scholarly journals Maternal and Neonatal Outcome after Caesarean and Vaginal Delivery in Eclampsia

2018 ◽  
Vol 24 (2) ◽  
pp. 111-117
Author(s):  
Rokeya Khatun ◽  
M Nowshad Ali ◽  
Chinmoy Kanti Das ◽  
Fatema Ashraf

This randomized control trial study was conducted at Rajshahi Medical College and Hospital, Bangladesh. This study includes 70 consecutive antepartum eclamptic patients who were admitted in the year 2008. The purpose of this study was to analyze the difference in maternal and perinatal outcome in caesarean and vaginal delivery and thereby describe the success rate of a particular mode of delivery in those cases. Bivariate and multivariable regression analyses were used to determine factors that were associated with assignment to, success of, and odds of maternal and neonatal outcome after caesarean and vaginal delivery.TAJ 2011; 24(2): 111-117

2003 ◽  
Vol 41 (144) ◽  
pp. 496-498
Author(s):  
Rachana Saha ◽  
N Bastola

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.


Author(s):  
Nikita . ◽  
Seetesh Ghose ◽  
Setu Rathod

Induction of labour after the period of viability by any methods medical, surgical or combined, for the purpose of vaginal delivery. The success of induction, to a great extent, depend upon pre-induction cervical status i.e. cervical ripening. So, ripening of cervix prior to induction i.e. pre-induction cervical ripening is one of the important steps for successful induction of labour. There are different methods for cervical ripening like prostaglandins (PGE). However, use of prostaglandins (PGE) and oxytocin as labour inducing agent has its own adverse effects on maternal and perinatal outcome. So, constant efforts are made for the less use of uterotonins. The present review aims to study the efficacy of oral Mifepristone for improvement in Bishop’s score, requirement of additional uterotonics, induction delivery interval, mode of delivery and neonatal outcome. Electronic databases were searched by using keywords ‘Mifepristone, RU486, PGE2 gel, Cervical ripening, Bishop’s score and Induction of labour’ and eleven articles were found from 2009 to 2018 which fulfils our study criteria and thus they were taken for review. Based on all the studies, Mifepristone appears to be effective cervical ripening in comparison to other agents with significant improvement in Bishop’s score, higher vaginal delivery rate, shorter induction delivery interval and good neonatal outcome.


2018 ◽  
Vol 16 (2) ◽  
pp. 209-214
Author(s):  
Anshumala Joshi ◽  
Meeta Thapa ◽  
Om Biju Panta

Background: Whether a mother should be allowed to choose between the modes of delivery is a matter of concern among practicing obstetricians. This study aims to explore the knowledge of the Nepalese women attending a tertiary care center about the benefits and complications of vaginal and caesarean delivery and their attitude and preference for the method of delivery.Methods: The study was a hospital based cross sectional questionnaire survey conducted in Nepal Medical College teaching Hospital, Jorpati from 1stShrawan 2074 to 31st Ashoj 2074. All pregnant women who were 36 weeks or more in gestation attending the clinic during the study period were included in the study. A questionnaire was made of 10 questions for knowledge assessment regarding mode of delivery consisting of the indications, the possible complications and advantages of vaginal and caesarean delivery. Results: A total of 256 pregnant women participated in the study. The knowledge of the mode of delivery, their benefit and complications was medium to good in approximately 90% of the mothers attending the antenatal OPD. Overall attitude for vaginal delivery was positive in 93% of women and negative or neutral in 6.6%.Overall attitude for caesarean delivery was positive in 24% and negative or neutral in 75.8%.Conclusions: Women in our setup agree that vaginal delivery is a natural and acceptable method of delivery and would prefer to have a vaginal delivery. Keywords: Attitude; knowledge; modes of delivery; women.


2021 ◽  
Author(s):  
Nobuhiro Suzumori ◽  
Takeshi Ebara ◽  
Hazuki Tamada ◽  
Taro Matsuki ◽  
Hirotaka Sato ◽  
...  

