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ZAMAN, BUSHRA SHER, Ali Zulqarnain, RASHAD QAMAR, Anza Saleem, and SUMERA SIDDIQUE. "VAGINAL DELIVERY VERSUS CESAREAN SECTION." Professional Medical Journal 17, no. 02 (June 10, 2010): 300–303. http://dx.doi.org/10.29309/tpmj/2010.17.02.2434.
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Objective: It is to compare neonatal morbidity in terms of birth trauma, respiratory distress syndrome, APGAR score in Primigravida with breech presentation delivered vaginally and emergency cesarean section. Design: Cross-sectional comparative study. Place and Duration of Study: Obstetrics and Gynaecology Unit-I, Bahawal Victoria Hospital, Bahawalpur from 1-5-2007 to 30-4-2008. Patients and Method: The study was carried out on all Primigravida with breech presentation reported through emergency in labour deliveredvaginally and by emergency cesarean section. The variable analyzed were birth trauma, respiratory distress syndrome and APGAR score at 1 and 5 minutes. Students-t test was used for comparison between means and chi square test for comparison between percentages. Significance was taken at P<0.05. Results: It was found that mean APGAR score at 1 and 5 minutes is 7.31 and 9.066 in vaginal and 8.533 and 9.644 incesarean group. Respiratory distress syndrome is more in cesarean (4.4%) than vaginal group (2.2%). Observed neonatal trauma is more in vaginal group (6.7%) than cesarean section (2.2%). Conclusion: Neonatal morbidity appears to be more in vaginal breech delivery than cesarean section for Primigravida with breech presentation at term.
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Nadeem, Saba, Shakila Yasmin, Naila Shabbir, Ayesha Javed, Shaheera Hussain, and Sara Reza. "Comparison of the Frequency of Wound Infection between Sub-cuticular Stitches Versus Interrupted Mattress Sutures after Cesarean Section." Pakistan Journal of Medical and Health Sciences 16, no. 2 (February 26, 2022): 619–22. http://dx.doi.org/10.53350/pjmhs22162619.
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Objectives: To compare the frequency of wound infection between subcuticular stitches versus interrupted mattress sutures after cesarean section. Setting: Obstetrics & Gynecology Department, Bahawal Victoria Hospital, Bahawalpur. Study duration: 21st July 2019 to 20th December 2020 Study design: Randomized controlled Clinical trial Materials & Methods: In this clinical trial study, A sum-total of 60 women, 18-40 yrs of age, scheduled for planned elective cesarean section through Pfannenstiel incision were enrolled. In Group I women, subcuticular sutures were placed while in group II women, interrupted mattress sutures were placed. All women were discharged on tablet Augmentin 1gram x twice a day for 7 days at which wound infection was noted. Results: The mean age of women in group I was 27.60 ± 5.16 years and was 27.40 ± 3.99 years in group II. My study has shown the wound infection in group I (sub-cuticular stitches) as 01 (3.33%) and in group II (interrupted mattress sutures) as 08 (26.67%) respectively with p-value of 0.011. Conclusion: The inference from my study shows that the wound infection after cesarean section is less after sub cuticular stitches as compared to interrupted mattress sutures. Keywords: cesarean section, sub cuticular stitches, wound infectio
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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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Sugiartini, Ni Ketut Ayu, Putu Krisa Lila Samhita, and Andini Mbati Anahida. "THE DESCRIPTION OF THE NEED FOR HOME CARE FOR POSTPARTUM WOMEN WITH CESAREAN SECTION DELIVERY DURING THE COVID-19 PANDEMIC." PLACENTUM: Jurnal Ilmiah Kesehatan dan Aplikasinya 10, no. 1 (February 28, 2022): 41. http://dx.doi.org/10.20961/placentum.v10i1.58024.
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<p><strong>Background</strong>: Childbirth requires a physiological process, but pathological conditions or complications can arise from pregnancy to delivery such as Cesarean Section. The purpose of this study was to identify the description of home care for postpartum mothers with Cesarean Section during the Covid-19 Pandemic.</p><p><strong>Methods</strong>: The design of this research is descriptive quantitative, was carried out at Udayana Hospital Denpasar with 30 respondents post Cesarean Section. The sampling technique is purposive sampling. Data was collected by questionnaire and data analysis was carried out by descriptive statistics</p><p><strong>Result:</strong> The results showed that half 50% of respondents needed vital sign monitoring during the postpartum period post Cesarean Section, most of the 60% respondents needed physical examination monitoring during the postpartum period post Cesarean Section, most of the 66.67% respondents needed psychological care during the postpartum period post Cesarean Section, almost entirely 86.67% of respondents require treatment for mobilization needs during the postpartum period post Cesarean Section, most 53.3% of respondents require treatment for family planning services during the postpartum period post Cesarean Section, almost 90% of respondents require breast care during the postpartum period post Cesarean Section, almost a total of 83.33% of respondents require wound care during the postpartum period post Cesarean Section.</p><p><strong>Conclusion:</strong> Based on the results of the study it was found that the postpartum women who had Cesarean Section, needed a home care during the pandemic.</p>
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Schulz, Karl W., Kelly Gaither, Corwin Zigler, Tomislav Urban, Justin Drake, and Radek Bukowski. "Optimal mode of delivery in pregnancy: Individualized predictions using national vital statistics data." PLOS Digital Health 1, no. 12 (December 29, 2022): e0000166. http://dx.doi.org/10.1371/journal.pdig.0000166.
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Child birth via Cesarean section accounts for approximately 32% of all births each year in the United States. A variety of risk factors and complications can lead caregivers and patients to plan for a Cesarean delivery in advance before onset of labor. However, a non-trivial subset of Cesarean sections (∼25%) are unplanned and occur after an initial trial of labor is attempted. Unfortunately, patients who deliver via unplanned Cesarean sections have increased maternal morbidity and mortality rates and higher rates of neonatal intensive care admissions. In an effort to develop models aimed at improving health outcomes in labor and delivery, this work seeks to explore the use of national vital statistics data to quantify the likelihood of an unplanned Cesarean section based on 22 maternal characteristics. Machine learning techniques are used to ascertain influential features, train and evaluate models, and assess accuracy against available test data. Based on cross-validation results from a large training cohort (n = 6,530,467 births), the gradient-boosted tree algorithm was identified as the best performer and was evaluated on a large test cohort (n = 10,613,877 births) for two prediction scenarios. Area under the receiver operating characteristic curves of 0.77 or higher and recall scores of 0.78 or higher were obtained and the resulting models are well calibrated. Combined with feature importance analysis to explain why certain maternal characteristics lead to a specific prediction in individual patients, the developed analysis pipeline provides additional quantitative information to aid in the decision process on whether to plan for a Cesarean section in advance, a substantially safer option among women at a high risk of unplanned Cesarean delivery during labor.
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Nedberg, Ingvild Hersoug, Tinatin Manjavidze, Charlotta Rylander, Ellen Blix, Finn Egil Skjeldestad, and Erik Eik Anda. "Changes in cesarean section rates after introduction of a punitive financial policy in Georgia: A population-based registry study 2017–2019." PLOS ONE 17, no. 7 (July 19, 2022): e0271491. http://dx.doi.org/10.1371/journal.pone.0271491.
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Background There is little research on how financial incentives and penalties impact national cesarean section rates. In January 2018, Georgia introduced a national cesarean section reduction policy, which imposes a financial penalty on hospitals that do not meet their reduction targets. The aim of this study was to assess the impact of this policy on cesarean section rates, subgroups of women, and selected perinatal outcomes. Methods We included women who gave birth from 2017 to 2019 registered in the Georgian Birth Registry (n = 150 534, nearly 100% of all births in the country during this time). We then divided the time period into pre-policy (January 1, 2017, to December 31, 2017) and post-policy (January 1, 2018, to December 31, 2019). An interrupted time series analysis was used to compare the cesarean section rates (both overall and stratified by parity), neonatal intensive care unit transfer rates, and perinatal mortality rates in the two time periods. Descriptive statistics were used to assess differences in maternal socio-demographic characteristics. Results The mean cesarean section rate in Georgia decreased from 44.7% in the pre-policy period to 40.8% in the post-policy period, mainly among primiparous women. The largest decrease in cesarean section births was found among women <25 years of age and those with higher education. There were no significant differences in the neonatal intensive care unit transfer rate or the perinatal mortality rate between vaginal and cesarean section births in the post-policy period. Conclusion The cesarean section rate in Georgia decreased during the 2-year post-policy period. The reduction mainly took place among primiparous women. The policy had no impact on the neonatal intensive care unit transfer rate or the perinatal mortality rate. The impact of the national cesarean section reduction policy on other outcomes is not known.
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Víctor Manuel, Vargas Hernández, Luján Irastorza Jesús Estuardo, Durand Montaño Carlos, Hernández Ramos Roberto, Ávila Pérez Felipe de Jesús, Guerrero Vargas José Juan, Kava Braverman Alejandro, Ávila Rebollar Daniela, and Pariente Fernández Maruxa. "Prevalence of the type of delivery in Mexican patients at the private level." Obstetrics & Gynecology International Journal 12, no. 3 (May 10, 2021): 124–28. http://dx.doi.org/10.15406/ogij.2021.12.00564.
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Background: Childbirth is a physiological event for the expulsion of the fetus. It has a low maternal morbidity or mortality, does not present problems in subsequent pregnancies and it has a lower risk of fetal death and neonatal morbidity. Despite this, there are circumstances where cesarean section is the best option. Objective: To determine the prevalence of delivery and cesarean section, and identify whether maternal age is an influencing factor when choosing the route of birth. Methods: Retrospective, observational and cross-sectional study, carried out in Mexican women in private institutions during the period from 2015 to 2019. Inclusion criteria: women who attended the private hospital and had a medical history including maternal age, gestational age, number of deliveries and cesarean sections (emergency and elective) were included. Exclusion criteria were twin pregnancies and preterm births. Three age study groups were formed for deliveries and caesarean section A) 18 to 29years of age, B) 30 to 39 years of age and C) 40 to 45years of age and differences between deliveries and caesarean sections were compared. The SPSS Statistics package, version 25, was used; Descriptive statistics were performed including mean (±) standard deviation or percentage and comparison of groups by Chi-squared test. Results: The decrease in childbirth is directly proportional to the increase in maternal age, with a higher prevalence of childbirth in women between 18 and 29years of age (Group A=60.79%) and a higher prevalence of cesarean delivery in women between 40 and 45years of age, age (Group C=48.19%). A statistically significant difference was found only in Groups A vs B, when comparing the prevalence of deliveries (60.79 vs 51.81%, p=0.05) and cesarean sections (29.21 vs 48.19%, p=0.05). Conclusions: physiological delivery is preferred in our private institution; although, complications during pregnancy and childbirth associated with maternal ageing influence the higher rate of cesarean section.
