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Kothapally, Kavitha, Archana Uppu, and Vijayalakshmi Gillella. "Study of the obstetric outcome of breech presentation in pregnancy in a tertiary hospital in a rural area in Telangana, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 5 (April 27, 2017): 2040. http://dx.doi.org/10.18203/2320-1770.ijrcog20171973.
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Background: The present study was undertaken to study the incidence, aetiology and obstetric outcome of breech presentation in pregnancy in a teaching hospital in a rural area.Methods: The present retrospective observational study was conducted in the department of obstetrics and gynaecology at Bhaskar Medical College and Bhaskar General Hospital, Yenkepally, Telangana from May 2014 to March 2017. 50 cases of breech presentation were included in the study. Demographic data like age, parity, gestational age of first detection of breech, aetiological factors of breech, mode of delivery, neonatal outcome were noted from case records.Results: The incidence of breech was 1.4% in pregnancies attending Bhaskar general hospital. 74% were in the age group of 20-24yrs & 20% were in the age group of 25-29yrs. Primis accounted for 62% of the study group. Common etiologies of breech presentation were oligohydramnios (28%) and uterine anomalies (28%). No obvious fetal anomalies were noted. Majority (96%) of cases were delivered by caesarean section for breech associated with oligohydramnios, gestational hypertension, intrauterine fetal growth restriction and preterm. Neonatal outcome was good in breech delivered by caesarean section.Conclusions: Breech delivery is a high risk pregnancy with adverse fetal outcomes during pregnancy and labour. Though caesarean section for breech presentation is not universally recommended, caesarean section can reduce the perinatal mortality and morbidity compared to vaginal birth for term breech pregnancy. Mode of delivery should be decided based on the case and obstetrician’s skill.
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Naz, Samina. "VAGINAL BREECH DELIVERY." Professional Medical Journal 22, no. 08 (August 10, 2015): 1024–28. http://dx.doi.org/10.29309/tpmj/2015.22.08.1149.
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Objective: To determine the obstetric and perinatal outcome of pregnancieswith singleton breech presentation, and to scrutinize the causes of increasing incidence ofcesarean section in breech presentation. Design: Analytical Observational study. Place andduration: Department of obstetrics and gynecology Fatima hospital Baqai university campusfrom Jan 2010 to Oct 2011. Patients & Methods: This study includes 135 patients with singletonbreech presentation ≥ 34 weeks of gestation, were analyzed in detail with help of designedperforma. Patients were categorized in three groups. Groups a, who had elective C-section,group b. who underwent emergency caesarean section or had C-section after failed trial ofvaginal delivery and group c. who had vaginal breech delivery. Elective caesarean section wasdone in those cases that had some other indications for carrying out this procedure apart frombreech presentation. Trial of vaginal breech delivery was planned for all multiparous womenexcept those falling in group A. All antepartum fetal demise, twin pregnancies and placentaprevia of major degree were excluded. Results: Of 135 women, 7(5%) underwent prelabourcesarean, and 128(95%), had trial of vaginal delivery, of whom 117(91.5%) delivered vaginally.Significantly more infants weighing> 3.5kg were selected for prelabour and intrapartumcesarean than vaginal delivery. Two neonates had Apgar score< 7 at 5 minutes but both werenormal neurologically. There were no nonanomalous perinatal death and no case of significanttrauma or neurological dysfunction. Two infants died due to lethal anomalies. Conclusion:Trial of vaginal breech delivery in well counselled patients, still taken as an appropriate optionwithout compromising prenatal and maternal outcome. It also decreases the rate of cesareansection.
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Fonseca, Andreia, Rita Silva, Inês Rato, Ana Raquel Neves, Carla Peixoto, Zita Ferraz, Inês Ramalho, et al. "Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?" Acta Médica Portuguesa 30, no. 6 (June 30, 2017): 479. http://dx.doi.org/10.20344/amp.7920.
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Introduction: The best route of delivery for the term breech fetus is still controversial. We aim to compare maternal and neonatal outcomes between vaginal and cesarean term breech deliveries.Material and Methods: Multicentric retrospective cohort study of singleton term breech fetuses delivered vaginally or by elective cesarean section from January 2012 - October 2014. Primary outcomes were maternal and neonatal morbidity or mortality.Results: Sixty five breech fetuses delivered vaginally were compared to 1262 delivered by elective cesarean. Nulliparous women were more common in the elective cesarean group (69.3% vs 24.6%; p < 0.0001). Gestational age at birth was significantly lower in the vaginal delivery group (38 ± 1 weeks vs 39 ± 0.8 weeks; p = 0.0029) as was birth weight (2928 ± 48.4 g vs 3168 ± 11.3 g; p < 0.0001). Apgar scores below seven on the first and fifth minutes were more likely in the vaginal delivery group (1st minute: 18.5% vs 5.9%; p = 0.0006; OR 3.6 [1.9 - 7.0]; 5th minute: 3.1% vs 0.2%; p = 0.0133; OR 20.0 [2.8 - 144.4]), as was fetal trauma (3.1% vs 0.3%: p = 0.031; OR 9.9 [1.8-55.6]). Neither group had cases of fetal acidemia. Admission to the Neonatal Intensive Care Unit, maternal postpartum hemorrhage and the incidence of other obstetric complications were similar between groups.Discussion: Although vaginal breech delivery was associated with lower Apgar scores and higher incidence of fetal trauma, overall rates of such events were low. Admission to the neonatal intensive care unit and maternal outcomes were similar.Conclusion: Both delivery routes seem equally valid, neither posing high maternal or neonatal complications’ incidence.
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Karning, Rashmi Kumar, Bhanu B. T., and Sarojini. "Mode of delivery and outcome of breech presentation: a prospective observational study in a tertiary centre." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 8 (July 26, 2017): 3409. http://dx.doi.org/10.18203/2320-1770.ijrcog20173453.
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Background: Breech presentation is the commonest malpresentation with the incidence of 3-4% at term. This study was done with the objective of studying the mode of delivery in breech presentation and to compare the maternal and fetal outcome in patients delivered vaginally to those delivered by cesarean section.Methods: This prospective observational study was conducted in Vanivilas Hospital, affiliated to Bangalore Medical College and Research Institute, from June 2014 to May 2015. The study group included 509 patients with breech presentation who were studied with respect to their gestational age, birth weight, type of breech, mode of delivery, maternal and perinatal outcome.Results: The incidence of breech presentation was 2.92% (509) among 17454 total deliveries with the incidence of 3.17% in primi and 2.73% in multies. 193 (38%) patients had vaginal breech delivery and 316 (62%) delivered by LSCS. Apgar score of less than 7 at 1 minute was seen with 21.42% of vaginally delivered fetuses and 9.09% of fetuses delivered by cesarean section. The perinatal mortality was 1.6% (8 cases) in vaginal group 0.8% (4 cases) in LSCS group. The short term maternal complications in LSCS group was 7.62% and in vaginal delivery group was 3.09%.Conclusions: The short term maternal morbidity is higher in patients with cesarean section compared to those with vaginal breech delivery. Perinatal outcome is better in babies delivered by cesarean section. Still vaginal breech delivery can be an option for breech babies with proper selection and when conducted by a skilled obstetrician.
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MUKHTAR,, BUSHRA, BUSHRA KHAN, and NUZHAT RASHEED. "BREECH PRESENTATION AT TERM;." Professional Medical Journal 20, no. 04 (August 15, 2013): 526–29. http://dx.doi.org/10.29309/tpmj/2013.20.04.1027.
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Objective: To compare the fetal outcome of elective cesarean section with elective vaginal birth for Term Breechpresentation in terms of APGAR Score, Respiratory Distress Syndrome, Admission in Neonatology Unit and Neonatal mortality. Design:Quasi experimental study. Setting: Department of Obstetrics & Gynaecololgy Bahawal Victoria Hospital, Bahawalpur. Methods: Total 120cases were included in the study divided into two groups, each having 60 fulfilling the inclusion criteria. Group 'A' had those who deliveredby planned cesarean and Group 'B' comprised those having planned vaginal delivery. Results: It was found that neonatal mortality was3.33 in vaginal and 0 in cesarean group. Mean APGAR Score at 1 and 5 minute was 8.47 and 9.53 in vaginal and 8.58 and 9.62 incesarean group. RDS was more in cesarean (5) than vaginal group (1.6). Admission in Neonatalogy Unit was more in vaginally deliveredgroup (8.33) as compared to the cesarean section group (5). Conclusion: Planned cesarean delivery in breech presentation at term isassociated with a reduction in neonatal mortality and morbidity as compared to the planned vaginal birth.
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Ong, S., and P. McKenna. "Breech presentation. Fetal loss associated with intended vaginal delivery." Irish Journal of Medical Science 165, no. 4 (October 1996): 263–64. http://dx.doi.org/10.1007/bf02943085.
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Sankaran, Suneela Mullakkal, and Jayasree Sukumara Sukumara Pillai. "Retrospective analysis of breech deliveries in tertiary care center." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 11 (October 27, 2020): 4549. http://dx.doi.org/10.18203/2320-1770.ijrcog20204808.
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Background: Breech presentation is the commonest malpresentation accounting for 3-4% of all deliveries at term. The most common cause for breech presentation is preterm delivery. The safest route of delivery for breech had long been a topic of debate and after the results of term breech trial mode of delivery has become abdominal route even in teaching institutions.Methods: This is a retrospective cross sectional study conducted at department of obstetrics and gynaecology, Government medical college, Kozhikode, for a period of 2 years from 01 January 2016 to 31 December 2017. Mothers with gestational age between 28 weeks to 41 weeks with singleton live fetus with breech presentation who had either vaginal or caesarean delivery were included. The case notes were retrieved from the medical records department.Results: A total of 823 breech deliveries occurred during the study period. Of the total mothers 429 were primies and 394 were multies. Common causes identified were prematurity, intrauterine growth restriction, uterine and fetal anomalies. Mode of delivery was caesarean in more than 80% of cases.Conclusions: Incidence of breech presentation was 3.2% during the study period. Increasing incidence of caesarean delivery is seen in breech presentation. Persistent breech presentation at term is most commonly seen in patients with associated oligamnios, intrauterine growth restriction, and uterine anomalies.