Abstract Background Postpartum depression is one of the most commonly experienced psychological disorders for women after childbirth, usually occurring within one year. This study aimed to clarify whether women with painless delivery, including epidural analgesia, spinal-epidural analgesia, and paracervical block, had a decreased risk of postpartum depression after giving birth in Japan. Methods The Japan Environment and Children’s Study (JECS) was a prospective cohort study that enrolled registered fetal records (n = 104,065) in 15 regions nationwide in Japan. Binomial logistic regression analyses were performed to calculate the adjusted odd ratios (aORs) for the association between mode of delivery with or without analgesia and postpartum depression at one-, six- and twelve-months after childbirth. Results At six months after childbirth, painless vaginal delivery was associated with a higher risk of postpartum depression (aOR: 1.218, 95% confidence interval: 1.067–1.391), compared with vaginal delivery without analgesia or cesarean section. Nevertheless, the risk disappeared one year after delivery. Among the pregnant women who requested painless delivery, 5.1% had a positive Kessler-6 scale (K6) score for depression before the first trimester (p < 0.0001), which was significantly higher than the proportions in the vaginal delivery without analgesia (3.5%) and cesarean delivery (3.5%) groups. Conclusions Our data suggested that the risk of postpartum depression at six months after childbirth tended to be increased after painless vaginal delivery, compared with vaginal delivery without analgesia or cesarean section. Requests for painless delivery continue to be relatively uncommon in Japan, and women who make such requests might be more likely to experience postpartum depressive symptoms because of underlying personality characteristics, including a tendency to worry.


Author(s):  
Nishu Bhushan ◽  
Surinder Kumar ◽  
Dinesh Kumar ◽  
Reema Khajuria

Background: The incidence of obesity has increased to pandemic proportions over the last 20 years. Obesity is a chronic illness which is associated with metabolic disease, nutritional deficiency, musculoskeletal complications and carcinomas. The aim of the study was to evaluate and compare the maternal and perinatal outcome in patients with BMI 20-24.9 kg/m2 (normal), with BMI 25-29.9 kg/m2 (overweight) and with BMI >30 kg/m2 (obese).Methods: This cross-sectional study was conducted on 300 singleton pregnant women with gestational age>37 weeks with cephalic presentation. The selected women were categorized into three groups of 100 each according to their BMI: Category I included normal women (BMI 20-24.9 kg/m2), Category II included overweight women (BMI 25-29.9 kg/m2) and Category III included obese women (BMI >30 kg/m2).Results: There was increased incidence of antepartum complications in obese women. The difference in the occurrence of pre-eclampsia among the three categories was statistically significant (p=0.001). Similarly, more obese women had eclampsia (5%) and gestational diabetes mellitus (6%) as compared to overweight and normal women and the difference was statistically significant in both these complications (p=0.02 for each). The risk of induction of labour was highest in obese women and so was the incidence of caesarean and instrumental deliveries and the difference was statistically significant. The difference in the onset of labour as well as mode of delivery among the three categories was statistically significant (p<0.05). In perinatal outcomes, the difference in mean birth weight of the babies among three categories was statistically significant (p<0.0001). The difference in incidence of low birth weight (<2.5 kg) as well as macrosomia (>4 kg) among babies of three BMI categories was statistically significant (p<0.05). The difference in the incidence of NICU admissions was statistically significant (p=0.02).Conclusions: Obesity is an independent risk factor for adverse pregnancy outcomes and hence preventable steps should be taken for reducing the maternal and perinatal morbidity and mortality.


2019 ◽  
Vol 31 (1) ◽  
pp. 23-26
Author(s):  
Mahe Jabeen ◽  
Sabiha Shimul ◽  
Ummay Salma ◽  
Jebunnesa

