scholarly journals A Prospective Study on the Relationship Between Cervical Dilatation at Initial Presentation in Labour and Subsequent Outcome in Nulliparous Women

2014 ◽  
Vol 13 (1) ◽  
pp. 39-41
Author(s):  
Smriti Kona Kabiraj ◽  
Juthi Bhowmik ◽  
Haradhan Deb Nath
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Fetal Distress ◽  
Cervical Dilatation ◽  
P Value ◽  
Nulliparous Women ◽  
Group I ◽  
Increased Risk ◽  
Group Ii

Background: The spontaneous birth of a live infant can convey a huge degree of both satisfaction and achievement for both the mother and her partner. Many factors influence the variation in rates of caesarean section among hospitals throughout the world. These included patients’ demographic characteristics, underlying medical and obstetric complication, hospital facilities, hospital practice and physician practice style. Objective: The present study was planned to determine how the outcome of women change with timing of admission either in active or latent phase of spontaneous labour.Methods: This was a prospective observational study, which was conducted at labour ward, department of Obstetrics and Gynaecology, BSMMU hospital and DMCH Dhaka, from February 1, 2008 to August 30, 2008, where data were collected prospectively. Patients with any medical or obstetric complications, rupture of membrane antenatally diagnosed fetal anomalies or death and with prior caesarean section were excluded from the study. Patients with cervical dilatation at less than 4cm were in group I. On the other hand, patients with cervical dilatation of 4 cm or more in active phase and these types of patients were allocated in group II.Results: Outcome differences were compared using chi-square(X2) test, fishers exact test, A ‘p’ value <0.05 considered significant. Main outcome variables were duration of labour, mode of delivery, indication for caesarean section, need for oxytocin, labour analgesia, Apgar score <7, maternal PPH and postpartum hospital stay. A total 500 patients were enrolled during the study period. Of them 308 patients were (61.6%) in group I and 192 patients (38.4%) in group II. Dystocia was the main indication for caesarean delivery in early admitted group which was 58.6% and fetal distress in late admitted group which was 37.5%. Second commonest indication for caesarean section was fetal distress which was 31.6% in group I and dystocia 50.0% in group II). Oxytocin for augmentation was used in 70.0% in group I and 30.0% in group II.Conclusion: It is shown that early admission to the hospital in low-risk women may negatively affect the outcome of labour and are at increased risk of prolonged labour, more oxytocin used, increased rate of caesarean section.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19417

scholarly journals Impact of Timing of Admission in Labour on Subsequent Outcome

2013 ◽  
Vol 2 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Junnu Rayen Janna ◽  
Saleha Begum Chowdhury
Keyword(s):  
Caesarean Section ◽  
Hospital Stay ◽  
Apgar Score ◽  
Caesarean Delivery ◽  
Active Phase ◽  
Cervical Dilatation ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Latent Phase

To examine the effect of timing at which women admitted either in active or latent phase of spontaneous labour on subsequent outcome. This cross-sectional study was conducted at labour ward, department of Obstetrics and Gynaecology, BSMMU hospital, Dhaka, Bangladesh, from August 2007 to November 2007, where data were collected prospectively. A total of 60 women with term, singletone pregnancy, cephalic presentation with spontaneous onset of labour admitted in labour either in active or latent phase were selected for evaluation. Patients with any medical or obstetric complications, rupture of membrane, antenatally diagnosed foetal anomalies or death and with prior caesarean section were excluded from the study. Patients with cervical dilatation at less than 4cm were categorized as latent phase and were in group I. On the other hand, patients with cervical dilatation of 4 cm or more were marked as in active phase and were allocated in group II. Baseline characteristics were compared. Outcome differences were compared using chi-square(X2) test, t test, fisher’s exact test, A ‘p’ value <0.05 considered significant.  Duration of labour, mode of delivery, indication for caesarean section, need for oxytocin, labour analgesia, Apgar score <7, birth weight of baby, maternal PPH and postpartum hospital stay. A total of 60 patients were enrolled during the study period. Of them 35 patients (58.3%)were in group I and 25 patients (41.7%) in group II. Duration of labour was more in early admitted group compared to late admitted group (mean± SD 17.0 ± 2.8 vs 14.3 ± 2.4). Latent phase women needed more caesarean delivery than active phase women (62.9% vs 28.0%). Dystocia was the main indication for caesarean delivery in the present study which was 68.2% and 28.6% in early and late admitted group respectively. Second commonest indication for caesarean section was foetal distress (6 in group I and 5 in group II). Oxytocin for augmentation was used in 62.9% in group I and 56.0% in group II and nulliparae women were the one who needed more augmentation (40.0% in group I, 36.0% in group II). Mean foetal weight between two groups did not reach any significant difference (p>0.05). Apgar score <7 shows insignificant difference between two groups. PPH was found in 5.7% cases and all were from group I. Total postpartum hospital stay was significantly longer in group I than group II (p<0.05). t is shown that early admission to the hospital in low-risk women may negatively affect the outcome of labour and are at increased risk of prolonged labour, more need for analgesia, increased rate of caesarean section, increased PPH and postpartum hospital stay. DOI: http://dx.doi.org/10.3329/cbmj.v2i1.14177 Community Based Medical Journal Vol.2(1) 2013 21-28

