scholarly journals Pattern of Vaginal Birth after Cesarean, its Variables and Outcome at the Interval of One Decade in Dhulikhel Hospital

2020 ◽  
Vol 18 (3) ◽  
pp. 411-415
Author(s):  
Suman Raj Tamrakar ◽  
Neeta Timilsina
Keyword(s):  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Fetal Distress ◽  
Vaginal Birth ◽  
P Value ◽  
Vaginal Birth After Cesarean ◽  
Cesarean Deliveries ◽  
Vaginal Deliveries ◽  
Delivery Obstetric ◽  
High Index Of Suspicion

Background: There should be high index of suspicion for timely detection of any complications for safe trial of labor in case of vaginal birth after cesarean. Emergency obstetric care must be available. Even with these provisions the vaginal birth after cesarean rate is decreasing in Dhulikhel Hospital in recent years. Methods: This retrospective study was conducted to compare different modes of delivery and pattern vaginal birth after cesarean in a gap of ten years in Dhulikhel Hospital (i.e. 2007 to 2009 versus 2017 to 2019). In this study factors associated with the successful vaginal birth after cesarean were also analyzed. Results: A total of 4215 deliveries conducted in the year 2007 to 2009, of them 890 (21.1%) were cesarean deliveries. Likewise altogether 9298 deliveries conducted in the year 2017 to 2019, of them 2849 (30.6%) were cesarean deliveries. Vaginal birth after cesarean rate is significantly decreased from 18.33% (33/180) to 8.8% (63/713) (p value = 0.0004). Instrumental deliveries, normal vaginal deliveries were significantly decreased in comparison to these in the year 2007 to 2009. Duration of labor of vaginal birth after cesarean (7.05±1.25 vs 7.13±2.02, p=0.8362) and mean fetal weight of vaginal birth after cesarean baby (2818.71±686.37 vs 2820.79±511.78, p=0.9867) were not much different. Conclusions: Over the years, vaginal birth after cesarean rate is decreased. Keywords: Cesarean section; fetal distress; institutional delivery; obstetric care; uterine rupture

Vaginal birth after cesarean (VBAC): fear it or dare it? An evaluation of potential risk factors

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Anastasia Lazarou ◽  
Magdalena Oestergaard ◽  
Johanna Netzl ◽  
Jan-Peter Siedentopf ◽  
Wolfgang Henrich
Keyword(s):  
Body Mass Index ◽  
Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Body Mass ◽  
Vaginal Birth ◽  
Vacuum Extraction ◽  
Vaginal Birth After Cesarean ◽  
Vaginal Deliveries ◽  
Spontaneous Delivery

Abstract Objectives The consultation of women aspiring a vaginal birth after caesarean may be improved by integrating the individual evaluation of factors that predict their chance of success. Retrospective analysis of correlating factors for all trials of labor after caesarean that were conducted at the Department of Obstetrics of Charité-Universitätsmedizin Berlin, Campus Virchow Clinic from 2014 to October 2017. Methods Of 2,151 pregnant women with previous caesarean, 408 (19%) attempted a vaginal birth after cesarean. A total of 348 women could be included in the evaluation of factors, 60 pregnant women were excluded because they had obstetric factors (for example preterm birth, intrauterine fetal death) that required a different management. Results Spontaneous delivery occurred in 180 (51.7%) women and 64 (18.4%) had a vacuum extraction. 104 (29.9%) of the women had a repeated caesarean delivery. The three groups showed significant differences in body mass index, the number of prior vaginal deliveries and the child’s birth weight at cesarean section. The indication for the previous cesarean section also represents a significant influencing factor. Other factors such as maternal age, gestational age, sex, birth weight and the head circumference of the child at trial of labor after caesarean showed no significant influence. Conclusions The clear majority (70.1%) of trials of labor after caesarean resulted in vaginal delivery. High body mass index, no previous spontaneous delivery, and fetal distress as a cesarean indication correlated negatively with a successful vaginal birth after cesarean. These factors should be used for the consultation of pregnant women.

scholarly journals Rising Trend of Caesarean Section in a Tertiary Hospital Over a Decade

1970 ◽  
Vol 29 (3) ◽  
pp. 126-132 ◽  
Author(s):  
R Nazneen ◽  
RA Begum ◽  
K Sultana
Keyword(s):  
Caesarean Section ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Tertiary Hospital ◽  
Background Information ◽  
P Value ◽  
Demographic And Health Surveys ◽  
College Hospital ◽  
Medical College ◽  
Foetal Movement