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Mohanraj, Uma, and A. Adhirai. "Study of fetomaternal outcome in various modes of breech delivery in a tertiary care hospital- MGM GH, Trichy." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 1 (December 26, 2020): 154. http://dx.doi.org/10.18203/2320-1770.ijrcog20205761.
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Background: Aim of the study was to optimize the fetomaternal outcome using different modes of delivery in breech presentation and objective of the study was to optimize the maternal and perinatal outcome in various modes of breech delivery.Methods: Among 150 mothers with different parity and gestational age having singleton breech were studied during May 2019- October 2019 for the period of 6 months at KAPV government medical college. Fetomaternal outcome was compared in various modes of breech delivery during this study period in our institute. This study was a prospective analytical study.Results: Incidence of breech presentation was 3.3% of total deliveries in this institute. Around 4 (26.6%) cases by emergency LSCS, 48 (32%) cases delivered vaginally, 62 (41.3%) cases by elective LSCS. Comparatively, large number of cases were delivered by planned caesarean section in our institute. The maternal and perinatal morbidity and mortality was found to be less in planned caesarean section compared with other modes of delivery in this study.Conclusions: In view of insignificant difference in the fetomaternal outcome balanced decision about mode of delivery on a case by case basis will go a long way in improving both fetal and maternal outcome. Regular drills and conduct of assisted vaginal breech delivery should be pursued in all maternity hospitals.
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Toijonen, Anna E., Seppo T. Heinonen, Mika V. M. Gissler, and Georg Macharey. "A comparison of risk factors for breech presentation in preterm and term labor: a nationwide, population-based case–control study." Archives of Gynecology and Obstetrics 301, no. 2 (November 18, 2019): 393–403. http://dx.doi.org/10.1007/s00404-019-05385-5.
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Abstract Purpose To determine if the common risks for breech presentation at term labor are also eligible in preterm labor. Methods A Finnish cross-sectional study included 737,788 singleton births (24–42 gestational weeks) during 2004–2014. A multivariable logistic regression analysis was used to calculate the risks of breech presentation. Results The incidence of breech presentation at delivery decreased from 23.5% in pregnancy weeks 24–27 to 2.5% in term pregnancies. In gestational weeks 24–27, preterm premature rupture of membranes was associated with breech presentation. In 28–31 gestational weeks, breech presentation was associated with maternal pre-eclampsia/hypertension, preterm premature rupture of membranes, and fetal birth weight below the tenth percentile. In gestational weeks 32–36, the risks were advanced maternal age, nulliparity, previous cesarean section, preterm premature rupture of membranes, oligohydramnios, birth weight below the tenth percentile, female sex, and congenital anomaly. In term pregnancies, breech presentation was associated with advanced maternal age, nulliparity, maternal hypothyroidism, pre-gestational diabetes, placenta praevia, premature rupture of membranes, oligohydramnios, congenital anomaly, female sex, and birth weight below the tenth percentile. Conclusion Breech presentation in preterm labor is associated with obstetric risk factors compared to cephalic presentation. These risks decrease linearly with the gestational age. In moderate to late preterm delivery, breech presentation is a high-risk state and some obstetric risk factors are yet visible in early preterm delivery. Breech presentation in extremely preterm deliveries has, with the exception of preterm premature rupture of membranes, similar clinical risk profiles as in cephalic presentation.
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Jennewein, Lukas, Dörthe Brüggmann, Kyra Fischer, Florian J. Raimann, Hemma Roswitha Pfeifenberger, Lena Agel, Nadja Zander, Christine Eichbaum, and Frank Louwen. "Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study." Journal of Clinical Medicine 10, no. 10 (May 14, 2021): 2117. http://dx.doi.org/10.3390/jcm10102117.
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Background: Vaginal breech delivery is becoming an extinct art although national guidelines underline its safety and vaginal breech delivery in an upright position has been shown to be a safe birth mode option. In order to spread clinical knowledge and be able to implement vaginal breech delivery into obstetricians’ daily practice, we need to gather knowledge from facilities who teach specialized obstetrical management. Methods: We performed a prospective cohort study on 140 vaginal deliveries out of breech presentation solely-managed by seven newly-trained physicians and compared fetal outcome as well as rates of manual assistance in respect to preexisting experience. Results: Fetal morbidity rate measured with a modified PREMODA score was not significantly different in three sub-cohorts sorted by preexisting expertise levels of managing obstetricians (experience groups EG, EG0: 2, 5%; EG1: 3, 7.5%; EG2: 1, 1.7%; p = 0.357). Manual assistance rate was significantly higher in EG1 (low experience level in breech delivery and only in dorsal position) compared to EG0 and EG2 (EG1 28, 70%; EG0: 14, 25%; EG2: 21, 35%; p = 0.0008). Conclusions: Our study shows that vaginal breech delivery with newly-trained obstetricians is a safe option whether or not they have advanced preexisting expertise in breech delivery. These data should encourage implementing vaginal breech delivery in clinical routine.
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Mirzai, Saeid, Samuel Brian Wolf, Saima Mili, and Ahmad Oussama Rifai. "Successful external cephalic version in a patient with uterus didelphys and fetal malpresentation." BMJ Case Reports 12, no. 11 (November 2019): e230965. http://dx.doi.org/10.1136/bcr-2019-230965.
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Müllerian anomalies are congenital malformations of the female reproductive organs that occur when the müllerian ducts develop abnormally. Different types of müllerian anomalies have different pregnancy outcomes. Breech presentation is a common occurrence in pregnant women with uterus didelphys, and caesarean section is the traditional mode of delivery under such circumstances. Here, we present the case of a 29-year-old woman (gravida 2, para 1) with her fetus in a frank breech presentation. The patient had a known history of uterus didelphys and previous vaginal delivery. She elected to undergo external cephalic version (ECV) at 37 weeks with a trial of labour at 39 weeks as opposed to planned cesarean delivery. The version was successful, and the fetus was subsequently delivered vaginally without complications. This case demonstrates ECV as a possible option in women with uterus didelphys, provided the risks of the procedure are carefully weighed and individualised to each patient.
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Djordjevic, Momcilo, Bozidar Jovanovic, Predrag Sazdanovic, and Gordana Djordjevic. "Neonate - newborn condition and prematurity with breech delivery." Medical review 62, no. 9-10 (2009): 456–60. http://dx.doi.org/10.2298/mpns0910456d.
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Introduction. Before birth, most of foetuses located in mother's uterus have head presentation down towards the breech exit. Preterm delivery presents the delivery before the end of the 37th gestational week. Etiology of preterm breech deliveries is the same as of the ones at term, such as uterine malformations and myomas, polyhydramnion, foetal abnormalities, high parity, short umbical cord, placenta previa. The complications include passing of the body through insufficiently dilated cervical channel and 'capturing' of the head, umbilical cord prolapse, intrapartal hipoxy, discoordinated delivery, aspiration pneumonia, traumatic injuries. The basic aim of the research was to determine prematurity, mortality, colority of the amniotic fluid, and newborn condition with breech deliveries comparing to the head presentation deliveries. Material and methods. The study group consisted of 282 newborns that came from breech deliveries and the same number of the controls born with head presentation. In cases of breech deliveries there was greatly higher quantity of green and meconium amniotic fluid, significantly higher prematurity, significantly lower average Apgar score as well as seven times higher mortality of newborns comparing with the values in head presentation deliveries. Discussion. Meconium amniotic fluid can result in greater risk than aspiration pneumonia which is the characteristics of breech deliveries. There are more causes endangering fetal vitality after breech delivery and those are along with prematurity, gretaer number of congenital malformations, often traumas which depend on delivery course as well as hipoxy caused during delivery. Prematurity of fetus is one of risk factors resulting in breech delivery but it is also its main characteristics. Conclusion. Breech delivery brings greater risk measured by Apgar score values, appearance of meconium amniotic fluid, prematurity with its consequences and perinatal mortality.
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Bassaw, B., N. Rampersad, S. Roopnarinesingh, and A. Sirjusingh. "Correlation of fetal outcome with mode of delivery for breech presentation." Journal of Obstetrics and Gynaecology 24, no. 3 (April 2004): 254–58. http://dx.doi.org/10.1080/01443610410001660733.
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Mishra, Rajesh Kumar, Shakti Vardhan, Sanjay Singh, and Swati Sagarika Panda. "Pregnancy outcome of external cephalic version in singleton pregnancy with breech presentation at term." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 6 (May 27, 2020): 2352. http://dx.doi.org/10.18203/2320-1770.ijrcog20202311.
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Background: Breech delivery is associated with poor perinatal outcomes irrespective of the route of delivery. External cephalic version can be a useful tool in management of breech presentation at term by converting it to a cephalic presentation. A study was conducted to evaluate maternal and neonatal outcome of external cephalic version in singleton pregnancies with breech presentation in third trimester.Methods: A prospective observational study was carried out at a tertiary care hospital over a period of 2 years. This study included a total of 65 uncomplicated cases of breech presentation who fulfilled the inclusion criteria. External cephalic version was carried out after 36 weeks of period of gestation in primigravida and after 37 weeks in multigravida women. These patients were followed up till delivery and data was collected and analysed regarding the mode of delivery, maternal and fetal outcome.Results: External cephalic version was successful in 41 patients with a success rate of 63%. Out of them, vaginal delivery could be achieved in 31 cases (75.6%) and LSCS was done for rest of the 10 cases. The success rate was higher in multigravida ladies compared to primigravida ladies. No major procedure related adverse event was noticed in our study.Conclusions: External cephalic version is a very safe and easy procedure which can reduce the rate of cesarean delivery in singleton pregnancies with breech presentation. The results of this study are in favor of wider practice of this procedure in selected cases.
