CLINICAL AND SUBCLINICAL CHARACTERICTIS AND PREGNANCY OUTCOME OF FETAL MACROSOMIA AT OBSTETRIC DEPARTMENT AT HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2020 ◽  
pp. 78-84
Author(s):  
Giang Truong Thi Linh ◽  
Quang Mai Van
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Vaginal Birth ◽  
Fetal Macrosomia ◽  
Major Influence ◽  
Maternal Complications ◽  
Perineal Tear ◽  
History Of

Background: Fetal macrosomia has a major influence on maternal, neonatal and pregnancy outcomes.Objective: To describe the clinical and subclinical features and the management of fetal macrosomia on pregnancy outcomes. Subjects and methods: Study subjects including pregnant women and babies born ≥ 3500 g with nulliparous and over 4000 grams with primiparous or multiparous at Departement of Obstetrics and Gynecology in Hue University of Medicine and Pharmacy Hospital. The time of choosing subjects to enter the research group is that after birth, the weight is above 3500/4000 grams, then follow up the pregnancy result and retrospect the clinical and subclinical characteristics. Results: From May 2019 to April 2020, there were 223 pregnant women with the birth weight ≥ 3500 g in this study. The mean neonatal weight for macrosomia was 3869.96 ± 315.72 (g). The birth weight ≥ 4000 g, the rate of cesarean section was 91.5%, vaginal birth was 8.5%. The birth weight 3500 - under 4000 g, the rate of cesarean section was 76%, vaginal birth was 24%. 1.1% maternal complications was perineal tear. Conclusion:Factors related to fetal macrosomia: Maternal age, gender of fetus, parity, a history of fetal macrosomia, maternal height, pregnancy weight gain. Caesarean section is the majority. Key words: Fetal macrosomia, gestational diabetes mellitus, normal labor, caesarean section.

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 The Outcome of Vaginal Birth After One Caesarean Section (VBAC)

2020 ◽  
Vol 39 (1) ◽  
pp. 36-45
Author(s):  
Mst Jesmin Akter ◽  
Eliza Shirin
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Multiple Pregnancy ◽  
Vaginal Birth ◽  
Fetal Survival ◽  
History Of

Background: Caesarean section has become the most performed major operation in obstetrics. The increasing rate of primary caesareans section becomes high worldwide due to early detection of fetal and maternal complications. Repeated caesarean section is one of the major contributory factors for increasing this rate very significantly. Now a day, vaginal delivery of pregnant mothers with the history of previous one caesarean with non-recurrent cause was established. It has been shown that the outcome of trial of labor in past caesarean delivery is acceptable, effective and safe for both mother and fetus, if the women are properly selected. Objective: The objectives of this study were to determine the outcomes of vaginal birth after caesarean section (VBAC) in case of previous one caesarean section to reduce the subsequence cesarean section with its complication. Materials and Methods: It was a cross sectional study carried out in the Maternity Unite-1, Department of Gynecology & Obstetrics, Sir Salimullah Medical College and Mitford hospital, Dhaka, Bangladesh, held on January 2010 to December 2010. Out of total 380 admitted pregnant women who had previous one caesarean section, 50 pregnant women of 37-42 weeks of gestational age with the history of one caesarean delivery with alive baby were selected as study population following consecutive and purposive sampling method. Patients with spontaneous onset labor but preterm pregnancy with any contraindication or prior caesarean section due to recurrent causes, history of classical caesarean section, more than one caesarean section, multiple pregnancy, pregnancy with medical disorder were excluded in the study. Results: Out of total 50 sampled pregnant women, vaginal delivery were done 16(32%) & emergency cesarean section were done 34(68%). According to the age group both vaginal & cesarean section 20- 30 years were predominant, which were 8(50%) and 17(50%) respectively. Regarding antenatal care 13(81.25%) of vaginal delivery cases were regular. On the other hand, only 10(29.41%) of cesarean section were regular in care. Fetal survival outcome in vaginal & caesarean were 14(87.5%) and 33(97.05%) respectively. Comparing the maternal complication maximum number of vaginal delivery group had no complications. Conclusion: It has been seen in this study that good antenatal care is of paramount importance and was associated with higer rate of vaginal delivery is pregnancy with history of one caesarean section. In this series the post Partum hemorrhage was higher in vaginal delivery group and wound infection rate was high in caesarean group. J Bangladesh Coll Phys Surg 2021; 39(1): 36-45

