scholarly journals Prelabour Rupture of Membranes: Mode of Delivery and Outcome

2015 ◽  
Vol 3 (2) ◽  
pp. 237-240 ◽  
Author(s):  
Vlora Ademi Ibishi ◽  
Rozalinda Dusan Isjanovska
Keyword(s):  
Cesarean Section ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Maternal Complications ◽  
Cephalopelvic Disproportion ◽  
Cesarean Section Delivery ◽  
Clinical Center ◽  
Failed Induction ◽  
The University

BACKGROUND: Pre-labour Rupture of Membranes (PROM) is an important cause of maternal and fetal morbidity and increased rate of cesarean section delivery. AIM: The aim of this study is to investigate the clinical characteristics, PROM-delivery interval, mode of delivery, and early maternal neonatal outcome among pregnant patients presenting with pre-labour rupture of membranes.MATERIAL AND METHODS: This prospective case control study is implemented at the Obstetric and Gynecology Clinic of the University Clinical Center of Kosovo. The study included 100 pregnant patients presenting with prelabour rupture of membranes of which 63 were primigravida and 37 patients were multigravida.RESULTS: The incidence of cesarean section in this study is 28 % and the most common indications for cesarean delivery were fetal distress, malpresentation, cephalopelvic disproportion, and failed induction. The most common maternal complications in this study are chorioamnionitis, retained placenta and postpartum hemorrhage. Neonatal infectious morbidity was present in 16 % of cases.CONCLUSION: PROM is a significant issue for obstetricians and an important cause of maternal and neonatal morbidity and increased rate of cesarean section delivery.

scholarly journals REVIVAL OF VAGINAL BREECH DELIVERY

1969 ◽  
Vol 5 (1) ◽  
pp. 597-602
Author(s):  
NASIM AKHTAR
Keyword(s):  
Cesarean Section ◽  
Neonatal Mortality ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
Maternal Complications ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Emergency Cesarean

BACKGROUND: Since the publication of term breech trail there had been a dramatic changeworldwide from selective to planned Cesarean Section for all women with breech presentation at term.This high cesarean section rate led to adverse consequences in subsequent pregnancy &on futurefertility. Choice of safest mode of delivery has always been a dilemma.OBJECTIVE: Prospective interventional study. This study was done to determine the safety of vaginalbreech birth in terms of neonatal & maternal complications, so that to encourage the trend of breechdelivery in carefully selected cases & to discourage the trend of routinely recommending cesareansection for all gravidas with fetus in breech presentation at term. The study was conducted atDepartment of Obstetrics & Gynae Mardan Medical Complex from January 2010 to December 2015.PATIENTS & METHOD: About 809 patients with singleton pregnancy with breech presentation wereincluded. Decision about mode of delivery was taken on the basis of clinical judgment and ultrasoundwhich was further reviewed in the light of rate of progress during labour .Delivery was conducted byexperienced obstetrician. Mother & infants were followed up to 6 wks post partum. The primaryoutcome was neonatal mortality, infant mortality & serious infant morbidity.RESULTS: out of 809 total patients with breech presentation, 714 were planned for vaginal delivery674 delivered (83%) while 40 pts (5%) had emergency Cesarean Sections.95 patients (12%) hadElective cesarean section. In the delivery group two (0.29%) neonates had serious neonatal morbidity. Inthe cesarean group there was no serious neonatal morbidity. Infection & blood loss was greater in thecesarean group. There were no serious maternal complications in the vaginal delivery group. Thedifference between neonatal morbidity, perinatal mortality &neonatal mortality between the two groupswas not significant.CONCLUSION: Vaginal breech delivery is still a safe option which better suits the clinical situation&problems of our patients .In our set up, Cesarean section should not be routinely advised to patientswith breech presentation no matter it may be the best management option in developed countries.Careful case selection & vigilant monitoring of progress of labour will save many patients fromunnecessary section without costing extra morbidity & mortality.KEY WORDS: Breech presentation, Breech Delivery, Cesarean section, Apgar score.

scholarly journals Planned versus emergency cesarean delivery with previous one cesarean section: a prospective observational study

2018 ◽  
Vol 7 (10) ◽  
pp. 4223
Author(s):  
Partha P. Sharma ◽  
Dipak K. Giri ◽  
Surendra N. Bera
Keyword(s):  
Blood Transfusion ◽  
Cesarean Section ◽  
Prospective Observational Study ◽  
Previous History ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Maternal Complications ◽  
Risk Pregnancy ◽  
Emergency Cesarean ◽  
History Of

