scholarly journals Autonomic Responses during Labor: Potential Implications for Takotsubo Syndrome

2021 ◽  
Vol 8 (11) ◽  
pp. 152
Author(s):  
Georgios E. Papadopoulos ◽  
Theoxaris I. Evaggelou ◽  
Errikos K. Moulias ◽  
Orestis Tsonis ◽  
Konstantinos C. Zekios ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Vagal Activity ◽  
Protective Effects ◽  
Takotsubo Syndrome ◽  
Autonomic Activity ◽  
Autonomic Responses ◽  
Non Invasive

Takotsubo syndrome is a serious complication of labor. Although the pathophysiologic role of excessive sympathetic activation is established in this process, concurrent vagal responses have not been adequately described. Moreover, it remains unclear whether autonomic activity depends on the mode of delivery. Here, we explored the hypothesis that the different management of cesarean and vaginal delivery may elicit diverse responses affecting both autonomic arms. For this aim, continuous electrocardiographic recording was performed in 20 women during labor, and non-invasive indices of sympathetic and vagal activity were compared between the two modes of delivery. We report sympathetic prevalence during cesarean delivery, caused by marked vagal withdrawal, whereas autonomic activity was rather stable during vaginal delivery. These differences may be attributed to the effects of anesthesia during cesarean delivery, along with the protective effects of oxytocin administration during vaginal delivery. Our results provide further insights on autonomic responses during labor that may prove useful in the prevention of complications, such as takotsubo syndrome.

scholarly journals Cardiac Magnetic Resonance in Takotsubo Syndrome

2017 ◽  
Vol 12 (1) ◽  
pp. 58 ◽  
Author(s):  
Konstantinos Bratis ◽  
Keyword(s):  
Heart Failure ◽  
Differential Diagnosis ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Risk Stratification ◽  
Takotsubo Syndrome ◽  
Unknown Aetiology ◽  
Non Invasive ◽  
Stress Cardiac Magnetic Resonance

Takotsubo syndrome is an acute, profound but reversible heart failure syndrome of unknown aetiology, usually but not always triggered by physical or emotional stress. Cardiac magnetic resonance has become an important tool for the non-invasive assessment of the syndrome, allowing for a comprehensive, safe and reproducible assessment of functional and anatomical myocardial properties, including perfusion, oedema and necrosis. This review focuses on the emerging role of cardiac magnetic resonance for the characterisation, differential diagnosis as well as risk stratification of patients with Takotsubo syndrome.

Comparison of Melatonin Levels in the Colostrum between Vaginal Delivery and Cesarean Delivery

2017 ◽  
Vol 35 (05) ◽  
pp. 481-485 ◽  
Author(s):  
Ziya Kalem ◽  
Tuncay Yuce ◽  
Batuhan Bakırarar ◽  
Feride Söylemez ◽  
Müberra Namlı Kalem
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Elective Cesarean Section ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional ◽  
Emergency Cesarean ◽  
Study Results ◽  
Elective Cesarean

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.

scholarly journals Survey of factors influencing women’s selection of the delivery method of their second child in Shanxi Province, China

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Jin-qiong Li
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Shanxi Province ◽  
Delivery Mode ◽  
Delivery Method ◽  
Childbearing Age ◽  
Second Child ◽  
Factors Influencing ◽  
Selection Of