TO COMPARE THE EFFICACY OF DROTAVERINE HYDROCHLORIDE AND VALETHAMATE BROMIDE IN SHORTENING OF THE FIRST STAGE OF LABOUR AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR

2021 ◽  
pp. 80-82
Author(s):  
Archana Jha ◽  
Satyendra Kumar ◽  
[Prof.] Usha Kumari ◽  
Debarshi Jana
Keyword(s):  
Side Effects ◽  
Average Duration ◽  
Average Rate ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Cervical Dilatation ◽  
Group I ◽  
Active Labour ◽  
Drotaverine Hydrochloride ◽  
Group Ii

Background: To compare the efcacy of Drotaverine Hydrochloride and Valethamate Bromide in shortening of the rst stage of Labor. Drotaverine is more effective in regards of shorten the 1st stage of labor, rate of cervical dilatation with less side effects in compare to Valethamate Bromide. Methods:Two Hundred demographically similes woman with full term pregnancy in active labour were included in the study and divided into two groups viz. First Group: 100 women were given injection Drotaverine Hydrochloride (Drotin) 40 mg intramuscularly at 3-4 cm dilation at two hour interval. Second Group: 100 women were given injection Valethamate Bromide Intramuscularly at 3-4 cm dilation at one hour interval. Maximum three injections were given in both the groups. Comparative analysis was carried out as regards to duration of various stages of labor, rate of cervical dilatation, mode of delivery, side effects and feto-maternal outcome. Results: In Group-I Average duration of active phase of rst stage of labor was 149.78 minutes. In Primigravida it was 170.22 minutes and 129.35 minutes in Multigravida. In Group II Average duration of active phase of rst stage of labor was 294.62 minutes. In Primigravida it was 321.71 minutes and 267.54 minutes in Multigravida. Average rate of cervical dilatation in Group-I was 2.81cm/hour. In Primigravida it was 2.50 cm/hour while in Multi gravid it was 3.33cm/hour. In Group-II average rate was 1.42 cm/hour, in Primigravida it was 1.30 cm/hour and in Multigravida1.57 cm/hour. Conclusions: Drotaverine signicantly shorten the duration of rst stage of labor and found to be safe with no adverse effect on the mother and fetus.

scholarly journals Comparison of progress of labour and maternofetal outcome among induced versus spontaneous labour in nulliparous women using modified WHO partograph

2018 ◽  
Vol 7 (2) ◽  
pp. 415
Author(s):  
Anamika Singh ◽  
Smitha B. Rao ◽  
Bhavana Sherigar ◽  
Reena D’souza ◽  
Soumya R. ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Outcome Data ◽  
T Test ◽  
Safe Procedure ◽  
Nulliparous Women ◽  
Spontaneous Labour ◽  
The Mean

Background: Induced or spontaneous labour has implication on the eventual mode of delivery and neonatal outcome. The aim of study is to compare the progress and outcome of induced versus spontaneous labour among nulliparous women using the modified WHO partograph.Methods: Comparative study involving nulliparous women in active phase of labour with the cervix at least 4cm dilated. Those whose labours were induced were compared with those on spontaneous labour; both labouring women were monitored using modified WHO partograph. Outcome measures include the mean duration of labour, the eventual mode of delivery and the Maternofetal outcome. Data were managed using SPSS software. Chi-square t-test and student t-test were used in data analysis. Level of significance was placed at P<0.05.Results: 115 women were compared in each group. There was no difference in mean age group, gestational age at delivery, cervical dilatation on admission, and the level of head of fifth palpable on admission. More women had spontaneous vaginal delivery among those in spontaneous labour (72.1% versus 64.7%) P=0.0001. There were less caesarean section among those in spontaneous labour. The mean Apgar scores were significantly better among induced labour babies (P=0.0001).Conclusions: Induced labour may increase the chances of caesarean section, it does not adversely affect the neonatal outcome. Therefore, it is advised induced labour can be a safe procedure among nulliparous women if labour is partographically monitored.

