A STUDY OF FETOMATERNAL OUTCOME OF INSTRUMENTAL VAGINAL DELIVERIES AT A RURAL TERTIARY CARE HOSPITAL IN MANDYA DISTRICT KARNATAKA

2021 ◽  
pp. 1-3
Author(s):  
Triza Kumar Lakshman ◽  
Ekta Chhabra ◽  
Ravindra S. Pukale
Keyword(s):  
Vaginal Delivery ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Care Hospital ◽  
Maternal Complications ◽  
Perineal Tear ◽  
Operative Vaginal Delivery ◽  
Vaginal Deliveries ◽  
Skilled Operator ◽  
Assisted Delivery

Introduction: Giving birth can be a long and painful process and is not always a perfect one. Instrumental vaginal delivery is an art and provides a 1 temporal advantage over cesarean delivery. It is also an alternative procedure for delivery in emergency obstetrics. Instrumental vaginal delivery is an integral part of Obstetrics care world wide. The present study was carried out to evaluate the maternal and neonatal outcome in operative/assisted vaginal delivery. Method: We performed a retrospective observational study of women with singleton term pregnancies who underwent operative vaginal delivery at Adichunchanagiri Institute of Medical Sciences. The study was conducted between August 2019 to August 2020 for the duration of 1 year and the data was accrued from patient database retrospectively and was entered in Microsoft Excel (Version 16.4) for Windows. Results: During the study period, 95 patients underwent Instrumental Vaginal Delivery, of which 74 were vacuum assisted and 21 were forceps nd delivery. The most common indication for Operative vaginal delivery was failure of maternal efforts followed by prolong 2 stage of labour in vacuum group and severe pre-eclampsia in forceps group. Vacuum was used more often than forceps for most of the deliveries. Maternal st nd complication like 1 and 2 degree perineal tear were seen more often with the use of forceps. Instrument marks and bruising were found in the neonates delivered by forceps and a greater incidence of cephalohaematomas and caput in the neonates delivered with vacuum. Conclusion: A successful instrumental vaginal delivery can be achieved with lesser maternal and neonatal morbidity with timely assessment of labour and skilled operator. The overall rate of perinatal and maternal morbidity and mortality vary by indication and operative instrument. Women who underwent forceps-assisted delivery had greater rates of maternal complications than those who underwent vacuum-assisted delivery

scholarly journals Fetomaternal outcome in operative vaginal delivery

2021 ◽  
Vol 10 (11) ◽  
pp. 4096
Author(s):  
Jeyamani B. ◽  
Nashreen Dhasleema A.
Keyword(s):  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Breech Presentation ◽  
P Value ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Second Stage ◽  
Operative Vaginal Delivery ◽  
Vaginal Deliveries ◽  
Assisted Delivery

Background: Operative vaginal deliveries (OVD) were performed with the help of vacuum or forceps in the second stage of labor when mother and foetus condition is threatening. A successful assisted vaginal delivery avoids caesarean section and its associated morbidity and implications for future pregnancy. The aim of the study was to assess the maternal and neonatal outcome of vacuum and forceps assisted vaginal deliveries.Methods: It was a retrospective comparative cross sectional study done in VMKVMCH, Salem in obstetrics and gynecology department, from the period of April to June 2021. All the mothers delivered by operative vaginal delivery were included. Mothers with multiple pregnancies, preterm and breech presentation were excluded. Data collected using patients information sheet and analysis was done using SPSS 23. P value <0.05 was considered significant.Results: The most common age group was 21-25 years of age in both groups and most commonly used in primigravida. The most common indication for forceps assisted delivery in our study was the prolonged second stage labour and in vacuum delivery was poor maternal effort. In our study, common complication noted was extended episiotomy followed by perineal tear in forceps group and vice versa in vacuum group. Cephalhematoma was found to be more common in vacuum and scalp and instrumental injuries were more common in forceps assisted vaginal deliveries.Conclusions: Operative vaginal deliveries helps in improving both maternal and foetal outcomes and reduces the caesarean delivery rate and vacuum significantly reduces maternal trauma than forceps. No difference noted in neonatal outcome. 

scholarly journals Maternal and neonatal outcomes in vacuum assisted births in the government tertiary care hospital in Mandya: a retrospective record-based study

2020 ◽  
Vol 9 (3) ◽  
pp. 965
Author(s):  
Shwetha M. ◽  
Shilpa M. N.
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Vacuum Extraction ◽  
Care Hospital ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Vaginal Deliveries ◽  
Assisted Delivery ◽  
The Government