Background information: Since the early 1990s, emergency obstetric care (EmOC) in Bangladesh has played important role to reduce the maternal mortality rate. Along with other indicators of improved maternal care, there is a trend of rising caesarean section rates over the last decade affecting the economy of the country. According to demographic and Health Surveys conducted between 1993 and 2004, rate of caesarean section has risen from 2% to 6% which is more pronounced in urban area. Objective: To assess the indications and the trends of caesarean sections done over a 10-year period from 1995- 2004. Study Design: A retrospective observational study of the cases of caesarean sections over a decade. Study setting: Holy Family Red Crescent Medical College Hospital. Results: 23748 women were admitted in department of Obstetrics and Gynacology. Total deliveries were 21149(89.05% of total admission). The caesarean birth rate increased from 45.85% to 70.55%. The indications varied a little in cases of malpresentation and eclampsia. APH and IUGR has risen a little (from 2.56 to 2.6 to 1.83 to 2.34%) respectively. But proportion of repeat caesarean section and that of presumed foetal distress (or less foetal movement) increased (from 25.99 to 31.45% and from 8 to 15%), recently the indication, as maternal choice is also coming up (from .43 to .8%). The proportion has fallen in prolonged labour for cervical dystocia (from 17 to 2.6%) and obstructed labour (from 4.6% to .36%). The data were compared and analyzed by Z Test and corresponding P value was calculated which was not significant. Conclusion: Though caesarean section is a very safe intervention in obstetrics at present, crucial evaluation of the indications is advocated to reduce the rates of caesarean secion. Keywords: Caesarean section rates; Indications DOI: http://dx.doi.org/10.3329/jbcps.v29i3.9432 JBCPS 2011; 29(3): 126-132

scholarly journals Validation of a Vaginal Birth After Cesarean Delivery Prediction Model in Women With Two Prior Cesarean Deliveries

2015 ◽  
Vol 125 (4) ◽  
pp. 948-952 ◽  
Author(s):  
Torri D. Metz ◽  
Amanda A. Allshouse ◽  
Allison M. Faucett ◽  
William A. Grobman
Keyword(s):  
Prediction Model ◽  
Cesarean Delivery ◽  
Vaginal Birth ◽  
Vaginal Birth After Cesarean ◽  
Cesarean Deliveries

scholarly journals A study on obstetric care in a primary health center of South Assam district, India

2018 ◽  
Vol 5 (8) ◽  
pp. 3629
Author(s):  
Ajit Kumar Dey ◽  
Debojit Chutia
Keyword(s):  
Age Groups ◽  
Multivariate Logistic Regression Analysis ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Safe Motherhood ◽  
Cross Sectional ◽  
Birth Prevalence ◽  
Care Services ◽  
Vaginal Deliveries ◽  
The Mean

Background: Maternal and child health are critically important in a country that is experiencing high infant mortality and maternal mortality. Research all over the world has suggested that one of the major solutions to this problem is availability of Emergency Obstetric Care services within the reach of people. Objectives of the study were to examine profile of mothers who have delivered in health facility during a year and the interplay of various factors in child birth and newborn outcome.Methods: Retrospective cross sectional study conducted by collecting information in predesigned format from medical records. Appropriate statistical methods and test of significance performed for qualitative and quantitative variables.Results: Out of 539 women, the majority of 42.9% were in the age group 20-25 years, the mean age (SD) of mother was 24.1 years (±4.09). Out of total 539 vaginal deliveries, 56.6% cases episiotomy was performed. 41.6% deliveries occurred from 8 AM to 4 PM. The mean birth weight was 2.830 kg SD 0.439 and low birth prevalence 16.0%. Parity with time to delivery after admission in different age groups revealed significant association (X2=66.456, p=0.000). Women aged less than 20 years are 12 times more at risk of episiotomy performed. The multivariate logistic regression analysis shows 60.67% specificity and 85.59% sensitivity in predicting episiotomy.Conclusions: From study it is evident that women report to hospital late in labor hence there is urgent need to provide quality antenatal care services at village and PHC level and augment awareness among the community for promotion of safe motherhood.

scholarly journals Analysis of success of vaginal birth after cesarean in relation to indication of primary caesarean section: a tertiary care experience

2019 ◽  
Vol 8 (11) ◽  
pp. 4440
Author(s):  
Neha Gupta ◽  
Arpita De ◽  
Nidhi Gupta
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Vaginal Birth ◽  
Successful Outcome ◽  
Vaginal Birth After Cesarean ◽  
Previous Pregnancy ◽  
Care Experience ◽  
Failed Induction ◽  
Vaginal Birth After Caesarean