Background: Women presents with previous history of cesarean section (CS) is a ‘high risk pregnancy’ and requires regular antenatal check-ups. Planned CS at term done for perinatal interest. Post cesarean pregnancy admitted through emergency required direct CS, for those not fit for vaginal birth as per different guidelines. Main objective of this study is to know neonatal and maternal outcome at term for planned versus emergency CS with previous one CS.Methods: Planned or emergency CS were done in 1003 pregnant women at term with previous one CS and outcome of both neonatal and maternal were noted. Emergency CS done in failed VBAC women were excluded from the study.Results: Planned CS before onset of labor were done in 22.93% and emergency CS in 77.07% in the present study. A significant number of women has undergone planned CS in cephalo-pelvic disproportion (45.21%), contracted pelvis (24.34%) and fetal growth restriction (6.95%) where P=0.000. Scar tenderness (20.18%), fetal distress (16.04%) and cephalo-pelvic disproportion (15.52%) were major indications for emergency CS. Maternal complications in the emergency CS group were pyrexia (P=0.000) and blood transfusion, required in 1.81% (P=0.000). There were two maternal death and hysterectomy required in 0.38% in the emergency CS compared to 1.30% in the planned CS (P=0.274). Neonatal complications were significant(P=0.018) in the emergency CS group. Common complications were jaundice (2.84% versus 1.73%, P=0.489), sepsis (0.25% versus 0.86%, P=0.487) and early neonatal death (2.97% versus 0.86%, P=0.119) in emergency CS compared to planned CS.Conclusions: Neonatal morbidity and mortality were significant in the emergency CS, compared to planned CS. Pyrexia and blood transfusion were significant maternal morbidity in the emergency CS group.

EFFECT OF HBA1C LEVEL ON MODE OF DELIVERY

2018 ◽  
Vol 6 (2) ◽  
pp. 781-784
Author(s):  
SAIMA PERVEEN ◽  
PARVEEN NAVEED ◽  
NAZISH HAYAT ◽  
NADIA RASHID
Keyword(s):  
Cesarean Section ◽  
Teaching Hospital ◽  
Gestational Age ◽  
Maternal Age ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Dominant Mode ◽  
Normal Vaginal Delivery ◽  
Number Of Patients ◽  
Sugar Levels

BACKGROUND: Perinatal outcome is related to the onset and duration of glucose intolerance. Theobjective of the study is to determine the effect of HbAlc on mode of delivery in Obs/Gynea departmentof Saidu Teaching Hospital, Swat.MATERIAL AND METHODS: This observational & descriptive study was carried out in theDepartment of Obstetrics and Gynecology at Saidu Teaching Hospital, Swat, from 1st March 2015 to29th Feb 2016. Total 313 pregnant women were included in the study, who had Gestational Diabetes orEstablished Diabetes.Detail history was taken regarding maternal age in years, gestational age in weeks.Abdominal examination was done for lie and presenting part of the fetus, and vaginal examination wereperformed. These patients were followed till the end of labour and their mode of delivery i-e; normalvaginal delivery, instrumental delivery or cesarean section was recorded. Maternal HbAlc level wasdone at the time of delivery and was categorized as Mild (< 6.5), Moderate (6.5-9) and severe (>9).Maternal HbAlc was measured in hospital laboratory. The numerical variables of mean HbAlc,maternal age in years and gestational age in weeks were analyzed by mean ± SD (range). Categoricalvariables like; grades of severity of HbAlc levels and frequency of modes of delivery were analyzed byfrequency (number) and relative frequency (percentages). SPSS 20 (SPSS Inc. Chicago, Illnios, USA)was used to analyze the data.RESULTS:The total number of patients was 313. Mean age of the study population was 27.85 ± 6.37(43 - 15) (95% Cl 28.39 - 27.30). The mean age of gestational amenorrhea, at which most of thepatients presented was 38.31 ± 3.02, ranging from 41 to 29, (95%CI 38.57 - 38.5). The meanglycosylated Hemoglobin (HbAlc) was 6.9 ± 1.69 (95% Cl 6.17 - 5.88). Majority of the patients hadpoorly controlled diabetes, i-e: 64%. In different levels of HbAlc levels, normal vaginal delivery wasthe pre dominant mode of delivery.CONCLUSION:^ patients with uncontrolled diabetes the rate of complications increased and so doesthe rate of macrosomia and fetal distress, leading to higher rate of cesarean section and instrumentaldelivery, so by strict control of the blood sugar levels in a diabetic patient one can reduce the risk ofoperative deliveries and complications.KEY WORDS:Hbalc levels, Mode of delivery, cesarean section