scholarly journals Effect of maternal BMI on labor outcomes in primigravida pregnant women

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eissa Khalifa ◽  
Alaa El-Sateh ◽  
Mohamed Zeeneldin ◽  
Ahmed M. Abdelghany ◽  
Mahmoud Hosni ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Active Phase ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Group Iii ◽  
Second Stage Of Labor ◽  
Group I ◽  
Increased Risk ◽  
Group Ii ◽  
Labor Outcomes

Abstract Background This study aims to detect the effects of increased BMI on labor outcomes in primigravida pregnant women. Methods A cross-sectional study involved 600 full-term singleton primigravida pregnant women who presented in the active phase of labor to the labor ward. They were divided according to BMI into three equals groups; women with normal BMI (group I), overweight women (group II), and women with class I obesity (group III). Results We found that high BMI was associated with a significantly increased risk of Caesarean section (C.S.) (13% in group I, 18% in group II and 40% in group III). Women with higher BMI and delivered vaginally had a significantly prolonged first and second stage of labor, consequently increased the need for oxytocin augmentation as well as the oxytocin dose. Regarding the maternal and fetal outcomes, there are significantly increased risks of postpartum sepsis, perineal tears, wound infection, as well as significantly increased birth weight and longer neonatal stay in the neonatal unit (NNU). Conclusion Obese primigravida pregnant women were at higher risk of suboptimal outcomes. Besides, prolonged first and second stages of labor and the incidence of C.S. have also been increased.

scholarly journals A study of post-dated pregnancy with special reference to maternal and perinatal outcome in nulliparous women

2020 ◽  
Vol 9 (11) ◽  
pp. 4574
Author(s):  
Shreyasi Karmakar ◽  
Sabyasachi Bid ◽  
Tapan Kumar Maiti
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Induction Of Labour ◽  
Control Group ◽  
Study Group ◽  
Nulliparous Women ◽  
And Control

Background: The study was aimed to determine the mode of delivery, maternal outcome and perinatal outcome in prolonged pregnancy.Methods: It was a prospective observational study. Uncomplicated nulliparous singleton pregnancies who have completed 37 weeks of gestation were included in the study. Inclusion and exclusion criteria were strictly followed. Total 200 cases were divided into study group and control group. Those who have crossed their Estimated date of delivery (EDD) were compared with term pregnancies (not crossed their EDD).Results: The study group and control group consist of 114 and 86 women respectively. The incidence of caesarean section (64.04%), induction of labour (50.88%) is significantly higher in the study group. It also shows that the occurrence of caesarean section (63.79%) is more in post-dated pregnant women who underwent induction of labour. The most common indication for caesarean section was fetal distress in both groups. The commonest maternal complication was prolonged labour and perinatal complication was fetal distress in both groups. The incidence of low birth weight was significantly less in post-dated pregnancy.Conclusions: Our study suggests that the incidence of induction of labour and caesarean section is significantly higher in post-dated pregnancy. Although the mean birth weight baby is more in them, a definite policy should be recommended for optimum timing of intervention to avoid maternal and perinatal complications.

scholarly journals FETAL OUTCOME;

2017 ◽  
Vol 24 (03) ◽  
pp. 462-465
Author(s):  
Afsheen Memon ◽  
Aisha Abdullah Sheikh ◽  
Anisa Kamal
Keyword(s):  
Caesarean Section ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
High Rate ◽  
P Value ◽  
Study Group ◽  
Nuchal Cord ◽  
Nicu Admission

