontaneous vaginal delivery, the rate of birth trauma remained unchanged in instrumental vaginal delivery and caesarean delivery. Among mothers, the rates of severe perineal lacerations declined, except for women with forceps delivery.

scholarly journals The impact of delivery mode on the risk of neonatal intracranial haemorrhage

2019 ◽  
Vol 53 (3) ◽  
Author(s):  
Nika Buh ◽  
Miha Lučovnik
Keyword(s):  
Vaginal Delivery ◽  
Intracranial Haemorrhage ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
Vacuum Extraction ◽  
Delivery Mode ◽  
Spontaneous Vaginal Delivery ◽  
Emergency Caesarean ◽  
Vaginal Deliveries ◽  
The Impact

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.

scholarly journals The Incidence of Anal Sphincter Ruptures and Risk Factors

2016 ◽  
pp. 31-36
Author(s):  
Budi I Santoso ◽  
Denny Khusen
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Gestational Age ◽  
Univariate Analysis ◽  
Forceps Delivery ◽  
Fourth Degree ◽  
Control Subjects ◽  
Vaginal Deliveries

Objective: To analyze the incidence of anal sphincter ruptures and to evaluate risk factors of obstetric anal sphincter ruptures in Dr. Cipto Mangunkusumo Hospital. Method: We reviewed 2009 vaginal deliveries based on the analysis of obstetric data base and patient records of our department during 2012. Cases and control subjects were chosen randomly and patient’s records were reviewed for the following variable: maternal age, parity, gestational age, labor induction, duration of 2nd stage labor, use of forceps, use of vacuum, use of episiotomy, birth weight, and presentation of the baby. Result: There were 91 (4.53%) anal sphincter ruptures during period of study (91 of 2009 patients). An univariate analysis of these 91 case and 91 randomly selected control subjects show that primiparity (p = .000), gestational age (p = .016), duration of second-stage labor (p = .000), forceps delivery (p = .000), vacuum delivery (p = .001), episiotomy (p = .000), and birth weight (p = .000) increased the risk for anal sphincter ruptures. In multivariate re-gression models, only 5 of the 10 predictor variables were significantly related to the likelihood of having a severe perineal trauma greater than second degree. Primiparity (p = .023; OR 2.74, 95% [CI], 1.15-6.51), forceps delivery (p = .000; OR 18.18, 95% [CI] 3.84-86.07), vacuum delivery (p = .005; OR 6.83, 95% [CI] 1.77-26.42), episiotomy (p = .015; OR 2.86, 95% [CI] 1.23-6.65), and birth weight (p = .000; OR 0.99, 95% [CI] 0.997-0.999). Conclusion: Damage of the anal sphincter resulting in a third- or fourth- degree perineal tear is a relatively rare but severe complication of vaginal delivery. We found that factors as sociated with anal sphincter ruptures were primiparity, forceps, vacuum, episiotomy and birth weight. [Indones J Obstet Gynecol 2016; 1: 31-36] Keywords: anal sphincter ruptures, third- or fourth- degree perineal tear, vaginal delivery

scholarly journals Obstetrical outcome in post caesarean pregnancy

2018 ◽  
Vol 7 (11) ◽  
pp. 4561
Author(s):  
Anitha Aldur Manjappa ◽  
Soundara Raghavan Subrahmanian
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Clinical Situation ◽  
Labour Induction ◽  
Previous Caesarean Section ◽  
Success Rates ◽  
Vaginal Deliveries ◽  
History Of ◽  
Obstetrical Outcome

Background: Rates of caesarean delivery have increased over past 40 years. The increase has been attributed to liberalization of indications for caesarean sections. Repeat caesarean section is a major contributor to caesarean rates; Vaginal Birth After Caesarean (VBAC) is one of the methods to contain increasing caesarean rates. Success rates of 60-80% have been reported.Methods: This was a descriptive study involving 1000 pregnancies of period of gestation more than 28 weeks with history of one previous caesarean section. The women under study were subjected to either trial vaginal delivery or elective repeat caesarean delivery depending upon the clinical situation. The percentage of successful vaginal deliveries, factors responsible for failure of vaginal delivery and differences in outcome between successful vaginal delivery and caesarean delivery group were analyzed.Results: Out of the 1000 women, 423 underwent elective repeat caesarean delivery, of the remaining 577, 403 (69.8%) had successful vaginal delivery. Age of the woman and onset of labour were the only factors influencing the success of vaginal delivery. Women aged 35 years or more and women who needed labour induction had lower success of vaginal delivery. Maternal and perinatal outcome were worse in failed vaginal delivery group when compared to elective repeat caesarean delivery or successful vaginal delivery groups.Conclusions: Factors which are usually thought to influence the decision about trial vaginal delivery like prior vaginal delivery, indication for previous caesarean section and interpregnancy interval are not absolute in determining the decision or the outcome. Labour induction should be resorted with great caution in women with post caesarean pregnancy.