Objective: To explore the factors influencing women’s selection of the delivery method of their second child. Methods: A questionnaire survey was administered among 431 women in the age range of interest from January 2015 to January 2017, and the survey results were evaluated and analyzed statistically. The experts evaluating the questionnaire are professionals in the Department of Obstetrics and Gynecology, Heji Hospital Affiliated to Changzhi Medical College. Results: A total of 70.99% of subjects were 28-35 years old. Approximately 82.35% wished to undergo vaginal delivery, and the remaining 17.65% expressed to undergo cesarean delivery. The reasons for cesarean delivery included the following: fetal factors: worry about fetal health (33.33%), birth trauma (12.90%), and fetal macrosomia (38.17%); maternal factors: advanced age (36.56%), inability to bear uterine contraction pains (21.51%), worry about uracratia after vaginal delivery (10.75%), worry about perineum laceration (8.60%) and the impacts on sexual gratification after delivery (5.38%); social factors: faster delivery mode (54.84%), selection of birth time (27.96%), and better planning of maternity leave (17.20%). Conclusion: Most women tend to undergo vaginal delivery. However, due to the influence of age, educational level and other factors, an increasing number of women prefer cesarean delivery. Medical institutions have the responsibility for providing overall and fair medical information to women of childbearing age to help them make informed choices regarding mode of delivery. doi: https://doi.org/10.12669/pjms.37.3.2634 How to cite this:Li JQ. Survey of factors influencing women’s selection of the delivery method of their second child in Shanxi Province, China. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.2634 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Influence of severity of total bile acids and mode of delivery on the perinatal outcomes in intrahepatic cholestasis of pregnancy

2021 ◽  
Author(s):  
Chengcai Kong ◽  
Fenglin Mei ◽  
Pingping Xue ◽  
Jingyun Cao ◽  
Yong Li ◽  
...  
Keyword(s):  
Bile Acids ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Intrahepatic Cholestasis ◽  
Mode Of Delivery ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Fetal Outcomes ◽  
Increased Risk ◽  
Total Bile Acids ◽  
Cholestasis Of Pregnancy

Abstract To assess the associations between mode of delivery and pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy (ICP) based on the severity of maternal hypercholanemia. A hospital-based retrospective cohort study was performed between January 1, 2015, and December 31, 2019. Among the 177 women with mild total bile acids, 123 (69.5%) had a vaginal delivery and 54 (30.5%) underwent a cesarean delivery, of which 42 (23.7%) were planned and 12 (6.8%) were unplanned. Among the 50 severe ICP women, 13 (26.0%) had a vaginal delivery and 37 (74.0%) underwent a cesarean delivery, of which 26 (52.0%) were planned and 11 (22.0%) were unplanned. Severe ICP was associated with an increased risk of preterm delivery (P < 0.001), low birthweight (P=0.001), and neonatal intensive care unit admission (P < 0.001). Women with severe ICP (aOR, 5.017; 95% CI 1.848–13.622), planned cesarean delivery (aOR, 5.444; 95%CI 1.723–17.203), or unplanned cesarean delivery (aOR, 5.792; 95%CI 1.384–24.236) had increased risks of adverse fetal outcomes compared to controls. Both planned and unplanned cesarean delivery are associated with a higher incidence of adverse fetal outcomes and severe ICP than vaginal delivery.

Cesarean delivery among women with prolonged labor induction

2016 ◽  
Vol 44 (7) ◽  
Author(s):  
Louise L. Highley ◽  
Rebecca A. Previs ◽  
Sarah K. Dotters-Katz ◽  
Leo R. Brancazio ◽  
Chad A. Grotegut
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Labor Induction ◽  
University Hospital ◽  
Delivery Rate ◽  
Multivariate Logistic Regression Model ◽  
Nulliparous Women ◽  
Prolonged Labor ◽  
Cesarean Delivery Rate

AbstractObjective:The objective of this study was to determine characteristics associated with cesarean delivery among women with labor induction lasting over 24 h.Study design:Women with live singleton pregnancies without prior cesarean delivery undergoing a labor induction lasting >24 h between September 2006 and March 2009 at Duke University Hospital were identified. Collected variables were compared between subjects by mode of delivery. A multivariate logistic regression model for the outcome cesarean delivery was constructed separately for nulliparous and parous women.Results:There were 303 women who met inclusion criteria. The overall cesarean delivery rate was 57% (n=172) and remained constant with time (P=0.15, test-for-trend). Nulliparous women having a cesarean delivery were more likely to be obese [adjusted OR (aOR) 2.00; 95% CI 1.05, 3.80] and have a larger fetus [aOR 1.11 (aOR for every 100 g increase in birthweight), 95% CI 1.03, 1.20] compared to those having a vaginal delivery.Conclusion:Increasing BMI and birthweight were independent predictors of cesarean delivery among nulliparous women with prolonged labor induction. Despite this, after 24 h of labor induction, the overall mean cesarean delivery rate remained constant at 57%, and did not change with time. Among women having a vaginal delivery following a prolonged labor induction, we saw high rates of shoulder dystocia, operative vaginal delivery and severe perineal laceration.

