Second Stage Of Labour
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2021 ◽  
Vol 58 (S1) ◽  
pp. 291-292
Author(s):  
H. Abbassi ◽  
H. Temessek ◽  
A. Ben Mansour ◽  
K. Dimassi

Author(s):  
Pravinkumar A. Jadav ◽  
Palak M. Dabhi ◽  
Dhruti A. Rathod

Background: Caesarean section (CS) performed in the second stage of labour has many implications for maternal and neonatal morbidity as well as for subsequent pregnancies. The objectives of this study were to determine the rates of CS at full dilatation, their indications, associated maternal and neonatal complications.Methods: This retrospective study assessed all the women with a singleton fetus in cephalic presentation at term (≥37 weeks) who underwent CS in the second stage of labor between 1 August 2019 and 31 March 2020 at a tertiary care hospital. Maternal demographics, labour and delivery details as well as neonatal outcomes were collected.Results: During the study period, 2124 (36%) babies were born by CS. Of these, 49 (2.3%) were performed in the second stage of labour at ≥37 weeks of gestation. The most common indication of CS was non-descent of head in 38 (77.55%) of cases. The majority of women 38 (77.55%) delivered by CS in the second stage of labor were primiparous. The 27 (55.10%) women were in the age group of 20-25 years. Most common intraoperative complication was blood-stained urine in 20 (40.81%) women. Overall transfusion rate was 18.36%. Maximum number of babies born 44 (89.79%) were having birth weight between 2.5-3.5 kg. Out of 65 babies born, 17 (34.69%) were admitted to neonatal intensive care unit.Conclusions: Formulation of an institutional protocol and training and supervision of trainees to improve the skill of operative vaginal delivery and second stage cesarean is needed.


Author(s):  
Archana Minz ◽  
Kallol Kumar Roy ◽  
Rinchen Zangmo

Anomalies of vagina may present with primary amenorrhea, dysmenorrhea, infertility, dyspareunia or can be detected as an incidental finding on physical examination or imaging study for another indication. We present a case report of a 21-year-old pregnant woman who was diagnosed with longitudinal vaginal septum on vaginal examination during her antenatal visit at term. At 38 weeks 2 days period of gestation, patient presented with labour pain. Resection of the longitudinal vaginal septum was performed during the second stage of labour which facilitated vaginal delivery. Both mother and baby were discharged from hospital in good health.


Author(s):  
Michael S. Archibong ◽  
Wilson S. Adenikinju ◽  
Olaniyi J. Olayemi ◽  
Mariam Amuda

Caesarean section done at full cervical dilatation (second stage of labour) has been on the rise globally and comes with its own unique challenges and complications. This commentary highlights the peculiar challenges associated with caesarean section in second stage of labour and gives an overview on various principles to be followed and techniques to employ to reduce fetal and maternal morbidity.


Author(s):  
Emma Spillane ◽  
Shawn Walker ◽  
Christine McCourt

Objective: To test the predictive value of the Physiological Breech Birth Algorithm. Design: Retrospective case-control study Setting: Teaching Hospital, United Kingdom Population/sample: Cases were all vaginal breech births >37 weeks’ gestation where neonatal admission or death occurred between April 2012 and April 2020. Controls were the two term breech births without admission immediately prior to the cases. Methods: Data was collected from intrapartum care records and analysed using SPSS v26 statistical software. The chi-square test was used to determine association between exposure to the variables of interest and admission to the neonatal unit. Multiple logistic regression was used to test the predictive value of delays defined as non-adherence to the Algorithm. Main outcome measures: Intervals between the start of labour, the start of second stage of labour and various stages of emergence (presenting part, buttocks, pelvis, arms, head). Results: Logistic regressing modelling using the Algorithm time frames had an 84.2% accuracy, a sensitivity of 66.7% and a specificity of 92.3%. Delays between umbilicus and head >3 minutes (OR: 9.508 [95% CI: 1.390-65.046] p=0.022) and from buttocks on the perineum to head >7 minutes (OR: 6.682 [95% CI: 0.940-41.990] p=0.058) showed the most effect. Lengths of time until the first intervention were also longer among the cases, suggesting that at least some of this delay is modifiable. Conclusions: Improved recognition of delay and efficient assistance may help improve vaginal breech birth outcomes. Further research should determine whether training based on the Physiological Breech Birth Algorithm can reduce neonatal admissions.


