scholarly journals Evaluation of risk factors in cesarean delivery among multiparous women with a history of vaginal delivery

2011 ◽  
Author(s):  
Aysel Uysal Derbent ◽  
Aysun Karabulut ◽  
Melahat Yildirim ◽  
Serap Aynur Simavli ◽  
Nilgun Ozturk Turhan
Keyword(s):  
Risk Factors ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Multiparous Women ◽  
History Of

scholarly journals Evaluation of the risk factors for antepartum hemorrhage in cases of placenta previa: a retrospective cohort study

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110547
Author(s):  
Momoko Kuribayashi ◽  
Hiroyuki Tsuda ◽  
Yumiko Ito ◽  
Atsuko Tezuka ◽  
Tomoko Ando ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Vaginal Delivery ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Placenta Previa ◽  
Significant Risk ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
History Of

Objective The aim of this study was to examine the risk factors for antepartum hemorrhage (APH) in women with placenta previa. Methods In this retrospective cohort study, we analyzed the medical records of 233 women with singleton pregnancies presenting with placenta previa whose deliveries were performed at our hospital between January 2009 and July 2018. Results Of the 233 women included in this study, 130 (55.8%) had APH. In the APH group, the gestational age and neonatal birth weight were significantly lower compared with the no hemorrhage group. Maternal age <30 years and multiparity were identified as significant risk factors for APH in both the univariate and multivariate analyses. Focusing on the previous route of delivery in multiparous women, the risk of APH was significantly higher in multiparous women who had experienced at least one vaginal delivery compared with nulliparous women (adjusted odds ratio (OR): 3.42 [95% confidence interval: 1.83–6.38]). Conclusion We showed that women with placenta previa who were under 30 years old and who had a history of vaginal delivery may be at significant risk of experiencing APH.

scholarly journals Risk Factors for Cesarean Delivery following Labor Induction in Multiparous Women

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Corine J. Verhoeven ◽  
Cedric T. van Uytrecht ◽  
Martina M. Porath ◽  
Ben Willem J. Mol
Keyword(s):  
Risk Factors ◽  
Cesarean Delivery ◽  
Preterm Delivery ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Maternal Height ◽  
Retrospective Case ◽  
Multiparous Women ◽  
Successful Induction ◽  
Potential Risk Factors

Objective. To identify potential risk factors for cesarean delivery following labor induction in multiparous women at term.Methods. We conducted a retrospective case-control study. Cases were parous women in whom the induction of labor had resulted in a cesarean delivery. For each case, we used the data of two successful inductions as controls. Successful induction was defined as a vaginal delivery after the induction of labor. The study was limited to term singleton pregnancies with a child in cephalic position.Results. Between 1995 and 2010, labor was induced in 2548 parous women, of whom 80 had a cesarean delivery (3%). These 80 cases were compared to the data of 160 parous women with a successful induction of labor. In the multivariate analysis history of preterm delivery (odds ratio (OR) 5.3 (95% CI 1.1 to 25)), maternal height (OR 0.87 (95% CI 0.80 to 0.95)) and dilatation at the start of induction (OR 0.43 (95% CI 0.19 to 0.98)) were associated with failed induction.Conclusion. In multiparous women, the risk of cesarean delivery following labor induction increases with previous preterm delivery, short maternal height, and limited dilatation at the start of induction.

scholarly journals The effect of initiating neuraxial analgesia service on the rate of cesarean delivery in Hubei, China: A 16-month retrospective study

2020 ◽  
Author(s):  
Yun ZHAO ◽  
Ying GAO ◽  
Guoqiang SUN ◽  
Ling YU ◽  
Ying LIN
Keyword(s):  
Retrospective Study ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Negative Correlation ◽  
Utilization Rate ◽  
Specialized Training ◽  
Neonatal Asphyxia ◽  
Neuraxial Analgesia ◽  
Operative Vaginal Delivery ◽  
Multiparous Women

