scholarly journals Vaginal Delivery

2021 ◽  
Author(s):  
Kizito Omona

Vaginal delivery refers to the birth of offspring in mammals or babies in humans, through the vagina, also known as the “birth canal”. It is the natural method of birth for most mammals excluding those which lay eggs. For women who deliver vaginally, childbirth progresses in three stages: labor, delivery of the baby and delivery of the placenta. There are two types of vaginal delivery: Unassisted vaginal delivery and assisted vaginal delivery. In the later, this assistance can vary from use of medicines to emergency delivery procedures. The following types of vaginal delivery have been noted; (a) Spontaneous vaginal delivery (SVD) (b) Assisted vaginal delivery (AVD), also called instrumental vaginal delivery (c) Induced vaginal delivery and (d) Normal vaginal delivery (NVD), usually used in statistics or studies to contrast with a delivery by cesarean section. Delivery of a full-term newborn occurs at a gestational age of 37–42 weeks, usually determined by the last menstrual period or ultrasonographic dating and evaluation. Nearly 80% of newborns are delivered at full term while approximately 10% of singleton pregnancies are delivered preterm and 10% of all deliveries are post-term.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3926-3926 ◽  
Author(s):  
Barbara Królak-Olejnik ◽  
Igor Olejnik

Abstract Natural killer (NK) cells take part in the early immunological response to infection. Their lower cytotoxic activity in the neonates, especially premature ones, compared to children and adults, is assumed to be one of the factors responsible for high susceptibility to infections. Moreover, alterations in every components of immune response during anesthesia and surgery have been suggested. The numbers of natural killer cells are decreased postoperatively. The aim of the study was to estimate the influence of the mode and time of delivery on the number of leukocytes, number and percentage of lymphocytes and natural killer (NK) cells. The NK cells were examined by the three-color flow cytometry with the use of monoclonal antibodies of Becton Dickinson in the following study groups: (1) full-term neonates born by normal spontaneous vaginal delivery (n=19); (2) preterm neonates born by normal spontaneous vaginal delivery (n=15); (3) full-term neonates born by elective cesarean section under epidural anesthesia (n=23); (4) preterm neonates born by cesarean section under epidural anesthesia (n=22). The number of leukocytes was similar in all examined neonates. The numbers of leukocytes were lower albeit not significantly in preterm neonates born by cesarean section. The numbers of lymphocytes were also similar in all examined neonates but the percentage of lymphocytes was higher in the preterm neonates than in the full-term ones (p<0,05). The number and percentage of natural killer (NK) cells were higher in the neonates born by normal spontaneous vaginal delivery both full-term and preterm ones. The significant lowest value of NK cells was in the preterm neonates born by cesarean section under epidural anesthesia. These results suggest that either mode of delivery or time of delivery might influence the NK cell numbers in the umbilical cord blood of the neonates.


2020 ◽  
Vol 10 (1) ◽  
pp. 32-38
Author(s):  
Aisha Khan Jadoon ◽  
Arzu Jadoon ◽  
Sarosh Khan Jadoon ◽  
Shahina Ishtiaq

Background: Postpartum Depression is a serious issue that can lead to irreversible disasters if not timely recognized and diagnosed. There are various modes of delivery; which may contribute towards physical and mental trauma. Methods: It was a prospective descriptive cross- sectional study carried out to evaluate the alliance of postnatal depression with different modes of delivery i.e. vaginal or lower segment caesarean section. The study was conducted at Ziauddin University Hospital. A sample size of 200 was taken. It was carried out from June 2019 to December 2019. A Performa was designed that questioned about different socio-demographic characteristics and risk factors for post-natal depression (PND). Edinburg Post-Natal Depression Scale (EPNDS) was used for authenticated identification of women with depression in purpeurium. Results: Out of the total sample of 200 women, 100 were taken from the spontaneous vaginal delivery group and 100 from cesarean section group. Mean age was 21-34 years. It was noticed that 60% women who underwent cesarean section became a victim of depression and 40% women who had a normal vaginal delivery were identified to have post natal depression. Conclusion: The study identifies cesarean section to be one of the culprits of postnatal depression as compared to woman undergoing spontaneous vaginal delivery.  There is an exponential rise in the frequency of performing unexplained cesarean sections that would also boost up the graphs of postnatal depression; hence there is a dire need to instruct women to follow up postnatal so that they can be evaluated for post partum depression.