Introduction: Compared with a fetus with cephalic presentation, a breech fetus faces increased risk during labour and delivery of asphyxia from cord compression and of traumatic injury during delivery of the shoulders and head. Caesarean section avoids most of this risk. The purpose of this study was to evaluate the feasibility of vaginal delivery of uncomplicated singleton breech presentation by evaluating early neonatal morbidity and mortality as well as maternal morbidity following vaginal and caesarean delivery for breech presentation. Materials and Methods: This is a cross sectional comparative study.104 women with singleton breech presentation at term in labour were included consequetively in labour ward of Institute of Child and Mother Health (ICMH). Informed consent was taken from them. Neonatal and maternal outcome were recorded and statistical analysis was done using SPSS version 22. Results: APGAR at 5 min and Neonatal Intensive Care Unite (NICU) admission were not affected by mode of delivery. Long term neonatal outcome is similar in either mode of delivery. Maternal morbidity and duration of hospital stay is increased in caesarean births. Conclusion: Neonatal outcome did not depend on mode of delivery though maternal morbidity and cost of care is increased following Caesarean Section. Proper selection of cases and by improving skill & confidence in new generation obstetrician, vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to a woman in a tertiary care centre. Medicine Today 2019 Vol.31(1): 23-26


Author(s):  
Sunanda N. ◽  
Akhila M. V.

Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies.


Author(s):  
Sharda Patra ◽  
Shruthi S. S. ◽  
Manju Puri ◽  
Sushma Nangia ◽  
S. S. Trivedi

Background: The objective of this study was to determine the significance of meconium staining of the amniotic fluid and find out an appropriate mode of delivery in women with MSL.Methods: A retrospective study was carried out in Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital, a tertiary government hospital, New Delhi over a time period of 1 year between 2009 to 2010 on 1425 consecutive women of which 142 women were diagnosed as having meconium staining of the amniotic fluid during labour.  All cases were critically analysed and maternal and fetal outcomes were studied in these women.Results: The incidence of MSL was 10% (142/1425), 45% had thin MSL and 55% had thick MSL. In women with thick MSL, 85% had early thick MSL and 15% had late thick MSL. In women who had early thick MSL (n=66), 55 (83.3%) delivered by LSCS and 11 (16.7%) delivered vaginally. On correlating the perinatal outcome with mode of delivery irrespective of fetal heart rate abnormality in early thick MSL, it was seen that the perinatal outcome was significantly affected by mode of delivery. The rates of respiratory distress and MAS was significantly higher in babies who delivered vaginally compared to those by LSCS (18% & 100% vs 9% & 40%, p=0.012, RR- 5.2 [95% CI: 1.8-3.42]. There were no perinatal mortality in early thick MSL.Conclusions: In distinguishing between thick and thin meconium, it was noted that finding of thick meconium in the latent phase of labour (i.e. early thick MSL) is ominous and demands an urgent caesarean delivery. 


2020 ◽  
Vol 18 (2) ◽  
pp. 54-58
Author(s):  
Most Sabina Yeasmin ◽  
Md Jalal Uddin ◽  
Shireen Akter Khanam

Background: Multiple pregnancies are prone to be associated with adverse maternal and perinatal outcome. The incidence of multiple pregnancies has shown a significant increase over the last decades. This study aimed to determine the maternal and perinatal outcome in a tertiary teaching hospital. Materials and methods: This prospective observational study was conducted in Chattogram-Maa-O-Shishu-Hospital Medical College, from July 2014 to June 2016. A total of 173 multiple pregnant women having 28 weeks completed gestation admitted for delivery were consecutively included in the study. Maternal and perinatal outcome were investigated. Results: The results show that the number of multiple pregnancies delivered during study periods was 173 with the incidence of 1.7% among total deliveries. There were 5 triplets pregnancies among these cases. The women with multiple pregnany were relatively older. There were no maternal mortality. Pregnancy complications were remarkabely higher. The main maternal adverse outcome were preterm delivery (84.97%), anaemia (39.88%), pregnancy induced hypertension (28.97%), premature rupture rupture of membrane (28.32%), postpartum haemorrhage (16.76%), antepartum haemorrhage (11.9%). The mean gestational age at delivery was 35.39 weeks for twins and 33.3 weeks for triplets. The commonest mode of delivery was by ceasarean section. The most common neonatal complications was low birth weight and most common cause of neonatal death was prematurity and neonatal sepsis. Conclusion: Majority of the multiple pregnancy is high risk one. So, all multiple pregnancies need early diagnosis, adequate antenatal, intra-natal and postpartum care to improve the outcome and should have mandatory hospital delivery. Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 54-58


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