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 Pregnancy with previous caesarean section: an overview of adverse fetomaternal sequelae

2018 ◽  
Vol 7 (5) ◽  
pp. 1817 ◽  
Author(s):  
Joyita Bhowmik ◽  
Amit Kyal ◽  
Indrani Das ◽  
Vidhika Berwal ◽  
Pijush Kanti Das ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Previous History ◽  
Successful Outcome ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Medical College ◽  
Increased Risk ◽  
Fetal Complications ◽  
History Of

Background: The Caesarean section epidemic is a reason for immediate concern and deserves serious international attention. The purpose of this study was to evaluate adverse maternal and fetal complications associated with pregnancies with history of previous caesarean section.Methods: A cross-sectional, observational study carried out over a period of 1 year from 1st June 2016 to 31st July 2017 in Medical College Kolkata. 200 antenatal patients with previous history of 1 or more caesarean sections were included. In all cases thorough history, complete physical and obstetrical examination, routine and case specific investigations were carried out and patients were followed till delivery and for 7 days thereafter. All adverse maternal and fetal complications were noted.Results: Out of 200 women, 30 candidates were tried for VBAC, of them 20 (66.66%) had successful outcome. Most common antenatal complication was APH (5.5%) due to placenta praevia followed by scar dehiscence. There were 12 cases (6.66%) of PPH and 6 cases (3.33%) of scar dehiscence in the study group. 3 cases required urgent hysterectomy due to placenta accreta. 42 out of 196 babies required management in SNCU immediately or later after birth.Conclusions: Women with a prior cesarean are at increased risk for repeat cesarean section. Vigilance with respect to indication at primary cesarean delivery, proper counselling for trial of labor and proper antepartum and intrapartum monitoring of patients are key to reducing the cesarean section rates and maternal complications.

scholarly journals Vaginal Birth After Previous Caesarean Section

2017 ◽  
Vol 2 (2) ◽  
pp. 36-44
Author(s):  
Chro N. Fattah ◽  
Hazha Jalal
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Prospective Observational Study ◽  
Vaginal Birth ◽  
Perineal Tear ◽  
Neonatal Complication ◽  
Significant Probability ◽  
Inter Pregnancy Interval ◽  
Selection Of ◽  
Vaginal Birth After Caesarean

The proportion of women who attempt vaginal birth after prior cesarean delivery has   decreased mainly because of the concern about safety.  The purpose of this study is to observe maternal & neonatal outcomes in women delivered either by vaginal birth after caesarean section, elective repeat caesarean section or failed trial of labour. To design a definite protocol for selection of patient to achieve successful vaginal birth after caesarean (VBAC) section. A prospective observational study was set at Sulaimani Maternity Teaching Hospital/ Kurdistan region of Iraq, from first July 2013 to first July 2014. In which 200 pregnant women (with one prior caesarean section & singleton, term, cephalic presentation) were enrolled, followed up during labour & puerperium for maternal & neonatal complications.  Data analysis was performed using the statistical software namely (SPSS   version 20). Planned vaginal birth was successful in 63.4% of pregnant women, with the least maternal and neonatal complication, apart from 3rd degree perineal tear (2.3%) which was statistically significant (probability value < 0.001). In conclusion, the women who had successful vaginal birth after caesarean, had better result for the mother and neonate than failed trial of labour and those who had elective repeat caesarean section. Women with body mass index of < 30kg/m2, age <30 years, inter pregnancy interval >18months, non-recurrent cause of previous scar and estimated fetal weight of < 4kg, had more successful VBAC rate.

