scholarly journals Symptoms of Discomfort and Problems Associated with Mode of Delivery During the Puerperium: An Observational Study

Author(s):  
Martínez-Galiano ◽  
Delgado-Rodríguez ◽  
Rodríguez-Almagro ◽  
Hernández-Martínez

Despite abundant literature on antenatal and delivery care received by pregnant women, there is a wide knowledge gap on the prevalence of symptoms of discomfort or problems during the postpartum period and their relationship with the mode of delivery. This cross-sectional study, carried out with 3324 participants in Spain in 2017, aimed to investigate the association between the mode of delivery and self-reported postpartum symptoms of discomfort and maternal problems during the puerperium. An ad hoc online questionnaire was used to collect data on socio-demographic and obstetric variables, symptoms of discomfort, and maternal problems during the puerperium. The crude odds ratios (OR) and adjusted OR (aOR) and their 95% confidence intervals (95%CI) were calculated using binary logistic regression. In total, 3324 women participated. Compared to a normal vaginal delivery, having a cesarean section was associated with increased odds of an infected surgical wound (aOR: 11.62, 95%CI: 6.77–19.95), feeling sad (aOR: 1.31, 23 95%CI: 1.03–1.68), and symptoms of post-traumatic stress (aOR: 4.64, 95%CI: 2.94–7.32). Instrumental delivery vs. normal vaginal delivery was a risk factor for constipation (aOR: 1.35 95%CI: 25 1.10–1.66), hemorrhoids (aOR: 1.28, 95%CI: 1.04–1.57), urinary incontinence (aOR: 1.30, 95%CI: 26 1.05–1.61), and fecal incontinence (aOR: 1.94, 95%CI: 1.29–2.92) during the puerperium. Women who gave delivery via cesarean section or instrumental delivery had higher incidences of infection and psychological alterations than those who had a normal vaginal delivery. Identifying women at risk of giving birth by cesarean section and informing them about subsequent symptoms of discomfort and maternal problems during the puerperium must be included in pregnancy health program policies and protocols to allow women to make informed decisions regarding their birthing plan.

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Neila Azka ◽  
Syahredi Syahredi ◽  
Eva Chundrayetti

AbstrakPada masa sekarang ini telah terjadi perubahan tren dalam persalinan, yaitu berupa peningkatan angka seksio sesarea. Peningkatan ini dipengaruhi berbagai faktor seperti: adanya kekhawatiran akan terjadinya cedera janin, peningkatan permintaan ibu untuk melakukan persalinan seksio sesarea, serta faktor sosioekonomi. Beberapa penelitian justru menunjukkan seksio sesarea dapat menimbulkan morbiditas pada bayi. Tujuan penelitian ini adalah membandingkan kondisi bayi antara persalinan normal dan seksio sesarea elektif dilihat dari nilai Apgar Penelitian dilaksanakan dari Mei 2014 sampai Januari 2014 di bagian rekam medis RSUP Dr. M. Djamil Padang.. Jenis penelitian yang digunakan adalah analitik dengan desain cross-sectional study. Sampel dalam penelitian ini terdiri dari 179  pasien dengan persalinan normal dan 56 pasien dengan seksio sesarea. Hasil penelitian menunjukkan bahwa pada menit pertama nilai Apgar 4-6 adalah 3,4% pada persalinan normal. Nilai Apgar 7-10 sebanyak 96,6% pada persalinan normal dan 100% pada seksio sesarea pada menit pertama. Pada menit kelima, nilai Apgar 4-6 adalah 1,1% pada persalinan normal, sedangkan nilai Apgar 7-10 sebanyak 98,9% pada persalinan normal dan 100% pada seksio sesarea pada menit kelima. Setelah dilakukan analisis dengan mann-whitney test didapatkan bahwa tidak terdapat perbedaan nilai Apgar pada menit-1 (p=0,777) dan menit-5 (p=0,887) antara persalinan normal dengan seksio sesarea.Kata kunci: persalinan normal, seksio sesarea elektif, nilai Apgar AbstractIn recent years, cesarean section have increased. Several factor are contributing, such as fears of injury to the fetus, increased women's request to do a cesarean section deliveries and socioeconomic factors. Some studies have also shown that cesarean section can lead to morbidity in infants. The objective of this study was to compare between Apgar scores of infant born by elective cesarean section and normal vaginal deliveries. The research was done from May 2013 to January 2014 at the medical records department of general hospital center Dr. M. Djamil Padang. This was an analytic study with cross-sectional study design. This study used 179 samples with normal vaginal delivery and 56 samples with cesarean section. The result showed that 1st minute Apgar score of 4-6 in normal vaginal delivery was 3.4%, and Apgar score 7-10 was 96.6% in normal vaginal delivery while in cesarean section was 100%. The 5th minute Apgar score of  4-6 in normal vaginal delivery was 1.1%, and Apgar score 7-10 was 98.9% in normal vaginal delivery while in cesarean section was 100%. After being analyzed using Mann-Whitney test, the study showed that there was no significant different in Apgar score of neonates born through normal vaginal delivery and neonates born trough cesarean section at first minute (p=0.777) and fifth minute (p=0.887).Keywords: normal vaginal delivery, elective cesarean section, Apgar score


