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

scholarly journals CLINICAL ANALYSIS OF RISK FACTORS AND OUTCOME IN PLACENTA PREVIA

2021 ◽  
pp. 1-3
Author(s):  
H. Anitha Virgin Kumari ◽  
S. Nivedita ◽  
M. Monisha
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Gestational Age ◽  
Maternal Age ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Age At Onset ◽  
Expectant Management ◽  
Clinical Analysis ◽  
Delivery Mode

BACKGROUND Placenta previa describes a placenta that is implanted somewhere in the lower uterine segment,either over or near the internal cervical os. AIM OF THE STUDY To analyse the risk factors and outcomes associated with placenta previa METHODS A prospective study of all the placenta previa patients delivered at Govt RSRM Lying in Hospital,Chennai from June 2019 to November 2020 are included.Control of 533 patients without placenta previa were selected randomly during the same period.The differences between the groups with respect to age,parity ,mal presentation,pregnancy associated complications,gestational age at onset of bleeding,gestational age at delivery,mode of delivery,third stage complications,neonatal outcome,during of hospital stay are noted. RESULTS The risk of occurrence of placenta previa is increased with advancing maternal age,parity and previous uterine surgery.Incidence is 0.5%,69% of placenta previa cases delivered by cesarean section,10% developed PPH,2% managed surgically,25% preterm delivery. CONCLUSION Accurate diagnosis,judicious expectant management with blood transfusion as required and timely delivery may lead to the most favorable outcome. The current study also suggested that advancing maternal age,parity and cesarean section increase the risk of placenta previa.

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.

CLINICAL STUDY OF PRIMARY CESAREAN SECTION IN MULTIPAROUS WOMEN AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2021 ◽  
pp. 7-8
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Major Surgery ◽  
Obstetrics And Gynaecology ◽  
Emergency Cesarean ◽  
Study Results ◽  
Multiparous Women

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients. Methodology: This was an observational study conducted at Department of Obstetrics and Gynaecology of Darbhanga Medical College and Hospital, Laheriasarai, Bihar. Aim of the study was to study the indication, maternal and fetal outcome in primary cesarean in multiparous women. All multiparous women admitted for delivery were included in the study Results: The total number of deliveries were 3064 and cesarean section were 1026 (33%).The total number of primary cesarean section in multiparous women were 84 constituting 2.7%. In this study, majority of women were Gravida 2. 91.6% of the cases were underwent emergency cesarean section and anesthesia was spinal. Majority of patients were between age group of 22 to 27 yrs (70%). Indications for cesarean section in our study were severe oligohydroamnios (22%), fetal distress (15.4%), and breech presentation (14%), premature rupture of membrane (12%).Intra operative ndings were meconium stained liquor, post partum hemorrhage, thinned out lower segment and extension of incision. Out of 84 cases, 48 cases needed intra operative or immediate post operative blood transfusion. The post operative morbidity was present in 6 cases i.e paralytic ileus, puerperal fever, urinary tract infection and wound gaping. Majority of babies, weighed in the range of 2-3kgs (55%).Out of 84 cases 7 were causes were placenta previa, obstructed labor and fetal distress. Conclusion: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.

scholarly journals Effect of “motivational interviewing” and “information, motivation, and behavioral skills” counseling interventions on choosing the mode of delivery in pregnant women: a study protocol for a randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahboubeh Shirzad ◽  
Elham Shakibazadeh ◽  
Abbas Rahimi Foroushani ◽  
Mehrandokht Abedini ◽  
Hamid Poursharifi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Section ◽  
Motivational Interviewing ◽  
Pregnant Women ◽  
Controlled Trial ◽  
Mode Of Delivery ◽  
Normal Vaginal Delivery ◽  
Behavioral Skills ◽  
Randomized Controlled ◽  
Counseling Interventions

Abstract Background Cesarean section is an important surgical procedure, when normal vaginal delivery imposes a risk to mother and/or baby. The World Health Organization states the ideal rate for Cesarean section to be between 10 and 15% of all births. In recent decades, the rate has been increased dramatically worldwide. This paper explains the protocol of a randomized controlled trial that aims to compare the effect of “motivational interviewing” and “information, motivation, and behavioral skills” counseling interventions on choosing mode of delivery in pregnant women. Methods A four-armed, parallel-design randomized controlled trial will be conducted on pregnant women. One hundred and twenty women will be randomly assigned to four groups including three intervention groups and one control group. The intervention groups included the following: (1) motivational interviewing; (2) face-to-face information, motivation, and behavioral skills model; and (3) information, motivation, and behavioral skills model provided using a mobile application. The inclusion criteria include being literate, being in gestational age from 24 to 32 weeks, being able to speak Persian, having no complications in the current pregnancy, having no indications for Cesarean section, and having enough time to participate in the intervention. The primary outcome of the study is the mode of delivery. The secondary outcomes are women’s intention to undergo Cesarean section and women’s self-efficacy. Discussion The interventions of this protocol have been programmed to reduce unnecessary Cesarean sections. Findings may contribute to a rise in normal vaginal delivery, and the effective intervention may be extended for use in national Cesarean section plans. Trial registration Iran Randomized Clinical Trial Center IRCT20151208025431N7. Registered on December 07, 2018.