Background: Vacuum extraction and forceps are the two options when an instrument is needed to facilitate a vaginal birth. Vacuum extraction has recently gained popularity because of new designs of vacuum cups with reduced risk of injury to the neonate. Vacuum extraction is one of the evidence-based interventions that can prevent complications by shortening the second stage of labour. The present study has been carried out to evaluate the maternal and neonatal morbidity, mortality and failure associated with vacuum assisted vaginal deliveries, at a Government tertiary care hospital in Mandya, Karnataka, India.Methods: The study was a record-based study including a total of 207 women who underwent vaginal assisted delivery in the form of vacuum assisted deliveries in a period of 6 months from January 2019 to June 2019 at the Government tertiary care hospital in Mandya, Karnataka, India. Records of women who had vacuum assisted deliveries and records of their newborn children were accessed.Results: In our study 41.5% of the subjects were in the age group of 21-25 years. Nearly 3/4th (74.4%) of the subjects were primigravida. More than half (54.1%) of the study subjects had to be put under vacuum assisted techniques for delivery because of the prolonged second stage of labour, failure rate was 0.4%. Out of 207 vacuum assisted deliveries maternal complication rate was 8.21%, 17.3% neonates had NICU admission and 14.97% had perinatal complications.Conclusions: Vacuum assisted vaginal delivery is comparatively a better choice in preventing the complications caused due to prolonged second stage of labour thus reducing the cesareans rate. It is a safe alternative to cesareans delivery in rightly chosen case. Vacuum assisted delivery by a skilled person and a proper technique is associated with lesser maternal and neonatal morbidity.

scholarly journals Vacuum Assisted Vaginal Delivery in Singleton Term Pregnancies: Short Term Maternal and Neonatal Outcome in a Tertiary Hospital of Nepal

2016 ◽  
Vol 4 (2) ◽  
pp. 104
Author(s):  
Buddhi Shrestha ◽  
Subha Shrestha ◽  
Babita Thapa
Keyword(s):  
Vaginal Delivery ◽  
Post Partum ◽  
Birth Asphyxia ◽  
College Teaching ◽  
Neonatal Morbidity ◽  
Short Term ◽  
Assisted Vaginal Delivery ◽  
Vaginal Deliveries ◽  
Skilled Operator ◽  
Assisted Delivery

Introduction: Other than cesarean delivery, assisted vaginal delivery is an alternative procedure for delivery in emergency obstetrics. Presently, vacuum delivery has gained more popularity than forceps for operative/ assisted vaginal delivery, when and where indicated, with success as well as lesser neonatal and maternal complications. This study was done to estimate the short term maternal and fetal morbidity/mortality due to vacuum assisted vaginal delivery.   Methods:  A prospective observational study was conducted at Lumbini Medical College Teaching Hospital from January 2015 to May 2016. One hundred and four pregnant women who had successful vacuum assisted vaginal deliveries were enrolled. Fetal and maternal outcome were assessed.   Results: One hundred and four successful vacuum deliveries (2.9%) were conducted among 3457 deliveries during our study period. Sixty seven (64.4%) were primigravida and most (n=59, 56.7%) parturients were of age group 20-30 years. The commonest (n=65, 62.5%) indication for vacuum application was prolonged second stage of labor. The maternal morbidity variables were: 6.7% (n=7) had genital tract injury, 3.8% (n=4) had primary post-partum hemorrhage, 3.8% (n=4) had urinary retention, 2.8% (n=3) needed blood transfusion. Among neonatal morbidity indicators, 19.2% (n=20) neonates had birth asphyxia, 4.8% (n=5) neonates had cephalohematoma, 0.96% (n=1) had brachial plexus injury. There was one early neonatal death due to meconium aspiration syndrome.   Conclusion: A successful vacuum assisted delivery can be achieved with lesser maternal and neonatal morbidity with timely assessment of labor, skilled operator, and availability of neonatal team.

scholarly journals Comparative study of vaginal delivery and caesarean section in antepartum eclampsia at tertiary care hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 457 ◽  
Author(s):  
Priti Kumari ◽  
Sipra Singh ◽  
Salma Khatun ◽  
. Shashikar
Keyword(s):  
Caesarean Section ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Fetal Outcome ◽  
Sudden Onset ◽  
Care Hospital ◽  
Maternal Complications

Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.

scholarly journals Risk factors for post-partum hemorrhage in patients who underwent operative vaginal delivery in a tertiary care center

2021 ◽  
Author(s):  
Gayatri Devi Sivasambu ◽  
Sujani B. Kempaiah ◽  
Urvashi Thukral
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Tertiary Care ◽  
Significant Risk ◽  
Post Partum Hemorrhage ◽  
Second Stage ◽  
Operative Vaginal Delivery ◽  
Vaginal Deliveries