Author(s):  
Muhammad Saleem Rana ◽  
Mohammad Asif ◽  
Asif Hanif ◽  
Syed Amir Gilani ◽  
Ume Habiba ◽  
...  

Objectives: To assess the association of perceived social support with postnatal depression among puerperal women of Faisalabad, Pakistan. Methods: It was a case-control study carried out during a period of 18 months (1-1-2019 to 30-06-2020). By using purposive sampling technique 284 postpartum women were enrolled from Allied hospital and Children hospital Faisalabad. The postnatal depression was diagnosed with Edinburg Postnatal Depression Scale (EPDS).The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure the social support that was perceived by women. Results: According to cut-off score ≥13 on EPDS 37.3% women were found depressed while 62.7% women were found non-depressed. The mean EPDS score ± SD was 10.12 ± 6.27 (min score 0; max score 27). The perceived social support from significant other, family and friends was found as significant predictor of postnatal depression. With one-point increase in global perceived social support, the postnatal depression decreased by 0.1 points on EPDS scale (p = 0.03) among women in normal vaginal delivery group, by 0.2 points in cesarean section group (p <0.001) and the postnatal depression decreased by 0.2 points in total sample (p < 0.001). Conclusion: A poor perceived social support from significant other, family and friends is a significant risk factor for postnatal depression among puerperal women.


2018 ◽  
Vol 6 (2) ◽  
pp. 781-784
Author(s):  
SAIMA PERVEEN ◽  
PARVEEN NAVEED ◽  
NAZISH HAYAT ◽  
NADIA RASHID

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


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Elina Holopainen ◽  
Svetlana Vakkilainen ◽  
Outi Mäkitie

Abstract Background Cartilage-hair hypoplasia (CHH) is a rare skeletal dysplasia characterized by disproportionate short stature, immunodeficiency, anemia and risk of malignancies. All these features can affect pregnancy and predispose to maternal and fetal complications. This study aimed to evaluate obstetric history and maternal and fetal outcomes in women with CHH. Methods Among 47 Finnish women with CHH, we identified 14 women with ICD codes related to pregnancies, childbirth and puerperium in the National Hospital Discharge Registry and obtained detailed data on gynecologic and obstetric history with a questionnaire. Offspring birth length and weight were collected and compared with population-based normal values. Results There were altogether 42 pregnancies in 14 women (median height 124 cm, range 105–139 cm; 4′1′′, range 3′5′′–4′7′’). Twenty-six pregnancies (62%), including one twin pregnancy, led to a delivery. Miscarriages, induced abortions and ectopic pregnancies complicated 9, 5, and 2 pregnancies, respectively. Severe pregnancy-related complications were rare. All women with CHH delivered by cesarean section, mostly due to evident cephalo-pelvic disproportion, and in 25/26 cases at full-term. In the majority, the birth length (median 48 cm, range 45.5–50 cm; 1′7′′, range 1′6′′–1′8′′) and weight (3010 g, range 2100–3320 g; 6.6 lb, range 4.6–7.3 lb) of the offspring in full-term singleton pregnancies was normal. Conclusions Despite CHH mothers’ significant short stature and other potential CHH-related effects on pregnancy outcome, most pregnancies lead to a term cesarean section delivery. Since fetal growth was generally unaffected, cephalo-pelvic disproportion was evident and planned cesarean section should be contemplated in term pregnancies.