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Chainarong, Natthicha, Kittiya Deevongkij, and Chusana Petpichetchian. "Secondary postpartum hemorrhage: Incidence, etiologies, and clinical courses in the setting of a high cesarean delivery rate." PLOS ONE 17, no. 3 (March 1, 2022): e0264583. http://dx.doi.org/10.1371/journal.pone.0264583.
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Objectives To evaluate the incidence, etiologies, and clinical outcomes of secondary postpartum hemorrhage in a hospital with a high cesarean section rate and to compare the etiologies of secondary postpartum hemorrhage following cesarean delivery versus vaginal delivery. Materials and methods This retrospective study included 123 women with secondary postpartum hemorrhage who were treated at a tertiary-level hospital between January 2004 and June 2018. Descriptive statistics and the chi-square test were used for data analysis. Results The incidence of secondary postpartum hemorrhage was 0.21%. The median onset of bleeding was 12 days after delivery. Fifty-two percent of the deliveries were by cesarean section. The most common etiology of secondary postpartum hemorrhage was endometritis (67.5%), followed by retained placental tissue (21.1%). Women who delivered by cesarean section had a higher rate of endometritis (80.0% vs 53.4%) and a lower rate of retained placental tissue (10.8% vs. 32.8%) than those who delivered vaginally. Surgical intervention included uterine evacuation in 29.3% and hysterectomy in 8.1% of the patients. Five percent of women were treated by embolization. Conclusions Endometritis was the most common cause of secondary postpartum hemorrhage. Women who delivered by cesarean section were less likely to have retained placental tissue but were at higher risk for endometritis and uterine pseudoaneurysm than those who delivered vaginally.
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Ran, Mingfei, Praneed Songwathana, and Jintana Damkliang. "Discharge readiness and its associated factors among first-time mothers undergoing cesarean section in China." Belitung Nursing Journal 8, no. 6 (December 27, 2022): 497–504. http://dx.doi.org/10.33546/bnj.2341.
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Background: Helping first-time mothers who have just undergone cesarean section and transitioning from hospital to home with their infant is a complex process. Therefore, understanding what contributes to discharge readiness is necessary. Objective: This study aimed to determine discharge readiness level and its associated factors among first-time mothers who have undergone cesarean section. Methods: A descriptive cross-sectional study was conducted among 233 first-time mothers who had undergone cesarean sections selected using quota sampling from the two largest referral centers in China. Data were collected from March to June 2021 using a demographic characteristics form, Readiness for Hospital Discharge Scale-New Mother Form (RHDS-NMF), and Quality Discharge Teaching Scale-New Mother Form (QDTS-NMF). Descriptive and inferential statistics were used for data analysis. Results: The discharge readiness of the respondents was at a moderate level. Age (r = -0.129, p = 0.049) and complications after cesarean section (r = -0.136, p = 0.038) had a negative correlation with discharge readiness. In contrast, the subscales of QDTS-NMF, particularly the content (r = 0.519, p = 0.000) and delivery (r = 0.643, p = 0.000), had a positive correlation with discharge readiness. Conclusion: The findings enable nurses, midwives, and other healthcare professionals to understand discharge readiness and its related factors among first-time mothers undergoing cesarean section. It is also suggested that the quality of discharge teaching with a comprehensive assessment of first-time mothers preparing for discharge from the hospital and following the guideline to prevent post-cesarean section complications should be reinforced.
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D.P., Pană, Georgescu Carmen, Mitran M., and Mitran Loredana. "Postpartum Hemorrhage after Cesarean Delivery - Causes and Management Statistics of „Prof. Dr. Panait Sîrbu „ Hospital- Bucharest." ARS Medica Tomitana 20, no. 1 (February 1, 2014): 30–34. http://dx.doi.org/10.2478/arsm-2014-0006.
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ABSTRACT Postpartum hemorrhages represent a major cause of maternal mortality everywhere in the world and in Romania obstetrical hemorrhages are directly incriminated in 47.85% from the cases reported between 1975 -2010. This retrospective study over a period of five years (2008 - 2012) includes the clinical-statistical analysis of postpartum hemorrhages (PPH) registered in “Prof. Dr. Panait Sîrbu” Clinical Hospital of Obstetrics and Gynecology in Bucharest. During the period under analysis there were 20204 births, out of which 13012 were vaginal and 7192 by caesarean section. There were 853 cases of postpartum hemorrhage with significant clinical manifestations, which required medical management, 4.22% of all births. In 459 cases there were reported hemorrhagic complications after caesarean section (6.368% of caesarean sections), representing 53.81% of postpartum hemorrhage. The severity of intra-operative and post-cesarean bleeding is due to its association to anesthetic risk, which is more important in cesarean, as well as to the associated pathology that indicated the caesarean section in the first place
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Herman, Andi, Budi Santoso, and Esty Yunitasari. "THE EFFECT OF CHEWING GUM ON IMPROVING THE INTESTINE PERISTALTIC AMONG POST CESAREAN SECTIO PATIENTS AT HOSPITAL OF KENDARI CITY." International Journal of Nursing and Health Services (IJNHS) 2, no. 3 (September 14, 2019): 158–63. http://dx.doi.org/10.35654/ijnhs.v2i3.129.
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Cesarean section is a surgical intervention that most significantly affects the central nervous system and slows down bowel movements post section Caesarea. Intestinal function in women undergoing section caesarian surgery is essential, starting early. The study aimed at examining the effect of chewing gum on increasing the intestinal peristalsis in post-cesarean section. This study used a quasi-experimental, pre, and post with a control group was applied in this study. Seventy-two samples were recruited using a non-probability sampling such as consecutive sampling. CG was given to the intervention group 3 times, per 3 hours for 5 minutes with a frequency of chewing 30 times. Data analysis was performed and presented in descriptive statistics, and significant findings were computed using the paired t-test. The results showed that the mean Intestine Peristaltic intervention group increases from 11,47+1,647 to 16,61+2,487 after the intervention. Meanwhile, in the control group, the mean Intestine Peristaltic level slightly increases from 11,31+1,470 to 14,22+1,290. The t-test obtained a p-value of 0.000, indicating that there were significant differences in the increase Intestine Peristaltic between the intervention and the control group. Chewing gum can increase intestinal peristalsis in cesarean section patients. Based on the findings, The nurse profession can use chewing gum to become one of the nursing independent interventions because easy.
Keywords: cesarean section, peristaltic, chewing gum.
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Friedman, N. Deborah, Ann L. Bull, Philip L. Russo, Lyle Gurrin, and Michael Richards. "Performance of the National Nosocomial Infections Surveillance Risk Index in Predicting Surgical Site Infection in Australia." Infection Control & Hospital Epidemiology 28, no. 1 (January 2007): 55–59. http://dx.doi.org/10.1086/509848.
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Background.The Victorian Hospital Acquired Infection Surveillance System (VICNISS) hospital-acquired infection surveillance system was established in 2002 in Victoria, Australia, and collates surgical site infection (SSI) surveillance data from public hospitals in Australia.Objective.To evaluate the association between the US National Nosocomial Infections Surveillance (NNIS) system's risk index and SSI rates for 7 surgical procedures.Methods.SSI surveillance was performed with NNIS definitions and methods for surgical procedures performed between November 2002 and September 2004. Correlations were assessed using the Goodman-Kruskal γ statistic.Results.Data were submitted for the following numbers of procedures: appendectomy, 545; coronary artery bypass graft (CABG), 4,632; cholecystectomy, 1,001; colon surgery, 623; cesarean section, 4,857; hip arthroplasty, 3,825; and knee arthroplasty, 2,416. NNIS risk index and increasing SSI rate were moderately well correlated for appendectomy (γ = 0.55), colon surgery (γ = 0.48), and cesarean section (γ = 0.42). A fairly positive correlation was found for cholecystectomy (γ = 0.17), hip arthroplasty (γ = 0.2), and knee arthroplasty (γ = 0.16). However, for CABG surgery, a poor association was found (γ = 0.02).Conclusions.The NNIS risk index was positively correlated with an increasing SSI rate for all 7 procedures; the strongest correlation was found for appendectomy, cesarean section, and colon surgery, and the poorest correlation was found for CABG surgery. We believe that risk stratification with the NNIS risk index is appropriate for comparison of data for most procedures and superior to use of no risk adjustment. However, for some procedures, particularly CABG, further studies of alternative risk indexes are needed to better stratify patients.
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Faridi, Sarwat, Humaira Imran, and Bushra Mukhtar. "Is striae gravidarum related to cesarean scar and peritoneal adhesions?" Professional Medical Journal 27, no. 08 (August 10, 2020): 1550–54. http://dx.doi.org/10.29309/tpmj/2020.27.08.3745.
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Objectives: Determination of the relationship among the peritoneal adhesions, cesarean scar and striae gravidarum. Study Design: Cross sectional Study. Settings: Gynecology and Obstetrics Department of Bahawal Victoria Hospital, Bahawalpur. Period: June 2018 to May 2018. Material & Methods: A total of 150 cases of cesarean section which presented at gynecology and obstetrics department of Bahawal Victoria Hospital, Bahawalpur were involved in this study. Davey scoring system was applied in order to determine the severity of striae gravidarum. Intraperitoneal adhesions were classified into five subcategories on the basis of Modified Blauer classification. Grouping was done on the random basis. Three groups were made. Group 1 consisted of the women with no striae gravidarum, group 2 had women with number of striae gravidarum from mild to moderate and group 3 had women of severe number of striae gravidarum. Comparison between different groups was done using the Mann-Whitney and student T test. Mean and standard deviation were calculated for quantitative variables while qualitative variables were assessed by their frequency and percentage. Statistically significant P value was 0.05 or less. Results: Intraperitoneal adhesions of grade 2-4, pigmentations and keliods were frequent in group 2 and 3 but the difference between these groups was not statistically significant (p-value 0.517, 0.427 and 0.372, respectively). There was no difference present among the group regarding the appearance of scar as well (p=0.541). As far as the length and width of the scar was concerned, the length was relatively more in patients of group 3 while width was relatively more in patients of group 1 but there were no statistically significant differences (Table-II) (p=0.289 and p=0.248 respectively). Conclusion: It can be concluded that there is no association between intraperitoneal adhesions and striae gravidarum but correlation between scar characteristics and striae gravidarum are evident.
