vacuum delivery
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2021 ◽  
Vol 34 (13) ◽  
Author(s):  
Susana Correia Costa ◽  
Pedro Viana Pinto ◽  
Paulo Morgado ◽  
Nuno Montenegro

Post-partum hemorrhage is one of the leading causes of maternal mortality and it’s etiology needs to be identified in order for adequate treatment to be provided. We report a case of a post-partum hemorrhage in a multiparous woman treated with selective coil packing embolization after identification of laceration of the right uterine artery’s ascending branch. The patient was admitted to an intensive care unit in hemorrhagic hypovolemic shock and disseminated intravascular coagulation and underwent total hysterectomy due to infectious complications.


Author(s):  
Julian Marschalek ◽  
Lorenz Kuessel ◽  
Maria Stammler-Safar ◽  
Herbert Kiss ◽  
Johannes Ott ◽  
...  

Abstract Purpose Vacuum-assisted deliveries (VAD) are complex procedures that require training and experience to be performed proficiently. We aimed to evaluate if a more resource intensive practice-based training program for conducting VAD is more efficient compared to a purely theory-based training program, with respect to immediate training effects and persistence of skills 4–8 weeks after the initial training. Methods In this randomized-controlled study conducted in maternity staff, participants performed a simulated low-cavity non-rotational vacuum delivery before (baseline test) and immediately after the training (first post-training test) as well as 4–8 weeks thereafter (second post-training test). The study’s primary endpoint was to compare training effectiveness between the two study groups using a validated objective structured assessment of technical skills (OSATS) rating scale. Results Sixty-two participants were randomized to either the theory-based group (n = 31) or the practice-based group (n = 31). Total global and specific OSATS scores, as well as distance of cup application to the flexion point improved significantly from baseline test to the first post-training test in both groups (pall < 0.007). Skill deterioration after 4–8 weeks was only found in the theory-based group, whereas skills remained stable in the practice-based group. Conclusion A practice-based training program for conducting VAD results in comparable immediate improvement of skills compared to a theory-based training program, but the retention of skills 4–8 weeks after training is superior in a practice-based program. Future studies need to evaluate, whether VAD simulation training improves maternal and neonatal outcome after VAD.


Author(s):  
Gabriel Levin ◽  
Joshua I. Rosenbloom ◽  
Maayan Sultani ◽  
Raanan Meyer ◽  
Shay Porat ◽  
...  

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 12-15
Author(s):  
Beautily V ◽  
Sharmila R

Pregnancy is a curious rousing and as frequently as possible upbeat hour in a woman's life, as spots of interest the woman's bewildering innovative and headway capacity while allowing a relationship with what's to come. There is a wide range of techniques for labour. Vaginal delivery is one of the most widely recognized and most secure sorts of labour. At the point when vital in specific conditions, forceps and vacuum delivery might be utilized. Now cesarean delivery is fundamental for the most secure of mother and child. The cesarean segment is the most every now and again performed a medical procedure on the planet. The point of the Study is to the adequacy of Hand and Foot Massage on Post cesarean pain among postnatal moms. Exploration approach utilized for the investigation was the quantitative methodology. The examination configuration was semi trial plan (pretest and post test control group). A complete of 60 members were choosing with non - likelihood purposive inspecting procedure was utilized and factual strategy applied for the investigation. The investigation was directed in a government hospital at Thiruvallur. The mean pre-test score in the exploratory gathering was 6.4 and meant the post-test score was 3.5. The 't' esteem is 33.72, which was huge at p≤0.05 level. Subsequently, it demonstrated that Hand and Foot Massage was viable in diminishing pain among post-cesarean moms in the experimental group. 


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wubet Alebachew Bayih ◽  
Getachew Yideg Yitbarek ◽  
Yared Asmare Aynalem ◽  
Biruk Beletew Abate ◽  
Aragaw Tesfaw ◽  
...  

Abstract Background More than one third of the neonatal deaths at Neonatal Intensive Care Unit (NICU) in Debre Tabor General Hospital (DTGH) are attributable to birth asphyxia. Most of these neonates are referred from the maternity ward in the hospital. Concerns have also been raised regarding delayed intrapartum decisions for emergency obstetrics action in the hospital. However, there has been no recent scientific evidence about the exact burden of birth asphyxia and its specific determinants among live births at maternity ward of DTGH. Moreover, the public health importance of delivery time and professional mix of labor attendants haven’t been addressed in the prior studies. Methods Hospital based cross sectional study was conducted on a sample of 582 mother newborn dyads at maternity ward. Every other mother newborn dyad was included from December 2019 to March 2020. Pre-tested structured questionnaire and checklist were used for data collection. The collected data were processed and entered into Epidata version 4.2 and exported to Stata version 14. Binary logistic regressions were fitted and statistical significance was declared at p less than 0.05 with 95% CI. Results The prevalence of birth asphyxia was 28.35% [95% CI: 26.51, 35.24%]. From the final model, fetal mal-presentation (AOR = 6.96: 3.16, 15.30), premature rupture of fetal membranes (AOR = 6.30, 95% CI: 2.45, 16.22), meconium stained amniotic fluid (AOR = 7.15: 3.07, 16.66), vacuum delivery (AOR =6.21: 2.62, 14.73), night time delivery (AOR = 6.01: 2.82, 12.79) and labor attendance by medical interns alone (AOR = 3.32:1.13, 9.78) were positively associated with birth asphyxia at 95% CI. Conclusions The prevalence of birth asphyxia has remained a problem of public health importance in the study setting. Therefore, the existing efforts of emergency obstetric and newborn care should be strengthened to prevent birth asphyxia from the complications of fetal mal-presentation, premature rupture of fetal membranes, meconium stained amniotic fluid and vacuum delivery. Moreover, night time deliveries and professional mixes of labor and/delivery care providers should be given more due emphasis.