2020 ◽  
pp. 000486742095428
Author(s):  
Lei Sun ◽  
Su Wang ◽  
Xi-Qian Li

Background: Postpartum depression is one of the most common postpartum diseases, which has an important impact on the interaction between mother, infant, partner and family, as well as the long-term emotional and cognitive development of infants. However, there are still great disagreements on whether the delivery mode will affect the risk of postpartum depression. The purpose of this study is to explore whether the mode of delivery will affect the risk of postpartum depression through the comprehensive network meta-analysis of elective cesarean section, emergency cesarean section, instrumental vaginal delivery and spontaneous vaginal delivery. Methods: We searched in three electronic databases: PubMed, EMBASE and Cochrane Library. Results: This paper included 43 studies with a total sample size of 1,827,456 participants. Direct meta-analysis showed that the odds ratio of postpartum depression risk was 1.33 (95% confidence interval = [1.21, 1.46]) between cesarean section and vaginal delivery. The odds ratios of high Edinburgh Postpartum Depression Scale score between cesarean section and vaginal delivery in the three postpartum periods (within 2 weeks, within half a year and over half a year) were basically the same. There was no difference between cesarean section and vaginal delivery in the risk of severe postpartum depression at the Edinburgh Postpartum Depression Scale cut-off point ⩾13 (odds ratio = 1.07; 95% confidence interval = [0.99, 1.16]). Network meta-analysis showed that the risk of postpartum depression in the pairwise comparisons emergency cesarean section vs spontaneous vaginal delivery and elective cesarean section vs spontaneous vaginal delivery was odds ratio = 1.53 (95% confidence interval = [1.22, 1.91]) and 1.47 (95% confidence interval = [1.16, 1.86]). Conclusion: The mode of delivery has a significant effect on the occurrence of mild postpartum depression. Women who give birth by cesarean section, especially who give birth by emergency cesarean section, are at a higher risk of mild postpartum depression. We should carefully monitor the progress of postpartum mental disorders in women who delivered by cesarean section and make it possible for women to have a quick access to mental healthcare.


2019 ◽  
Vol 301 (2) ◽  
pp. 387-392
Author(s):  
Sedigheh Hantoushzadeh ◽  
Mamak Shariat ◽  
Raheleh Moradi ◽  
Neda Nikobakhat ◽  
Fatemeh Sabzevari

Author(s):  
Balraj S. Jhawar ◽  
Adrianna Ranger ◽  
David A. Steven ◽  
Rolando F. Del Maestro

ABSTRACT:Objective:To determine physical and cognitive outcomes of full-term infants who suffered intracranial hemorrhage (ICH) at birth.Methods:A retrospective hospital-based, follow-up study of infants treated in London, Ontario between 1985 and 1996. Follow-up was conducted by telephone interviews and clinic visits. Outcome was measured according to physical and cognitive scales. Perinatal risk factors and hemorrhage characteristics were correlated with final outcome.Results:For this study 66 infants with ICH were identified, of which seven died during the first week of life. We obtained follow-up in all but ten cases (median = 3-years; range 1.0 to 10.9 years). Overall, 57% of infants had no physical or cognitive deficits at follow-up. Death occurred most frequently among those with primarily subarachnoid hemorrhage (19%) and the most favorable outcomes occurred among those with subdural hemorrhage (80% had no disability). In univariate models, thrombocytopenia (platelet count ≤ 70 x 109/L), increasing overall hemorrhage severity, frontal location and spontaneous vaginal delivery as opposed to forceps-assisted delivery increased risk for poor outcome. In multivariate models, all these factors tended towards increased risk, but only thrombocytopenia remained significant for physical disability (OR = 7.6; 95% CI = 1.02 – 56.6); thrombocytopenia was borderline significant in similar models for cognitive disability (OR = 4.6; 95% CI = 0.9 – 23.9).Conclusion:Although forceps-assisted delivery may contribute to ICH occurrence, our study found better outcomes among these infants than those who had ICH following a spontaneous vaginal delivery. Hemorrhage in the frontal lobe was the most disabling hemorrhage location and if multiple compartments were involved, disability was also more likely to occur. However, in this report we found that the factor that was most likely to contribute to poor outcome was thrombocytopenia and this remained important in multivariate analysis.


1985 ◽  
Vol 6 (5) ◽  
pp. 189-193 ◽  
Author(s):  
Leigh Grossman Donowitz ◽  
Sandra M. Norris

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.


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