The Efficacy of Antibiotic Prophylaxis in the Prevention of Post-Cesarean Section Endometritis

1985 ◽  
Vol 6 (5) ◽  
pp. 189-193 ◽  
Author(s):  
Leigh Grossman Donowitz ◽  
Sandra M. Norris
Keyword(s):  
Cesarean Section ◽  
Antibiotic Prophylaxis ◽  
Cost Effective ◽  
University Of Virginia ◽  
Spontaneous Vaginal Delivery ◽  
Cesarean Section Delivery ◽  
Short Course ◽  
Patient Groups ◽  
The University ◽  
Emergent Cesarean Section

AbstractEndometritis is an infectious complication in 9% to 65% of patients delivered by cesarean section. The risk of developing endometritis is greater in the high-risk emergent patient as compared to routine repeat abdominal deliveries. This study describes the incidence of endometritis following cesarean section delivery in different patient groups at the University of Virginia Hospital during a 1-year period and reviews the literature on the efficacy and risks of prophylactic antibiotics in this setting. Of patients not receiving antibiotic prophylaxis, 11 (<1%) of 1,461 normal spontaneous vaginal delivery patients, 7 (16.7%) of 42 repeat and 39 (29.8%) of 131 emergent cesarean section patients developed endometritis. This contrasts to none of the 24 emergent patients who received antibiotic prophylaxis. The literature review shows multiple prospective well-designed and executed studies that demonstrate reliable decreases in the incidence of endometritis with short course antibiotic prophylaxis. Our conclusion is that short course antibiotic prophylaxis is a safe, reproducible, cost-effective and indicated method of reducing the incidence of this costly and serious postoperative infection.

scholarly journals Feto-maternal outcome in pregnancy beyond 40 weeks

2017 ◽  
Vol 6 (2) ◽  
pp. 527 ◽  
Author(s):  
Paras V. Dobariya ◽  
Parul T. Shah ◽  
Hina K. Ganatra
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Maternal Complications ◽  
Cross Sectional ◽  
In Pregnancy

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 conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: A prospective cross sectional study of 84 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital. The aim of the study was to know fetomaternal outcome in pregnancy beyond 40 weeks in consideration of spontaneous and induced labour.Results: Out of 84 patients, 58 (69.05%) were in the age group of 20-30 years, 44 (52.38%) were between 41-42 weeks of gestation according to their LMP and 38(45.24%) were between 40-41 weeks of gestation. In 27 (32.14%) patients mode of delivery was caesarean section, in whom most common indication being fetal distress in 48.15% followed by failure to progress in 22.22%. In present study perinatal morbidity like IUFD, neonatal asphyxia, MAS, RDS were 4.76%, 9.52%, 7.14% and 3.57% respectively. Maternal morbidity like prolonged labor, PPH, fever, wound infection were 10.71%, 5.95%, 3.57% and 3.57% respectively.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. Confirmation of diagnosis of exact term of pregnancy is very important as many patients don’t have regular menstrual history and LMP. Diagnosis can be confirmed by first trimester ultrasound which is most important non-invasive method and readily available.

scholarly journals Prevalence and Outcome of Cesarean Section at Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal

2017 ◽  
Vol 9 (2) ◽  
pp. 1-6
Author(s):  
Rubina Tamrakar Gurung ◽  
G Gurung ◽  
R Shrestha ◽  
T Gurung ◽  
P Sharma
Keyword(s):  
Cesarean Section ◽  
Teaching Hospital ◽  
College Teaching ◽  
Fetal Distress ◽  
Safe Motherhood ◽  
Research Centre ◽  
Cesarean Sections ◽  
Old Patients ◽  
Medical College ◽  
Failed Induction