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Beiranvand, Shourangiz, Fatemeh Valizadeh, Reza Hosseinabadi, and Yadollah Pournia. "The Effects of Skin-to-Skin Contact on Temperature and Breastfeeding Successfulness in Full-Term Newborns after Cesarean Delivery." International Journal of Pediatrics 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/846486.
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Background. The skin-to-skin contact (SSC) of mother and newborn is uncommon full-term newborns after delivering via cesarean section due to the possibility of hypothermia in the infants. The aim of this study was to compare mothers’ and infant’s temperatures after delivering via cesarean section.Material and Methods. In this randomized clinical trial, 90 infant/mothers dyads delivered via cesarean section were randomized to SSC (n=46) and routine care (n=44). In experimental group, skin-to-skin contact was performed for one hour and in the routine group the infant was dressed and put in the cot according to hospital routine care. The newborns’ mothers’ temperatures in both groups were taken at half-hour intervals. The data was analyzed using descriptive statistics,t-tests, and chi-square tests.Results. The means of the newborns’ temperatures immediately after SSC (P=0.86), half an hour (P=0.31), and one hour (P=0.52) after the intervention did not show statistically significant differences between the two groups. The mean scores of the infants’ breastfeeding assessment in SSC (8.76±3.63) and routine care (7.25±3.5) groups did not show significant differences (P=0.048).Conclusion. Mother and infant’s skin-to-skin contact is possible after delivering via cesarean section and does not increase the risk of hypothermia.
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Maghzi, Amir-Hadi, Masoud Etemadifar, Kiyan Heshmat-Ghahdarijani, Safieh Nonahal, Alireza Minagar, and Vahab Moradi. "Cesarean delivery may increase the risk of multiple sclerosis." Multiple Sclerosis Journal 18, no. 4 (October 7, 2011): 468–71. http://dx.doi.org/10.1177/1352458511424904.
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Background: Prenatal and perinatal factors are believed to contribute to the risk of developing multiple sclerosis (MS). Objective: This study was designed to evaluate whether mode of delivery (vaginal versus cesarean section), as a perinatal factor, affects susceptibility to MS. Methods: MS patients were recruited from the MS registry of Isfahan Multiple Sclerosis Society (IMSS) and were compared with their healthy siblings. Data regarding mode of delivery, birth order, and gestation week of birth were obtained through a specially designed questionnaire. Preterm or post term deliveries were excluded. We used conditional logistic regression statistics and adjusted for gender and birth order. Results: This study included 1349 participants (449 MS patients and 900 controls). Subjects who were born by cesarean section had significant risk of MS (odds ratio, OR = 2.51; 95% confidence interval, CI: 1.43–4.41; p = 0.001). There was significant MS risk for females who were born by cesarean section (OR = 2.69, 95% CI: 1.30–5.58; p = 0.008), but not for males (OR = 2.25, 95% CI: 0.90–5.63; p = 0.082). The mean age at onset was lower in MS patients born by cesarean section (24.58 ± 6.33) compared with that of patients born by vaginal delivery (27.59 ± 7.97; p = 0.041). There was no significant difference between the two groups for birth order ( p = 0.417). Conclusion: Our results suggest that those born by vaginal delivery are at a lower risk of subsequent MS. These preliminary findings will need to be addressed in a much larger and preferably prospective study.
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Maducolil, Mariam K., Shameena Ajmal, Enas A. Alzebdeh, Abubaker YH Abdel Rahim, Enaam M. Ali Rudwan, Smitha Joel, Huda Abdullah Hussain Saleh, Stephen W. Lindow, and Thomas A Farrell. "Category 1 cesarean section decision to delivery interval: the causes of delay and impact on neonatal outcomes." International Journal of Pregnancy & Child Birth 7, no. 4 (August 5, 2021): 98–104. http://dx.doi.org/10.15406/ipcb.2021.07.00236.
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Objectives: The introduction of cesarean section categorization and recommendations on decision to delivery interval was a major step forward towards standardizing clinical response to obstetric emergencies. The recommended decision to delivery interval (DDI) for category 1 cesarean sections is 30 minutes, however there is a balance to be struck to ensure that reducing fetal hypoxic risk is not at the expense of increasing maternal and fetal morbidity. The aim of the study was to review category 1 cesarean sections, focusing on reasons for delays and neonatal outcomes. Design: The study was conducted as a quality improvement initiative to review the performance of the institution in managing women delivered as category 1 cesarean section between January 2020 and August 2020. Methods: The data was extracted from the operating theatre log book and patient electronic records (Cerner system) and analyzed using SPSS statistics package. Results: There were 577 cases of category 1 Cesarean section undertaken during the study period. The recommended DDI of 30 minutes was achieved in 385/577 (67%) of cases but was exceeded in 192/577 (33%) of cases. The most common indication of category 1 cesarean section was fetal distress (58%). It was noted that significantly more women (88.8%) in the <30-minute group had the decision taken in the labor ward, which is in close proximity to the obstetric theatre. Significantly more women in the <30-minute group had epidural or general anesthesia. Significant delays in the preparation time, transfer time, anesthesia time and delivery time were noted in the >30-minute group. The neonates in the <30-minute group had significantly lower pH and base excess measurements at birth however fewer were admitted to the neonatal intensive care unit. Conclusion: This study has demonstrated that only two thirds of category 1 cesarean deliveries are performed within the 30-minute recommendation. The delays were evident at every stage of the process of performing the cesarean. There are some factors which are not modifiable such as non labor ward transfers. Continued monitoring of category 1 cesarean outcomes is recommended.
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Malik, Madeeha, Zirwa Asim, and Azhar Hussain. "POSTPARTUM HEALTH RELATED QUALITY OF LIFE AFTER DIFFERENT MODES OF DELIVERY AMONG WOMEN IN PAKISTAN: THE NEGLECTED LINK FOR BETTER MATERNAL and CHILD HEALTH." International Journal of Pharmacy and Pharmaceutical Sciences 10, no. 7 (July 1, 2018): 55. http://dx.doi.org/10.22159/ijpps.2018v10i7.21284.
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Objective: The present study was designed to evaluate women postpartum quality of life after different modes of delivery in Pakistan.Methods: A descriptive cross-sectional study design was used. A pre-validated tool SF-36 was self-administered to a sample of 382 women in the postpartum period (6-8 w, 10-12 w, 14-16 w,>9 mo,>15 mo) undergone through elective/emergency cesarean sections or normal vaginal delivery and had delivered a single live child. After data collection, data was cleaned coded and entered in SPSS version 21.0. Descriptive statistics comprising of frequency and percentages was calculated. The non-parametric tests including Mann-Whitney and Kruskal-Walis (p ≥ 0.05) were performed to find out the difference among different variables.Results: Comparison of HRQOL domains by mode of delivery using Mann-Whitney test demonstrated a significant difference (p=0.01) between normal delivery and cesarean section. Women undergoing normal delivery had significantly higher scores as compared to women having cesarean section. Also, a significant difference (p=0.027) among HRQOL scores was observed between working women and house wives and as well who had better socioeconomic status (p=0.018).Conclusion: The results of the present study concluded that postpartum quality of life of most of the women undergoing normal vaginal delivery was better as compared to women undergoing cesarean sections in twin cities of Pakistan. Surgical intervention during cesarean section might lead to consistent postpartum pain, inability to cope with needs of newborn and family which in turn can reduce postpartum quality of life among women.
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Krolak-Olejnik, Barbara, and Igor Olejnik. "The Effect of Anesthesia on Chemokine Production in the Cord Blood Off Neonates." Blood 108, no. 11 (November 16, 2006): 3875. http://dx.doi.org/10.1182/blood.v108.11.3875.3875.
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Abstract Animal experiments have shown a correlation between anesthesia and surgery on one hand, and depressed immune response and infections on the other hand. Patients who are anergic or become anergic post-operatively and patients with a severe depression of T lymphocyte proliferative responses are at the risk of developing life-threatening sepsis. Activation of inflammatory mediators and the acute inflammatory response remains a local event after minor injury, whereas more severe tissue injury may provoke a systemic response. Chemokines play a major role in the course of inflammatory events. Chemokines represent a large superfamily of chemotactic cytokines that facilitate leukocyte recruitment and activation during immunological response at the site of inflammation. The majority of chemokines are members of CC or CXC family, based on relative position of their cysteine residues. CXC chemokines containing the ELR sequence, such as IL-8, GRO-α and ENA-78 attract mainly neutrophils, while CC chemokines such as RANTES, MIP-1α and MIP-1β do not act on neutrophils, but attract monocytes, eosinophils, basophils and T lymphocytes. The aim of the study was to investigate chemokine production in the umbilical cord blood of neonates with regard to mother’s anesthesia during labor. We also tried to answer the question, whether cesarean section can influence the concentrations of chemokines in the neonate. Concentrations of the chemokines were quantified in the umbilical cord blood by specific ELISA using double-antibody sandwich technique according to manufacturer’s instructions (Quantikine IL-8, GRO-α, ENA-78, RANTES, MIP-1α and MIP-1β, R&D Systems). The study group comprised 115 singleton neonates, without congenital malformations. All neonates were mature, appropriate for gestational age, the APGAR score were ≥ 8 in the first minute of life. The mothers were infection free during pregnancy and before delivery, which was performed either vaginally (n=69), or by cesarean section, urgent (n=16) or scheduled (n=30). Descriptive statistics are given by median and quartiles. Overall group comparisons were carried for each chemokine using the Mann-Whitney’s U- test and logistic regression (Wald Chi2test, OR, −95%CL, +95% CL). Concentrations of CC chemokines were similar in all examined neonates. Concentrations of CXC chemokines were higher in neonates born by normal spontaneous vaginal delivery (without any anesthesia). MIP-1α and MIP-1β were lower but not significantly both in urgent (systemic anesthesia) and scheduled (epidural anesthesia) cesarean section. RANTES concentrations were also lower in cesarean section (p=0,00001), but similar in urgent and scheduled cesarean section. Model of logistic regression of RANTES concentration in the umbilical cord blood neonates born vaginally and by cesarean section showed significant odds ratio (OR = 6,83; −95%CL= 3,34; +95% CL =13,97; p=0,00005). Vaginal delivery promotes the production of CXC chemokines, mainly RANTES, which are implicated in neonatal immunity. Mother’s anesthesia during cesarean section does not alter chemoattractant cytokines in the cord blood of neonates. Cesarean section, perhaps injury stress or others mediators (immunologic, endocrine, oxygen) may down regulate CXC chemokines.
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Mary, J. Jenifer Florence, R. Sindhuri, A. Arul Kumaran, and Amol R. Dongre. "Early initiation of breastfeeding and factors associated with its delay among mothers at discharge from a single hospital." Clinical and Experimental Pediatrics 65, no. 4 (April 15, 2022): 201–8. http://dx.doi.org/10.3345/cep.2021.00129.