Background: Apprehensions related to vaginal birth after caesarean (VBAC) has reduced rates of successful vaginal trials over last decade. The objective of this study was to identify the indications of first caesarean section that can lead to a successful trial of labour in subsequent pregnancy.Methods: Retrospective cohort study was done between November 2014 and October 2017. Data from the case records was analysed.Results: Study over 3 years from 2014 to 2017 revealed fetal distress (82.7%),  breech (72.2%), transverse lie (66.7%), antepartum haemorrhage (56.2%) and twins with first non-cephalic (57.9%) have successful outcome of VBAC whereas obstructed labour (19.2%) and failed induction (18.4%) in previous pregnancy have poor outcome for VBAC.Conclusions: Attempts to allow trial of labour after one previous caesarean section with fetal distress, malpresentation and twins as indications of caesarean in previous pregnancy are safe and should be encouraged.

scholarly journals MATERNAL WEIGHT;

2017 ◽  
Vol 24 (02) ◽  
pp. 263-266
Author(s):  
Sana Zahiruddin ◽  
Pushpa Chetan Malhi ◽  
Nigar Jabeen ◽  
Raheela Baloch
Keyword(s):  
Cesarean Delivery ◽  
Maternal Obesity ◽  
Cross Sectional Study ◽  
Vaginal Birth ◽  
University Hospital ◽  
P Value ◽  
Maternal Weight ◽  
Vaginal Birth After Cesarean ◽  
Cross Sectional ◽  
Study Results

Impact of maternal weight on success of VBAC. Introduction: WorldwideCesarean section is the commonest obstetrical procedure to be performed and same situationis in Pakistan. One strategy is to offer vaginal birth after cesarean section to reduce the alarmingcesarean rate. Many factors have been Identified which can affect success of trial of labor.Maternal weight has an important relation with the reproductive health of women, as obesityduring pregnancy is associated with increased maternal and fetal risk. Maternal obesity hasbeen shown to be associated with increased rates of primary cesarean delivery and failed trialof vaginal birth after cesarean delivery. Objectives: To determine the effect of maternal weighton success of VBAC. Study Design: Cross sectional study. Period: May 2012 to October 2013.Setting: Liaquat university hospital, Hyderabad. Material and Methods: a total of 96 womenwhich fulfilled the selection criteria were included in the study. Results: The women included inthe study had a mean age of SD (range), 29.94+ 4.41 (20-40 years) successful vaginal birthswas observed in 57(59.4%) women and 39(40.6%) had an emergency repeat cesarean delivery.Body mass index was noted among all the women, 23(24.0%) were obese and 73 (76.0%)were non-obese. Out of 23(24.0), 7(30.4%) had successful VBAC and 16(69.6%) women hadsuccessful trial of labor and 23(31.5%) delivered by repeat Caesarean delivery. (P.0.002) P value= 0.001 is statistically significant and calculated by Fisher’s exact X2 test. Conclusions: Obesityis associated with decreased chances of successful VBAC, making it a risky option for obesewomen.

scholarly journals Emergency obstetric care among referrals in more than 24 weeks gestation at a tertiary care teaching institution in Kerala, India

2020 ◽  
Vol 9 (8) ◽  
pp. 3313
Author(s):  
Heera Shenoy T. ◽  
Sheela Shenoy T. ◽  
Remash K. ◽  
Sony Simon
Keyword(s):  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
P Value ◽  
Skilled Delivery ◽  
Near Misses ◽  
Emergency Group ◽  
Emergency Interventions ◽  
Referral Decision

Background: One of the biggest barriers confronting efforts to reduce maternal mortality through increased skilled delivery is access to emergency obstetric care. This study aimed to look into the profile of emergency obstetric referrals. Referral-decision interval, reasons and morbidities of referral were analysed and their neonatal outcomes assessed.Methods: This observational study reviewed 90 emergency obstetric referrals over 3 years from June 2013 to February 2016.Results: In-labour referrals constituted the majority of emergency obstetric referrals. Preterm obstetric referrals needed emergency interventions in view of medical/obstetric indications and it was statistically significant. Referral- decision and referral-arrival interval was significant in emergency group (p-value-0.001). Babies born to mothers who were obstetric emergency referrals had extended NICU stay (p-value-0.001). There was a maternal death and four near-misses in this research.Conclusions: Timely decisions taken during interhospital emergency referrals resulted in better perinatal outcomes by prompt maternal interventions.

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