Influence of the category of urgency of the caesarean section on the adaptive capabilities of pregnant and parturient women

2017 ◽  
pp. 10-15
Author(s):  
I.A. Usevych ◽  
◽  
V.L. Kolesnik ◽  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maximum Level ◽  
Psychological Problems ◽  
Control Group ◽  
Pregnancy And Childbirth ◽  
Adaptive Capabilities ◽  
Section Operation ◽  
History Of

Psychological problems during pregnancy and childbirth for today is a little studied subject of modern obstetrics. The possibilities for solving psychological problems that arise in cases of emergency obstetric situations are almost not used by Ukrainian specialists through the marriage of knowledge and skills to provide crisis psychological help to obstetric patients. The objective: to determine the level of psychoemotional load in pregnant and parturient women, depending on the category of urgency of cesarean section. Material and methods. The main group of the study was presented: 1 group - pregnant women, who had planned a cesarean section operation according to the ІV category of urgency and who had already had a caesarean section in the anamnesis; ІІ group – pregnant women who planned an operation according to the IV category of urgency and who had no previous caesarean section in their history; ІІІ group – pregnant and parturient women who underwent surgery, respectively, in the I–III category of urgency; Control group – 30 pregnant women in the period of 37–41 weeks of pregnancy. A survey was conducted using the questionnaires of J.Teylor, Ch.Spielberger and SAN-test. Results. On the eve of labor in pregnant women there is an increase in the psychoemotional load, which can be determined using the above questionnaires. There is a direct dependence on the category of urgency of cesarean section and the level of psychoemotional load. Also revealed the correlation dependence of the voltage of the adaptation reserves of the pregnant woman on the presence of a history of caesarean section. Conclusion. Almost 50 percent of pregnant women, in cases of cesarean section, respectively, 1–3 categories of urgency in the preoperative period have the maximum level of psychoemotional load according to the questionnaires used. Pregnant women who have undergone a caesarean section in anamnesis are more adapted and have less psycho-emotional stress than women who have a cesarean section for the first time. Key words: cesarean section, psychoemotional state, pregnancy, childbirth, scale J. Teylor, scale Ch. Spielberger, SAN-test.

scholarly journals Outcome of pregnancy among high risk pregnancies in rural area of Nagpur, Central India

2017 ◽  
Vol 4 (3) ◽  
pp. 628
Author(s):  
Ashok Rupraoji Jadhao ◽  
Mahendra D. Gawade ◽  
Suresh N. Ughade
Keyword(s):  
Birth Weight ◽  
High Risk ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Rural Area ◽  
Mode Of Delivery ◽  
Central India ◽  
High Risk Pregnancy ◽  
Risk Pregnancy ◽  
History Of

Background: All pregnant women, by virtue of their pregnancy status, face some level of maternal risk. Some pregnancies are complicated by problems associated with mother’s health. Most maternal morbidities could be prevented if mother had access to appropriate and timely healthcare during pregnancy. Study was intended to find out prevalence of high risk pregnancy and pregnancy outcome among them in rural area of Nagpur district, Central India.Methods: Community based observational descriptive study was conducted on consecutive sample of 214 pregnant women, who had 20 weeks and above gestational period.Results: Prevalence of high risk pregnancy observed was 33.64% (95% CI 27.31%-39.97%). Caesarean section (OR=7.63, 95% CI=4.04-14.40, P=0.0001) and birth weight less than 2500gm (OR= 3.47, 95% CI=1.47-8.20, P=0.003) were significantly associated with high risk pregnancy. Mode of delivery caesarean section had strong relationship with previous history of caesarean section (OR=37.53, 95% CI=8.64-163.05, P=0.0001) and mothers height less than or equal to 140cm (OR=8.87, 95% CI=1.02-77.32, P = 0.0183). Pregnancy outcome low birth weight was significantly associated with oligohyramnios (OR = 8.45, 95 % CI=1.61-44.48, P=0.003) and history of caesarean section (OR=2.67, 95 % CI=1.01-7.07, P = 0.041).Conclusions: Prevalence of high risk pregnancy was almost one-third in pregnant women in rural area of central India. Mode of delivery caesarean section and birth weight less than 2500gm was significantly associated with high risk pregnancy. History of caesarean section and height less than or equal to 140 cm influence the outcome of pregnancy i.e. caesarean section. Birth weight, LBW (Low Birth Weight) was associated with history of caesarean section and oligohyramnios.

Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maternal Age ◽  
Unwanted Pregnancy ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

scholarly journals Outcome of Twin Pregnancy in a Periurban Hospital

2016 ◽  
Vol 27 (2) ◽  
pp. 57-62
Author(s):  
Saria Tasnim ◽  
FM Anamul Haque ◽  
Sameena Chowdhury
Keyword(s):  
Birth Weight ◽  
Twin Pregnancy ◽  
Perinatal Death ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Labor Pain ◽  
Maternal Complications ◽  
Management Options ◽  
History Of ◽  
Second Twin

Objective: To determine the socio demographic characteristics, clinical presentation and obstetric outcome at delivery and immediate postpartum period of twin gestation in a periurban hospitalMaterial & Methods: An observational study was conducted between January 2000 to December 2004 at Institute of Child and Mother Health. All twin pregnancy irrespective of gestational age admitted in the in-patient department of Institute of Child and Mother Health for delivery and also those undiagnosed cases found to have twin birth were enrolled in the study consecutively from January 2001 to December 2004. Data on socio-demographic factors, predisposing factors for twin gestation and obstetric characteristics was collected using a structured questionnaire. Hospital records were consulted for recording the investigation reports and management options. The outcome variables were maternal complications during antenatal, intranatal and immediate postnatal period, mode of delivery, birth weight and sex of newborn and fetal outcome. All twin pregnancies from the admitted obstetric patients were enrolled consecutivelyResults: During the study period there were 11,185 deliveries and among them 107 were twin gestation. About 22% were primigravida, 78.5% multigravida, 27.1% were illiterate. Most common age group were 24-29 years (39.4%). Antenatal care was availed by 71% of patients and 27.1% twins were not diagnosed till delivery. Family history of twin on maternal side was present in 58.1% and 31.8% had history of taking oral contraceptive immediately before the pregnancy. Ovulation inducing agents were given to 8.3% of twin. Presentations of fetus were both vertex 54.2%, 1st vertex and second breech 16%, and both breech 5.7%. About 55.1% were admitted with labor pain, 6.5% were undelivered second twin. Preterm birth was 27.2% and low birth weight of 1st baby 79.6% and second baby 80.9% respectively. Mode of delivery was vaginal delivery of both fetus 41.6%, caesarean section of both fetus 62.4%, and caesarean for second twin 3.1%. Same sex of both twins was found in 78% and male-male pair was 50%. There was one stillbirth, one conjoined twin and perinatal death was 11.2% Complications encountered during perinatal period were severe abdominal pain 9.3%, retained placenta in 7.3%; and post partum hemorrhage in 4.6% cases.Conclusion: Twin pregnancy is quite common and warrants specialized care during ante partum, intrapartum and postpartum period.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 57-62

scholarly journals Caesarean section at Koudougou regional hospital centre: indications and prognosis

2020 ◽  
Vol 9 (12) ◽  
pp. 4792
Author(s):  
Djiguemde Nebnomyidboumbou Norbert Wenceslas ◽  
Lankaonde Martin ◽  
Savadogo-Komboigo B. Eveline ◽  
S. I. B. Sansan Rodrigue ◽  
Ouedraogo Wendlassida Estelle ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Caesarean Section Rate ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Important Place ◽  
History Of ◽  
Group 3 ◽  
Group 5 ◽  
Uterine Scar

Background: Objective was to study the indications and the prognosis of cesarean section in the obstetrics and gynecology department of CHR Koudougou from August 1st to October 16th 2018.Methods: This was a cross-sectional study for descriptive purposes with prospective collection of data over the month and monitoring of parturients up to the 42nd day post caesarean section. The study covered the period from August 1 to October 16, 2018. Gestures received in the work room and those hospitalized for a scheduled cesarean were involved in this study.Results: This study involved 316 deliveries. The caesarean section rate was 34.8% (n=110). The average age was 26.75 years with extremes of 12 and 42 years. Term pregnancies represented 90.9%. History of cesarean section was observed in 47, 3%. The main groups contributing to the caesarean section rate represent: Groups 5 (9.5%), Group 1 (9.2%), Group 3 (5.1%), the scar uterus (17.3%) and suffering fetal (14.6%). The reported complications were 15.5% including 3.6% parietal suppuration and 0.8% stillbirth.Conclusions: The caesarean section occupies an important place in the maternity service of the RHC of Koudougou. Robson's group 5 was the largest contributor to the overall cesarean rate in our study. Measures should be taken in this group so that the uterine scar does not become an absolute indication for cesarean.

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