Background: Operative vaginal delivery is a timely intervention to cut short second stage labor when imminent delivery is in the interests of mother, fetus, or both. It reduces second stage cesarean section morbidity and uterine scar and its influence on future obstetric career. The possible structural neonatal adverse outcomes due to operative vaginal delivery are well quantified. However, its effects on maternal outcome need to be understood better. In this paper, we study the effect of operative vaginal delivery on maternal post-partum hemorrhage (PPH) and the associated risk factors.Methods: It was a retrospective study carried out for the period July 2016 to July 2020 at Ramaiah Medical College, Bengaluru. Total number of vaginal deliveries in this period were 6318. Out of these, 1020 patients underwent assisted vaginal delivery using vacuum/ forceps/ sequential use of instrument. Blood loss greater than 500 ml is considered PPH for the purpose of this study. 15% of the study population was noted to have PPH. We employ a multivariate logistic regression to identify statistically significant risk factors for PPH in women undergoing operative vaginal delivery.Results: The logistic regression model identifies multiparity, maternal age, neonatal birth weight more than 3.5 kg, application of forceps in women with hypertensive disorders, III-degree tear, cervical tear to significantly increase the risk of PPH in our study population.Conclusions: Certain factors seem to increase the risk of PPH in operative vaginal delivery. The risks and benefits must be weighed properly before use of instruments.

scholarly journals Study of maternal and fetal outcome in postdate pregnancy in tertiary care hospital

2020 ◽  
Vol 9 (9) ◽  
pp. 3585
Author(s):  
Patel Yogeshkumar Pransukhbhai ◽  
Poonam Londhe
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Medical College ◽  
Vaginal Deliveries

Background: Fetal, neonatal and maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study was conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: This was a prospective cross-sectional study of 70 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital B. J. Medical College, Ahmedabad, Gujarat, India.Results: Out of 70 patients, majority of the subjects belongs to 26-30 years of age (50%). The gestational age of 90% of patients were between 40-42 weeks. About 42-44% of the foetus had a birth weight of 2.5-3.5 kgs. Maximum patients underwent vaginal deliveries in spontaneous group (57%) and 64% underwent LSCS in induced group. Mode of delivery is significantly associated with presence of adequate liquor.Conclusions: With regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up.

PRIMIGRAVIDAS;

2017 ◽  
Vol 24 (02) ◽  
pp. 258-262
Author(s):  
Sarwat Memon ◽  
Sumaira Rauf
Keyword(s):  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
University Hospital ◽  
Maternal Complications ◽  
Spontaneous Vaginal Delivery ◽  
Birth Attendants ◽  
Products Of Conception ◽  
Vaginal Deliveries ◽  
Study Setting

Objectives: To determine frequency of different mode of deliveries andassociated maternal complications in primigravidas in tertiary care setup. Study Design: Caseseries study. Setting: Department of Obstetrics and Gynaecology (Liaquat University Hospital)Hyderabad, Sindh, Pakistan. Period: 6 months from Jan 2009 till June 2009. Methodology: Allthe primigravidas underwent delivery by any means i-e emergency\elective caesarean sectionor spontaneous vaginal delivery\instrumental vaginal delivery and developed postpartumcomplications up till 7 days after delivery were included. Data was analyzed on pre- designedprofoma and was analyzed through software program SPSS version 10. Results: In this studymost frequent mode of delivery were found to be spontaneous vaginal delivery 46(36.8%)and emergency caesarean section 29(23.2%) while forceps 8.8%, vacuum 20% and electivecaesarean section 1.2%. Complications associated with mode of deliveries included postpartumhemorrhage were reported to be 51.2%, abdominal wound infection 11.2%, perineal woundinfection 17.6%, retained products of conception 28% and puerperal sepsis 16.8%. Conclusion:Deliveries in our setup are mostly conducted by dais (birth attendants) without any asepticmeasures and without assessing the abnormalities that will leads to emergency caesareansection or instrumental vaginal deliveries and in the consequence of these entire patientsdevelop postpartum complications.

scholarly journals Prevalence of teenage pregnancy and its obstetric and perinatal outcomes in a rural tertiary care hospital

2020 ◽  
Vol 9 (10) ◽  
pp. 3989
Author(s):  
Venkata Ramya Krishna Madala ◽  
Keshav Gangadharan ◽  
Pradeep Shivaraju ◽  
Devivaraprasad Mateti
Keyword(s):  
Developing Countries ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Teenage Pregnancy ◽  
Tertiary Care ◽  
Developed Countries ◽  
Care Hospital ◽  
Maternal Complications ◽  
Hypertensive Disorders

