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

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

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 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 Evaluation of Maternal and Fetal Stress Hormones During the Process of Birth

2018 ◽  
Vol 24 (2) ◽  
pp. 65
Author(s):  
Burcu Kisa Karakaya ◽  
Ozlem Moraloglu ◽  
Rahime Bedir Findik ◽  
Necati Hancerliogullari ◽  
Hatice Celik ◽  
...  
Keyword(s):  
Stress Response ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Umbilical Cord ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Normal Vaginal Delivery ◽  
Singleton Pregnancy ◽  
Beta Endorphin ◽  
Tertiary Center

<p><strong>Objective:</strong> This study aims to determine whether mode of delivery is associated with the endocrine stress response in mother and newborn.</p><p><strong>Study Design:</strong> This prospective observational study was conducted with 86 women with a normal singleton pregnancy who delivered healthy infants between 37 and 41 weeks of gestation in a tertiary center. Study groups included; (1) women undergoing normal vaginal delivery with epidural anesthesia, (2) women undergoing vaginal delivery with immersion in water for pain relief during labor, (3) women delivered through elective caesarean section without labor. After delivery, thyroid stimulating hormone, cortisol, insulin, prolactin and Beta-endorphin levels were measured in maternal and umbilical cord serum and their relationships between modes of delivery were investigated.</p><p><strong>Results:</strong> It was found that the concentrations of cortisol and beta-endorphin after vaginal delivery with immersion in water group in both mothers and infants were higher than other two modes of delivery and these differences were statistically significant. Umbilical cord concentration of cortisol was the lowest in the caesarean section group.</p><p><strong>Conclusions:</strong> Maternal and fetal stress response was found to be associated with the mode of delivery and labor.</p>

scholarly journals Mode of Delivery of Women with Complicated Pregnancy in a Tertiary Level Hospital in Bangladesh

2021 ◽  
Vol 16 (2) ◽  
pp. 31-34
Author(s):  
Morsheda Tania Rashid Khan ◽  
Md Ashraful Alam ◽  
Syed Abul Hassan Md Abdullah ◽  
Farzana Zafreen
Keyword(s):  
Caesarean Section ◽  
Quality Care ◽  
Mode Of Delivery ◽  
Maternal Health Services ◽  
Normal Vaginal Delivery ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
The Right ◽  
Complicated Pregnancy

Introduction: Every year, a great number of women die from pregnancy or childbirth related complications, which can be prevented. In developing countries, they don’t have access to maternal health services and cannot afford high quality care. Maternal death is usually occurs due to three delays: in decision making to seek care, reaching care and receiving care. Right decision at the right time regarding mode of delivery has a direct impact on healthy outcome of pregnancy as well as the maternal wellbeing. Objectives: To find out the outcome of complicated pregnancy. Materials and Methods: This cross-sectional observational study was conducted at obstetrics and gynaecology department of Dhaka Medical College Hospital from January to June 2011. Total 107 mothers who delivered recently with or without pregnancy complications were selected purposively. Data were collected by face to face interview with semi structured questionnaires. Verbal consents were taken prior to interview. Results: Among the respondents about 68.2% had antenatal complications and about 31.8% had no antenatal complication. Among the women having antenatal complications, 83.6% delivered by caesarean section and only 16.4% delivered by normal vaginal delivery. There was significant association of antenatal complications with mode of delivery by caesarean section. Conclusion: Women having antenatal complications had significant association with caesarean section. Though every pregnancy is at risk but early detection of complications, timely referral and timely intervention can save lives of many women during the process of child birth. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 31-34

scholarly journals Effect of Different Methods of Induction on the Mode of Delivery and Fetal Outcome

2013 ◽  
Vol 26 (2) ◽  
pp. 81-85
Author(s):  
Nabila Aminu Buhari ◽  
Sumayya Lugman Ahmed ◽  
Nastaran Redha Sohrabi ◽  
Hidayat Yetunde Ogunsola ◽  
Riwana B Shaikh ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Normal Vaginal Delivery ◽  
College Hospital ◽  
Medical College ◽  
Mean Time