scholarly journals Prediction of labor outcome by measuring the angle of progression using two dimensional trans-perineal Ultrasound: A prospective cohort study

2021 ◽  
Vol 12 (3) ◽  
pp. 200-204
Author(s):  
Diaa Abdelhalim ◽  
Hussein Abolmakarem ◽  
Mohamed Hassan
Keyword(s):  
Vaginal Delivery ◽  
Primary Outcome ◽  
Mode Of Delivery ◽  
Perineal Ultrasound ◽  
Vaginal Route ◽  
Fetal Head ◽  
Spontaneous Vaginal Delivery ◽  
Non Invasive ◽  
Secondary Outcomes ◽  
Angle Of Progression

Background: Failure of descent due to fetal malposition is one of the most common indications for performing surgical deliveries. It has recently been suggested that trans-perineal intra-partum ultrasonography may be useful in assessing fetal head engagement, position and station as well as it’s reliable, cheap, painless and effective tool. Measuring the ‘angle of progression’ could assist in the obstetrician’s decision regarding mode of delivery. Objectives: The primary outcome is to use the AOP to develop a predictive model for the probability of successful vaginal delivery. Secondary outcomes including assessment of possibly successful VBAC in previous one CS women. Methods: We recruited 500 women in labor. For each woman, a (TPU) was performed to measure the AOP in late first and second stages of labor. We compared AOP between women who delivered fetuses through vaginal route to those who delivered by CS. Results: Through 467 women included in the study, AOP was significantly Higher in spontaneous vaginal delivery group (with cut off 123°±8.5°) as compared with women delivered by vacuum or by CS (113°±10.5°) (P=0.003). The VBAC as another secodary outcome seems to be insignificant. Conclusions: TPU is safe, non-invasive and easily preformed technique which is useful to predict labor outcomes.

scholarly journals The Impact of Race on Postpartum Opioid Prescribing Practices: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Tyler Ryan McKinnish ◽  
Adam K. Lewkowitz ◽  
Ebony B. Carter ◽  
Ashley E. Veade
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
White Women ◽  
Private Insurance ◽  
Mode Of Delivery ◽  
Sensitivity Analyses ◽  
Wound Complications ◽  
Fourth Degree ◽  
Black And White ◽  
The Impact

Abstract BackgroundTo identify the association between inpatient postpartum opioid consumption, race, and amount of opioids prescribed at discharge after vaginal or cesarean delivery. MethodsA total of 416 women who were prescribed an oral opioid following vaginal or cesarean delivery at a single tertiary academic institution between July 2018 and October 2018 were identified. Women with postoperative wound complications, third and fourth degree lacerations, cesarean hysterectomy, or a history of opioid abuse were excluded. The primary outcome was the number of oxycodone 5 mg tablets prescribed at discharge, stratified by race and mode of delivery. Only “Black” and “White” women were included in analyses due to low absolute numbers of other identities. Black women were compared to white women using multivariable logistic regression. Multiple sensitivity analyses were performed.ResultsThe median number of oxycodone tablets consumed during hospitalization following cesarean delivery was seven (IQR: 2.5–12 tablets) and following vaginal delivery was one (IQR: 0-3). White women were more likely to be older at delivery regardless of route (median 32 vs. 30 years for cesarean delivery, and 29 vs. 27 years for vaginal delivery; p<0.01 for both). White women undergoing cesarean delivery did so at a lower maternal BMI (31.6 vs. 34.5; p=0.02). White women were also significantly more likely to have private insurance and to experience perineal lacerations following vaginal delivery. The number of inpatient opioid tablets consumed, as well as the number prescribed at discharge, were not statistically different between Black and White women, regardless of mode of delivery. These findings persisted in sensitivity analyses.ConclusionAt our large, academic hospital the number of tablets prescribed at discharge had no association with patient race or inpatient usage regardless of mode of delivery.