Abstract Background No Pain Labor ＆Delivery (NPLD) is a nongovernmental project to increase access to safe neuraxial analgesia through specialized training. This study explores the change in overall cesarean delivery (CD) rate and maternal request CD(MRCD) rate in our hospital after the initiation of neuraxial analgesia service (NA). Methods NA was initiated in May 1st 2015 by the help of NPLD. Since then, the application of NA became a routine operation in our hospital, and every parturient can choose to use NA or not. The monthly rates of NA, CD, MRCD, multiparous women, intrapartum CD, episiotomy, postpartum hemorrhage (PPH), operative vaginal delivery and neonatal asphyxia were analyzed from January 2015 to April 2016. Results The rate of NA in our hospital was getting increasingly higher from 26.1% in May 2015 to 44.6% in April 2016 (p<0.001); the rate of CD was 48.1% (3577/7360) and stable from January to May 2015 (p＞0.05), then decreased from 50.4% in May 2015 to 36.3% in April 2016 ( p<0.001); the rate of MRCD was 11.4% (406/3577) and also stable from January to May 2015 (p＞0.05), then decreased from 10.8% in May 2015 to 5.7% in April 2016 (p<0.001). At the same time, the rate of multiparous women remained unchanged during the 16 month of observation (p＞0.05). There was a negative correlation between the rate of NA and rate of overall CD, r=-0.782 (95%CI [-0.948, -0.534], p＜0.001), and between the utilization rate of NA and rate of MRCD, r=-0.914 (95%CI [-0.989, -0.766], p＜0.001). The rates of episiotomy, PPH, operative vaginal delivery and neonatal asphyxia in women who underwent vaginal delivery as well as the rates of intrapartum CD, neonatal asphyxia, and PPH in women who underwent CD remained unchanged, and there was no correlation between the rate of NA and anyone of those rates from January 1st 2015 to April 30th 2016 (p＞0.05). Conclusions: Our study shows that the rates of CD and MRCD in our department were significantly decreased from May 1st 2015 to April 30th 2016, which may be due to the increasing use of NA during vaginal delivery with the help of NPLD.

scholarly journals The initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective studyThe initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective study

2020 ◽  
Author(s):  
Yun ZHAO ◽  
YING GAO ◽  
Guoqiang SUN ◽  
Lin YU ◽  
Ying LIN
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Negative Correlation ◽  
Labor Analgesia ◽  
Utilization Rate ◽  
Maternal Request ◽  
Neonatal Asphyxia ◽  
Neuraxial Analgesia ◽  
Operative Vaginal Delivery ◽  
Multiparous Women

Abstract Background No Pain Labor ＆Delivery (NPLD) is a nongovernmental project to increase access to safe neuraxial analgesia through specialized training. This study explores the change is overall cesarean delivery (CD) and maternal request CD(MRCD) rate in our hospital after the initiation of neuraxial analgesia service. Methods The neuraxial labor analgesia（NA） was initiated in May 1st 2015 by the help of NPLD. Since then, the application of NA became a routine operation in our hospital, and every parturient can choose to use NA or not according to her own requirement. The monthly rates of NA, CD, MRCD, multiparous women, intrapartum CD, episiotomy, postpartum hemorrhage (PPH), operative vaginal delivery and neonatal asphyxia of vaginal delivery were analyzed from May 1st 2015 to April 30th 2016. Results The rate of NA in our hospital was getting increasingly higher from 26.1% in May 2015 to 44.6% in April 2016 (p<0.001); the rate of CD was decreased from 50.4% in May 2015 to 36.3% in April 2016 ( p<0.001); the rate of MRCD was decreased from 10.8% in May 2015 to 5.7% in April 2016 (p<0.001), but the rate of multiparous women had no change (p＞0.05). There was a negative correlation between the rate of NA and that of overall CD, r=-0.803 (95%CI[-0.951, -0.642], p=0.002), and also a negative correlation between the utilization rate of NA and that of MRCD, r=-0.790 (95%CI[-0.971, -0.497], p=0.004). The rates of episiotomy, PPH, operative vaginal delivery and neonatal asphyxia in women underwent vaginal delivery as well as the rates of intrapartum CD, neonatal asphyxia, and PPH in women underwent CD remained unchanged from May 1st 2015 to April 30th 2016. Conclusions: Our study shows that the rates of CD and MRCD in our department significantly were decreased over a year period (2015. 05.01~2016. 04.30), which may be due to the increasing use of NA during vaginal delivery by the help of NPLD. Key Words: Neuraxial Labor Analgesia; Cesarean Delivery; Maternal Request Cesarean Delivery