Background: Teenage pregnancy has been reported as one of the leading causes of death in adolescent girls in both developed and developing countries. In developed countries teenage pregnancies are most common in unmarried girls whereas in developing countries like India where early marriages are more common, teenage pregnancies are seen mostly in married women.Methods: In this retrospective observational study, data between January 2018 and December 2019 was studied; data was evaluated using MS excel for statistical purpose. In the present study, only pregnant women less than 20 years were included.Results: Out of 6,028 pregnant women delivered during this period, 686 i.e. 11.3% age of women were less than 20 years, 609 (88.7%) had delivery at term and the remaining 77 (11.2%) women had preterm delivery. As per this study, incidence of hypertensive disorders were 12.24%, 5.5% were associated with anemia and most of them had vaginal delivery (65.01%) including induced and instrumental; cesarean section was 35.5%. In present study, 24.1% babies were of low birth weight and 3.49% of babies were intrauterine growth restricted (IUGR) babies.Conclusions: This study showed hypertensive disorders were the most common maternal complication and the incidence of vaginal delivery was higher compared to that of cesarean section, incidence of anaemia was less compared with other studies. Proper antenatal care, institutional delivery and postnatal care can reduce fetal and maternal complications in childbearing women in teenage age group. 

Fetomaternal Outcome in Operative Vaginal Deliveries in a Tertiary Care Centre: A Descriptive Retrospective Study

2020 ◽  
Vol 3 (2) ◽  
pp. 23-27
Author(s):  
Rakshya Joshi ◽  
Sabita Shrestha ◽  
Jully Chaudhary ◽  
Upendra Pandit ◽  
Renuka Tamrakar
Keyword(s):  
Retrospective Study ◽  
Vaginal Delivery ◽  
Care Center ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Tertiary Care Centre ◽  
Fourth Degree ◽  
Operative Vaginal Delivery ◽  
Nulliparous Women ◽  
Vaginal Deliveries

Background: Operative vaginal delivery is safe and effctive when applied by well-trained personnel. However, it is an underutilized component of obstetric care. We aimed to estimate the frequency of operative vaginal delivery in a tertiary care center and evaluate the immediate maternal and fetal morbidities. Methods: This descriptive retrospective study was carried out in the Department of Obstetrics and Gynecology, Chitwan Medical College and Teaching Hospital. Medical records of all operative vaginal deliveries conducted from May 2019 to April 2020 were retrieved. Data regarding demography, delivery characteristics, maternal and fetal morbidity and mortality associated with operative vaginal deliveries were collected. Results: The frequency of operative vaginal delivery was found to be 2.3% among 3060 deliveries. It was more commonly used in nulliparous women (n = 54, 76.1%); the commonest age group being 20 to 35 years. The commonest indication was fetal distress (n = 32, 45.1%) followed by prolonged second stage of labor (n = 26, 36.6%). The associated maternal morbidities included postpartum hemorrhage (n = 12, 16.9%), need of blood transfusion (n = 9, 12.7%), fever (n = 6, 8.5%), cervical tear (n = 3, 4.2%) and third/fourth degree perineal tears (n = 3, 4.2%). One neonate had cephalhematoma and 14 neonates (19.7%) needed admission in neonatal intensive care unit. Conclusion: Operative vaginal delivery accounted for 2.3% of the total deliveries and was associated with a few maternal and fetal morbidities.

scholarly journals Outcome of Assisted Vaginal Deliveries in a Tertiary Care Centre in Bengaluru

2021 ◽  
Vol 10 (40) ◽  
pp. 3538-3542
Author(s):  
Sivasambu Gayatri ◽  
Sujani B. K. ◽  
Urvashi Urvashi ◽  
Priyanka Sinha
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Assisted Vaginal Delivery ◽  
Safe Delivery ◽  
Vaginal Deliveries

BACKGROUND The lower segment caesarean section (LSCS) audit shows an increase in caesarean section rates worldwide. Assisted vaginal delivery and, if needed, emergency caesarean section are options available to the obstetrician to handle challenges in the second stage when spontaneous and safe delivery is not imminent. Judicious use of the instrument as well as continuing medical education in the art of assisted vaginal delivery is a must to achieve the twin goal of containing the surging caesarean section rate as well as bring about a successful and safe assisted vaginal delivery. The objective of this study was to quantify the various morbidities associated with assisted vaginal deliveries among patients in a tertiary care teaching hospital in Bengaluru. METHODS It is a retrospective study carried for four years between July 2016 and June 2020 at Ramaiah Medical College at Bengaluru. The total number of vaginal deliveries was 6318 out of which 1020 had a successful assisted vaginal delivery and were studied in terms of outcomes, maternal and foetal indications and morbidity. RESULTS Out of 1020 assisted vaginal deliveries, 86.96 % were vacuum-assisted, 3.9 % were forceps assisted and 9.11 % were both vacuum and forceps assisted. The success rate of forceps deliveries was more compared to vacuum. No significant maternal and neonatal mortality and morbidity were observed in our study. CONCLUSIONS In this study, vacuum was the most used method of assisted vaginal delivery and was safer for mothers and babies. It is also easier to teach and learn. Forceps delivery was more used in preterm delivery. KEY WORDS Assisted Vaginal Delivery, Vacuum, Forceps, Sequential use of Instruments, Maternal and Neonatal Morbidity.

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