Influence of Patient-Level Factors on Mode of Delivery among Operative Vaginal Delivery Candidates in Modern Practice

2017 ◽  
Vol 34 (10) ◽  
pp. 0974-0981 ◽  
Author(s):  
Christina Gonzalez ◽  
Amanda Allshouse ◽  
Erick Henry ◽  
Sean Esplin ◽  
Torri Metz
Keyword(s):  
Vaginal Delivery ◽  
Gestational Age ◽  
Maternal Age ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Second Stage ◽  
Patient Level ◽  
Operative Vaginal Delivery

Objective We aimed to evaluate which patient-level factors influence mode of delivery among candidates for operative vaginal delivery. Study Design Cross-sectional study of candidates for operative vaginal delivery from 18 hospitals over 8 years. Probabilities of mode of delivery were estimated using hierarchical logistic modeling adjusting for clustering within physician and hospital. Results Total 3,771 (64%) women delivered with forceps, 1,474 (25%) vacuums, and 665 (11%) cesareans. Odds of forceps versus vacuum were higher with induction (OR = 2.16, 95% CI: 1.76–2.65), nulliparity (OR = 2.06, 95% CI: 1.59–2.66), epidural (OR = 2.05, 95% CI: 1.19–3.56), maternal indication (OR = 1.53, 95% CI 1.16–2.02), older maternal age (OR 1.18, 95% CI 1.06–1.31 per 5 years), and longer second stage (OR = 1.10, 95% CI: 1.01–1.20 per hour).Odds of cesarean versus operative vaginal delivery were higher with maternal indication (OR = 9.0, 95% CI: 7.23–11.20), a perinatologist (OR = 2.51, 95% CI: 1.09–5.78), longer second stage (OR = 1.79, 95% CI: 1.65–1.93 per hour), older gestational age (OR = 1.10, 95% CI: 1.01–1.20 per week), and longer labor (OR = 1.02, 95% CI: 1.01–1.04 per hour). Conclusion Patient-level factors influence the decision to proceed with an operative vaginal delivery and the choice of instrument, thereby emphasizing the importance of maintaining availability of both forceps and vacuums.

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 Maternal risk factors for low birth weight of neonates in al- diwaniyah province, iraq

2019 ◽  
Vol 10 (3) ◽  
pp. 1904-1909
Author(s):  
Adel J. Hussein
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Prenatal Care ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Teaching Hospital ◽  
Maternal Age ◽  
Maternal Risk Factors ◽  
Socioeconomic Condition ◽  
Maternal Risk

The LBW infants as weighting less than 2.5kg at birth. Infants with low birth weight are probable to suffer medical troubles and delay development from the time of delivery to adult life. This study was planned to discover the prevalence of LBW infants in Ad-Diwaniyah city (Iraq) and the maternal risk factors, which contribute to the occurrence of low birth weight, and it is rated and what the suitable recommendations can be made to prevent this problem.  Unfortunately, in Iraq, several studies reveal an increase in the delivery of LBW infants in the last years. The present study was aimed to identify the prevalence of LBW and possible maternal factors in children, teaching hospital in Al-Diwaniyah city during the period of the beginning of February 2017 to February 2018. This is a cross-sectional survey held out in Pediatric, teaching hospital through 1012 pregnant mothers giving a live LBW. Whole children weight on a weighing machine. Data was collected through the interview of mothers. Maternal age and education level, socioeconomic condition, number of prenatal visits, interpregnancy interval and maternal diseases, and infant gender were registered in questionnaire format. The result of the current study detects that the rate of LBW was 20.2%. The highest percentage of them (LBW) was preterm 67.4% and full, term (IUGR) 32.5%. 61.5% of the children in the LBW group were male, and 38.4% were female.  Besides the outcome indicates that there are many important risk factors contributed to the incidence of LBW, these are; multiple pregnancies were found to be 66.8% of LBW infants,  maternal age 21 – 35 years (39.7%),  lack of Prenatal Care (60.3%),  delivery by cesarean section (70.6%),  mothers who illiterate (64.8%),  a large number of mothers from the rural area (68.6%),  the presence of maternal diseases (63.5%),  all these are considered a risk factor. The current study demonstrates the essential elements give rise to low birth weight in neonates are gestational age (preterm delivery), maternal education and age, multiple births, regular prenatal care, cesarean section, and bad obstetric history.

