Effectiveness Bearing Down Techniques During Second Stage of Labour on Maternal and Neonatal Outcome among Primigravida Mothers

2020 ◽  
Vol 11 (1) ◽  
pp. 453
Author(s):  
Poonam Yadav ◽  
Shital V. Waghmare ◽  
Seeta Devi A. ◽  
Manuacharoy Anon
Keyword(s):  
Neonatal Outcome ◽  
Second Stage ◽  
Second Stage Of Labour

scholarly journals Maternal and neonatal outcome in second stage cesarean section versus first stage: a comparative study

2018 ◽  
Vol 7 (11) ◽  
pp. 4640
Author(s):  
Anusha S. R. ◽  
Deepak A. V. ◽  
K. J. Jacob
Keyword(s):  
Cesarean Section ◽  
Neonatal Outcome ◽  
Cross Sectional Study ◽  
Fetal Head ◽  
Cross Sectional ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Adjacent Structures ◽  
Duration Of Surgery ◽  
Fetal Complications

Background: Cesarean Section is the most commonly performed abdominal operation in women all over the world. Variable rates of cesarean section are reported between and within countries. Cesarean section at full cervical dilatation with an impacted fetal head can be technically difficult and is associated with increased trauma to the lower uterine segment and adjacent structures, as well as increased hemorrhage and infection.Methods: This is a comparative cross-sectional study comparing maternal and neonatal outcome between first stage and second stage cesarean section performed at Govt Medical College Thrissur.Results: In present study out of 90 cesarean sections 30 were performed in second stage and 60 in first stage.74 % were primigravida in second stage cs group. Arrest due to malposition was major indication for second stage (76% of cases). The most important complication among second stage cs group was PPH (76.7%) and majority of them needed blood transfusion. These complications were less in first stage cs group. Other Complications like increased duration of surgery (mean=53.3 min), post op fever (36% post op Wound infection (13.3%) was seen in second stage group. Fetal complications like low APGAR scores were seen in 16.7% of cases compared to first stage group and most of them needed resuscitation.Conclusions: Women undergoing cesarean section in second stage of labour had increased maternal and fetal morbidity. They required special care and hence Operation should ideally perform and supervised by an experienced obstetrician. Timely decision for cesarean section should be made especially when risk factors for failure to progress are present.

scholarly journals Evaluation of categories of intrapartum fetal heart rate tracings in pregnancies complicated with fetal growth restriction and its relation to perinatal outcome

2021 ◽  
Vol 10 (3) ◽  
pp. 1128
Author(s):  
Bhavya H. U.
Keyword(s):  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Neonatal Outcome ◽  
Strong Association ◽  
Active Phase ◽  
Fetal Hypoxia ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Timely Response ◽  
Normal Outcome

Background: Intrapartum FHR monitoring is widely used during labour as changes in FHR precede brain injury, so timely response to abnormal FHR patterns might be effective in preventing it. There is a strong association between stillbirth and FGR which warrants intensive intrapartum fetal surveillance for optimal perinatal outcome. In this study we aimed to classify intrapartum FHR tracings into different categories in FGR pregnancies and correlate with perinatal outcome.Methods: A total 100 singleton pregnant women >34 weeks gestation with FGR were included in study. FHR tracings were followed throughout first and second stage of labour. FHR tracing were categorized into NICHD 3-tier classification as category I, II and III. Maternal and neonatal outome in each category were analysed.Results: Mean duration of category I tracings was 9.05 hours, category II was 7.66 hours and that of category III was 0.49 hours. During late active phase 25/95 patients with category I FHR tracings had vaginal delivery, 62/95 had category II FHR tracings, of which 95.1% had vaginal delivery and 4.9% had instrumental. 8/95 with category III FHR tracings required caesarean section. All patients with category I tracings had normal neonatal outcome, among patients with category II FHR tracings, 74.6% had normal whereas 25.4% had adverse outcome, all with category III FHR tracings had adverse outcome.Conclusions: Categorizing FHR tracings is helpful to distinguish neonates who are likely to have normal outcome from those who are at risk for fetal hypoxia. When the category II tracings are present, it requires more vigilant monitoring and decision taking.

scholarly journals Thyroid storm in the second stage of labour: a case report

2021 ◽  
Vol 14 (7) ◽  
pp. e243159
Author(s):  
Yudianto Budi Saroyo ◽  
Achmad Kemal Harzif ◽  
Beryliana Maya Anisa ◽  
Fistyanisa Elya Charilda
Keyword(s):  
Treatment Guidelines ◽  
Thyroid Storm ◽  
Lung Oedema ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Failure Treatment ◽  
Life Threatening ◽  
Thyroid Hormone Levels ◽  
Peripartum Period ◽  
In Pregnancy

A thyroid storm (or thyroid crisis) is an emergency in endocrinology. It is a form of complication of hyperthyroidism that can be life-threatening. Inadequate control of hyperthyroidism in pregnancy could develop into thyroid storm, especially in the peripartum period. We present a woman came in the second stage of labour, with thyroid storm, superimposed pre-eclampsia, acute lung oedema and impending respiratory failure. Treatment for thyroid storm, pre-eclampsia protocol and corticosteroid was delivered. The baby was born uneventfully, while the mother was discharged after 5 days of hospitalisation. Delivery is an important precipitant in the development of thyroid storm in uncontrolled hyperthyroidism in pregnancy. Although very rare, it can cause severe consequences. Diagnosis and treatment guidelines for thyroid storm were available and should be done aggressively and immediately. Uncontrolled hyperthyroidism should be prevented by adequate control in thyroid hormone levels, especially before the peripartum period.

scholarly journals Clincial Experience with Patient-Controlled and Staff-Administered Intermittent Bolus Epidural Analgesia in Labour

1995 ◽  
Vol 23 (4) ◽  
pp. 459-463 ◽  
Author(s):  
M. J. Paech ◽  
T. J. G. Pavy ◽  
C. Sims ◽  
M. D. Westmore ◽  
J. M. Storey ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Randomized Study ◽  
Obstetric Delivery ◽  
Second Stage ◽  
Intermittent Bolus ◽  
Second Stage Of Labour ◽  
Pain Scores ◽  
Maximum Pain ◽  
Delivery Unit ◽  
Ib Method

A prospective randomized study was Performed to detail clinical experience with both patient-controlled epidural analgesia (PCEA) and midwife-administered intermittent bolus (IB) epidural analgesia during labour, under the conditions pertaining in a busy obstetric delivery unit. Both methods used 0.125% bupivacaine plus fentanyl, and similar rescue supplementation although management decisions related to epidural analgesia were made principally by attending midwives One hundred and ninety-eight women were recruited and data analysed from 167 (PCEA n = 82 IB n=85) The groups were demographically similar. Median hourly pain scores, ratings of analgesia and satisfaction did not differ Maximum pain scores were significantly higher in those receiving IB epidural analgesia (P<0.05). The PCEA group had a significantly higher rate of supplementation and bupivacaine use (P<0.01), and a longer duration of the second stage of labour (P<0.03) The relative risk of instrumental delivery with PCEA versus the IB method was 1.57 (CI 1.07–2.38) Experience within our unit with PCEA is contrasted with that of IB epidural analgesia, the method most commonly used; and with that of controlled trials comparing these two methods.

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