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Buekens, P., R. Lagasse, F. Puissant, and F. Leroy. "Do Breech Presentations in Twins and Singletons Run Different Risks?" Acta geneticae medicae et gemellologiae: twin research 34, no. 3-4 (October 1985): 207–11. http://dx.doi.org/10.1017/s000156600000475x.
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AbstractWe have compared breech twins and breech single births in a population recorded between 1974 and 1978 in 10 Belgian maternity centers. In 190 twin pregnancies, 38 first and 65 second twins were delivered in breech presentation. These twins were compared to 853 singleton breeches, of which 95 delivered by cesarean section were excluded. Data were stratified according to birthweight. No significant difference between twins and singletons was found in terms of perinatal mortality rates. However, Apgar scores below 7 at 5 minutes were significantly less numerous among first twins than among singletons. Therefore, first twins in breech presentation might be at lower risk of fetal distress. This difference should be taken into account in the management of first twins presenting by the breech.
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David, Liji, Anuja Abraham, Preethi Navaneethan, and Annie Regi. "Breech presentation at term: outcomes and mode of delivery in a tertiary care teaching hospital In South India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 10 (September 26, 2019): 4111. http://dx.doi.org/10.18203/2320-1770.ijrcog20194394.
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The aim of this study was to study the outcomes of all patients who presented with breech presentation at term (≥37 weeks), to assess what percentage of patients were offered External cephalic version (ECV), the rates of success of the procedure and the rates of vaginal delivery following successful ECV. It was a retrospective study of 669 patients diagnosed with breech at term, their clinical records were retrieved and data like age, BMI, parity, type of breech and scan findings noted. ECV was done in 256 patients and was successful in 35.5% of women with 51.1% being multigravidas and 26.8% in primigravidas. 76.9% of women with successful ECV delivered vaginally. There was no significant fetal or maternal morbidity documented as a result of ECV in this study.
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Herbst, Andreas. "Term breech delivery in Sweden: mortality relative to fetal presentation and planned mode of delivery." Acta Obstetricia et Gynecologica Scandinavica 84, no. 6 (May 18, 2005): 593–601. http://dx.doi.org/10.1111/j.0001-6349.2005.00852.x.
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El-Sayed, Y. Y. "Term Breech Delivery in Sweden: Mortality Relative to Fetal Presentation and Planned Mode of Delivery." Yearbook of Neonatal and Perinatal Medicine 2006 (January 2006): 51–52. http://dx.doi.org/10.1016/s8756-5005(08)70224-5.
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N., Deepika, and Arun Kumar. "External cephalic version at 36 weeks and its outcome." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 10 (September 23, 2017): 4602. http://dx.doi.org/10.18203/2320-1770.ijrcog20174449.
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Background: External cephalic version (ECV) is well known non-invasive procedure done for the management of breech presentation but is not routinely practised by obstetricians in many clinical settings. The aim of the study was to assess the success rate of external cephalic version, labour outcome of pregnancy after successful ECV, to study maternal and foetal complications associated with ECV and to explore the reasons for failed ECV.Methods: It was a prospective interventional study to assess the labour outcomes of pregnancies with successful and uncomplicated ECV. All women who had singleton breech presentation at 36+ weeks were included unless contraindications for ECV were present. After obtaining consent, ECV was attempted after giving tocolysis.Results: The total number of deliveries was 6038 in the same period. Out of these 301 were breech presentations thus the incidence of breech presentation was 4.9%. ECV was offered to 81 women (26.9%) and out of these 77 women (95.06%) gave consent for the procedure. The remaining 4 (4.93%) did not give consent due to anxiety about the procedure. The success rate was 54.54%. Out of total 301 women with breech presentation 40 women (13.3%) had assisted breech delivery and 216 women (71.8%) had caesarean section due to obstetric indications. Thus the caesarean section rate for breech presentation at our institute was 71.8%. ECV was successful in 63.82% of the multigravida on which it was attempted as compared to 40% of the primigravida. The success rate of ECV in the present study is maximum when ECV was performed at a gestational age of 38-39 weeks and when fetal weight was less than 3000 grams. Out of the 42 successful ECV cases, 4 babies (9.52%) had neonatal sepsis and 1 was still born (2.3%) which was unrelated to ECV.Conclusions: ECV is a valuable though under used option in the management of breech presentation at term. It is a relatively safe procedure, simple to learn and perform. Vigilance for breech presentation after 36 weeks is important. ECV at term using tocolytics should be part of the routine management of breech presentation.
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Koike, T., H. Minakami, M. Sasaki, M. Sayama, T. Tamada, and I. Sato. "The problem of relating fetal outcome with breech presentation to mode of delivery." Archives of Gynecology and Obstetrics 258, no. 3 (May 1996): 119–23. http://dx.doi.org/10.1007/s004040050112.
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Babovic, Ivana, Snezana Plesinac, Zoran Radojicic, Jasna Opalic, Rajka Argirovic, Zorica Mladenovic-Bogdanovic, and Darko Plecas. "Vaginal delivery versus cesarean section for term breech delivery." Vojnosanitetski pregled 67, no. 10 (2010): 807–11. http://dx.doi.org/10.2298/vsp1010807b.
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Background/Aim. The optimal method of delivery for breech presentation at term still remains a matter of controversy. This is probably due to the fact that the skills of vaginal breech delivery are being lost. The aim of this study was to examine risk factors: mother's age, parity, labor's duration, estimated neonatal birth weight for the mode of breech presentation delivery at term as well as the influence of the delivery mode on neonatal outcome. Methods. A retrospective study of 401 terms (more than 37 week's gestation) breech deliveries at the Institute of Gynecology and Obstetrics, Belgrade, from 2007 to 2008 was made. The following groups with respect to mode of delivery were included: the group I - vaginal delivery (VD) in 139 patients; the group II - urgent cesarean section (UCS) in 128 patients; and the group III - elective cesarean section (ECS) in 134 patients. Mother's age, parity, duration of VD, neonatal birth weight (BW), the Apgar score at 5th minute, and duration of stay in a neonatal intensive care unit (NICU) vere determined. Neonatal mortality and major neonatal morbidity were compared according to the route of delivery. Fetuses and neonates with hemolytic disease and fetal and neonatal anomalies were excluded from the study. For statistical analyses we performed Student's t test, ?2 likelihood ratio, Kruskall-Wallis test, Mann Whitney test, and ANOVA. Results. The mean age of patients in the group I was 28.29 ? 4.97 years, in the group II 29.68 ? 5.92 years and in the group III 30.06 ? 5.41 years. Difference in mother's age between the group I and III was significant (p = 0.022). In the group III there were 73.9% nuliparous similarly to the gropu II (73.4%). We performed ECS in 54.6% of the nuliparous older than 35 years, and 54.4% multiparous younger than 35 years were delivered by VD. The use of oxytocin for stimulation of vaginal labor was not associated with its duration (p = 0.706). Lowset maneuver was performed in 88.5% of the VD. Mean BW of neonantes was 3189.93 ? 399.42 g in the VD group, 3218.59 ? 517.71 g in the UCS and 3427.99 ? 460.04 g in the ECS group. Neonates of the estimated BW below 2 500 g were delivered by UCS in 5.5% cases, vaginally in 3.6% cases and by ECS in 2.2% cases. Neonates of the estimated BW above 3 500 g were delivered by ECS in 44.8% cases, vaginally in 23.0% cases and by UCS in 30.5% cases. There was a statistically significant difference between the VD and UCS groups (p = 0.004). Neonatal well-being was diagnosed in 75.5% of the neonates in the VD group, in 72.4% of the neonates in the ECS group, and in 65.5% of the neonates in the UCS group. The Apgar score at 5th min ? 8 was observed in 96% of the neonates in the VD group, in 97.5% of the neonantes in the ECS group and in 94.5% of the neonantes in the UCS group. In breech presentation, perinatal asphyxia remained increased in the VD group by 9.4% as compared with the UCS group, 5.5% (p = 0.001) and the ECS group, 3.0% (p = 0.016). Neonates stayed in NICU significantly longer after UCS compared with VD or ECS (7.21 ? 10.74 days vs 3.99 ? 1.33 days and 5.34 ? 2.88 days, respectively; p = 0.001 and p = 0.037, respectively). There was no diagnosed intracranial hemorrhage, brachial plexus injury and birth trauma in any groups. Also, there was no early neonatal death. Conclusion. For breech presentation elective cesarean section remains the major delevery method in nuliparous older than 35 years, while vaginal delivery is considered to be the method of choice in younger multiparous with ultrasonographically estimated neonatal birth weight 2 500-3 500 grams.
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Chalifoux, Laurie A., Jeanette R. Bauchat, Nicole Higgins, Paloma Toledo, Feyce M. Peralta, Jason Farrer, Susan E. Gerber, Robert J. McCarthy, and John T. Sullivan. "Effect of Intrathecal Bupivacaine Dose on the Success of External Cephalic Version for Breech Presentation." Anesthesiology 127, no. 4 (October 1, 2017): 625–32. http://dx.doi.org/10.1097/aln.0000000000001796.
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Abstract Background Breech presentation is a leading cause of cesarean delivery. The use of neuraxial anesthesia increases the success rate of external cephalic version procedures for breech presentation and reduces cesarean delivery rates for fetal malpresentation. Meta-analysis suggests that higher-dose neuraxial techniques increase external cephalic version success to a greater extent than lower-dose techniques, but no randomized study has evaluated the dose–response effect. We hypothesized that increasing the intrathecal bupivacaine dose would be associated with increased external cephalic version success. Methods We conducted a randomized, double-blind trial to assess the effect of four intrathecal bupivacaine doses (2.5, 5.0, 7.5, 10.0 mg) combined with fentanyl 15 μg on the success rate of external cephalic version for breech presentation. Secondary outcomes included mode of delivery, indication for cesarean delivery, and length of stay. Results A total of 240 subjects were enrolled, and 239 received the intervention. External cephalic version was successful in 123 (51.5%) of 239 patients. Compared with bupivacaine 2.5 mg, the odds (99% CI) for a successful version were 1.0 (0.4 to 2.6), 1.0 (0.4 to 2.7), and 0.9 (0.4 to 2.4) for bupivacaine 5.0, 7.5, and 10.0 mg, respectively (P = 0.99). There were no differences in the cesarean delivery rate (P = 0.76) or indication for cesarean delivery (P = 0.82). Time to discharge was increased 60 min (16 to 116 min) with bupivacaine 7.5 mg or higher as compared with 2.5 mg (P = 0.004). Conclusions A dose of intrathecal bupivacaine greater than 2.5 mg does not lead to an additional increase in external cephalic procedural success or a reduction in cesarean delivery.