scholarly journals Clinical predictive factors for vaginal delivery following induction of labour among pregnant women in Jordan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rawan A. Obeidat ◽  
Mahmoud Almaaitah ◽  
Abeer Ben-Sadon ◽  
Dina Istaiti ◽  
Hasan Rawashdeh ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Bishop Score ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
The Mean

Abstract Background Induction of labour (IOL) is an important and common clinical procedure in obstetrics. In the current study, we evaluate predictors of vaginal delivery in both nulliparous and multiparous women in north Jordan who were induced with vaginal prostaglandins. Method A prospective study was conducted on 530 pregnant women at King Abdullah University Hospital (KAUH) in north Jordan. All pregnant mothers with singleton live fetuses, who had induction of labour (IOL) between July 2017 and June 2019, were included in the study. Mode of delivery, whether vaginal or caesarean, was the primary outcome. Several maternal and fetal variables were investigated. The safety and benefit of repeated dosage of vaginal prostaglandin E2 (PGE2) tablets, neonatal outcomes and factors that affect duration of labour were also evaluated. Pearson χ2 test was used to investigate the significance of association between categorical variables, while student’s t-test and ANOVA were applied to examine the mean differences between categorical and numerical variables. Linear regression analysis was utilized to study the relation between two continuous variables. A multivariate regression analysis was then performed. Significance level was considered at alpha less than 0.05. Results Nulliparous women (N = 254) had significantly higher cesarean delivery rate (58.7% vs. 17.8%, p < 0.001) and longer duration of labour (16.1 ± 0.74 h vs. 11.0 ± 0.43 h, p < 0.001) than multiparous women (N = 276). In nulliparous women, the rate of vaginal delivery was significantly higher in women with higher Bishop score; the mean Bishop score was 3.47 ± 0.12 in nulliparous women who had vaginal delivery vs. 3.06 ± 0.10 in women who had cesarean delivery (Adjusted odds ratio (AOR) = 1.2, 95% CI: 1.03–1.28, p = 0.03). In multiparous women, the rate of vaginal delivery was significantly higher in women with higher Bishop scores and lower in women with higher body mass index (BMI). The mean Bishop score was 3.97 ± 0.07 in multiparous women who had vaginal delivery vs. 3.56 ± 0.16 in women who had cesarean delivery (AOR = 1.5, 95% CI: 1.1–2.1, p = 0.01). The mean BMI was 30.24 ± 0.28 kg/m2 in multiparous women who had vaginal delivery vs. 32.36 ± 0.73 kg/m2 in women who had cesarean delivery (AOR = 0.89, 95% CI: 0.84–0.96, p = 0.005). 27% of nulliparous women who received more than two PGE2 tablets and 50% of multiparous women who received more than two PGE2 tablets had vaginal delivery with no significant increase in neonatal morbidity. Conclusion Parity and cervical status are the main predictors of successful labour induction. Further studies are required to investigate the benefit of the use of additional doses of vaginal PGE2 above the recommended dose for IOL.

Abstract 13525: The Association Between Multiparity and Adipokine Levels: The Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Carla P Rodriguez ◽  
Oluseye Ogunmoroti ◽  
Renato Quispe ◽  
Olatokunbo I Osibogun ◽  
Chiadi E Ndumele ◽  
...  
Keyword(s):  
Risk Factors ◽  
Covariate Adjustment ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Live Births ◽  
Grand Multiparity ◽  
Adjustment Model ◽  
Multiparous Women ◽  
History Of ◽  
The Relationship