Objectives: To compare the effect of nuchal cord versus without cord aroundthe neck on mode of delivery and fetal outcome. Study design: Case control comparativestudy. Period: 1st August 2013 to 31st March 2014. Setting: Gyn /Obs Department at Sir SyedHospital Karachi. Material and Methods: A comparative study was carried out on 2 groupsof parturient ladies. The study group comprised of those ladies who at the time of delivery(vaginal delivery/caesarean-section) had clinically cord around the neck while the other group(control) did not have nuchal cord. Duration of labour, mode of delivery were noted. Perinataloutcome was measured in terms of Apgar score and NICU admission. High risk pregnancieswere excluded from the study. Result: Incidence of nuchal cord at the time of delivery was22.7%. A high rate of caesarean delivery observed in study group as compared to controlgroup (70 % vs 40%) (P value 0.00006). Fetal heart rate irregularities & meconium stainedliquor finding was not significantly different in two groups (p< 0.161) & (p<0.169) respectively.Similarly fetal outcome measured in terms of Apgar score at 1 & 5 min & NICU admissionwas also not significantly different between the two groups. Conclusion: A significant highrate of caesareans section rate was observed in the study group mainly due to fetal distress(FHR irregularities). This means cord around the neck is a risk factor & needs extra monitoringspecially through intermittent CTG monitoring during labour so that fetal distress can be pickedup early & emergency caesarean section can be performed to avoid fetal compromise.

scholarly journals A randomized comparative study of effect of intramuscular valathemate bromide (epidosin) and intramuscular camylofin dihydrochloride (anafortan) on cervical dilatation in labour

2021 ◽  
Vol 10 (12) ◽  
pp. 4488
Author(s):  
Dinesh Mehra ◽  
Madhubala Chouhan ◽  
Shatendra Goyal
Keyword(s):  
Pain Relief ◽  
Comparative Study ◽  
Pain Score ◽  
Active Phase ◽  
Cervical Dilatation ◽  
Study Group ◽  
Medical College ◽  
Group I ◽  
Group Ii ◽  
Vertex Presentation

Background: Our aim is to search for a good cervical dilating agent which is not only more efficacious in cervical dilatation but also effective in relieving pain during labour with no or very little harmful effects on mother and foetus.Methods: The type of study was simple randomized comparative study. The present study was conducted in R. N. T. Medical College, Udaipur between October 2019 and December 2020. 118 patients were selected randomly. Two groups were made each consisting of 59 patients. First group received intramuscular camylofin dihydrochloride, second group received intramuscular (IM) valethamate bromide. Patients included in study group were: primigravidae/multigravidae, singleton full term gestation (37-40 weeks) with vertex presentation, cervical dilatation of ≥3 cm and patient excluded from study group with preclampsia, eclampsia, antepartum haemorrhage, any obstetric complications: cephalo pelvic disproportion, abnormal presentations.Results: Mean duration of active phase of first stage of labor was shorter in group I (313.17 minutes) than in group II (356.3 minutes) but not statistically significant. Mean cervical dilatation rate was significantly more in group I (2.02 cm/hour) than group II (1.81 cm/hour). Anafortan was effective in pain relief with mean pain score 5.31±1.06 while mean pain score for epidosin group was 7.37±1.07.Conclusions: In our study we observed that intramuscular camylofin dihydrochloride (anafortan) was more efficacious than IM valethamate bromide (epidosin) in shortening the duration of labor as well as in pain relief.

scholarly journals Effect of Temperature Variation of Intrathecal Bupivacaine on Shivering in Parturients Undergoing Spinal Anaesthesia

2021 ◽  
Vol 10 (7) ◽  
pp. 425-429
Author(s):  
Karen Herniques ◽  
Amrusha Mukesh Raipure ◽  
Dipakkumar Hiralal Ruparel ◽  
Naresh Tirpude
Keyword(s):  
Caesarean Section ◽  
Temperature Variation ◽  
Spinal Anaesthesia ◽  
Onset Time ◽  
Effect Of Temperature ◽  
P Value ◽  
Double Blind Study ◽  
Sensory Blockade ◽  
Group I ◽  
Group Ii

BACKGROUND Shivering is commonly encountered complication following spinal anaesthesia leading to discomfort and interference with monitoring during caesarean section. There is no definite aetiology for this and hence no definite treatment is available. Hence, we wanted to study effect of temperature variation of spinal inject on post spinal shivering during caesarean section. METHODS This prospective randomized double-blind study was conducted on 80 parturients posted for elective caesarean section allocated to two groups of 40 each receiving 2.0 mL of 0.5 % hyperbaric bupivacaine with temperature of 220 C (group I) or 370 C (group II) intrathecally at L3 - L4 interspace. Onset of shivering, its severity and incidence were noted. Data was analysed using various tests and P-value < 0.05 was considered as significant and P-value < 0.01 was considered highly significant. RESULTS Demographic characters, surgical parameters as well as onset time of sensory blockade, maximum sensory blockade, time to achieve maximum sensory and motor blockade were comparable in the two groups. Shivering was present in 57.5 % of patients in group I and 32.5 % in group II and this difference was statistically significant. Overall, shivering percentage was 45 % although difference in mean onset time was not significant in the two groups. Grades of shivering were comparable in both groups. CONCLUSIONS Warm solutions used intrathecally can reduce incidence of shivering following spinal anaesthesia in caesarean section although it doesn’t influence intensity of shivering. KEY WORDS Neuraxial Anaesthesia, Temperature Variation, Post Spinal Shivering

scholarly journals Central Sagittal Angle of the Sacrum as a New Risk Factor for Patients with Persistent Low Back Pain after Caesarean Section