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ZAHIRUDDIN, SANA, SUMERA RAUF QURESHI, and UMER FAROOQ. "VAGINAL BIRTH AFTER CAESAREAN SECTION;." Professional Medical Journal 20, no. 05 (October 15, 2013): 759–64. http://dx.doi.org/10.29309/tpmj/2013.20.05.1514.
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Background: Cesarean section is the commonest obstetrical procedure, associated with increase in maternal morbidity,the cesarean section rate is steadily on the rise in our country which can give rise to a number of complications. Objective: To determinethe factors associated with successful vaginal delivery after previous cesarean section. Study Design: Cross sectional study. Period:May 2009 to October 2009. Setting: Liaquat university hospital, Hyderabad. Material and Methods: a total of 96 women which fulfilledthe selection criteria were included in the study. Results: The women included in the study had a mean age of+SD(range),29.94+4.41successful vaginal birth was observed in 57(59.5%) women and 39(40.6%) had an emergency repeat cesareandelivery. The factors favoring successful vaginal delivery were history of previous vaginal delivery and previous cesarean due to fetaldistress or breech presentation, and patients having cesarean due to non progress of labor and no prior vaginal delivery were less likely tohave a successful vaginal birth after having previous cesarean delivery. Conclusions: vaginal birth after caesarean section can berecommended in patients having prior vaginal delivery and previous caesarean due to fetal distress and breech presentation.
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Schneuber, Susanne, Eva Magnet, Josef Haas, Albrecht Giuliani, Thomas Freidl, Uwe Lang, and Vesna Bjelic-Radisic. "Twin-to-Twin Delivery Time: Neonatal Outcome of the Second Twin." Twin Research and Human Genetics 14, no. 6 (December 2011): 573–79. http://dx.doi.org/10.1375/twin.14.6.573.
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Objective: To examine the effect of twin-to-twin delivery time (TTDT) on neonatal outcome. Methods: We evaluated twin deliveries >34 weeks of gestation. Twin pregnancies with both twins delivered by cesarean section and pregnancies with antenatal complications were excluded. We analyzed TTDT and neonatal outcomes of the second twin (umbilical arterial pH value (pHart), Apgar scores at 1, 5 and 10 minutes, need for intensive care). The study population was divided into two homogenous groups based on the mode of delivery: (A) vertex presentation and vaginal delivery of both twins, (B) vertex presentation and vaginal or vaginal operative delivery of twin I, breech or transverse presentation and vaginal breech delivery or cesarean section (CS) of twin II. Results: A total of 207 twin pairs were included in our study. In Group A (n = 151) there were no significant correlations between TTDT and pHart or Apgar scores at 1, 5 and 10 minutes of twin II (p = .156; 0.861; 0.151 and 0.384, respectively). In Group B (n = 56), the mean pHart of twin II was inversely correlated to TTDT, but not significantly (p = .417). TTDT was inversely related to 1-min and 5-min Apgar scores, but not significantly (p = .330; p = .138, respectively). The 10-min Apgar score showed no correlation with TTDT (p = .638). Conclusion: Increasing TTDT was not associated with adverse fetal outcome. Expectant management of the second twin appears possible and elapsed time alone does not appear to be an indication for intervention.
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Takeda, Jun, Gen Ishikawa, and Satoru Takeda. "Clinical Tips of Cesarean Section in Case of Breech, Transverse Presentation, and Incarcerated Uterus." Surgery Journal 06, S 02 (March 18, 2020): S81—S91. http://dx.doi.org/10.1055/s-0040-1702985.
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AbstractCesarean section in breech or transverse presentation involves more complicated procedures than cesarean section in cephalic presentation because the former requires additional manipulations for guiding the presenting part of the fetus, liberation of the arms, and the after-coming head delivery; therefore, those cesarean sections are likely to be more invasive. Making a rather wide uterine incision to prevent uterine injury during delivery of the fetus facilitates smooth delivery of the fetus. Furthermore, in cases of breech or transverse presentation, it is important to initially identify the presenting part of the fetus and guide it to the incision opening in the lower uterine segment, because delivering the presenting part of the fetus first is a basic rule of delivery of the fetus. Smooth delivery of the fetus by means of breech extraction can prevent excessive stress or injury to the fetus. Therefore, it is important to acquire the knowledge and skills necessary to perform these techniques, including the internal version. Smooth delivery of the fetus is also less invasive for the mother because an extension of the uterine excision or injury to arteries and veins in the uterus and parametrium can be avoided. Incarcerated uterus occurring in cases of pregnancy with intrapelvic adhesion, endometriosis, cervical myoma, or extended cervix may result in excessive uterine and cervical injury when a transverse incision of the lower uterine segment is performed without caution. These conditions may result in difficulty in fetal delivery. Therefore, it is important to identify risks in advance and to choose the incision line with great care. Countermeasures for difficult delivery of the fetus need to be mastered by all practitioners of obstetrics. If the transverse incision fails to reach the uterine cavity, an inverted T-shaped or J-shaped incision should be made. Risks of complications such as injury to the cervical canal, the vagina, the bladder or ureter, and massive hemorrhage must be kept in mind.
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Watfeh, Rana, Rania Nejjar, A. Ansari Chenguiti, M. Yousfi, and S. Bargach. "PSEUDO UNICORNUATE UTERUS: CLINICAL CASE AND LITERATURE REVIEW." International Journal of Advanced Research 9, no. 4 (April 30, 2021): 649–52. http://dx.doi.org/10.21474/ijar01/12745.
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The pseudo unicornuate uterus is a rare uterine malformation resulting from incomplete unilateral Müllerian aplasia and is estimated to occur in about 10-14% of all uterine anomalies. It is the consequence of a developmental arrest of one of Mullers ducts, which results in a normal hemi-uterus and a rudimentary horn with or without a cavity. We present a case that illustrates this pathology: This is Mrs. S. H, 30 years old, without any notable history, G2P2, G1: the first pregnancy was followed normally at the health center and the delivery took place by cesarian section for breech presentation in a primiparous woman at term, G2: The second pregnancy was followed up until 39 weeks of amenorrhea at the health center, admitted in early labor, obstetrical ultrasound revealed a single fetal pregnancy with breech presentation, the indication for extraction by the high route was indicated for breech presentation in a scarred uterus. On exploration we noted the presence of a right hemi-uterus in which the pregnancy had developed with a homolateral horn and adnexa, and a small rudimentary remnant on the left continuing with a tube.
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Kune, Guta, Habtamu Oljira, Negash Wakgari, Ebisa Zerihun, and Mecha Aboma. "Determinants of birth asphyxia among newborns delivered in public hospitals of West Shoa Zone, Central Ethiopia: A case-control study." PLOS ONE 16, no. 3 (March 16, 2021): e0248504. http://dx.doi.org/10.1371/journal.pone.0248504.
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Birth asphyxia is one of the leading causes of death in low and middle-income countries and the prominent cause of neonatal mortality in Ethiopia. Early detection and managing its determinants would change the burden of birth asphyxia. Thus, this study identified determinants of birth asphyxia among newborns delivered in public hospitals of West Shoa Zone, central Ethiopia. A hospital-based unmatched case-control study was conducted from May to July 2020. Cases were newborns with APGAR (appearance, pulse, grimaces, activity, and respiration) score of <7 at first and fifth minute of birth and controls were newborns with APGAR score of ≥ 7 at first and fifth minute of birth. All newborns with birth asphyxia during the study period were included in the study while; two comparable controls were selected consecutively after each birth asphyxia case. A pre-tested and structured questionnaire was used to collect maternal socio-demographic and antepartum characteristics. The pre-tested checklist was used to retrieve intrapartum and fetal related factors from both cases and controls. The collected data were entered using Epi-Info and analyzed by SPSS. Bi-variable logistic regression analysis was done to identify the association between each independent variable with the outcome variable. Adjusted odds ratio (AOR) with a 95% CI and a p-value of <0.05 was used to identify determinants of birth asphyxia. In this study, prolonged labor (AOR = 4.15, 95% CI: 1.55, 11.06), breech presentation (AOR = 5.13, 95% CI: 1.99, 13.21), caesarean section delivery (AOR = 3.67, 95% CI: 1.31, 10.23), vaginal assisted delivery (AOR = 5.69, 95% CI: 2.17, 14.91), not use partograph (AOR = 3.36, 95% CI: 1.45, 7.84), and low birth weight (AOR = 3.74, 95% CI:1.49, 9.38) had higher odds of birth asphyxia. Prolonged labor, breech presentation, caesarean and vaginal assisted delivery, fails to use partograph and low birth weights were the determinants of birth asphyxia. Thus, health care providers should follow the progress of labor with partograph to early identify prolonged labor, breech presentation and determine the mode of delivery that would lower the burden of birth asphyxia.
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Kak Hussein, Shahen, and Shahla Alalaf. "Fetal malposition and malpresentation: Mode of delivery and perinatal outcomes at Maternity Teaching Hospital in Erbil city." Zanco Journal of Medical Sciences 24, no. 3 (December 25, 2020): 367–75. http://dx.doi.org/10.15218/zjms.2020.044.