Background: Multiparity is a risk factor for cardiovascular disease (CVD). However, the mechanism of this relationship is unknown. Adipokines may predispose multiparous women to certain cardiometabolic complications that can increase their risk of future CVD. Methods: We studied 975 female MESA participants (ages 45-84 yrs and initially free of CVD) who had complete data on parity assessed at baseline and adipokine levels measured at either Exam 2 or 3. Parity was categorized as nulliparity (reference), 1-2, 3-4 and ≥5 live births. Multivariable linear regression was used to evaluate the association of parity categories with log-transformed levels of leptin, resistin, and adiponectin. Results: The women (38% white, 23% black, 13% Chinese, and 26% Hispanic) had mean age at MESA visit 2/3 of 63±9 yrs. Median adipokine levels by parity group are shown in the Table . Compared to nulliparity, a history of 3-4 live births was associated with higher leptin levels, even after full covariate adjustment including body mass index (BMI) and CVD risk factors (model 4). Grand multiparity (≥5 births) was associated with greater leptin after adjustment for demographic and lifestyle factors (models 1 & 2), but these associations were no longer significant after BMI adjustment (model 3). Grand multiparity was also associated with lower adiponectin levels in demographic/lifestyle-adjusted models but not after adjustment for BMI. In contrast, grand multiparity remained associated with higher resistin levels after full covariate adjustment (model 4). Conclusions: In a multiethnic U.S. cohort of women, multiparity is associated with adipokine levels, specifically with higher leptin and resistin levels. Further studies are needed to determine whether adipokines mediate the relationship between multiparity and CVD.

scholarly journals Risk Factors for Intrapartum Cesarean Section Delivery in Low-risk Multiparous Women Following at Least a Prior Vaginal Birth (Robson Classification 3 and 4)

2021 ◽  
Vol 43 (06) ◽  
pp. 436-441
Author(s):  
Gul Nihal Buyuk ◽  
Hatice Kansu-Celik ◽  
Zeynep Asli Oskovi Kaplan ◽  
Burcu Kisa ◽  
Sule Ozel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Fetal Distress ◽  
Vaginal Birth ◽  
Low Risk ◽  
Cervical Dilatation ◽  
Abdominal Circumference ◽  
Robson Classification ◽  
Multiparous Women ◽  
History Of

Abstract Objective The aim of the present study was to evaluate the risk factors for cesarean section (C-section) in low-risk multiparous women with a history of vaginal birth. Methods The present retrospective study included low-risk multiparous women with a history of vaginal birth who gave birth at between 37 and 42 gestational weeks. The subjects were divided into 2 groups according to the mode of delivery, as C-section Group and vaginal delivery Group. Risk factors for C-section such as demographic characteristics, ultrasonographic measurements, smoking, weight gain during pregnancy (WGDP), interval time between prior birth, history of macrosomic birth, and cervical dilatation at the admission to the hospital were obtained from the charts of the patients. Obstetric and neonatal outcomes were compared between groups. Results The most common C-section indications were fetal distress and macrosomia (33.9% [n = 77 and 20.7% [n = 47] respectively). A bivariate correlation analysis demonstrated that mothers aged > 30 years old (odds ratio [OR]: 2.09; 95% confidence interval [CI]: 1.30–3.34; p = 0.002), parity >1 (OR: 1.81; 95%CI: 1.18–2.71; p = 0.006), fetal abdominal circumference (FAC) measurement > 360 mm (OR: 34.20; 95%CI: 8.04—145.56; p < 0.001)) and < 345 mm (OR: 3.06; 95%CI: 1.88–5; p < 0.001), presence of large for gestational age (LGA) fetus (OR: 5.09; 95%CI: 1.35–19.21; p = 0.016), premature rupture of membranes (PROM) (OR: 1.52; 95%CI: 1–2.33; p = 0.041), and cervical dilatation < 5cm at admission (OR: 2.12; 95%CI: 1.34–3.34; p = 0.001) were associated with the group requiring a C-section. Conclusion This is the first study evaluating the risk factors for C-section in low-risk multiparous women with a history of vaginal birth according to the Robson classification 3 and 4. Fetal distress and suspected fetal macrosomia constituted most of the C-section indications.

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