2017 ◽  
Vol 11 (5) ◽  
pp. 726-732 ◽  
Author(s):  
Hizir Kazdal ◽  
Ayhan Kanat ◽  
Osman Ersagun Batcik ◽  
Bulent Ozdemir ◽  
Senol Senturk ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Control Group ◽  
Sacral Slope ◽  
Low Back ◽  
Group I ◽  
Increased Risk ◽  
Group Ii

<sec><title>Study Design</title><p>Retrospective.</p></sec><sec><title>Purpose</title><p>This study investigated the possible association of persistent low back pain (LBP) with caesarean section (CS) under spinal anesthesia.</p></sec><sec><title>Overview of Literature</title><p>Many women suffer from LBP after CS, which is commonly performed under spinal anesthesia. However, this type of LBP is poorly understood, and there is poor consensus regarding increased risk after spinal anesthesia.</p></sec><sec><title>Methods</title><p>We examined two groups of patients who underwent cesarean delivery under spinal anesthesia. Group I included patients who presented to a neurosurgical clinic complaining of LBP for at least 6 months. Group II was a control group with patients without LBP. We analyzed clinical and sagittal angle parameters, including age, body mass index, parity, central sagittal angle of the sacrum (CSAS), and sacral slope (SS).</p></sec><sec><title>Results</title><p>Fifty-three patients participated in this study: 23 (43.1%) in Group I and 30 (56.9%) in Group II. Non-parametric Mann–Whitney U-tests showed that age, parity, and CSAS significantly differed between the two groups at 6 months.</p></sec><sec><title>Conclusions</title><p>Age, parity, and CSAS appear to be associated with increased risk for LBP after CS under spinal anesthesia. Future prospective studies on this subject may help validate our results.</p></sec>

scholarly journals Outcome of Mode of Delivery in Nulliparous and Multiparous Women Presenting with Early and Late Cervical Dilatation

2019 ◽  
Vol 7 (1) ◽  
pp. 16-20
Author(s):  
Ferdous Ara Shuchi ◽  
Salma Lovereen ◽  
Mst Nazumnnaher Mina
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Cervical Dilatation ◽  
Normal Vaginal Delivery ◽  
Medical College ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
Dilatation Group ◽  
Spontaneous Onset

Background: Knowledge of the patterns of normal and abnormal labour, and of women’s behavior, is fundamental to the formulation of mode of delivery. It is observed that women admitted to hospital early have a higher frequency of obstetric interventions in labour than those admitted later. Objective: To study the outcome of spontaneous onset of labour in nulliparous and multiparous patients. Materials and method: During the study period of 1st July 2008 to 31st Dec 2008, 568 pregnant women admitted in Kumudini Women’s Medical College were included in this study. Mothers were observed since admission with spontaneous onset of labour and followed up till they were released from the hospital. Labour outcome was measured and mode of delivery was compared among nulliparous and multiparous women. Results: Among the nulliparous women, normal vaginal delivery occurred in 71 (23%) patients presented with early cervical dilatation (0-3 cm) and in 142 (46%) patients presented with late cervical dilatation (>4 cm). In nulliparous women caesarean section were needed in 60 (45.8%) patients in early cervical dilatation group and in 35 (19.8%) patients in late cervical dilatation group. In multiparous women, normal vaginal delivery occurred in 66 (25%) patients presented with early cervical dilatation and in 133 (51%) patients presented with late cervical dilatation whereas cesarean section were done in 35 (34.7%) patients and in 25 (15.8%) patients in the two groups respectively. Duration of labour between nulliparous and multiparous was significantly different (8 hours vs. 6 hours). Indication of caesarean section were, 61 (40%) patients due to prolong labour, 48 (34%) due to foetal distress and 44 (26%) due to cephalopelvic disproportion. Conclusion: Normal vaginal delivery occurred more and duration of labour was shorter in patients admitted with advanced labour (cervical dilatation >4cm). Delta Med Col J. Jan 2019 7(1): 16-20

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