Prevention of the First Cesarean Delivery: The Role of Operative Vaginal Delivery

2012 ◽  
Vol 36 (5) ◽  
pp. 365-373 ◽  
Author(s):  
Alfredo F. Gei
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Operative Vaginal Delivery

scholarly journals Knowledge of blood loss at delivery among postpartum patients

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2361 ◽  
Author(s):  
Michaela K. Farber ◽  
Claire M. Miller ◽  
Bharathi Ramachandran ◽  
Priya Hegde ◽  
Kulsum Akbar ◽  
...  
Keyword(s):  
Blood Loss ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Mode Of Delivery ◽  
Clinical Implications ◽  
Transfusion Therapy ◽  
Obstetric Morbidity ◽  
To Receive ◽  
Clear Information

BackgroundPostpartum hemorrhage (PPH) is a leading cause of obstetric morbidity. There is limited understanding of patients’ knowledge about blood loss at delivery, PPH, and PPH-related morbidities, including transfusion and anemia.MethodsWe surveyed 100 healthy postpartum patients who underwent vaginal or cesarean delivery about blood loss, and whether they received information about transfusion and peripartum hemoglobin (Hb) testing. Responses were compared between women undergoing vaginal delivery vs. cesarean delivery;P< 0.05 considered as statistically significant.ResultsIn our cohort, 49 women underwent vaginal delivery and 51 women underwent cesarean delivery. Only 29 (29%) of women provided blood loss estimates for their delivery. Women who underwent cesarean delivery were more likely to receive clear information about transfusion therapy than those undergoing vaginal delivery (43.1% vs. 20.4% respectively;P= 0.04). Women who underwent vaginal delivery were more likely to receive results of postpartum Hb tests compared to those undergoing cesarean delivery (49% vs. 29.4%;P= 0.02).ConclusionOur findings suggest that women are poorly informed about the magnitude of blood loss at delivery. Hematologic information given to patients varies according to mode of delivery. Further research is needed to better understand the clinical implications of patients’ knowledge gaps about PPH, transfusion and postpartum anemia.

scholarly journals Morbidity in neonates according to the mode of delivery: a comparative study

2010 ◽  
Vol 8 (3) ◽  
pp. 308-314 ◽  
Author(s):  
Maria Cecilia Santa Cruz Breim ◽  
Conceição Aparecida de Mattos Segre ◽  
Umberto Gazi Lippi
Keyword(s):  
Cesarean Section ◽  
Respiratory Distress ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Maternity Hospital ◽  
Birth Injury ◽  
Cross Sectional ◽  
Abdominal Approach

ABSTRACT Objective: The objective of this study was to compare the effects of the modes of delivery on the health of newborns in a private maternity hospital in the city of São Paulo. Methods: Between January 1995 and December 1998, all patients consecutively admitted for deliveries were included in this cross-sectional retrospective study. A total of 8,457 medical records were analyzed, being excluded of the sample 460 multiple pregnancies and 517 pregnant women with obstetric and/or clinical disorders. The incidence of neonatal birth injury, respiratory distress and anoxia was analyzed, as well as birth weight, type of delivery and gestational age (according to Näegele and Capurro). Results: The final sample consisted of 7,480 neonates, and 69.6% were born by cesarean section, 24% vaginally and 6.4% through the vagina with the aid of forceps. A significant association was found between anoxia and the three types of delivery (p < 0.001). Respiratory distress was more frequent in cesarean delivery in newborns with gestational age superior to 37 weeks and in newborns weighing more than or equal to 2,500 g. Respiratory distress was significantly associated with cesarean delivery and/or forceps delivery, as compared with vaginal delivery, in the entire sample. Neonatal birth injury was associated with the use of forceps. In neonates born by cesarean section, anoxia was associated with lower gestational age estimated by the Capurro method and with lower weight. Conclusions: The abdominal approach is associated with greater morbidity of fetuses due to respiratory distress. Vaginal delivery is safer in newborns with more than 37 weeks of gestation and in those weighing more than 2,500 g.

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