Introduction: Gandaki Medical College Teaching Hospital is providing specialized obstetrician and gynecologist services since last one decade.Objectives: This study was conducted to know the prevalence and outcome of cesarean section at Gandaki Medical College Teaching Hospital and Research Centre during 2013 – 2015 A.D. (2070 – 2072 B.S.).Methods: It was a retrospective study of women undergoing cesarean section from 2013 to 2015 A.D. (2070 – 2072 B.S.).Results: During the period of three years 2013 – 2015 A.D. (2070 –2072 B.S.) otal deliveries were 2627. Among total deliveries cesarean section was performed in 1084 patients (41.26%). In 1084 patients 803 (74%) cesarean sections were performed as an emergency and 281(26%) were elective. In this study 15 to more than 35 years old patients were enrolled. Among cesarean sections done, 52% were primigravida, 46% were para and 2% were grandmulti. The indications for cesarean section were CPD (28%), fetal distress (25%), previous cesarean (14%), mal presentation (7%), premature rupture of membrane (5%), pre-eclampsia (6%), failed induction (5%), bad obstetric history (2%), antepartum hemorrhage (1%), and twins (1%).Conclusion: This study at Gandaki Medical College Teaching Hospital and Research Centre provided the prevalence, outcome and different indications of cesarean section which is life saving for both mother and newborn. And also the study can be useful to the hospital to improve facilities for safe motherhood and safety of newborn.Journal of Gandaki Medical CollegeVolume, 09, Number 2, July December  2016, Page: 1-6

scholarly journals LABOR AT TERM

2016 ◽  
Vol 23 (11) ◽  
pp. 1354-1357
Author(s):  
Quddsia Tanveer ◽  
Anees Fatima ◽  
Ummara Maqsood Sana
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Apgar Score ◽  
Postpartum Hemorrhage ◽  
Neonatal Morbidity ◽  
Medical Illness ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Nulliparous Women

Objectives: To compare the obstetric outcome between primigravida andmultigravida presenting in labor at term. Study Design: Cross sectional study. Period: Sixmonths from Jan 2013 to Jun 2013. Setting: Obs/Gynae unit III, Jinnah hospital, Lahore.Patients and methods: 800 patients were included in the study which comprised 400of primigravida and 400 of multigravida. Patients having single, alive fetus with cephalicpresentation at 37-41 weeks were included in the study. Those having recurrent miscarriages,parity >5, antepartum hemorrhage, previous uterine scars and significant medical illness wereexcluded from the study. The data was collected on specially designed proforma. Observationsmode of delivery including the indication of cesarean section or instrumental vaginal deliveryif applicable. Maternal complications such as postpartum hemorrhage along with its cause,retained placenta and uterine inversion were also recorded. Fetal and neonatal observationsincluded CTG abnormalities, oligohydramnios, low birth weight, macrosomia, Apgar score < 7at 5minutes, NICU admission, fresh still birth and early neonatal death. Results: Mean age was25.57+ 3.46 years in primigravida women while it was 25.75 + 3.44 years in multigravida group.CTG abnormalities (15.5% VS 4.25%), instrumental deliveries (9.75% VS 1%), cesarean section(15.25% VS 1%) and postpartum hemorrhage (5.7% VS 1.75%) were commoner in primigravidawomen. In addition, NICU admissions, low birth weight babies and a low Apgar score at5-minute were also commoner in primigravida women. Conclusion: Nulliparous women areat greater risk of labor abnormalities, fetal distress, instrumental deliveries, cesarean section,postpartum hemorrhage and neonatal morbidity. These adverse factors should therefore belooked for and treated well in time.

scholarly journals A cross sectional observational study to evaluate the maternal and fetal outcome in postdated pregnancies

2020 ◽  
Vol 10 (1) ◽  
pp. 159
Author(s):  
Ritika Narayan ◽  
Sheela S. R.
Keyword(s):  
Observational Study ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Significant Risk ◽  
Fetal Distress ◽  
Perinatal Complications ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Increased Risk

Background: Post-dated pregnancy is when the gestation is more than 40 weeks or 280 days. They last longer than the estimated date of delivery. Postdated pregnancies are associated with increased perinatal and maternal complications. These risks are greater than it was originally thought. Risks have been underestimated in the past leading to increasing number of complicated postdated pregnancies which appears to be otherwise low risk. The maternal risks are very often underappreciated resulting in increased maternal morbidity.Methods: This cross sectional observational study was done to evaluate maternal and fetal complications associated with Postdated pregnancies was carried out in the department of obstetrics and gynecology in a tertiary care centre, Sir Devraj Urs Medical College and RL Jalappa Hospital, Kolar between July 2018 and July 2019, fulfilling all the inclusion and exclusion criteria.Results: 50 out of 100 patients had full term normal deliveries where as 45% patients required cesarean section. Most common indication for cesarean section was meconium stained liquor with fetal distress (25%). 42% of the babies born needed NICU admission. Most common maternal complication seen was Postpartum Hemorrhage.Conclusions: The present study we conclude that postdated pregnancy was associated with significant risk of perinatal complications such as fetal distress, meconium aspiration syndrome and IUGR. There was increased risk of obstetric complications as well like atonic PPH, oligohydramnios, obstructed labor.