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Background: According to the National Family Health Survey– 4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery.Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among them.Methods: This was a hospital-based analytical cross-sectional study of 108 new mothers. After obtaining Institutional Review Board approval and informed consent, we interviewed the new mothers on the day of discharge. Multivariate logistic regression was performed using IBM SPSS Statistics ver. 24.Results: The median breastfeeding initiation time was 90 minutes (interquartile range, 30–180 minutes). Overall, 43.5% of the mothers practiced EIBF, 77.4% practiced exclusive breastfeeding, and 43.5% were rooming in at discharge. Reasons for breastfeeding delays included extended recovery time from spinal anesthesia, maternal lassitude, and uncomfortable breastfeeding position due to post-cesarean pain. In the multivariate analysis, a birth weight less than 2,500 g (adjusted odds ratio [aOR], 4.33; 95% confidence interval [CI], 1.12–16.82; P=0.03), cesarean section delivery (aOR, 4.68; 95% CI, 1.57– 13.92; P=0.005), and mother’s poor knowledge of breastfeeding (aOR, 4.61; 95% CI, 1.44–14.72; P=0.010) were more likely to delay the initiation of breastfeeding.Conclusion: EIBF was practiced by less than half of the new mothers as determined by the cesarean section, baby’s birth weight, and mothers’ awareness of breastfeeding. Thus, it is vital to improve breastfeeding and nutritional counseling among mothers during the antenatal period and improve healthcare professionals’ training to facilitate EIBF, even in circumstances such as cesarean section.
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Nazarenko, L. G., and K. M. Nedorezova. "Dynamic of the structure of delivery methods in women with cesarean section in anamnesis." HEALTH OF WOMAN, no. 1(127) (February 28, 2018): 64–67. http://dx.doi.org/10.15574/hw.2018.127.64.
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The article presents results of the dynamic of specific gravity of the cesarean delivery (CD) among all methods of delivery, the ratio of primary and recurrent CD, the percentage of women with scar on the uterus after the CD, who agreed to attempt the VBAC and the rate of the cases of successful vaginal birth after cesarean section (VBAC) among them. The objective: to determine the changes in the number of women with uterine scar in the cohort of individuals who pursue their further reproductive intent and have a new pregnancy. Materials and methods. Сlinical and statistical results of the department, belonging to the 2nd level of perinatal care for the 10-year period (from 2008 to 2017). Results. It has been established that the high rate of CD does not influence on the reduction of perinatal mortality (PM) parameters. The CD level above 20% does not influence in respect of reduction of PM, therefore it is not justified from the position of perinatal statistics. Indicator of the CD influences on intranatal component of the PM and almost does not influence on antenatal component. Growth of the index of primary CD has the basis for predicting a further increasing in the rate of repeated CD and women with «operated uterus». Conclusion. The practice of VBAC reduces the level of operations in the department, belonging to 2nd level of perinatal care. Key words: cesarean section, scar, vaginal births.
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Várkonyi, István, Ildikó Makai, Gyöngyi Papdiné Nyíri, György Bacskó, and László Kardos. "Evaluation of a cesarean section postoperative wound infection surveillance program at Kenézy Hospital, Debrecen, Hungary." Orvosi Hetilap 152, no. 1 (January 2011): 14–22. http://dx.doi.org/10.1556/oh.2011.28979.
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Wound infection is a typical, partly preventable complication of cesarean sections. We started extended recording of cesarean section data in October, 2008 as part of our general wound infection surveillance program. Aim: To describe the circumstances and outcomes of the sections and analyze associations between them. Methods: We analyzed 523 cases over the period October 1, 2008 to September 30, 2009. Variables were assessed using descriptive statistics. Associations between explanatory factors and wound infection were evaluated using logistic regression. Results: Infections (overall rate: 3.6%) were more frequent in younger subjects, those with anemia, subcutaneous hematoma, in pregnancies with meconium stained or purulent amniotic fluid, and decreased to about a third after infection control was tightened. Conclusions: by being a proxy variable of factors with which wound infection is associated, age is a clinically valuable predictive variable. Good infection control practice is effective in preventing wound infections. The results are consistent with appropriate prescription practices of prophylactic antibiotic use, and with prophylactic measures being effective. Orv. Hetil., 2011, 152, 14–22.
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Mashak, Banafsheh, Maryam Hashemnejad, Kourosh Kabir, Mansoureh Refaei, Sara Esmaelzadeh Saeieh, Shoukofeh Torkashvand, Leili Salehi, and Mansoureh Yazdkhasti. "The Effect of Ginger on Preventing Post-spinal Puncture Headache in Patients Undergoing Cesarean Section." International Journal of Women's Health and Reproduction Sciences 7, no. 2 (December 19, 2018): 204–10. http://dx.doi.org/10.15296/ijwhr.2019.34.
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Objectives: Post-spinal puncture headache (PSPH) has constantly been one of the research priorities, especially in women undergoing cesarean section (C-section) and it is related to physical and psychological problems. The present study aimed to evaluate the effect of ginger on preventing PSPH in patients undergoing C-section. Materials and Methods: This clinical trial was conducted on 160 women undergoing C-section with spinal anesthesia, who were eligible to enter the study in the experimental and control groups. One ginger capsule (250 mg) was prescribed every 8 hours (TDS) to the experimental group 24 hours before the C-section. The prescription of ginger was continued half an hour after transfer to the post-partum ward until the PSPH onset. PSPH intensity was measured by using visual analog scale (VAS) pain scores at 6 timepoints (Time 1=30, Time 2=60, and Time 3=90 minutes vs. Time 4=3, Time 5 =6, and Time 6=12 hours) after C-section. No interventions were performed in the control group. The data were analyzed using the SPSS software by descriptive statistics and analytical tests were applied to determine the changes in PSPH intensity. Results: The comparison results of the mean score of PSPH intensity in the experimental and control groups indicated significant differences over time (P<0.05), except for the sixth time point (12 hours after C-section). In addition, the trend of changes at 6 timepoints based on the results of the repeated-measures test demonstrated that PSPH intensity significantly differed in the two groups over time (P<0.001). Conclusions: Based on the result, the oral prescription of ginger to women undergoing C-section under spinal anesthesia led to effective PSPH prevention at 5 time-points (30, 60, and 90 minutes, along with 3 and 6 hours). Further, the trend of the changes represented that the intensity of PSPH decreased in the experimental group over time. Therefore, ginger is suggested as a noninvasive and efficient method used for preventing PSPH.
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Bhattarai, Saraswoti Kumari Gautam, and M. Dahal. "Comprehensive Emergency Obstetrical and Neonatal Care (CEmONC) at Karnali Academy of Health Sciences, Teaching Hospital, Jumla." Journal of Karnali Academy of Health Sciences 1, no. 3 (December 31, 2018): 31–34. http://dx.doi.org/10.3126/jkahs.v1i3.24151.
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Introduction: Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries like Nepal with a high burden of maternal and newborn mortality. So this study aims to find out the status of comprehensive emergency obstetrical and neonatal care (CEmONC) service.
Method: A retrospective cross-sectional study was conducted using secondary data sources at maternity ward of KAHS teaching hospital, Jumla. Total 291 women admitted in maternity ward for childbirth were included in the study of six month period of 2075. Sampling technique was census for the study who were admitted for child birth purpose. Cases were selected from the record of the maternity ward. The data was collected by using structured tool. Ethical approval was taken from the ethical review committee of KAHS for ethical clearance. Data was analyzed by using descriptive statistics.
Result: There were 291 women admitted in the maternity ward for the purpose of childbirth during six-month period. Among them 224(76.97%) women delivered baby by spontaneous vaginal delivery; 61(20.96%) delivered with C/S and 6(2.06%) were delivered with instrumental delivery. Regarding the indication of 61 cesarean section (C/S) delivery; 22.95% with fetal distress, 16.39% with cephalopelvic disproportion and 11.47% with meconium stained liquor
Conclusions: About one third childbirth was done by cesarean section with indication of fetal distress, cephalo-pelvic disproportion and meconium stained liquor in higher proportion. Although CEONC service is effective, the rate of cesarean section can be reduced by providing good quality antenatal care.
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Nosratabadi, Mahnaz, Nasrin Sarabi, Leila Masoudiyekta, Zahra Abbaspoor, and Aziz Kassani. "Attitudes of Primary Pregnant Women Toward Preference of Birth Method in Dezful, Iran: A Cross-Sectional Study." Modern Health Science 4, no. 1 (April 25, 2021): p1. http://dx.doi.org/10.30560/mhs.v4n1p1.
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Introduction: Choosing the birth method is a major issue for pregnant women that is affected by multifaceted physiological, psychological and socio-cultural factors.
Aim(s): The aim research was performed to explore factors influencing pregnant women’s attitude toward birth method.
Methods: This is a cross-sectional study on 220 healthy nulliparous pregnant women with uncomplicated pregnancies without any contraindication for vaginal birth in Medical Centers of Dezful, in the south west of Iran. Data collection tool was a questionnaire for factors affecting the choice of delivery method. Differences in attitude were compared between two groups of natural vaginal delivery preference and cesarean delivery preference. Statistical analysis was performed with SPSS Version 16.0 statistic software package. Descriptive statistics were used to report percentages, mean, and standard deviation, and t-test, chi-square were applied to analyze the data.
Results: During the study period, 206 primary pregnant women were examined to determine the attitudinal influencing factors the birth method preference. 131 women (64%) chose the natural delivery method and 71 women (36%) chose the cesarean delivery method. In addition, the results showed a statistically significant difference between the two groups regarding the general attitude of the participants towards natural delivery (164.43 in the normal vaginal delivery (NVD) group versus 134.50 in the cesarean section (CS) group (p < 0.001)).
Conclusion: There is a direct relationship between the attitude of pregnant women towards vaginal birth and the tendency to normal vaginal delivery and cesarean section. Also, according to the results of the study of 8 components of attitudes, counseling sessions and prenatal training sessions can be identified based on counseling needs and be guided counseling sessions more purposefully.
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Mokhtari Sorkhani, Tayebeh, Elahe Namazian, Samaneh Komsari, and Shima Arab. "Investigating the Relationship between Childbirth Type and Breastfeeding Pattern Based on the LATCH Scoring System in Breastfeeding Mothers." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 43, no. 10 (October 2021): 728–35. http://dx.doi.org/10.1055/s-0041-1735985.