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Background and objective: Delivering a malpositioned and malpresenting fetus remains uncertainty, despite advances in obstetric practice. This study aimed to determine the mode of delivery and neonatal outcome in cases of fetal malposition and malpresentation. Methods: A cross-sectional study of women delivering malpositioned and malpresenting fetuses was conducted at Maternity Teaching Hospital, Erbil city, Kurdistan Region, Iraq, from the 1st of June, to the 30th of November, 2018. Three hundred women and their newborns were followed for seven days of life. Results: The total rate of malposition and malpresentation was 4.8%. Most women (87.3%) delivered by cesarean section, 25% of the neonates were admitted to the neonatal intensive care unit, where 69.3% of these infants stayed for seven days. There were three early neonatal deaths (1.0%), all of them were in occipito-posterior, or occipito-transverse position and were delivered abdominally. Among occipito-posterior and occipito-transverse deliveries, 2.2% ended with the death of the fetus (P = 0.360). An Apgar score of 7 was recorded after 5 minutes for 97.7% of the infants. Around 11% of the women had postpartum hemorrhage. Conclusion: Fetal malpresentation and malposition are not uncommon during labor, and most cases are delivered by cesarean section. Neonatal morbidity and mortality are dependent on the type of presentation and the mode of delivery. Keywords: Malposition; Malpresentation; Perinatal outcome; Breech presentation.
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Pageni, Prem Raj, Rajesh Adhikari, Padma Raj Dhungana, and Deepak Raj Kafle. "Prevalence of Caesarean Section in Matri Shishu Miteri Hospital of Gandaki Province." Medical Journal of Pokhara Academy of Health Sciences 3, no. 1 (October 9, 2020): 244–48. http://dx.doi.org/10.3126/mjpahs.v3i1.31925.
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Background: Caesarean section (CS) is one of the commonest obstetrics procedure to reduce the risks for mother and fetus when vaginal delivery is not anticipated. The objective of the study was to determine the rate and clinical indication of Caesarean section.
Materials and Methods: This was a hospital based descriptive retrospective study done within a time frame of a year (from Shrawan 2075 BS to Ashad 2076 BS; 17 July 2018 to July 16 2019) in Matri Shishu Miteri Hospital, Pokhara, Nepal. The total number of deliveries, their modes of delivery, indication for the Cesarean section, age group, number of parity, period of gestation and type of Caesarean section either elective or emergency were descriptively analyzed.
Results: A total of five hundred and eighty eight cases underwent delivery during the study period. Of them 128 (21.76%) cases were delivered by Caesarean section. Analysis revealed that the common age group for the CS patients was between 20-30 years (64.8%) of them 66 (51.6%) cases were primi gravida. Emergency Caesarean section was done for 75(58.6%) cases and elective Caesarean section for 53(41.4%) cases. The most common indication for Caesarean section was found to be previous caesarean section 21% (n=27), cephalopelvic disproportion (CPD) 18% (n=23), fetal distress 18% (n=23), failed induction 14.1% (n=18), breech presentation 10.2 %( n=13), non progress of labor (NPOL) 9.4 %( n=12) and oligohydramnios 7.8% (n=10).
Conclusion: Our study revealed that the rate of Caesarean section is higher than that recommended by World Health Organization (WHO), which needed to be 10-15% of the total deliveries. The common indications for Caesarean sections were pervious Caesarean section, fetal distress, CPD, failed induction, breech presentation, non progress of labour (NPOL) and oligohydramnios among others.
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Meehan, F. P., I. M. Magani, and G. Mortimer. "Perinatal Mortality in Multiple Pregnancy Patients." Acta geneticae medicae et gemellologiae: twin research 37, no. 3-4 (October 1988): 331–37. http://dx.doi.org/10.1017/s0001566000003925.
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AbstractA study of perinatal mortality in multiple pregnancy over a period of 12 years, 1972 to 1984, showed prematurity and low birthweight as the major causes of fetal loss. The highest risk was found at 28 to 30 weeks gestation (306/1,000). There was a significantly greater risk to babies delivered by the breech (136/1,000), and likewise in the second twin when compared with the first, ratio 1:1.4. A significant drop in the perinatal mortality rate, from 98/1,000 to 39/1,000, was observed between 1972-1978 and 1979-1984. Ultrasound has facilitated the earlier diagnosis of twins and provides more accurate serial fetal assessment. Bedrest, more vigilant antenatal care, intrapartum surveillance and improved neonatal care, are required to maintain and further reduce the perinatal mortality rate. When regional analgesia was employed in labour, the number of babies lost was 41/1,000, vs 93/1,000 in patients not receiving regional analgesia. External cephalic version and vertex delivery of the second twin is preferable to internal version and breech extraction. It should also be contemplated, as an alternative to elective cesarean section for a transverse lie or brrech presentation of the second fetus.
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Tripathi, M., and A. Sherchand. "Outcome of Teenage Pregnancy." Journal of Universal College of Medical Sciences 2, no. 2 (September 27, 2014): 11–14. http://dx.doi.org/10.3126/jucms.v2i2.11168.
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INTRODUCTION: Teenage pregnancy is coming up as one of the most important social and public health problem all over the world. Teenage pregnancy is a common social phenomenon with public health and medical consequences worldwide. The study was done to compare obstetric and perinatal outcome in teenage and non-teenage pregnancies. METHODS: This is a comparative study. The study duration was from 10th January 2010 to 9th January 2012. All teenage mothers (aged 13-19 completed years at delivery) delivering in the Gandaki Medical College (GMC) hospital, Pokhara were taken as cases (study group). Next 2 consecutive deliveries in the age group of 20-30 year were selected as control for each case. RESULTS: The incidence of complications in teenage primigravida (study group) compared with non-teenage (control group) deliveries were anemia (20% vs 6%), preterm labour (20 % vs 7%), Urinary tract infection(UTI) (8 % vs 4%), pre-eclampsia (4 % vs 2%) and Prelabour Rupture of Membrane(PROM) (10% vs 4%). Similarly, abnormal presentation (6% vs 2%), placenta praevia (4% vs 1%), Fetal distress(FD) (8% vs 3%), Cephalo Pelvic Disproportion(CPD) (6 % vs 2%) and Low Birth Weight(LBW) (24 % vs 9 %)were recorded respectively. In study group, 58% of the patients were delivered vaginally & 24% were delivered by caesarean section, 6% delivered by breech and 12% of patients had instrumental delivery. In non-teenage group, 74% of the patients delivered vaginally & 14% were delivered by caesarean section, 4% delivered by breech and 8% of patient had instrumental delivery.CONCLUSION: Teenage pregnant mothers had high rate of inadequate prenatal care, suffered more from anemia, UTI, & were more likely to deliver preterm and had low birth weight babies. They had high rates of operative and instrumental delivery. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11168 Journal of Universal College of Medical Sciences (2014) Vol.2(2): 11-14
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Kumari, Jasmeet, and Rosemary Harkin. "Abdominal apoplexy during pregnancy." BMJ Case Reports 13, no. 10 (October 2020): e235946. http://dx.doi.org/10.1136/bcr-2020-235946.
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We report a case of idiopathic spontaneous intraperitoneal haemorrhage (ISIH) in a 31-year-old patient at 37 weeks gestation in her second pregnancy. The patient presented to the labour ward with abdominal pain and uterine contractions. The initial complain was of sudden onset, severe sharp pain in left iliac fossa. She started having uterine contractions within 30 min of her presentation. Examination confirmed early labour with a footling breech presentation. Urgent caesarean section was performed that confirmed peritoneal bleeding of unknown origin with safe delivery of the baby. Mother and baby were safely discharged on day 5. ‘Abdominal apoplexy’ (ISIH), is a rare obstetric emergency with increased risk of fetal and maternal morbidity and mortality. With various clinical presentations as a possibility, diagnosis is challenging. High index of suspicion with prompt management of suspected cases can be pivotal life saving measure for the fetus and mother.
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Gunay, Taner, Abdulkadir Turgut, Ergul Demircivi Bor, and Meryem Hocaoglu. "Comparison of maternal and fetal complications in pregnant women with breech presentation undergoing spontaneous or induced vaginal delivery, or cesarean delivery." Taiwanese Journal of Obstetrics and Gynecology 59, no. 3 (May 2020): 392–97. http://dx.doi.org/10.1016/j.tjog.2020.03.010.
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Suzuki, Shunji, and Mariyo Nakata. "Factors Associated with the Recent Increasing Cesarean Delivery Rate at a Japanese Perinatal Center." ISRN Obstetrics and Gynecology 2013 (June 17, 2013): 1–4. http://dx.doi.org/10.1155/2013/863282.
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Objective. We examined which specific factors contributed to the increase in Cesarean delivery rate at our hospital over a 10-year period. Methods. From January 2002 to December 2012, data on the Japanese singleton deliveries at ≥22-week gestation managed at Japanese Red Cross Katsushika Maternity Hospital were collected. Potential factors associated with the increasing Cesarean delivery rate were selected according to previous studies. In this study, the incidences of intrauterine fetal demise, umbilical artery pH <7.1, and severe perineal laceration were calculated for each year. Results. The Cesarean delivery rate at our institution increased significantly during the study period (17.3% in 2002 versus 23.4% in 2012, P<0.01). During the study period, the Cesarean delivery rates in the cases of nulliparity, preterm delivery, low birth weight (<2,500 g), previous Cesarean deliveries and breech presentation were increased significantly. The incidence of intrauterine fetal demise and low umbilical artery pH was significantly decreased, and a negative correlation was found between the Cesarean delivery rate and the incidence of low umbilical artery pH for each year (r=−0.92, P<0.01). Conclusion. At our institute, the neonatal outcomes seemed to be improved associated with the increased Cesarean delivery rate between 2002 and 2012.
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Shmueli, Anat, Amir Aviram, Ron Bardin, Kinneret Tenenbaum-Gavish, Arnon Wiznitzer, Rony Chen, and Rinat Gabbay-Benziv. "Sonographic prediction of small and large for gestational age in breech-presenting fetuses." Journal of Perinatal Medicine 46, no. 7 (September 25, 2018): 744–49. http://dx.doi.org/10.1515/jpm-2016-0323.