2021 ◽  
Vol 4 (1) ◽  
pp. p1
Author(s):  
Mahnaz Nosratabadi ◽  
Nasrin Sarabi ◽  
Leila Masoudiyekta ◽  
Zahra Abbaspoor ◽  
Aziz Kassani

Introduction: Choosing the birth method is a major issue for pregnant women that is affected by multifaceted physiological, psychological and socio-cultural factors. Aim(s): The aim research was performed to explore factors influencing pregnant women’s attitude toward birth method. Methods: This is a cross-sectional study on 220 healthy nulliparous pregnant women with uncomplicated pregnancies without any contraindication for vaginal birth in Medical Centers of Dezful, in the south west of Iran. Data collection tool was a questionnaire for factors affecting the choice of delivery method. Differences in attitude were compared between two groups of natural vaginal delivery preference and cesarean delivery preference. Statistical analysis was performed with SPSS Version 16.0 statistic software package. Descriptive statistics were used to report percentages, mean, and standard deviation, and t-test, chi-square were applied to analyze the data. Results: During the study period, 206 primary pregnant women were examined to determine the attitudinal influencing factors the birth method preference. 131 women (64%) chose the natural delivery method and 71 women (36%) chose the cesarean delivery method. In addition, the results showed a statistically significant difference between the two groups regarding the general attitude of the participants towards natural delivery (164.43 in the normal vaginal delivery (NVD) group versus 134.50 in the cesarean section (CS) group (p < 0.001)). Conclusion: There is a direct relationship between the attitude of pregnant women towards vaginal birth and the tendency to normal vaginal delivery and cesarean section. Also, according to the results of the study of 8 components of attitudes, counseling sessions and prenatal training sessions can be identified based on counseling needs and be guided counseling sessions more purposefully.


2020 ◽  
Vol 15 (1) ◽  
pp. 35-38
Author(s):  
Farzana Zafreen ◽  
Md Abdul Wahab ◽  
Mohsen Uddin Ahmed ◽  
Md Habibur Rahman ◽  
Md Abdur Razzak

Introduction: Childbirth is a personal and individual journey that is different for every woman. Perception of the birth experience is thought to be influenced by many factors, the most significant of which may be the type of delivery. Normal vaginal delivery (NVD) is a natural process and cesarean section (CS) an operative process for child birth. Awareness regarding mode of delivery have a very important role for the future wellbeing of mother and child both. Objectives: To assess the awareness regarding normal vaginal delivery among pregnant women attending the out patients department (OPD) of an Upazilla Health Complex. Materials and Methods: This descriptive cross-sectional study was conducted at Kaliganj Upazilla Health Complex, Gazipur from January to March 2018 among 300 pregnant women. Age range of the patients was 15-40 years and selected purposively who were willing to attend and having no major complications. Data were collected by face to face interview with structured questionnaire and analyzed by SPSS version 20.0 Results: Out of 300 respondents 103(34.3%) was within 21-25 years, 87(29%) was within 26-30 years and 61(20.3%) was below 20 years of age. Respondents’ age at marriage found 113(37.7%) was within 21-25 years and 107(35.7%) below 20 years. About 178(59.3%) was regular and 122(40.7%) was irregular about their antenatal care visit. Common health problem was weakness 185(61.7%), GDM 67(22.3%) and swelling feet 21(7%). Among 211 respondents 133(63%) was satisfied, 40(19%) was dissatisfied and 38(18%) having mixed feelings about their previous delivery. Regarding awareness about mode of delivery 207(69.3) opted NVD better, 56(18.7%) opted CS better and 30(10%) was confused. Regarding preferred mode of delivery 191(63.7%) opined for NVD, 52(17.3%) opined for CS and 57(19%) was not clear about their opinion. Conclusion: Study found that majority of respondent was aware about the NVD but still good number of participant opted CS as their choice. Proper health education and creating awareness by mass media and healthcare worker and community leader may improve the situation. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 35-38


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yongjie Zhou ◽  
Hui Shi ◽  
Zhengkui Liu ◽  
Songxu Peng ◽  
Ruoxi Wang ◽  
...  