scholarly journals Maternal and perinatal outcome in severe preeclampsia and eclampsia at the Rivers State university teaching hospital, Nigeria

2020 ◽  
Vol 9 (11) ◽  
pp. 4389
Author(s):  
Peter A. Awoyesuku ◽  
Dickson H. John ◽  
Dickson H. John ◽  
Lewis B. Lebara ◽  
Lewis B. Lebara
Keyword(s):  
Birth Weight ◽  
Teaching Hospital ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Case Fatality ◽  
Severe Preeclampsia ◽  
University Teaching ◽  
State University ◽  
The Mean ◽  
Rivers State

Background: Severe preeclampsia and eclampsia remain a challenge in tropical obstetric practice. It is a major contributor to feto-maternal morbidity and mortality in developing countries. This study seeks to determine the prevalence, associated risk factors and the feto-maternal outcome of severe preeclampsia and eclampsia at the rivers state university teaching hospital (RSUTH).Method: A retrospective study of all women who had severe preeclampsia and eclampsia and were delivered at the RSUTH in a two-year period, 1ST January 2018 to 31ST December 2019, was carried out. Data on patients’ age, parity, education, booking status, gestational age at delivery, diagnosis, complications, mode of delivery and fetal sex, birth weight and Apgar scores were retrieved using structured pro-forma. Data were analyzed using SPSS version 20.Results: There were 4496 deliveries of which 128 had severe preeclampsia and eclampsia, giving a prevalence of 2.85%. Of these, 94 (73.4%) had severe preeclampsia and 34 (26.6%) had eclampsia. The mean age of the women ± SD was 29.84±5.44 years, median parity was para 1, and mean gestational age ± SD was 35.38±3.84 weeks. There were 10 maternal deaths giving case fatality of 7.8%. The mean birth weight ± SD was 2.61±0.91 kg and stillborn rate was 14.4%. There was significant association with maternal age, education, booking status, method of delivery and Apgar score of the baby.Conclusion: The prevalence in this study is high with associated high maternal mortality and stillborn rates. Timely and appropriate intervention including primary management and judicious termination of pregnancy will reduce mortality of mother and fetus.

scholarly journals Effect of "motivational interviewing" and "information, motivation and behavioral skills” counselling interventions on choosing the mode of delivery in pregnant women: A study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Mahboubeh Shirzad ◽  
Elham Shakibazadeh ◽  
Abbas Rahimi Foroushani ◽  
Mehrandokht Abedini ◽  
Hamid Poursharifi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Section ◽  
Motivational Interviewing ◽  
Pregnant Women ◽  
Controlled Trial ◽  
Mode Of Delivery ◽  
Normal Vaginal Delivery ◽  
Behavioral Skills ◽  
Randomized Controlled ◽  
Counselling Interventions

Abstract Background: Caesarean Section is an important surgical procedure, when normal vaginal delivery imposes a risk to mother and/or baby. The World Health Organization states the ideal rate for Cesarean section to be between 10% and 15% of all births. In recent decades, the rate has been increased dramatically worldwide. This paper explains the protocol of a randomized controlled trial that aims to compare the effect of "motivational interviewing" and "information, motivation, and behavioral skills” counselling interventions on choosing mode of delivery in pregnant women.Methods: A four-armed, parallel-design randomized controlled trial will be conducted on pregnant women. One hundred and twenty women will be randomly assigned to four groups including three intervention groups and one control group. The intervention groups included: 1) motivational interviewing; 2) face-to-face information, motivation, and behavioral skills model; and 3) information, motivation, and behavioral skills model provided using a mobile application. The inclusion criteria include being literate, gestational age from 24 to 32 weeks, being able to speak Persian, having no complications in the current pregnancy, having no indications for Cesarean section, and having enough time to participate in the intervention. The primary outcome of the study is the mode of delivery. The secondary outcomes are women’s intention to undergo Cesarean section, and women’s self-efficacy.Discussion: The interventions of this protocol have been programmed to reduce unnecessary Cesarean sections. Findings may contribute to a rise in normal vaginal delivery; and the effective intervention may be extended for use in national Cesarean section plans.Trial registration: This study has been registered in Iran Randomized Clinical Trial Center (IRCT20151208025431N7). Registered December 07, 2018.

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