scholarly journals Maternal Mortality in Eclampsia after Cesarean Section versus Vaginal Delivery

2018 ◽  
Vol 23 (4) ◽  
pp. 430-434
Author(s):  
Ghazala Saeed ◽  
Rabia Wajid ◽  
Ayesha Yousaf Dar
Keyword(s):  
Cesarean Section ◽  
Maternal Mortality ◽  
Vaginal Delivery ◽  
Case Series ◽  
Cesarean Deliveries ◽  
Vaginal Deliveries ◽  
Fetal Complications ◽  
Section Versus ◽  
The Mean ◽  
Clonic Convulsions

Preeclampsia with generalized tonic-clonic convulsions is termed as eclampsia. Eclampsia isassociated with multiple maternal and fetal complications.  Eclampsiais an obstetric emergency and quick decision making is required to save lives. The objective of the study was to compare the maternal mortalityafter cesarean section versus vaginal delivery among eclampsiapatients. It is a descriptive case series conducted in Department of Obstetrics and Gynecology, Lady Willingdon Hospital, from December 2014 to June 2015. In our study, 62.86 % (n=88) patients were between18-25 years of age and 37.14 % (n=52) werebetween 26-35 years of age. The mean+SD was calculated as 25.12+4.53 years. Frequency ofvaginal delivery in patients with eclampsia was 30.71 % (n=43) while69.29 % (n=97) were delivered through cesarean section. Comparisonof maternal mortality in two groups was recorded, where out of 43 spontaneous vaginal deliveries mortality was recorded in 6.98 % (n=3). Out of 97 cesarean deliveries, mortality was recorded in 17.53% (n=17). We concluded that mortality rates are higher in patients undergoing cesarean section.

scholarly journals PREDICTORS OF UNSUCCESSFUL OF TREATMENT FOR FECAL INCONTINENCE BIOFEEDBACK FOR FECAL INCONTINENCE IN FEMALE

2019 ◽  
Vol 56 (1) ◽  
pp. 61-65 ◽  
Author(s):  
Sthela M MURAD-REGADAS ◽  
Francisco Sergio P REGADAS ◽  
Francisco Sergio P REGADAS FILHO ◽  
José Jader de MENDONÇA FILHO ◽  
Roberto S ANDRADE FILHO ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Vaginal Delivery ◽  
Cleveland Clinic ◽  
Squeeze Pressure ◽  
Unsuccessful Treatment ◽  
Vaginal Deliveries ◽  
Before And After ◽  
History Of ◽  
The Mean ◽  
Satisfactory Clinical Response

ABSTRACT BACKGROUND: Biofeedback is an effective method of treatment for fecal incontinence but there is controversy regarding factors that may be correlated with its effectiveness. OBJECTIVE: To evaluate the efficacy of biofeedback in the treatment of fecal incontinence, identifying the predictive factors for unsuccessful treatment. METHODS: Consecutive female patients who had fecal incontinence and were treated with a full course of biofeedback were screened. The symptoms were evaluated using Cleveland Clinic incontinence (CCF) score before and six months after the completion of therapy. Patients had a satisfactory clinical response to biofeedback if the CCF score had decreased by more than 50% at six months (GI) and an unsatisfactory response if the CCF score did not decrease or if the score decreased by <50% (GII). The groups were compared with regard to age, score, anal resting and squeeze pressures and sustained squeeze pressure by manometry, history of vaginal delivery, number of vaginal deliveries, menopause, hysterectomy, and previous anorectal surgery. RESULTS: Of 124 women were included, 70 (56%) in GI and 54 (44%) in GII. The median CCF score decreased significantly from 10 to 5 (P=0.00). FI scores were higher in GII. Patients from GII had more previous vaginal deliveries and previous surgeries. The mean sustained squeeze pressure was higher in GI. Patients from GI and GII had similar ages, number of vaginal deliveries, menopause, hysterectomy, anal pressures, and sphincter defects. The median sustained squeeze pressure increased significantly before and after biofeedback in GI. CONCLUSION: Biofeedback therapy shows effective treatment with 50% reductions in FI score in half of patients. Factors associated with unsuccessful outcome include FI score ≥10, previous vaginal delivery, previous anorectal and/or colorectal surgery, and reduced mean sustained squeeze pressure.

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