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Abstract Objective The role of breast milk in the physical and mental health of infants and in the prevention of infant death is widely known. The benefits of breastfeeding for mothers and infants have been proven, but several factors can affect breastfeeding. Childbirth is one of the most influential factors. The present study aimed to investigate the effect of the type of delivery (natural childbirth and cesarean section) on breastfeeding based on the latch, audible swallowing, type of nipple, comfort, hold (LATCH) scoring system. Methods The present cross-sectional observational study was performed using the census method among women who referred to Afzalipour Hospital for delivery in May 2020; the breastfeeding pattern was completed by observation and the in-case information, by LATCH checklist. Data were analyzed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, United States) software, version 19.0, analysis of variance (ANOVA), and the Chi-squared statistical test. Results Out of a total of 254 deliveries (127 natural childbirths and 127 cesarean deliveries), there was no statistically significant difference between the 2 study groups in terms of age, maternal employment status, and infant weight, but there was a statistically significant relationship between the type of delivery, the maternal level of schooling, and the appearance, pulse, grimace, activity, and respiration (Apgar) score in the first minute. The mean score of breastfeeding patterns among the natural childbirth group (9.33) was higher than that of the cesarean section group (7.21). Conclusion The type of delivery affects the mother's performance during breastfeeding, and mothers submitted to cesarean sections need more support and help in breastfeeding.
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Martin, Tracy, Jennifer Fenwick, Yvonne Hauck, Janice Butt, and Jennie Wood. "Providing Information and Support to Postnatal Women Who Have Experienced a Cesarean Section: A Pilot Study." International Journal of Childbirth 5, no. 1 (2015): 44–54. http://dx.doi.org/10.1891/2156-5287.5.1.44.
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BACKGROUND:Australia has a low uptake of vaginal birth after cesarean despite the evidence that this is best practice. A new midwifery-led service was introduced with the overall goal to improve the quality of care offered to women and their families that have experienced a cesarean section. The postnatal arm of the service targeted women who had experienced their first cesarean section. The service included an early hospital postnatal visit from the next birth after cesarean (NBAC) midwives whereby women were given an opportunity to share their experiences. Women were subsequently given an evidence-based resource on birth after cesarean as well as the midwives’ contact details should they wish to contact them anytime during the first 6 weeks after birth.AIM:To evaluate the effectiveness the postnatal arm of the service on women’s birth mode intentions in a subsequent pregnancy and their levels of childbirth fear and self-efficacy at 12 weeks postpartum.METHOD:Comparative descriptive design (pre-/posttest). Fifty-three women receiving standard care (comparison group) and 50 women receiving the NBAC postnatal service completed a childbirth fear measure (Wijma Delivery Expectancy/Experience Questionnaire Version B), a self-efficacy scale (New General Self-Efficacy Scale [NGSE]), and were asked their preferred birth mode for a subsequent pregnancy. Data was collected at 3–5 days and 12 weeks postpartum. Descriptive statistics and chi-square analysis were used to test several formulated hypotheses.RESULTS:Although women who received a visit from the NBAC midwives were more likely to state they intended to birth vaginally in a next pregnancy, compared to women receiving standard care, the finding was not significant (p= .272). Likewise, there was no difference in childbirth fear with both groups of women having high levels of childbirth fear (comparison [86.27] and NBAC group [84.67]). Comparison of self-efficacy items between groups at 12 weeks were not significant aside from NBAC women feeling more confident with their ability to complete tasks well (p= .005).CONCLUSION:Although the findings of this small study were not statistically significant, the simple and timely nature of the intervention seems worthy of further consideration and investigation. In addition, research needs to continue to focus on how midwives can better meet women’s emotional needs in the postpartum period helping to ameliorate women’s fear and build confidence for their next pregnancy and birth experience.
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Sharma G, Ram Prasad, Laxmi Rajbanshi, Basanta Thapa, Jaya Prasad Singh, and Renuka Tamrakar. "Surgical Site Infection and Its Associated Factors Following Obstetric Surgeries: A Retrospective Study." MedS Alliance Journal of Medicine and Medical Sciences 1, no. 1 (December 31, 2021): 32–36. http://dx.doi.org/10.3126/mjmms.v1i1.42943.
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INTRODUCTION: Surgical site infection (SSI) is most common type of Hospital Acquired Infection (HAI) in low and middle-income countries. The objective of the study was to find out the incidence and associated factors of SSI following obstetric surgeries especially Lower Segment Cesarean Section (LSCS).
MATERIALS AND METHODS: A retrospective cross sectional study was conducted at Chitwan Medical College Teaching Hospital. A total of 1739 patients files who had undergone Lower Segment Cesarean Section from 14th April 2019 to 12 April 2020 was reviewed. Data was analysed using IBM SPSS Version 20.0 and interpreted in descriptive and inferential statistics.
RESULTS: Among 1739 obstetric surgeries performed, 50 patient showed signs and symptoms of SSI yielding to an infection rate of 2.9%. Majority (80%) of patients developed SSI after they were discharged. There was significant association between SSI and type of surgery (p=0.007) and, SSI was not associated with haemoglobin level, blood transfusion, residence and age of the patients.
CONCLUSIONS: Though overall infection rate was low, most of the women developed infection after being discharged, thus it is recommended that discharge counselling about wound care should be emphasized.
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Harville, Emily W., Tri Tran, Xu Xiong, and Pierre Buekens. "Population Changes, Racial/Ethnic Disparities, and Birth Outcomes in Louisiana After Hurricane Katrina." Disaster Medicine and Public Health Preparedness 4, S1 (September 2010): S39—S45. http://dx.doi.org/10.1001/dmp.2010.15.
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ABSTRACTObjective: To examine how the demographic and other population changes affected birth and obstetric outcomes in Louisiana, and the effect of the hurricane on racial disparities in these outcomes.Methods: Vital statistics data were used to compare the incidence of low birth weight (LBW) (<2500 g), preterm birth (PTB) (37 weeks' gestation), cesarean section, and inadequate prenatal care (as measured by the Kotelchuck index), in the 2 years after Katrina compared to the 2 years before, for the state as a whole, region 1 (the area around New Orleans), and Orleans Parish (New Orleans). Logistic models were used to adjust for covariates.Results: After adjustment, rates of LBW rose for the state, but preterm birth did not. In region 1 and Orleans Parish, rates of LBW and PTB remained constant or fell. These patterns were all strongest in African American women. Rates of cesarean section and inadequate prenatal care rose. Racial disparities in birth outcomes remained constant or were reduced.Conclusions: Although risk of LBW/PTB remained higher in African Americans, the storm does not appear to have exacerbated health disparities, nor did population shifts explain the changes in birth and obstetric outcomes.(Disaster Med Public Health Preparedness. 2010;4:S39-S45)
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Milani, Forozan, Katayoun Haryalchi, Seyedeh Hajar Sharami, Zahra Atrkarroshan, and Sara Farzadi. "Prophylactic Effect of Tranexamic Acid on Hemorrhage During and After the Cesarean Section." International Journal of Women's Health and Reproduction Sciences 7, no. 1 (July 23, 2018): 74–78. http://dx.doi.org/10.15296/ijwhr.2019.12.
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Objectives: Recent guidelines of the World Health Organization (WHO) indicated administering tranexamic acid (TXA) in order to treat postpartum hemorrhage (PPH). Therefore, finding low-cost and low-risk alternative methods to control obstetric hemorrhage is of great importance. The present study aimed to evaluate the prophylactic effect of TXA on hemorrhage during and after the cesarean section (CS). In addition, it was attempted to explore the impact of TXA as a safe and inexpensive method for decreasing bleeding during and after CS so that to decrease the hazard of blood transfusion or hysterectomy in these patients. Materials and Methods: This randomized double-blind control trial was performed on 60 women who underwent CS using spinal anesthesia. These women were randomly assigned to two groups. The experimental group received 1 g of TXA 15 minutes before the incision while the control group received dextrose 5% in water as a placebo. The amount of bleeding was measured during and after the surgery. Data were entered into SPSS software version 21 and reported by descriptive statistics and analyzed using chi-square, t test, Mann-Whitney U test, paired t test, and ANCOVA and Wilcoxon tests. Results: Based on the results, no significant difference was found between the groups regarding the mean age, mean gestational age, and the prothrombin time (PT) and partial thromboplastin time (PTT) (P > 0.05). The mean of the total bleeding volume was 551.8 and 713.1 mL for experimental and control groups, respectively which means that a significant difference was observed between both groups in this respect (P = 0.006). However, no significant difference was noted between the groups regarding changes in hemoglobin (Hb) concentration, systolic and diastolic blood pressure (BP), and heart rate. Conclusions: Generally, administering 1 mg of TXA in CS significantly reduced the volume of PPH. However, it did not cause significant changes in hemodynamic state or Hb level. Therefore, it can be recommended as an appropriate treatment for these patients.
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B., Srinivasa, and Basavaraj C. Kotinatot. "Drug utilization of antibiotics in post-operative cesarean section inpatients in tertiary care hospital: a prospective observational study." International Journal of Basic & Clinical Pharmacology 9, no. 6 (May 21, 2020): 859. http://dx.doi.org/10.18203/2319-2003.ijbcp20202182.
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Background: The aim of this study is to evaluate the pattern and rational use of antibiotics in post-operative caesarean section (CS) inpatients in tertiary care teaching hospital, BIMS Belagavi.Methods: This cross sectional prospective observational study was conducted from December 2019 to February 2020, prior permission from institutional ethics committee was taken. Detailed data of post-operative caesarean section (CS) inpatients including age, diagnosis, line of management, complications and any adverse effects if occurred during the study was collected and entered in a specially designed proforma and MS word excel and analyzed by descriptive statistics like percentage.Results: Total 100 post-operative caesarean section inpatients were involved in the study. Most common indication for C-section was cephalopelvic disproportion. Average no of antibiotics per prescription was 3.32. Most commonly prescribed antibiotic was cefotaxime (27.71%) followed by gentamycin (25.90%) and metronidazole (24.59%). Majority (90%) of patients who admitted for ≤3 days (66%) had received combination antibiotic i.e., cefotaxime, metronidazole and gentamycin. IV fluids (21.21%) and analgesics (13.13%) were most frequently prescribed concomitant drugs. Majority (97.8%) of patients received parenteral preparation. 306 antibiotics (92.17%) used were from national model list of essential medicines (NLEM) and 332 antibiotics (100%). used were by generic name. Polypharmacy was 7.92.Conclusions: Cefotaxime was the most frequently prescribed antibiotic. Most of the antibiotics prescribed was rationally from NLEM and were by generic name.
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Shrestha, U., and Binod Aryal. "Delivery Profile and indications of Cesarean Section in a rural referral Hospital: what could be the implications?" Journal of Karnali Academy of Health Sciences 1, no. 3 (December 31, 2018): 8–13. http://dx.doi.org/10.3126/jkahs.v1i3.24147.