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Abstract Introduction: To evaluate various sonographic estimated fetal weight (sEFW) formulas’ accuracy for small- and large-for-gestational age (SGA/LGA) prediction in breech-presenting fetuses. Materials and methods: A retrospective analysis of all ultrasound-based fetal biometrical measurements performed within 3 days of delivery in term pregnancies, in one medical center (2007–2014). Overall, 274 breech-presenting fetuses (study group) were compared to 274 vertex-presenting fetuses (control group) matched by gender, gestational age and birth weight. sEFW was calculated by six previously published formulas. Accuracy was compared utilizing systematic error and random error for every formula. Prediction precision of SGA and LGA was evaluated by calculating each formula’s sensitivity, specificity, +/− predictive value, and the area under the receiver-operating characteristic (ROC) curve (AUC). Results: Systematic error and random error varied greatly between formulas, ranging from −7.4% to 3.1%, 7.3% to 8.3% for the vertex-presenting fetuses and −8.9% to 1.9%, 7.9% to 8.6% for the breech-presenting fetuses, respectively. There was no statistical difference in small- or large-for-gestational age prediction parameters between the groups. The highest sensitivity and specificity for prediction was achieved by same formula regardless of presentation. Conclusion: In our cohort, overall accuracy was slightly superior among vertex-presenting fetuses without difference in prediction accuracy for small- and large-for-gestational age neonates.
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Krupnyk, O. M. "OBSTETRICIANS’ TACTICS IN THE DELIVERY BY PATIENTS WITH BREECH POSITION OF THE FOETUS AFFECTED BY THE UTERINE MYOMA." Актуальні питання педіатрії, акушерства та гінекології, no. 2 (October 29, 2018): 118–21. http://dx.doi.org/10.11603/24116-4944.2018.2.9542.
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The aim of the study – improvement of pregnancy outcomes in women with pelvic presentation on the background of uterine myoma by developing optimal obstetric delivery tactics.
Materials and Methods. In order to achieve the stated goal, a prospective analysis of cases of first- and second-time delivering patients with full-term one fetus pregnancy in pelvic presentation (incomplete and complete) amid the uterine myoma – the main group (MG) – (n = 30) was conducted. Into the control group (CG) – (n = 30) were included the first- and second-time bearing women without fetal myoma with full-time pregnancy and the pelvic presentation. Statistical processing of the results was performed using the Microsoft Office Excel 2017 software.
Results and Discussion. The analysis of the presented data shows that among pregnant women with pelvic prevalence of fetuses on the background of uterine fibroids, more frequent cases are registered: clinical manifestations of the threat of interruption of pregnancy MG – 26 (86.7 %), CG – 9 (30 %) and pre-eclampsia MG – 8 (26.7 %), CG – 3 (10 %) (p < 0.05). Raising the risk of complications of pregnancy and the expected birth of the uterine myoma requires pre-planning for the most part the operational method of delivery of MG – 19 (63.3 %). Exception, in the absence of other contraindications, there may be women with single myomatous nodes in sizes up to 5 cm – 11 (36.7 %). Only the extension of the cesarean section requires only pregnant women with uterine myoma 7 (36.8 %), and most of these interventions occur during precarious surgical delivery 4 (20 %).
Conclusion. Consequently, the presented data indicate the expediency and validity of taking into account the presence of uterine myoma at BP in order to develop an optimal obstetric tactic for the delivery of such patients in order to improve their pregnancy outcomes.
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Carpenter, Richard James, and Glen Liddell Mola. "Outcomes of singleton and twin breech deliveries in a ten year (2005 to 2014) retrospective audit at two rural hospitals in Papua New Guinea’s Gulf Province." Pacific Journal of Reproductive Health 1, no. 2 (December 30, 2015): 85. http://dx.doi.org/10.18313/pjrh.2015.907.
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<p><span style="text-decoration: underline;">Introduction</span><em> </em>The aim of this audit was to investigate the rates of breech-related perinatal death and maternal and neo-natal morbidity in a resource-poor setting where caesarean sections are difficult to perform. <span style="text-decoration: underline;">Method</span><em>. </em>An audit of 5,102 babies born at two rural Papua New Guinean hospitals, Kapuna and Kikori, from 2005 to 2014 inclusive was performed. Information was gathered from the facility obstetric registers and supplemented by Kikori Hospital’s surgical register. During the period there were 179 breech presentations (103 singletons, 76 twins). The primary outcome was defined as perinatal death. Secondary outcomes were neonatal morbidity and maternal post-partum haemorrhage. Exclusion criteria were applied prior to analysis. These included: Likely pre-labour intrauterine death; mother presenting to hospital in second or third stage; baby born before arrival at hospital; prematurity recorded in the notes or birth weight less than 1500g as a surrogate marker; significant fetal abnormality; and significant maternal medical condition. <span style="text-decoration: underline;">Findings</span><em>. </em>The adjusted incidence of the outcomes were: Perinatal death for vaginal breech singletons 235/1,000 (95% CI 158-336/1,000) and vaginal breech twins 31/1,000 (95% CI 9-107/1,000); neonatal morbidity for vaginal breech singletons 141/1,000 (95% CI 82-231/1,000) and vaginal breech twins 31/1,000 (95% CI 9-107/1,000); post-partum haemorrhage for vaginal breech singletons 129/1,000 (95% CI 74-217/1,000) and vaginal breech twins 230/1,000 (95% CI 137-361/1,000). <span style="text-decoration: underline;">Conclusions</span><em>. </em>Poor outcomes for singleton vaginal breech delivery at the two hospitals were common. The potential in the rural setting for increased education on safe trial of vaginal breach delivery as well as increasing access to caesarean sections deserves consideration. </p>
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Begum, Poly, Dipti Rani Saha, and Dilruba Zeba. "Indication and Outcome of Caesarean Section in Multigravid Women with a History of Vaginal Delivery in a Tertiary Care Hospital." Faridpur Medical College Journal 14, no. 2 (July 14, 2020): 86–89. http://dx.doi.org/10.3329/fmcj.v14i2.48185.
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It is commonly believed that if the first child of a mother is born by normal vaginal delivery, all the subsequent deliveries will follow the same. As a result, such multiparous mothers often neglect routine antenatal check ups and intranatal care which may cause poor delivery outcome. For these reasons, attention should be given to analyze the indication of caesarean section (CS) in women who had history of previous vaginal delivery. Our objective was to know the indications and outcome of CS in multigravid women having a child previously delivered vaginally. This observational cross-sectional study was carried out in the Department of Obstetrics and Gynaecology in Diabetic Association Medical College Hospital, Faridpur. One hundred and ten multigravid women who had undergone elective as well as emergency CS for various indications were included in this study. Most common indication of CS was fetal distress (33.64%). Others were obstructed labour (10.9%), breech presentation (10.9%), and pre-eclampsia (9.09%). In the postpartum period, 75.5% patients were healthy. Others developed sepsis (10.9%) and URTI (8.2%). Most of the babies (95.5%) were alive. Understanding these insights may help both the mother and the caregiver an idea about the associated risks and what actions should be taken for a safe delivery outcome.
Faridpur Med. Coll. J. Jul 2019;14(2): 86-89
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KASHIF, SUNBAL, MALAHAT MANSOOR, RUBINA TARIQ, and Tayyaba Tahira. "VAGINAL BIRTH AFTER CAESAREAN SECTION." Professional Medical Journal 17, no. 04 (December 10, 2010): 665–69. http://dx.doi.org/10.29309/tpmj/2010.17.04.3018.
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Introduction: Vaginal birth after caesarean section is currently the preferred method of delivery for pregnant women who had previous one lower segment caesarean section. This common practice warrants some reconsideration in light of recent clinical data on the risks associated with VBAC. Objectives: To evaluate conditions which can achieve successful vaginal birth after one caesarean section. Study Design: Cross-sectional analytic study. Setting: Department of Obstetrics and Gynaecology, Unit-I, Services Hospital, Lahore. Duration of Study with Dates: Study was carried out over a period of six months from 08-06-2006 to 07-12-2006. Subjects and Methods: One hundred pregnant women meeting inclusion criteria were included. During trial of labour patients were closely monitored by vital signs, fetal cardiac activity, lower abdominal pain and tenderness, fetal distress, vaginal bleeding and loss of presenting part. Results: Mean age of the patients was 34.27 + 6.45. According to distribution of cases by parity, maximum number i.e 64 (64.0%) was P 3-6. 79 patients (79.0%) had prior vaginal delivery. Maximum 41.0% patients were due to fetal distress while in 28% indication for previous caesarean were breech presentation. In 71% patient membranes were intact while 29.0% patients presented with per vaginal leaking. 51.0% had dilatation between 3-4cm. VBAC was more successful in patients 58.0% with favourable Bishop score. Conclusions: BMI <20, prior vaginal delivery, non-recurrent indication for previous caesarean, spontaneous onset of labour, cervical dilatation or favourable Bishop score, weight of baby < 3.5kg predict an individual’s likelihood of successful VBAC.
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Mevada, Shraddha A., Archana A. Bhosale, Sayali Wankhedkar, and Rucha Choudhari. "An interesting case report of ruptured pyogenic liver abscess with 40 weeks gestation in labour." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 5 (April 28, 2020): 2205. http://dx.doi.org/10.18203/2320-1770.ijrcog20201838.