Abstract Coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide, with a staggering number of cases and deaths. However, available data on the psychological impacts of COVID-19 on pregnant women are limited. The purposes of this study were to assess the prevalence of psychiatric symptoms among pregnant women, and to compare them with non-pregnant women. From February 28 to March 12, 2020, a cross-sectional study of pregnant and non-pregnant women was performed in China. The online questionnaire was used to collect information of participants. The mental health status was assessed by patient health questionnaire, generalized anxiety disorder scale, insomnia severity index, somatization subscale of the symptom checklist 90, and post-traumatic stress disorder (PTSD) checklist-5. Totally, 859 respondents were enrolled, including 544 pregnant women and 315 non-pregnant women. In this study, 5.3%, 6.8%, 2.4%, 2.6%, and 0.9% of pregnant women were identified to have symptoms of depression, anxiety, physical discomfort, insomnia, and PTSD, respectively. However, the corresponding prevalence rates among non-pregnant women were 17.5%, 17.5%, 2.5%, 5.4%, 5.7%, respectively. After adjusting for other covariates, we observed that pregnancy was associated a reduced risk of symptoms of depression (OR = 0.23; 95% CI: 0.12–0.45), anxiety (OR = 0.26; 95% CI: 0.16–0.42), insomnia (OR = 0.19; 95% CI: 0.06–0.58), and PTSD (OR = 0.15; 95% CI: 0.04–0.53) during the COVID-19 epidemic. Our results indicate that during the COVID-19 epidemic in China, pregnant women have an advantage of facing mental problems caused by COVID-19, showing fewer depression, anxiety, insomnia, and PTSD symptoms than non-pregnant women.


Author(s):  
Juan Martínez-Galiano ◽  
Antonio Hernández-Martínez ◽  
Julián Rodríguez-Almagro ◽  
Miguel Delgado-Rodríguez ◽  
Ana Rubio-Alvarez ◽  
...  

Background: Discomfort during the puerperium period is very frequent in the lives of women but the influence of this discomfort on the women’s quality of life has been little studied. The objective of this study is to establish the association between discomfort and frequent problems of women in the puerperium and their quality of life score. Methods: A cross-sectional study on postpartum Spanish women was performed. Women older than 18 years and who had had a live birth were included. Less than 1% of women refused to participate in the study. Data were collected on socio-demographic, obstetric and newborn variables, on maternal problems/ discomfort in the postnatal period and on parameters that are quality of life indicators. An ad hoc online questionnaire which included the SF-36 Health Survey was used. Crude mean difference (cMD) and adjusted mean difference (aMD) were calculated through multiple linear regression. Results: 2990 women participated in the study. The greater problems causing quality of life loss were depressive symptoms (aMD = −12.40, CI 95%: −10.79, −14.01), lactation problems (aMD = −4.30, CI 95%: −2.97, −5.63), problems for sexual intercourse after childbirth (aMD = −6.34, CI 95%: −5.07, −7.60) and urinary incontinence (aMD = −4.97, CI 95%: −6.30, −3.65), among others. These have been detected as risk factors that affect the quality of life of the postpartum woman. Conclusions: The discomfort and problems manifested in the 6 weeks after childbirth have an influence that deeply affects the quality of life of postpartum women.


2017 ◽  
Vol 35 (05) ◽  
pp. 481-485 ◽  
Author(s):  
Ziya Kalem ◽  
Tuncay Yuce ◽  
Batuhan Bakırarar ◽  
Feride Söylemez ◽  
Müberra Namlı Kalem

Objective This study aims to compare melatonin levels in colostrum between vaginal and cesarean delivery. Study Design This cross-sectional study was conducted with 139 mothers who gave live births between February 2016 and December 2016. The mothers were divided into three groups according to the mode of delivery: 60 mothers (43.2%) in the vaginal delivery group, 47 mothers (33.8%) in the elective cesarean delivery, and 32 mothers (23.0%) in the emergency cesarean delivery group. Colostrum of the mothers was taken between 01:00 and 03:00 a.m. within 48 to 72 hours following the delivery, and the melatonin levels were measured using the enzyme-linked immunosorbent assay (ELISA) and compared between the groups. Results The melatonin levels in the colostrum were the highest in the vaginal delivery group, lower in the elective cesarean section group, and the lowest in the emergency cesarean group (265.7 ± 74.3, 204.9 ± 55.6, and 167.1 ± 48.1, respectively; p < 0.001). The melatonin levels in the colostrum did not differ according to the demographic characteristics of the mothers, gestational age, birth weight, newborn sex, the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores, and for the requirement for neonatal intensive care. Conclusion Our study results showed that melatonin levels in the colostrum of the mothers who delivered vaginally were higher than those who delivered by cesarean section. Considering the known benefits of melatonin for the newborns, we believe that vaginal delivery poses an advantage.