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Introduction: There is huge difference in cesarean section rate between rural (3.5%) and urban (15%) areas of Nepal. The national CS rate is around 5% whereas global CS rate is 26%. The objective of this study is to find out the delivery profile and rate and indications of CS in a rural university hospital.
Methodology: This is a three -year’s retrospective cross-sectional study done from January 2016 to January 2019 (Magh 2072 to Poush 2075) at Karnali Academy of Health Sciences, Jumla. The data was retrieved from hospital birth profile records and analyzed using SPSS 20. Permission was taken from Institutional review committee (IRC) to conduct the study.
Results: Total number of delivery during this period was 1841 out of which 172 were Cesarean delivery giving a CS rate of 9.3%. The most common indication of CS were fetal distress (33.7%), previous CS (9.3%), failed induction of labor (9.3%). Non progress of Labor (8.1%) and post term pregnancy (8.1%). Majority of the CS were done as an emergency procedure.
Conclusion: The CS rate at KAHS teaching hospital was within WHO recommendation of between 5-15% and was very low in comparison to other centers situated in urban areas of the country. The indications of CS was also similar to the other national and international statistics.
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Christopher, Kenneth E., Panagiota Kitsantas, Kiara K. Spooner, Joseph F. Robare, and Dan Hanfling. "Implications of Prenatal Exposure to the Spring 2011 Alabama and Missouri Tornadoes on Birth Outcomes." Disaster Medicine and Public Health Preparedness 13, no. 02 (June 20, 2018): 279–86. http://dx.doi.org/10.1017/dmp.2018.55.
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ABSTRACTObjectiveDespite emerging evidence of the detrimental effects of natural disasters on maternal and child health, little is known about exposure to tornadoes during the prenatal period and its impact on birth outcomes. We examined the relationship between prenatal exposure to the spring 2011 tornado outbreak in Alabama and Joplin (Missouri) and adverse birth outcomes.MethodsWe conducted a retrospective, cross-sectional cohort study using the 2010-2012 linked infant births and deaths data set from the National Center for Health Statistics for tornado-affected counties in Alabama (n=126,453) and Missouri (Joplin, n=6,897). Chi-square and logistic regression analyses were performed to estimate associations between prenatal exposure to tornadoes and birth outcomes.ResultsPrenatal exposure to the tornado incidents did not influence birth weight outcomes. Women exposed to Alabama tornadoes were less likely to have a preterm birth compared to unexposed mothers (OR: 0.93, 95% CI: 0.91, 0.96). Preterm births among Joplin-tornado exposed mothers were slightly higher (13%) compared with unexposed mothers (11.2%). Exposed mothers from Joplin were also more likely to have a cesarean section compared to their counterparts (OR: 1.14, 95% CI: 1.02, 1.26).ConclusionsWe found no association between tornado exposure and adverse birth weight and infant mortality rates. Our findings suggest that prenatal exposure can amplify the odds for a cesarean section. (Disaster Med Public Health Preparedness. 2019;13:279–286)
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Gurol-Urganci, Ipek, Lara Waite, Kirstin Webster, Jennifer Jardine, Fran Carroll, George Dunn, Alissa Frémeaux, et al. "Obstetric interventions and pregnancy outcomes during the COVID-19 pandemic in England: A nationwide cohort study." PLOS Medicine 19, no. 1 (January 10, 2022): e1003884. http://dx.doi.org/10.1371/journal.pmed.1003884.
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Background The COVID-19 pandemic has disrupted maternity services worldwide and imposed restrictions on societal behaviours. This national study aimed to compare obstetric intervention and pregnancy outcome rates in England during the pandemic and corresponding pre-pandemic calendar periods, and to assess whether differences in these rates varied according to ethnic and socioeconomic background. Methods and findings We conducted a national study of singleton births in English National Health Service hospitals. We compared births during the COVID-19 pandemic period (23 March 2020 to 22 February 2021) with births during the corresponding calendar period 1 year earlier. The Hospital Episode Statistics database provided administrative hospital data about maternal characteristics, obstetric inventions (induction of labour, elective or emergency cesarean section, and instrumental birth), and outcomes (stillbirth, preterm birth, small for gestational age [SGA; birthweight < 10th centile], prolonged maternal length of stay (≥3 days), and maternal 42-day readmission). Multi-level logistic regression models were used to compare intervention and outcome rates between the corresponding pre-pandemic and pandemic calendar periods and to test for interactions between pandemic period and ethnic and socioeconomic background. All models were adjusted for maternal characteristics including age, obstetric history, comorbidities, and COVID-19 status at birth. The study included 948,020 singleton births (maternal characteristics: median age 30 years, 41.6% primiparous, 8.3% with gestational diabetes, 2.4% with preeclampsia, and 1.6% with pre-existing diabetes or hypertension); 451,727 births occurred during the defined pandemic period. Maternal characteristics were similar in the pre-pandemic and pandemic periods. Compared to the pre-pandemic period, stillbirth rates remained similar (0.36% pandemic versus 0.37% pre-pandemic, p = 0.16). Preterm birth and SGA birth rates were slightly lower during the pandemic (6.0% versus 6.1% for preterm births, adjusted odds ratio [aOR] 0.96, 95% CI 0.94–0.97; 5.6% versus 5.8% for SGA births, aOR 0.95, 95% CI 0.93–0.96; both p < 0.001). Slightly higher rates of obstetric intervention were observed during the pandemic (40.4% versus 39.1% for induction of labour, aOR 1.04, 95% CI 1.03–1.05; 13.9% versus 12.9% for elective cesarean section, aOR 1.13, 95% CI 1.11–1.14; 18.4% versus 17.0% for emergency cesarean section, aOR 1.07, 95% CI 1.06–1.08; all p < 0.001). Lower rates of prolonged maternal length of stay (16.7% versus 20.2%, aOR 0.77, 95% CI 0.76–0.78, p < 0.001) and maternal readmission (3.0% versus 3.3%, aOR 0.88, 95% CI 0.86–0.90, p < 0.001) were observed during the pandemic period. There was some evidence that differences in the rates of preterm birth, emergency cesarean section, and unassisted vaginal birth varied according to the mother’s ethnic background but not according to her socioeconomic background. A key limitation is that multiple comparisons were made, increasing the chance of false-positive results. Conclusions In this study, we found very small decreases in preterm birth and SGA birth rates and very small increases in induction of labour and elective and emergency cesarean section during the COVID-19 pandemic, with some evidence of a slightly different pattern of results in women from ethnic minority backgrounds. These changes in obstetric intervention rates and pregnancy outcomes may be linked to women’s behaviour, environmental exposure, changes in maternity practice, or reduced staffing levels.
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Bezerra, Larissa Figueiredo, Letícia Figueiredo Bezerra, Alessandro De Oliveira Silva, and Marcelo Costa Cronemberger Marques. "Classificação de Robson nas maternidades brasileiras: estatísticas prós e contras." Revista Remecs - Revista Multidisciplinar de Estudos Científicos em Saúde 4, no. 7 (December 28, 2019): 38–46. http://dx.doi.org/10.24281/rremecs2526-2874.2019.4.7.38-46.
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Classificação de Robson é uma ferramenta de avaliação, monitorização e comparação do parto cesárea, instituída pela Organização Mundial de Saúde em 2014. Consiste em 10 grupos definidos por características obstétricas rotineiras. Comparar os resultados de estudos brasileiros fundamentados na implantação da Classificação. Trata-se de revisão integrativa, cujas bases foram PubMED, Scielo, EBSCO, LILACS. As palavras-chaves foram: Classificação de Robson, cesariana, parto. Foram selecionados 6 artigos originais que fundamentaram sua pesquisa no emprego da Classificação em seus serviços. Os grupos mais numerosos encontrados no Brasil foram 1 e 3, embora tenham sido os que menos contribuíram para a elevação da taxa de cesariana. As maiores taxas absolutas de cesarianas foram vistas nos grupos 6 e 9, enquanto as relativas predominaram no 2 e no 5. Classificação de Robson evidencia o panorama de partos nos serviços, sinaliza os problemas e permite melhor atuação da gestão, na tentativa de solucionar conflitos.Descritores: Classificação de Robson, Cesariana, Parto. Robson classification in brazilian maternities: statistics, pros and consAbstract: Robson's classification is a tool for evaluation, monitoring, comparison of cesarean section, established by WHO in 2014. It consists of 10 groups defined by obstetric characteristics. To compare the results of Brazilian studies based on the implementation of the Classification. This is an integrative review, based on PubMED, Scielo, EBSCO, LILACS. The keywords: Robson classification, cesarean, labor. We selected 6 original articles that supported their research on the use of Classification in their services. The most numerous groups found in Brazil were 1 and 3, although they were the ones that contributed least to the increase in cesarean section rate. The highest absolute cesarean section rates were seen in groups 6 and 9, while relative ones predominated in groups 2 and 5. Robson's classification highlights the panorama of deliveries in services, signals the problems and allows better management performance in an attempt to resolve conflicts.Descriptors: Robson Classification, Cesarean Section, Childbirth. Clasificación de Robson en las maternidades brasileñas: estadísticas, pros y contraResumen: Clasificación de Robson es una herramienta para evaluación, monitoreo y comparación de cesáreas, establecida por Organización Mundial de la Salud en 2014. Consta de 10 grupos definidos por características obstétricas. Comparar resultados de estudios brasileños basados en la implementación de la Clasificación. Revisión integradora, basada en PubMED, Scielo, EBSCO, LILACS. Palabras clave: clasificación de Robson, cesárea, parto. Seleccionamos 6 artículos que respaldaron su investigación sobre el uso de la Clasificación. Los grupos más numerosos encontrados en Brasil fueron 1 y 3, aunque fueron los que menos contribuyeron al aumento en la tasa de cesáreas. Las tasas de cesáreas absolutas más altas se observaron en los grupos 6 y 9, mientras que las tasas relativas predominaron en los grupos 2 y en el 5. La clasificación de Robson destaca el panorama de los partos en los servicios, señala los problemas y permite un mejor desempeño de la gestión en un intento de resolver conflitos.Descriptores: Clasificación de Robson, Cesárea, Parto.
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Sabetghadam, Shadi. "The Quality of Obtaining Surgical Informed Consent for Cesarean Section in Public Hospitals of Iran." Journal of Holistic Nursing And Midwifery 31, no. 1 (January 1, 2021): 1–8. http://dx.doi.org/10.32598/jhnm.31.1.2044.