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Pyogenic liver abscess during pregnancy is an extremely rare condition. Although rare, in situations of sepsis or septic shock in pregnancy, as well as the common sources of infection, a possibility of a liver abscess should be considered. We present a case report of 32-year-old primigravida 37.3 weeks by date, 37 weeks by scan with breech presentation with premature rupture of membranes and pain in abdomen since 12 hours with breathlessness, fever and diarrhoea since 2 days came in emergency to study hospital. General condition of the patient on arrival was pulse-140 beats per minute, blood pressure was 90/60 mmHg, respiratory rate was 40/min, on per abdominal examination, breech presentation with fetal heart rate of 150 beats per minute on doppler was noted. Per vaginal examination revealed cervical os 5 cm dilated, 40% effacement, breech presentation, absent membranes. With urgent report of complete hemogram and acid blood gas analysis, metabolic acidosis was noted which was corrected and patient was taken for emergency lower segment caesarean section. Intra-operative, 250 ml greenish pus flakes fluid was noted inside the abdominal cavity. Fluid was drained and sent for culture sensitivity with maximum aseptic precautions, uterus was opened, baby was delivered followed by uterus closure. Ruptured liver abscess 6×4×2 cm in 2nd and 3rd segment of liver was noted, abdominal wash with antibiotics and NS was given, drain was kept. Appropriate antibiotics were started and was discharged on day 14 after suture removal.
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Akther, R., T. Hossain, and M. Rashid. "Complications and Immediate Outcome of Pregnant Diabetic Women." Journal of Bangladesh College of Physicians and Surgeons 30, no. 1 (July 22, 2012): 10–16. http://dx.doi.org/10.3329/jbcps.v30i1.11361.
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Aim: To see complications and immediate outcome among pregnant diabetic women. Methods: This observational retrospective study included sixty nine pregnant women with diabetes (both pregestational and gestational diabetes) those who got admitted and treated at Dhaka Medical College Hospital (DMCH), Dhaka Bangladesh from the 1st August 2007 to the 31st August 2008. Detailed analysis of their obstetric history, ante partum and intra partum complications and mode of delivery were performed. Results: Majority of the women (76.92%) were admitted through labor emergency. Mean age of the women was 28.9 (18-45) years. Fifty four (54%) percent of women belonged to 21-30 years age group. Sixty two (62.31%) percent of women had gestational diabetes whereas 37.68% had pregestational diabetes. All women were followed up both by obstetrician and diabetologist. Twenty five percent(25%) women developed pre-eclampsia and pregnancy induced hypertension, thirteen percent(13% )women developed premature ruptur of fetal membrane(PROM), twenty three percent (23.25% )women had fetal distress, three(2.88%) percent women present with ante-partum hemorrhage(APH) and one percent(1.44%) women develop acute polyhydromnios. Average gestational age was 36.83(41-28) weeks. Sixty percent (60%) delivered after 37weeks of gestation and forty one (40.58%) delivered before 37weeks of gestation. Ten percent women delivered vaginally and ninety percent (90%) women delivered by caesarean section (CS) because of post CS, repeat CS, breech presentation, preeclampsia, fetal distress and obstructed labor. Maternal mortality is 1.44% and peri-natal is mortality 8.62%. Conclusion: Ante-partum and intra-partum complications are more common among pregnant diabetic women. Knowledge of the importance of maternal glycemic control, as well as development of surveillance techniques to prevent complications, resulted in a decline in fetal and neonatal mortality. DOI: http://dx.doi.org/10.3329/jbcps.v30i1.11361 J Bangladesh Coll Phys Surg 2012; 30: 10-16
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Sah, Shanti, Ruchica Goel, and Jai Kishan Goel. "Analysis of caesarean section rate according to Robson’s criteria in tertiary care centre." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 8 (July 26, 2018): 3060. http://dx.doi.org/10.18203/2320-1770.ijrcog20182947.
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Background: Caesarean Section (C.S.) delivery rate is steadily increasing worldwide, including India. It is difficult to determine the optimum categorisation of C.S. Robson system is most widely accepted classification worldwide. The objective of the present study is to analyze the incidence of deliveries and caesarean section rate according to Robson’s criteria at SRMS-IMS, Bareilly, Uttar Pradesh.Methods: The record of total women admitted in labour unit from June 2017 to May 2018 were analyzed based on their age, parity, gestation age, mode of delivery and group they belong according to Robson’s classification.Results: Among 2560 women who delivered during the study period, 1030(40.23%) had caesarean section. Out of the total caesarean section 55.15% had primary caesarean section while repeat section were done in 44.85%. The most frequent indication for primary caesarean were fetal compromise and failure to progress while for repeat caesarean scar tenderness was the frequent indication. Robson’s group V had maximum caesarean section rate followed by group I. Breech presentation contributed to 11.55% to overall caesarean sections.Conclusions: In present study group V, I, II were found to be major contributors to overall caesarean section rates. Modifiable factor for reducing caesarean rate would be to improve successful induction of labour which would decrease primary caesarean rate hence the chance of repeat section.
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Dwa, Yam Prasad, Sunita Bhandari, Devendra Shrestha, and Ajaya Kumar Dhakal. "Perinatal outcomes in adolescent pregnancy." Journal of Chitwan Medical College 8, no. 2 (June 30, 2018): 27–31. http://dx.doi.org/10.3126/jcmc.v8i2.23734.
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Introduction: Adolescent pregnancy is prevalent in Nepal and bears significant consequences to both mother and newborn.
Methods: All pregnant women aged 19 years or less who were admitted for delivery at KIST Medical College during 14th April 2017 to 15th July 2018 were included in this study. Maternal and immediate neonatal outcomes were analyzed retrospectively from their medical records.
Results: There were 135 pregnant adolescent women out of 1300 deliveries. Preeclampsia was observed in 2 pregnancies. Vaginal delivery (99; 73.3%) was the predominant mode of delivery. Emergency LS CS was performed in 35 (25.9%) deliveries and most frequent indications for LS CS were nonprogress of labor (8/35), breech presentation (8/35) and fetal distress (6/35). 10 (7.4%) babies were born preterm. 23 (17%) babies were born low birth weight. 37 (27.4%) neonates were symptomatic and required neonatal admission. Respiratory distress was the most frequent neonatal problem (29; 21.5%), followed by neonatal sepsis (18; 13.3%) and perinatal asphyxia (9; 6.7%). There were 3 (2.2%) still birth and 2 (1.5%) early neonatal deaths.
Conclusion: Adolescent pregnancy was common and associated with increased early neonatal problems.
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Şanlı, Cengiz, Salih Burçin Kavak, Melike Aslan, Ebru Çelik Kavak, İbrahim Batmaz, and Gülay Bulu. "The assessment of twin pregnancies delivered in our clinic: three-year experience." Perinatal Journal 28, no. 3 (December 1, 2020): 170–75. http://dx.doi.org/10.2399/prn.20.0283005.
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Objective: Twin pregnancies constitute 1–2% of all pregnancies. With the recent developments in assisted reproductive technologies, the incidence of multiple pregnancy has increased. Preterm labor is held responsible for the poor neonatal outcomes primarily. In our study, we aimed to assess fetal-maternal outcomes of twin pregnancies seen in our clinic. Methods: One hundred and thirty twin pregnancy cases out of 4241 pregnant women who delivered in our clinic between 01.01.2017 and 01.01.2020 were included in the study. The labor records of the patients were reviewed retrospectively and their data for age, week of gestation, delivery type, birth weight, fetal sex, chorionicity characteristics and laboratory parameters were recorded. Definitive statistics and SPSS 21.0 for statistical analyses were used to evaluate the data obtained from the study. The data were presented as mean ± SD (standard deviation). Results: The incidence of twin pregnancy was found 3%. In the ultrasonographic imaging evaluated during diagnosis, 27.7% of the cases were monochorionic and 72% of them were dichorionic. Of the pregnant women, 12.3% were at term and 87.7% were at preterm period. When the preterm fetuses were evaluated, 37.7% of 114 preterm fetuses were delivered at late preterm period, 29.2% of them at mid-preterm period and 20.8% at premature preterm period. The rates of treatment pregnancy (pregnancy provided by ovulation induction and assisted reproductive technologies) and spontaneous twin pregnancy were 20% and 80%, respectively. Mean maternal age was found 31.3. When evaluated in terms of maternal morbidity, preterm labor and premature rupture of membrane were the most common problems. Mean newborn weight was 1832g and 59.3% of the newborns had low birth weight and 21.8% of them had very low birth weight. While one fetus had transverse presentation in 12.5% of the patients, at least one fetus had breech presentation in 53.1% of the cases and 34.4% of the cases had head-head presentation. Conclusion: Twin pregnancies are characterized by the increased feto-maternal risks. Therefore, both antenatal and intrapartum management should be maintained diligently.
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Timokhina, Elena V., E. V. Gubanova, and T. M. Silayeva. "PREGNANCY WITH UTERINE MYOMA AND AFTER MYOMECTOMY: RESULTS OF THE COHORT STUDY." V.F.Snegirev Archives of Obstetrics and Gynecology 6, no. 3 (September 15, 2019): 132–39. http://dx.doi.org/10.18821/2313-8726-2019-6-3-132-139.
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Objective - to identify risk factors, complications, and pregnancy outcomes in patients with uterine fibroid (myoma) and after myomectomy. Material and methods. Investigated 100 pregnancy and delivery stories, where 1st group consists of 40 patients with uterine myoma from 3 to 12 cm, 2nd group - 30 patients with a history of myomectomy, 3rd group - control of 30 patients. Results. The average age of patients from group 1 is 34.9 years, group 2 - 35.7 years. Both in group 1 and group 2 there is a large percentage of surgical interventions on the uterus: a history of abortion (35%/20%) and miscarriage (15%/36.6%). Significant sizes of fibroids contribute to incorrect fetal position - breech presentation (17.5%/3.3%), transverse (2.5%), oblique (2.5%). The presence of fibroids is associated with certain complications: the growth of the placenta in the myomatous node (5%), disorder of blood supplying and ischemic changes of the nodes during pregnancy (2.5%), late postpartum hemorrhage (2.5%), fetal distress (12.5%). Surgical delivery by Cesarean section (85%) is the method of choice for uterine myoma, based on a combination of another relative indications. Caesarean section in such patients is associated with an increase in the volume of surgical intervention, in the form of conservative myomectomy according to indications (58.8%), which may be a factor in pathological blood loss (2.5%). Pregnancy and delivery after myomectomy is accompanied by the occurrence of specific complications: scar failure after myomectomy, the threatening of uterine rupture in the scar (6.7%), adhesions in the pelvis III-IV degrees (16.7%).