scholarly journals Outcomes of induction in trial of labor after cesarean delivery

2019 ◽  
Vol 8 (3) ◽  
pp. 1076
Author(s):  
Anubha Varshney ◽  
Zehra Mohsin
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Induction Of Labor ◽  
Control Group ◽  
Study Group ◽  
Previous Cesarean Section ◽  
Trial Of Labor ◽  
Previous Cesarean

Background: The objective of this study is to evaluate the outcomes of induction of labor in women attempting trial of labor after cesarean delivery and to compare maternal and neonatal morbidity and mortality in women who were induced to those delivering spontaneously.Methods: The prospective study was carried out in the Department of Obstetrics and Gynecology in collaboration with the Neonatal Section, Department of Pediatrics at J.N. Medical College and Hospital, AMU Aligarh. The sample included 280 women with one previous cesarean section, of whom 130 women underwent induction of labor (study group) and 150 were admitted with spontaneous onset of labor. Prostaglandin gel and intracervical Foley’s were used for cervical ripening in the study group. Indication of cesarean section, mode of delivery, maternal and neonatal outcome were studied in between groups.Results: Overall rate of vaginal delivery after cesarean section was 45.3% and 56% in both study and control group respectively. The rate of cesarean section were higher in women who were induced and having unfavorable cervix. Maternal and neonatal morbidity were not significantly higher as compared in both groups, however one case of scar rupture was found in study group.Conclusions: Induction of labor in women with previous cesarean section had higher rates of cesarean section however it does not adversely affect neonatal and maternal morbidity. Overall vaginal birth is safe and effective in women with previous cesarean section by prostaglandin gel or intracervical Foley’s. Authors cautiously suggest, induction of labor should be considered in preselected patient with strict monitoring.

scholarly journals Oral: Vaginal Misoprostol: Which route for induction of term labor?

1970 ◽  
Vol 2 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Ratna Khatri (Adhikari) ◽  
Jyoti Sharma ◽  
Archana Amatya
Keyword(s):  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Labour Induction ◽  
Active Stage ◽  
Singleton Pregnancy ◽  
Oral Misoprostol ◽  
Significant Difference ◽  
Vaginal Misoprostol ◽  
Failed Induction ◽  
Group B

Aim: To compare the effectiveness of oral misoprostol with vaginal misoprostol for induction of labour at or more than 40 weeks of pregnancy. Method: Study design: Prospective comparative study. Duration: March 2005 to February 2006 (12 months)in the Dept of Obs/Gyn, TU Teaching Hospital, Kathmandu. Methods: Hundred nullipara (primi or gravida 2 with 1 spontaneous or induced abortion < 12 gestational weeks) in a singleton pregnancy > 40 but with Bishop's score < 4 were induced equally with either oral (100 mgm) Group A or vaginal (25mcg) Group B: were administered 4 hourly up to maximum of 6 doses. Primary outcome measures: duration of induction to active stage of labour or delivery, spontaneous rupture of membrane (SROM), meconium stained liquor (MSL), caesarean and neonatal morbidity with respect to Apgar score were assessed. Results: In vaginal 33 oral 17 had SROM with higher incidence of MSL (60% versus 12%) and higher caesarean 15%: 4%. Even there was > fetal distress 11/15: 2/7 group B/, which was statistically significant. No significant difference was noted in the pre induction cervical score, number of doses, induction to active stage of labour, induction to delivery time, use of oxytocin, failed induction and Apgar scores. Conclusion: Oral misoprostol found to be associated with less SROM, meconium stained liquor and vaginal birth and comparatively less neonatal care unit admissions outweighs its advantages over the vaginal misopristol, although either route were equally proven to be effective for inducing labour in women with unfavourable cervix (Bishop's score < 4) at term pregnancy.   doi:10.3126/njog.v2i1.1472 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 23 - 28 May -June 2007

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