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Introduction: Nowadays, about 50-65% of births in Iran occur by Cesarean Section (CS). Informed consent (IC) is one of the most important ethical, legal and professional requirements of a surgical procedure. Objectives: This study aims to assess the quality of obtaining surgical IC from women underwent CS in public hospitals of Iran. Materials and Methods: In this analytical study with cross-sectional design, 300 postpartum women who had CS referred to two public hospitals in Rasht, Iran were participated through stratified random sampling method in 2016. Data were collected using a two-part researcher-made questionnaire. Collected data were analyzed by using descriptive statistics, Kruskal-Wallis test, Mann-Whitney U test, and Spearman’s correlation test. Results: The mean age of participants was 29.84 ± 5.9 years. The majority of them (45.3%) had education lower than high school. The overall mean score for the quality of obtained IC was 62.23±23.38, out of 150 points. Regarding its dimensions, quality of acquiring IC form (20.21±7.12, out of 40 points), provision of CS-related information (15.67±11.10, out of 45 points), voluntariness (7.53±6.95, out of 25), and the physician–patient relationship (18.81±8.87, out of 40 points) were perceived poor. Women’s educational level had a significant correlation with the IC quality dimensions of voluntariness (P=0.0001) and physician–patient relationship (P=0.043). The number of deliveries (P=0.008), live births (P=0.031), and stillbirth (P=0.0001) had a significant correlation with acquiring the IC form. The voluntariness was significantly associated with the number of live births (P=0.023) and stillbirth (P=0.001). The physician-patient relationship dimension was significantly associated with the number of pregnancies (P=0.023) and abortions (P=0.0001). The overall quality of obtained IC was significantly correlated with the women’ age (r= 0.162, P= 0.005). Conclusion: Most of women in Iran are not informed enough about the CS and its consequences. Health care providers should pay more attention to the women’s characteristics when obtaining IC for the CS. We recommend essential changes in the process of obtaining surgical IC for the CS in public hospitals of Iran. Obtaining IC during pregnancy may reduce unnecessary CSs.
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Khan, Sharin, Hiba Arshad Shaikh, Tahira Kunbhar, Marya Mushtaque, Ayesha Mustafa, and Rashida Akbar. "Frequency of Adverse Perinatal Outcome in Women Undergoing Emergency Lower Segment Cesarean Section at Term Due To Non–Reassuring CTG at Tertiary Care Hospital." Pakistan Journal of Medical and Health Sciences 16, no. 3 (March 26, 2022): 743–44. http://dx.doi.org/10.53350/pjmhs22163743.
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Objective: To determine the frequency of adverse perinatal outcome in women undergoing emergency lower segment cesarean section at term due to non–reassuring CTG at Tertiary Care Hospital. Study Design: Descriptive case series-longitudinal. Study Setting: Study was conducted at Department of Gynaecology and Obstetrics, Aga Khan University Hospital. Duration of Study: Six months from 1st July, 2018 till 31st December 2018. Subjects and Methods: Data was prospectively collected from patients after taking a consent. A total of 211 patients were included. Demographic data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables were presented as frequency and percentages. Post stratification chi square test was applied taking p-value of ≤ 0.05 as significant. Results: Mean age in group A and B was 33.56±3.91 and 34.71±4.01 years respectively. Adverse fetal outcome showed that birth weight < 2500 gm (20.4% vs 12.3%), APGAR score < 7 (16.6% vs 12.3%), Umblical cord ph < 7.1 (14.2% vs 9%), NICU admission (11.8% vs 8.5%) and still birth patients (4.3% vs 1.9%) who were in decision to delivery group of < 30 minutes and > 30 minutes respectively. Conclusion: This study showed that there are still avoidable delays in emergency caesarean section. Improving health care delivery so as to eliminate the identified causes would go a long way in reducing these delays. But given the results of this study, adverse fetal outcomes appears to be less in DDI > 30 minutes group when compared with DDI < 30 minutes group. Keywords: Elective lower segment cesarean section, decision to delivery time, birth weight, APGAR score, NICU admission, umbilical ph and still birth.
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Main, Elliott K. "Reducing Cesarean Birth Rates With Data-driven Quality Improvement Activities." Pediatrics 103, Supplement_E1 (January 1, 1999): 374–83. http://dx.doi.org/10.1542/peds.103.se1.374.
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Reduction of cesarean section rates has been a difficult process that has not been easily accomplished by the institution of guidelines. It is more a process of changing physician behavior rather than of medical education. This article analyzed the role of intensive feedback of outcomes to bring about such changes. Two large private obstetric services in San Francisco, CA, were studied. Intensive outcomes feedback using a computerized information system, The Perinatal Data Center, regarding cesarean birth rates and a variety of obstetric outcomes was provided to the medical and nursing staff at one hospital. The other center served as a control. After the first observation period, the outcomes system was introduced to the second hospital. Finally, “open label” feedback, intradepartmental release of everyone's key statistics with names attached, was performed. Active management of labor was not practiced at either hospital. Results. Cesarean birth rates were stable in the baseline period from 1980 through 1988 at 24% to 25%. Introduction of the Perinatal Data Center outcomes system was associated with a reduction to 21% at the first hospital with no change in the control hospital. Subsequent introduction of the system 3 years later in the control hospital resulted in a decline from 25% to 20.5%. After merger of the two obstetric units and the institution of “open label” feedback, an additional decline to 18.5% was observed. Conclusion. Physician practice patterns and cesarean birth rates can be altered with the intensive use of comparative outcome data and strong physician leadership. Nonblinded, intradepartmental distribution of outcomes is an even more effective tool.
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Abebe, Ayele Mamo, Girma Wogie Fitie, Desalegn Abebaw Jember, Mihretab Mehari Reda, and Getu Engida Wake. "Teenage Pregnancy and Its Adverse Obstetric and Perinatal Outcomes at Lemlem Karl Hospital, Tigray, Ethiopia, 2018." BioMed Research International 2020 (January 20, 2020): 1–8. http://dx.doi.org/10.1155/2020/3124847.
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Introduction. One of the major public health issues across the whole world these days is teenage pregnancy which is defined as being pregnant in the age ranging from 13–19 years. About 11% of all births which occurred worldwide accounted for girls aged 15 to 19 years. From these, 95% teenage deliveries occur in low- and middle-income countries. World health 2014 statistics show that complications during pregnancy and childbirth are the second cause of death for 15–19-year-old girls globally. The aim of this study was to determine adverse obstetrical and perinatal outcomes of teenage pregnancy among deliveries at Lemlem Karl General Hospital, Tigray, Ethiopia, 2018. Result. This study result showed that 17.5% of the teenagers and 6.8% of the adults deliver low birth weight neonates. From the total teenage mothers, about thirty-five (11.3%) of them had developed pregnancy-induced hypertension, whereas about thirteen (4.2%) of adults develop pregnancy-induced hypertension. Regarding cesarean delivery, forty (12.9%) of those teenage mothers deliver by a cesarean section while 58 (18%) of the adult mothers deliver by cesarean delivery. Teenage pregnancy was significantly associated with adverse obstetric and perinatal outcomes, a cesarean delivery (AOR: 0.57; 95% CI, 0.36–0.90), episiotomy (AOR: 2.01; 95% CI, 1.25–3.39), and low birth weight (AOR: 2.22; 95% CI, 1.13–4.36), and premature delivery were 2.87 (1.49–5.52). This study shows that adverse obstetric and perinatal outcomes were significantly associated with teenagers than adult mothers. Therefore, giving health education on focused ANC is very important to bring change to the teenager at this study area.
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Syed, Tehmina P., Zakia Sheikh, and Farah Hameed. "Assessment of Patient Satisfaction after Counseling by a Health Care Provider before Emergency Cesarean Section in a Tertiary Care Hospital." Journal of South Asian Federation of Obstetrics and Gynaecology 9, no. 1 (2017): 33–38. http://dx.doi.org/10.5005/jp-journals-10006-1453.
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ABSTRACT Introduction Patient satisfaction is one of the most frequently reported outcome measures for quality of health care. In recent years, effective counseling has become a very important tool to involve patient participation in decision-making. The objective of this study was to assess the patient satisfaction by the counseling of a health care provider before emergency cesarean section (C-section) in a tertiary care hospital. Materials and methods A descriptive cross-sectional questionnaire study of 53 women, who had their first babies by C-section or had C-section first time with previous normal deliveries, in Hamdard University hospital in 3 months. Data analysis Questionnaires were distributed among patients on their second postoperative day after emergency C-section. A good total response rate for patient satisfaction survey is in the 40 to 60% range. Statistical Package for the Social Sciences version 20 was used to analyze the data, patient satisfaction was analyzed by using descriptive statistics (%, frequency), and independent sample t-test and analysis of variance were applied to assess the satisfaction level for demographic indicators. Results Out of 53 women, 38 (71.7%) were satisfied with the counseling while 15 (28.3%) were dissatisfied; 35 (66%) were primigravida while 17 (32%) were multigravida. The majority was in the age group of 25 to 30 (41%) years; 21 (39.6%) were undergraduate, out of them 12 (55.2%) were satisfied; 32 (60.3%) were graduate, out of them 26 (82%0) agreed; 46 (86%) participants know their counselor; and 44 (83%) reported good attitude. A safe atmosphere was created by the counselor in 38 (71.7%) cases, and 24 (45%) participants reported that the counselor used medical jargons. Privacy was not maintained in 39.6%, and 18 (33.9%) reported negative feelings like anxiety and depression after their counseling. Conclusion Patient satisfaction is an important quality outcome indicator to measure success of the health care services. Evaluation of patient care is vital to provide opportunity for improvement like strategic framing of health plans. How to cite this article Syed TP, Sheikh Z, Hameed F. Assessment of Patient Satisfaction after Counseling by a Health Care Provider before Emergency Cesarean Section in a Tertiary Care Hospital. J South Asian Feder Obst Gynae 2017;9(1):33-38.
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Malagon, Genaro Vega, Luis Nelson Bautista Garcia, Silvia Barrios Lugo, Jesús Vega Malagón, Alma Becerril Santos, and Javier Avila Morales. "Risk Factors in Obstetric Hysterectomy in a Second Level Hospital in Mexico." European Scientific Journal, ESJ 13, no. 30 (October 31, 2017): 52. http://dx.doi.org/10.19044/esj.2017.v13n30p52.