2017 ◽  
Vol 34 (10) ◽  
pp. 0974-0981 ◽  
Author(s):  
Christina Gonzalez ◽  
Amanda Allshouse ◽  
Erick Henry ◽  
Sean Esplin ◽  
Torri Metz

Objective We aimed to evaluate which patient-level factors influence mode of delivery among candidates for operative vaginal delivery. Study Design Cross-sectional study of candidates for operative vaginal delivery from 18 hospitals over 8 years. Probabilities of mode of delivery were estimated using hierarchical logistic modeling adjusting for clustering within physician and hospital. Results Total 3,771 (64%) women delivered with forceps, 1,474 (25%) vacuums, and 665 (11%) cesareans. Odds of forceps versus vacuum were higher with induction (OR = 2.16, 95% CI: 1.76–2.65), nulliparity (OR = 2.06, 95% CI: 1.59–2.66), epidural (OR = 2.05, 95% CI: 1.19–3.56), maternal indication (OR = 1.53, 95% CI 1.16–2.02), older maternal age (OR 1.18, 95% CI 1.06–1.31 per 5 years), and longer second stage (OR = 1.10, 95% CI: 1.01–1.20 per hour).Odds of cesarean versus operative vaginal delivery were higher with maternal indication (OR = 9.0, 95% CI: 7.23–11.20), a perinatologist (OR = 2.51, 95% CI: 1.09–5.78), longer second stage (OR = 1.79, 95% CI: 1.65–1.93 per hour), older gestational age (OR = 1.10, 95% CI: 1.01–1.20 per week), and longer labor (OR = 1.02, 95% CI: 1.01–1.04 per hour). Conclusion Patient-level factors influence the decision to proceed with an operative vaginal delivery and the choice of instrument, thereby emphasizing the importance of maintaining availability of both forceps and vacuums.


Author(s):  
Inas Mohamed Elhassan Abd. Alkareem ◽  
Mohamed Ahmed A/Gadir Ounsa ◽  
Elsadig Yousif Mohamed ◽  
Elsadig Mohamed ◽  
Sawsan Abdalla

Background: Postpartum dyspareunia affects many women following childbirth: however, the extent of the problem is difficult to estimate. The objectives of the current study were to determine the prevalence of postpartum dyspareunia and to estimate its risk factors.Methods: This is a cross-sectional study conducted at the National Ribat University Hospital, Sudan. The study was carried out on women attended the refer clinics of obstetrics and gynecology and pediatrics departments in the hospital. The sample size was calculated as 380. The data were collected by a pre-tested questionnaire along with a clinical examination of the vulva and vagina after obtaining the ethical approval. The SPSS was used to analyze the data.Results: The prevalence of postpartum dyspareunia in women attended the National Ribat University hospital was 42.6 %. Regarding age, 8 (61.5%) of women less than 20 years of age experienced dyspareunia, 102 (46.4%) and 52 (35.4%) of women whose age was 20-29 years; and more than 29 years experienced the condition. One hundred forty (51.7%) of women who delivered by normal vaginal delivery developed postpartum dyspareunia. Eight (72.7%), 8 (12.5%) and 6 (17.6%) of women delivered by Operative vaginal, Elective C/S and Emergency C/S developed postpartum dyspareunia respectively. One hundred forty-eight (62.4%), 153 (51.3%) women who had decircumcision and episiotomy in last delivery had postpartum dyspareunia respectively. Forty-six (93.3%), fifty-three (86.9%) and 60 (87%) women who had infected episiotomy, scar tissue at episiotomy and tight interoitus developed the condition respectively.Conclusions: The prevalence of postpartum dyspareunia in women attended the National Ribat University hospital was 42.6 %. Regarding age, 8 (61.5%) of women less than 20 years of age experienced dyspareunia, 102 (46.4%) and 52 (35.4%) of women whose age was 20-29 years; and more than 29 years experienced the condition. One hundred forty (51.7%) of women who delivered by normal vaginal delivery developed postpartum dyspareunia. Eight (72.7%), 8 (12.5%) and 6 (17.6%) of women delivered by Operative vaginal, Elective C/S and Emergency C/S developed postpartum dyspareunia respectively. One hundred forty-eight (62.4%), 153 (51.3%) women who had decircumcision and episiotomy in last delivery had postpartum dyspareunia respectively. Forty-six (93.3%), fifty-three (86.9%) and 60 (87%) women who had infected episiotomy, scar tissue at episiotomy and tight interoitus developed the condition respectively.