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Liaquat, Fozia, Erfa Sehar Anis, Uzma Altaf, Uzma Aziz, and Nosh Afreen. "Neonatal Outcome in Patients with Meconium Stained Liquor." Pakistan Journal of Medical and Health Sciences 15, no. 8 (August 26, 2021): 2130–31. http://dx.doi.org/10.53350/pjmhs211582130.
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Objective: determine the neonatal outcome in patients with meconium stained liquor. Setting: Gynaecology Deptt, Unit-III, Jinnah Hospital, Lahore. Methodology: In this study we included a total of 150 cases with singleton pregnancy (on USG), Cephalic presentation (on USG), Gestational age 37 completed weeks to 42 weeks (calculated from LMP) with meconium stained liquor observed during labour by the attending doctor whereas those with breech presentation, they were excluded by clinical examination and ultrasound, Still birth, they were excluded by ultrasound, and Congenital fetal anomalies, they were excluded by ultrasound. Complete abdominal pelvic examination was done. The subjects were followed till delivery and neonatal outcome i.e. birth asphyxia & meconium aspiration syndrome by the researcher herself. Results: In our study, most of the patients i.e. 64.67%(n=97) were between 18-30 years of age range, mean age was 27.93+4.82 yrs while frequency of neonatal outcome in patients with meconium stained liquor reveals as 2.67%(n=4) having Birth asphyxia while 34.67%(n=52) had Meconium aspiration syndrome. Conclusion: The frequency of meconium aspiration syndrome(MAS) is higher among patients with meconium stained liquor. Keywords: Meconium stained liquor, neonatal outcome, birth asphyxia, meconium aspiration syndrome, frequency.
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Tasnim, Saria, FM Anamul Haque, and Sameena Chowdhury. "Outcome of Twin Pregnancy in a Periurban Hospital." Bangladesh Journal of Obstetrics & Gynaecology 27, no. 2 (October 10, 2016): 57–62. http://dx.doi.org/10.3329/bjog.v27i2.29919.
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Objective: To determine the socio demographic characteristics, clinical presentation and obstetric outcome at delivery and immediate postpartum period of twin gestation in a periurban hospitalMaterial & Methods: An observational study was conducted between January 2000 to December 2004 at Institute of Child and Mother Health. All twin pregnancy irrespective of gestational age admitted in the in-patient department of Institute of Child and Mother Health for delivery and also those undiagnosed cases found to have twin birth were enrolled in the study consecutively from January 2001 to December 2004. Data on socio-demographic factors, predisposing factors for twin gestation and obstetric characteristics was collected using a structured questionnaire. Hospital records were consulted for recording the investigation reports and management options. The outcome variables were maternal complications during antenatal, intranatal and immediate postnatal period, mode of delivery, birth weight and sex of newborn and fetal outcome. All twin pregnancies from the admitted obstetric patients were enrolled consecutivelyResults: During the study period there were 11,185 deliveries and among them 107 were twin gestation. About 22% were primigravida, 78.5% multigravida, 27.1% were illiterate. Most common age group were 24-29 years (39.4%). Antenatal care was availed by 71% of patients and 27.1% twins were not diagnosed till delivery. Family history of twin on maternal side was present in 58.1% and 31.8% had history of taking oral contraceptive immediately before the pregnancy. Ovulation inducing agents were given to 8.3% of twin. Presentations of fetus were both vertex 54.2%, 1st vertex and second breech 16%, and both breech 5.7%. About 55.1% were admitted with labor pain, 6.5% were undelivered second twin. Preterm birth was 27.2% and low birth weight of 1st baby 79.6% and second baby 80.9% respectively. Mode of delivery was vaginal delivery of both fetus 41.6%, caesarean section of both fetus 62.4%, and caesarean for second twin 3.1%. Same sex of both twins was found in 78% and male-male pair was 50%. There was one stillbirth, one conjoined twin and perinatal death was 11.2% Complications encountered during perinatal period were severe abdominal pain 9.3%, retained placenta in 7.3%; and post partum hemorrhage in 4.6% cases.Conclusion: Twin pregnancy is quite common and warrants specialized care during ante partum, intrapartum and postpartum period.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 57-62
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Tiwari, Kenusha, Aruna Karki, Ganesh Dangal, Hema Pradhan, Ranjana Shrestha, Kabin Bhattachan, Rekha Paudel, Nishma Bajracharya, and Sonu Bharati. "Successful Pregnancy after Previous Uterine Rupture." Europasian Journal of Medical Sciences 2, no. 1 (March 3, 2020): 99–102. http://dx.doi.org/10.46405/ejms.v2i1.22.
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Uterine rupture is a rare and catastrophic incidence with high maternal and fetal morbidity rates. It is most commonly seen in the scarred uterus. The unscarred uterus is least susceptible to rupture with the incidencebeing 1 in 8000 deliveries. In the past, pregnancy after uterine rupture was not widely advised and patients underwent hysterectomy or tubal ligation but with the evolving practice, women are motivated for pregnancy which can be successful with proper obstetric care and emphasis on time and mode of delivery. Here we present a case of 31 years old female, gravida-2 para-1 living 0 with previous uterine rupture after medical induction of labor with stillbirth 4 years ago. She underwent emergency laparotomy with the repair. The patient spontaneously conceived and had close antenatal care throughout the pregnancy. The patient was admitted at 34 weeks of gestation and kept under close surveillance. Corticosteroid was administered. She underwent spontaneous labor at 37 weeks of gestation and emergency cesarean section was planned, delivered via a breech presentation to a live baby of 2.4 kg, APGAR score of 8/10, 9/10 at 1 and 5 minutes.
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Christe, D. M., Shaanthy T. K. Gunasingh, and V. Bharani. "Delivery by repeat caesarean section today: an overview." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 10 (September 26, 2018): 4127. http://dx.doi.org/10.18203/2320-1770.ijrcog20184140.
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Background: To find out the maternal and neonatal outcome and background characteristics of women delivering by repeat caesarean section in a tertiary care centre in Chennai, South India.Methods: Parturition records for the year 2017, were accessed and case records, for the calculated sample size were selected. Demographic features, obstetric history, gestational age and antenatal complications were recorded. Maternal outcome and baby details including sex of the baby, birth weight, APGAR and admission to New born Intensive Care Unit (NICU) data and acceptance of postpartum contraception was noted.Results: In the study group, 156 women delivered by repeat caesarean section. The age group of women ranged from 20 years to 38 years. Majority of 83.4% of women were Para one. Threatening rupture was recorded in 2.6% of women. The risk of previous two CS scars was noted in 3.2% of women. More than 41% of women had other complications. Most often observed complications were Gestational hypertension, Gestational diabetes, preeclampsia and eclampsia. Pregnancy complications of oligohydramnios, twins, breech and abnormal presentation, were significant. 1% of women had associated medical complications of anaemia and hypothyroidism. Maternal and Fetal causes were the most important indication for caesarean section in 74% of women. There were no maternal deaths in present study group. Postpartum contraception was accepted by 55 % of women.Conclusions: Majority of repeat caesarean section was observed most commonly in para one women in the age group of 26-30 years More than 41% of women had associated medical and obstetric complications. There were no maternal deaths in this study. Neonatal deaths were 2.5%.
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NAZ, Shabnam, IRUM MEMON, SHOAIBUNISA SOOMRO, and Rehana Parveen. "VACUUM EXTRACTION AND FORCEPS DELIVERIES;." Professional Medical Journal 19, no. 05 (October 8, 2012): 652–56. http://dx.doi.org/10.29309/tpmj/2012.19.05.2337.
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Objective: To compare the maternal and neonatal morbidity between vacuum extraction versus forceps vaginal delivery. Studydesign: Quasi-experimental study. Period: January 2009 to December 2010. Setting: Department of Obstetrics and Gynecology CMC,SMBBMU Larkana. Methodology: All patients delivered by forceps or vacuum with singleton pregnancy were included, the patient withmultiple gestation, breech presentation and gestational age less than 34 weeks were excluded. Data collected in pre-set Proforma include typeof instrument used, indication of instrumental delivery, maternal and neonatal complications of procedure. Data was analyzed; frequency andpercentage will be calculated for maternal age, gestational age, and degree of perineal and cervical tears. .chi-square test was applied tocompare the degree of neonatal and maternal complications. P-value less than 0.05 taken as significant. Results: Total 9, 5600 deliveries wereconducted, among them assisted vaginal deliveries were169 making the frequency of 2.66%, among which 96 have forceps and 64 wereventouse vaginal deliveries. Majority of women were primigravida. In infants of less than 37 weeks of gestation the use of forceps wassignificantly more common, delay in second stage of labor was the most common indication for vacuum extraction while fetal distress was morecommon reason for forceps delivery. Severe birth canal injuries (third and fourth degree perineal tears) and procedure related blood loss ofmore than 500 ml was significantly more common in forceps delivery group. Cephalhaematoma, neonatal jaundice and severe caputsuccedanum at discharge were more seen in vacuum deliveries, but facial injuries were more common after forceps delivery. Intracranialhemorrhage was identified in two infants born by vacuum extraction and none in forceps group. Two infants delivered by vacuum extractionexpired, one due to respiratory distress and other due to intracranial hemorrhage, and one of the infants delivered by forceps expired due tomeconium aspiration syndrome (MAS). Conclusions: Each instrument has its own merits and demerits .Maternal and neonatal outcomedepends on indications of instruments, patient selection and skill of operator. We conclude that forceps delivery is more associated withmaternal genital tract trauma and vacuum delivery is associated with more neonatal complications. So it is the choice of obstetrician to selectthe proper instruments . We also suggest that obstetricians learn these skills not on patients but in a skill laboratory using models.