Author(s):  
Mumtaz Adiba Bt Juanda ◽  
Suzanna Daud

Pelvic floor disorders, which includes pelvic organ prolapse (POP), have shown an increasing prevalence among women worldwide. (Wu 2014) It is perceived as embarrassment and affect the women’s quality of life. A 68-year-old housewife, Para 3, complained of a 50-cent coin size lump coming down from her vagina since 2019, which could be reduced back manually inside the vagina. The symptom exacerbated by straining and carrying heavy objects. Ignoring the symptom, causing the lump to increase in size and protruded out from her vagina for the past 2 months. She had 3 SVD with maximum birth weight of 3.75kg and a prolonged second stage of labour in her second pregnancy. She was not aware and never practiced pelvic floor exercise nor taken any HRT. There were no urinary symptoms nor constipation. Her BMI is 25.2kg/m2. Abdominal examination was unremarkable. On speculum examination, vagina was atrophic and third degree uterine prolapse was evident. She was arranged to have Vaginal hysterectomy, anterior colporrhaphy and sacrospinous fixation done. The positive risk factors in this case are multiparity, menopausal status, a history of prolonged labor and frequent heavy lifting. The delay in presentation is due to lack of awareness. It was also found in a study that feeling of embarrassment and social stigma could be the reason. (Abhyankar 2019) Pelvic Floor exercise and avoidance of heavy lifting may be beneficial at onset of symptom. For conclusion, POP awareness is crucial to empower women to prevent POP and seek treatment as soon as they are symptomatic.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S24


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Zohal Faiz ◽  
Eline M. Van ’t Hof ◽  
Gerard J. Colenbrander ◽  
Ralf Lippes ◽  
Petra C.A.M. Bakker

Abstract Objectives The aim of this study is to determine the quality of the foetal heart rate (FHR) recording, defined as signal loss, during preterm labour below 28 weeks gestational age (GA) and contribute to the discussion if cardiotocography (CTG) is of value for the extreme preterm foetus. Methods From January 2010 to December 2019 a retrospective study was conducted with data of 95 FHR recordings of singletons born between 24 and 28 weeks GA at the Amsterdam University Medical Centre, location VUmc. FHR tracings had a duration of at least 30 min and were obtained via external ultrasound mode. Data of all recordings were divided in two groups according to gestation (24–26 weeks and 26–28 weeks). Signal loss was analysed. Statistical significance was calculated by non-parametric tests and chi-square tests. The median signal loss and the proportion of cases exceeding the International Federation of Gynaecology and Obstetrics Guidelines (FIGO) threshold of 20% signal loss were calculated. Results One-third of the recordings exceeded the 20% FIGO-criterion for adequate signal quality during the first stage of labour. In the second stage, this was nearly 75%. Similarly, the median signal loss was 13% during the first and 30% during the second stage of labour (p<0.01). Conclusions The quality of FHR monitoring in the extreme preterm foetus is inadequate in a large proportion of the foetuses, especially during the second stage. FHR monitoring is therefore controversial and should be used with caution.


2021 ◽  
pp. postgradmedj-2020-139382
Author(s):  
Asrat Hailu Dagne ◽  
Shimeles Biru Zewude

BackgroundPostpartum haemorrhage is one of the direct and the leading causes of maternal morbidity and mortality. There are many risk factors of postpartum haemorrhage, which vary in different settings. Therefore, the purpose of this study was to assess postpartum haemorrhage and associated factors among mothers who gave birth in public health facilities.MethodsA cross-sectional study was employed from 17 November 2019 to 15 February 2020. The study participants were selected using a systematic sampling technique. The data were entered and cleaned using EpiData V.3.1 then exported to SPSS V.20 for analysis. Factors associated with postpartum haemorrhage were selected for multiple logistic regression at the probability value (p value) of less than 0.2 in the χ2 analysis. Statistically significant associated factors were identified at probability value (p value) less than 0.05 and adjusted OR (AOR) with a 95% CI.ResultsThe mean age of participants was 31.3 (SD ±5.7) years. This study found that the prevalence of postpartum haemorrhage was 13.6% (67). Age of participants (AOR 12.5, 95% CI 4.0 to 38.6), disrespectful maternity care (AOR 8.4, 95% CI 3.2 to 22.0), labour induction and augmentation (AOR 6.97, 95% CI 2.34 to 20.8), the prolonged second stage of labour (AOR 9.9, 95% CI 2.6 to 37.1) and no antenatal care visit (AOR 10.1, 95% CI 3.4 to 29.7) were statistically significant associated factors of postpartum haemorrhage.ConclusionsThe prevalence of postpartum haemorrhage is high. The age of the participants, disrespectful maternity care, labour induction and augmentation, the prolonged second stage of labour and no antenatal care visit were independent predictors of postpartum haemorrhage.


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