2020 ◽  
Vol 5 (2) ◽  
pp. 1065-1070
Author(s):  
Shreyashi Aryal ◽  
Deepak Shrestha ◽  
Sweta Mahato

Introduction: Operative delivery at full cervical dilatation can be either a caesarean section or instrumental deliveries. Instrumental deliveries are well debated options for reducing caesarean section rates but they have their own set of maternal and fetal morbidities. CS at full dilatation of cervix is also demanding due to impacted fetal head. Choice between the two depends on the treating obstetrician.  Objective: To assess perinatal morbidities between vacuum delivery and caesarean section at full cervical dilatation.  Methodology: This is an observational cross-sectional comparative study done for the duration of one year from January to December 2019. Women undergoing vacuum delivery or caesarean section in full cervical dilatation were compared for maternal and neonatal morbidities. Risk factors associated with these morbidities were also assessed. The morbidities in each group were compared using Pearson's chi square test. Likelihood of morbidities in relation to risk factors was calculated using univariate logistic regression.  Results: Prevalence of maternal complications in vacuum delivery was 33.3% (28) and in caesarean was 42.9% (15). Neonatal complications in vacuum delivery was 50% (42) and in caesarean was 48.6% (17). Being a referred case (OR=1.14) and a primigravida (OR=1.45) were risk factors for perinatal morbidities in vacuum delivery. Referred cases (OR=1.52), primigravidas (OR=5.90), head station lower than zero (OR=1.26) and birth weight of more than 3500 gms (OR=2.60) were associated with more number of morbidities in caesarean at full cervical dilatation. Conclusion Operative deliveries at full cervical dilatation, either vacuum or CS carry risk of maternal and neonatal morbidities. Obstetrician should make a decision keeping in mind certain risk factors like referred cases, parity, head station, number of pulls, method of delivery of head and fetal weight so that severe morbidities can be prevented.


2019 ◽  
Vol 2 (3) ◽  
pp. 137-141
Author(s):  
Padma Raj Dhungana ◽  
Rajesh Adhikari ◽  
Prem Raj Pageni ◽  
Apsara Koirala ◽  
Anand Nepal

Background: Labor is a naturally occurring physiological process associated with uterine contractions, effacement, dilatation of cervix and descent of presenting part. Drotaverine hydrochloride is a non-anticholinergic isoquinoline derivative which acts by elevating intracellular cyclic Adenosine Mono Phosphate (cAMP) and cyclic Guanosine Mono Phosphate (cGMP) promoting smooth muscle relaxation. Materials and Method: This was a hospital based prospective study on effectiveness of Drotaverine Hydrochloride on enhancing dilatation of cervix and acceleration of active phase of labor. The sample size was 100. Fifty cases of women in active phase of labor received injection drotaverine hydrochloride 40 mg (group i) and fifty cases of women did not receive any drug (group ii) among those at term with singleton pregnancy and vertex presentation. Variables like maternal age, interval between administration of drug and delivery, mode of delivery, apgar score at 5 minutes, NCU (Neonatal Care Unit) admission and neonatal outcomes were recorded. Data analysis was done with the help of SPSS program. Results: The mean interval between drug administration to delivery in primipara and multipara in group i was 3.05 hours and 2.31 hours while in group ii was 4.5 hours and 3.75 hours respectively. The mean interval between drug administration and delivery was shorter in both groups of multipara. In group i, 96% had normal delivery and 4 % had vacuum delivery and in group ii 90% and 10% had normal delivery and vacuum delivery respectively. None of the participants had caeserian section. There were no perinatal mortalities. Conclusion: The administration of drug Drotaverine Hydrochloride is effective in shortening duration of labor with favorable feto-maternal outcome.  


2019 ◽  
Vol 36 (S 02) ◽  
pp. S91-S98 ◽  
Author(s):  
Stefano Uccella ◽  
Paolo Manzoni ◽  
Antonella Cromi ◽  
Nicola Marconi ◽  
Baldo Gisone ◽  
...  

Objective To systematically evaluate pregnancy and labor course, obstetrical complications, and maternal and neonatal outcomes in women with endometriosis, stratifying according to the specific location of the disease. Study Design We retrospectively analyzed our prospectively maintained obstetrical database from January 2011 to August 2014 to identify all women with a previous histological diagnosis of endometriosis who delivered at our institution (cases). We divided the cases according to the specific location of the disease (deep infiltrating endometriosis, ovarian endometriosis, and peritoneal endometriosis). As controls, we identified all unaffected women who delivered in the year 2013. To avoid the confounding effect of parity, we limited our analysis to nulliparous women. Results A total of 118 nulliparous women with endometriosis and 1,690 nulliparous controls were identified. Women with endometriosis were significantly older, had a lower body mass index, and had a higher incidence of assisted reproductive technology. The duration of pregnancy was significantly shorter among women with endometriosis. A higher incidence of placenta previa (3.4 vs. 0.5%; p = 0.006), hypertension (11 vs. 5.9%; p = 0.04), cesarean section (41.5 vs. 24.2%; p < 0.0001), and vacuum delivery (10.1 vs. 2.9%; p = 0.006) was found in women with endometriosis. Neonatal outcomes were similar between groups. The incidence of placenta previa in patients with deep endometriosis was 11.7 versus 0.5% among controls (p < 0.0001), whereas in women with ovarian and peritoneal endometriosis, it was similar to the controls. Conclusion Women with endometriosis have a higher incidence of vacuum delivery, cesarean section, and placenta previa compared with unaffected women. The higher risk of placenta previa is attributable exclusively to women with deep endometriosis. Neonatal outcomes are unaffected by the presence of the disease.


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