2021 ◽  
Author(s):  
Mohammad Rafi Fazli ◽  
Amena Mansouri ◽  
Hania Wahidi

Abstract Background: In the past few decades, the rate of cesarean section (CS) has increased worldwide which is common in high income countries. Although cesarean section has lots of socioeconomic impacts in the career of mothers and babies especially in LMICs like Afghanistan, it is also increasing in such countries. In compare to vaginal delivery the cesarean section has higher risks for maternal health. The most important aim of this study is to search the commonest indications of cesarean section at the only teaching hospital in west region of Afghanistan, Ghalib Teaching Hospital in 2017.Material and Method: This was a cross-sectional study. Among 456 pregnant women who came to Ghalib Teaching Hospital, 287(63%) had vaginal delivery and 169 (37%) had cesarean section delivery in 2017. Data was collected reviewing medical records; patients discharge certificate and a questionnaire which consisted of the data like; history of previous cesarean sections, age, and so on. Data was analyzed by epi info 7.Results: the prevalence of cesarean section in Ghalib Teaching Hospital was 37%, the median age was 28 years old, the mean age was 23.83 and the most ages were between 21-25 (42.5%). The commonest indications were severe oligohydramnios (29.5%) followed by previous cesarean section (12.4%) and elective cesarean section 10.9% (on maternal request). The least indication was cephalopelvic disproportion (3.09%). In our research we had more than one indication about 10.3%.Conclusion: according to the research the commonest indication of cesarean section was severe oligohydromnios which shows emergency indication among pregnant women. As the women in Afghanistan want many children so they usually do not consider having cesarean section deliveries. Cesarean section on maternal request also has high rate which needs appropriate guidelines and also policies to decrease this high rate of selective cesarean section. In our research 52.1% of indications of CS was fetal factors. This shows in LMICs many fathers have valued to the health of babies instead of mothers. It is highly needed to inform fathers to know about health of both babies and mothers.


Author(s):  
Bhavani Bhagat ◽  
V. Sitalakshmi ◽  
K. L. Azad ◽  
Nirmala Banoth

Background: Iso-immunization has been defined as the process whereby immune antibodies are produced in an individual in response to antigens from another individual of same species. Objective was to study the fetal outcome in immunized and non-immunized women and also to prevent isoimmunization during pregnancy and labour.Methods: A total of 40 patients attending outdoor antenatal clinic or admitted in the indoor wards in obstetric unit of Obstetrics and Gynecology department were included in the present study which was hospital based cross sectional study. The study was carried out for one year at Government Medical College Jagdalpur, Chhattisgarh, India. Permission from Institutional Ethics Committee was obtained. From each and every patient included in the study, initially informed individual consent was taken.Results: Maximum patients (25%) had an income of Rs. 200- 300 per month and minimum patients (10%) had an income of Rs. 500- 600 per month. Maximum cases of Rh – negative patients 87.5% are Hindus and 10 % are Muslims while only 2.5% are Christians. The percentage of patients below 20 years is 2.5, that between 20 to 25 are 67.5, between 26 to 30 is 27.5 and between 31 to 35 is 2.5. Thus, maximum patients belong to the age group 20 to 25 years and above 31 years.. Accordingly, 6 patients had history of abortion, 2 had pre- term deliveries, and 18 had full term deliveries. 4 had history of operation and 1 had history of jaundice in previous children. Cases with presence of Rh- Antibody in Maternal Circulation during Pregnancy. It was found that one out of 40 patients, had Rh- Antibody in titer of 1: 128 and 39 cases, did not show presence of Rh- Antibody in their circulation. Outcome of pregnancy in 40 patients studied. 3 patients had pre- mature labour, 26 had normal vaginal delivery, 10 had caesarean section and one patient was Ante- natal.Conclusions: Present study reveals more than Maximum patients were from low socioeconomic group and minimum cases were from higher socio- economic group. Majority of cases were Hindus, next in order Muslims and then Christians. Age of maximum patients ranged from 20-25 years. Maximum patients had normal full term deliveries. In 65% cases, outcome of pregnancy was normal vaginal delivery.


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