Objectives: To study various methods of induction of labor and their effect on mode of delivery  and fetal outcome.Methods: 104 pregnant women induced in Gulf Medical College hospital from August to   November 2009 were included. Mothers were observed from the start of their induction and  followed up till they were discharged. The methods of induction compared were the use of prostaglandin, oxytocin, prostaglandin and oxytocin combined and artificial rupture of membranes.Results: Out of 104 pregnant women, 86 (89%) had normal vaginal delivery. Of these, 36 (41.9%) were induced with combination of prostaglandin and oxytocin, 32 (37.2%) with prostaglandin, 14 (16.2%) with oxytocin, and 4 (4.6%) with artificial rupture of membranes. 13 (12.5%) mothers delivered through caesarean section of these, 7 (53.8%) mothers were induced with prostaglandin, 3 (23%) with prostaglandin and oxytocin, 2 (15.3%) with oxytocin alone, and 1 (7.7%) with artificial rupture of membranes. Induction of labor with combination of prostaglandin and oxytocin was found to be the most effective method. Duration of labor between primigravidas and multigravidas were significantly different with primigravidas having longer duration of labor with mean time of 12.47 hours while multigravidas had 9.16 hours.Conclusion: Induction of labor with combination of prostaglandin and oxytocin was found to be the most effective method in this study with very good progressing to normal vaginal delivery. Further research is needed on a larger scale to compare other methods of labor induction on parturient to be able to recommend the most effective method of labor induction. DOI: http://dx.doi.org/10.3329/bjog.v26i2.13785 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 81-85  

scholarly journals VAGINAL DELIVERY OF THE TRIPLETS

2003 ◽  
Vol 41 (144) ◽  
pp. 496-498
Author(s):  
Rachana Saha ◽  
N Bastola
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Teaching Hospital ◽  
Perinatal Outcome ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
College Teaching ◽  
Medical College ◽  
Spontaneous Conception

The spontaneous conception & delivery of triplets occurs in 1: 6889 births. Most ofthe literature recommends caesarean section for triplets for better perinatal outcomeof especially second and third baby, however, we describe vaginally delivered tripletswith good perinatal outcome.1. Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.Address for correspondence : Dr. Rachana Saha, LecturerDepartment of Obstetrics and GynaecologyKathmandu Medical College Teaching Hospital, SinamangalP. O: 5919, Kathmandu, NepalKey Words: Triplets, Mode of delivery, Neonatal outcome.

STUDY THE ASSESSMENT OF RISK FACTOR FOR PRIMARY CAESAREAN SECTION IN MULTIGRAVIDA

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Pravin Kumar ◽  
Mohinee Dhaka ◽  
Sindhu Sudha Gaur ◽  
Reena Pant ◽  
Krishna Priya Banerjee
Keyword(s):  
Risk Factor ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Continuous Variable ◽  
Nonparametric Tests ◽  
Normal Vaginal Delivery ◽  
Age Group ◽  
Maternal Condition ◽  
Medical College ◽  
Study Hospital

Background: It is a study of the assessment of risk factor of primary caesarean section in multigravida women who has had previous vaginal delivery of viable neonates. Aim of Study: To study the risk factor of primary caesarean section in a multigravida. Methods: Prospective study, hospital based descriptive type of observational study conducted in department of Obstetrics & Gynaecology, SMS Medical College, Jaipur, India from June 2018 to August 2019 ,1000 multipara women previous delivered vaginally  with gestational age >28 weeks with giving written and informed consent were included and excluded previous caesarean section and Labor was monitored by using partograph. Decision for caesarean section was based on clinical evaluation of progress of labor, fetal and maternal condition and complications were noted. Statistical analysis: Continuous variable was expressed as Mean and Standard deviation. Nominally / Categorized variable was summarized as Proportion. Parametric and Nonparametric Tests used for continuous and nominal variable as per yield of data. Result: 42.18% women in the age group of 26- 30 years and 71.90% were second gravida. 67.30% had emergency caesarean section. Among the various risk factor of caesarean section, malpresentation was commonest (12.79%). Conclusion: There are many cases where a caesarean section becomes mandatory for her. Many unforeseen complications occur in women who previously had a normal vaginal delivery.

scholarly journals A Clinical Study of Labour and Outcome in Hundred Cases of Primigravida in Dhaka Medical College and Hospital

2018 ◽  
Vol 27 (1) ◽  
pp. 9-13
Author(s):  
Kaniz Fatema ◽  
Tabassum Ghani ◽  
Subinoy Krishna Paul ◽  
Noorjahan ◽  
Afrina Begum ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Study Data ◽  
Normal Vaginal Delivery ◽  
Age Group ◽  
Medical College ◽  
Number Of Patients ◽  
Predominant Factor ◽  
First Time

Introduction: Primigravida is one, who is pregnant for the first time. A successful well managed vaginal delivery first time around usually leads to subsequent deliveries being relatively uneventful. Conversely, a poorly managed first labour can add to subsequent obstetric problems. Therefore, utmost care and expertise is a predominant factor for a successful delivery. Aims and objectives: Objectives of this study is to enhance the rate of safer delivery for primigravida through monitoring progress of labour, mode of delivery and fetomaternal outcome. Methodology: This prospective study was carried out at labour ward in the Department of obstetrics and Gynaecology of Dhaka Medical College & Hospital from January, 2007 to June 2007. Hundred cases of primigravida were selected for this study. Data had been collected through questionnaires. Results : Largest number of patients (50%) had age group 20-24 years and likely to have normal vaginal delivery. Sixty percent patients had regular antenatal check up. Risk factors like PIH, Breech presentation, Face presentation, Rh negative, Jaundice and Pyrexia were found in 23% cases.About 96% fetuses presented by vertex, among them 52% had non engaged head. Sixty patients came with cervix at or less 3 cm dilated and 40 patients were at cervical dilatation 4 cm or more. Progress of labour was monitored by modified WHO partograph. Sixty two percent patient delivered vaginally, among them 3% patients need instrumental delivery. Thirty eight patients pregnancy were terminated by caesarean section. Ninety nine percent babies were live birth and 1% was still birth. Conclusion :Safest age group for delivery of primigravida in this study between 20-24 years. So, women should be encouraged to have their 1st child at this age. People should be made aware of the benefits of proper antenatal check up and choosing safest place for delivery. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 9-13

scholarly journals A Five-Year Prospective Analysis of the Efficacy, Safety and Morbidity of Epidural Anaesthesia Performed by a General Practitioner Anaesthetist in an Isolated Rural Hospital

1992 ◽  
Vol 20 (3) ◽  
pp. 348-353 ◽  
Author(s):  
R. W. Watts
Keyword(s):  
Blood Pressure ◽  
General Practitioner ◽  
Caesarean Section ◽  
Systolic Blood Pressure ◽  
Vaginal Delivery ◽  
Caesarean Section Rate ◽  
Rural Hospital ◽  
Cervical Dilatation ◽  
Visual Analogue Pain ◽  
Dilatation Group

During a five-year period, 324 epidurals were performed by a general practitioner anaesthetist in an isolated rural hospital. Of these 160 were for obstetric purposes, 72% in primagravida patients, the majority in early and established labour (median cervical dilatation of 3.0 cm). The median epidural insertion time was seven minutes: 80% were free of all complications, there were no dural taps and there was a failure rate of 2%. The median visual analogue pain score (VAPS) was 8.3 prior to insertion and at peak of epidural blockade it was reduced to 0.5. Ten per cent of patients had unblocked segments, half of these were corrected and 90% of patients had even blocks. Despite higher pain scores in the 6–10 cm cervical dilatation group, epidural analgesia was just as effective when compared to the 0.5 cm group. Seventy-seven percent of women interviewed the day after delivery were fully satisfied with the epidural: 19% said it was considerable help, 2% some help and 2% said no help at all. During epidural caesarean section (n = 72), 75% of patients were comfortable, 17% had some discomfort and 7% required general or spinal anaesthesia. The incidence of hypotension (systolic blood pressure < 90 mmHg), was 24.6% with a median ephedrine dose of 10 mg; however, with a greater than 20% drop in systolic blood pressure, the dose of ephedrine required to maintain blood pressure increased in a log-dose fashion. For women who received epidurals in labour, the caesarean section rate was 25%, instrumental vaginal delivery 34% and spontaneous vaginal delivery 41%. There were no adverse neonatal outcomes.

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