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Objective - To determine the risk factors for obstetric hysterectomy in a second level hospital in Mexico. Methodology.- Epidemiological study of cases and controls from January 2014 to December 2016 at the Child and Women Specialties Hospital of Querétaro. The cases were 56 women with obstetric hysterectomy, controls, 56 women without the procedure, sampling was random simple probabilistic in both groups, analyzed: age, schooling, parity, route of abortion, antecedent of previous cesarean sections, Uterine hypotonia, placental accretismo. For the analysis, descriptive and inferential statistics were used with chi2 test, student t, odds ratio (O.R.), and I.C. 95%, and a value of p <0.05). Results.-The mean age of the group of cases was 30.3 years (D.E. of 7,139) and the controls of 25.08 (D.E. of 5.979) with a p: <0.05. The factors that showed statistically significant difference (p: <0.05) were: Placental acretism (O.R., 126.17); Hypotonia or uterine atony (O.R., 8.22); Multiparity of 3 or more pregnancies (O.R., 5.11); Age of 28 years or more (O.R. of 4.86), placenta previa (O.R. of 3.11); Antecedent of two previous C-sections (O.R. of 2.77); Route of interruption of pregnancy by cesarean section (O.R. of 2.75) and cesarean antecedent (O.R. of 2.55). There was one maternal death in the case group. Conclusions: Obstetric hysterectomy is an emergency surgery, so the risk factors for this complication must be identified during prenatal care.
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Baran, Joanna, Aneta Weres, Rafał Baran, Ewelina Czenczek-Lewandowska, Justyna Leszczak, and Justyna Wyszyńska. "Preterm Birth and the Type of Birth and Their Impact on the Incidence of Overweight and Obesity in Children." International Journal of Environmental Research and Public Health 19, no. 19 (September 23, 2022): 12042. http://dx.doi.org/10.3390/ijerph191912042.
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The purpose of the study was to evaluate the influence of the type of birth and preterm birth on the risk of overweight and obesity in the children studied. The study involved 749 children of pre-school and school age, between 4 and 15 years of age. Information about the type of delivery and the potential preterm birth came from the child’s health book and the mother’s pregnancy card. The authors assessed the body height and body weight of each child. The analysis showed that on average every six children were born before due date (before the end of 37 weeks of gestation) and slightly more than 40% of the children were born by cesarean section (CS). A statistical analysis was performed, including descriptive statistics and Spearman’s correlation, and to evaluate the differences in the analyzed groups, nonparametric tests and chi-square independence tests were used: the Mann-Whitney test, and the Kruskal-Wallis test due to the lack of a normalized distribution. The incidence of overweight and obesity was higher in 7–11-year-old boys born with CS vs. vaginal birth (VD) (p = 0.026). There were no statistically significant differences between BMI centile value and preterm birth. Cesarean section birth significantly increases the percentage of boys with overweight and obesity in early school age and may be associated with higher percentile values of children with BMI in this age group.
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Choudry, Abeera, Maria Habib, Zaineb Shamim, Syeda Zubda Batool, Marium Haroon, and Uzma Rehman Kallu. "Frequency of meconium stained liquor in low risk laboring women and its effect on perinatal outcome in a tertiary care hospital." Professional Medical Journal 28, no. 7 (July 1, 2021): 936–43. http://dx.doi.org/10.29309/tpmj/2021.28.07.5194.
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Objective: To evaluate the frequency of meconium stained liquor (MSL) in low risk women and its effect on perinatal outcomes. Study Design: Prospective Case Control study. Setting: Department of Obstetrics and Gynecology Military Hospital, Rawalpindi. Period: January to August 2017. Material & Methods: Distribution of MSL was studied according to its grade. Data included demographic profile, mode of delivery, intrapartum factors and neonatal outcomes. Descriptive statistics and chi-square were used for analysis. Results: Frequency of MSL was 376 (3.65%) among 10,281 deliveries during study period. A total of 752 women were included in the study which were divided into cases and controls. Nulliparity and advanced gestational age were significantly associated with MSL. Distribution of grade of meconium was 20.5%, 56.4% and 23.1% for grade I, II and III MSL. Breech presentation, fetal heart rate abnormalities and cesarean section were significantly associated with MSL. Low apgar score at 1 and 5 minutes, Neonatal intensive unit care admissions and fetal complications had positive correlation with MSL. Frequency of meconium aspiration syndrome (MAS) was 16.4%, birth asphyxia 5.31% and respiratory distress syndrome (RDS) 1.32% amongst all the cases of MSL. However, frequency of MAS, birth asphyxia and RDS was 0.6%, 0.19%, 0.02% in general obstetric population. Neonatal mortality was 29% in MAS, 3.4% in MSL and 0.12% in general population. Adverse neonatal outcomes had positive correlation with increasing grade of meconium. Conclusion: There is a significant frequency of meconium stained liquor even in low risk women. MSL is significantly associated with increased cesarean section rates and adverse neonatal outcomes.
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Tesfaye, Degefa Gomora, Yohannes Tekalegn Efa, Fikreab Desta, Mulugeta Adugnew Gebeyehu, and Sana’a Kedir Abdella. "Maternal autonomy and associated factors in making decision to utilize health service for themselves and neonates in south Ethiopia: A community based cross-sectional survey." PLOS ONE 17, no. 10 (October 6, 2022): e0275303. http://dx.doi.org/10.1371/journal.pone.0275303.
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Background The definition of women’s autonomy used in the study is control over finances, decision–making power, and the extent of freedom of movement by women. Lower autonomy of women affects the socio-economic, emotional, fertility decision, contraceptive use, and sexual life of the women. Thus, this study aimed to assess maternal autonomy and associated factors in making a decision to utilize health services for themselves and neonates in south Ethiopia. Methods Community-based cross-sectional study design was conducted from January 1 to March 2, 2021, in Shashamane town. Four hundred ten postpartum mothers were selected using a stratified random sampling technique and interviewed for the survey using questions composed of decision-making autonomy components (decision–making power, control over finances, and freedom of movement). The data were checked for consistency, coded, and entered using EpiData Manager (version 4.6.0.4) and analyzed using Statistical Package for Social Science (SPSS) version 26. Descriptive statistics, composite score analysis, and binary and multivariate logistic regression were done to capture the objectives. Result 410 postpartum mothers were interviewed while the mean and standard deviation of the participants’ age was 26.96 ± 5.38. About 48.5% of mothers had high decision-making autonomy for their own and their neonates’ health service utilization. Being in monogamous marriage (AOR = 1.82, 95% CI: 1.21, 2.74), and mode of delivery (Cesarean section) (AOR = 1.91, 95% CI: 1.18, 3.07) were significantly associated with having high maternal decision-making autonomy. Conclusions More than half of the study participants had low maternal decision-making autonomy for their own and their neonates’ health service utilization. Being in monogamous marriage, and mode of delivery (Cesarean section) were factors significantly associated with high maternal decision-making autonomy. Encouraging mothers to use facility delivery was recommended.
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Babaei, Shadi, Maryam Mirzaei, Narges Maleki, Zahra Alizadeh, Fahimeh Yasari, and Marefat Ghaffari Novin. "Isolation and evaluation of biological properties and differentiation potential of human umbilical cord-derived mesenchymal stem cells in covid-19 positive patients." LAPLAGE EM REVISTA 7, no. 3D (October 14, 2021): 542–51. http://dx.doi.org/10.24115/s2446-6220202173d1745p.542-551.
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The present study investigated the biological properties of umbilical cord-derived mesenchymal stem cells and their ability to differentiate in patients who have had positive COVID-19 PCR test result during their pregnancies. In this experimental laboratory study, the whole placenta specimens were obtained from 30 positive COVID-19 women undergoing cesarean section, with age 20 to 40 years, and kept under standardized conditions. The mesenchymal cells were isolated by enzymatic method and their morphological characteristics were examined by microscopy and absorption spectroscopy and their biological properties, in particular expression of CD markers, were determined by flow cytometry. Finally, mesenchymal stem cells were cultured in specific media in order to differentiate into osteocyte and adipocyte. Data were analyzed using descriptive statistics. Morphological and physical examinations by microscope and absorption spectroscopy as well as presenting of CD44, CD73, CD90, and CD105 markers and lacking CD34 and CD45 markers demonstrated the mesenchymal entity of stem cells. Mesenchymal stem cells successfully differentiated into osteocyte and adipocyte.
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Diema Konlan, Kennedy, Elizabeth Kpodotsi Baku, Milipaak Japiong, Kennedy Dodam Konlan, and Roberta Mensima Amoah. "Reasons for Women’s Choice of Elective Caesarian Section in Duayaw Nkwanta Hospital." Journal of Pregnancy 2019 (July 7, 2019): 1–7. http://dx.doi.org/10.1155/2019/2320743.
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Background. Caesarean section is one of the most commonly performed major surgeries in obstetric practice intended to save the mother and child and in turn reduce maternal and perinatal mortality. The steadily increasing global rate of caesarean section has become one of the most debated topics in maternity care. This study identified the factors that influence women’s choice of elective cesarean sections in the Duayaw Nkwanta Hospital. Methodology. This study used descriptive cross-sectional survey method to collect data from 78 post-caesarean section women above age 18 years. A whole population sampling method was used to trace respondents to their homes to administer a pretested questionnaire. Data was double-entered into Microsoft Excel spreadsheet, compared, cleaned, and transported to Statistical Package for Social Sciences (SPSS) version 21. Data was analyzed using descriptive statistics with a Pearson correlation test. Results. Post-caesarean section women (37.2%) indicated CS is a pain-free method of birth while 57.1% reported CS is safe for both mother and baby. Others (28.2%) chose CS based on a friend’s advice and 19.2% on religious advice. The relationship between age of respondents and the number of times of having CS showed a weak positive correlation (r= .170, N= 78, p≤0.136, two-tailed test). There was a significant positive correlation between average monthly income of respondents and the number of times of having a CS birth (r= .320, N= 78, p≤ 0.004). Conclusion. It is imperative that there is heightened interest in educating mothers on associated benefit and risk of elective caesarean sections as a method of birthing by nurses and midwives in the antenatal clinics.
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Nadeem, Saba, Sara Reza, Hafiz Muhammad Salman Yousaf, and Nimrah Sattar. "EVALUATING THE DIAGNOSTIC PERFORMANCE OF TOTAL BILE ACIDS AND TRANSAMINASES IN INTRAHEPATIC CHOLESTASIS OF PREGNANCY." Pakistan Journal of Pathology 33 (September 3, 2022): 99–103. http://dx.doi.org/10.55629/pakjpathol.v32i3.727.
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Objective: The objective of this study is to evaluate diagnostic performance of total bile acids and transaminases in intrahepatic cholestasis of pregnancy (ICP). Material and Methods: This observational cross-sectional study was conducted at Gynecology & Obstetrics ward, Bahawal Victoria Hospital and Pathology Laboratory of Quaid-e-Azam Medical College, Bahawalpur. Thirty pregnant females with intrahepatic cholestasis of pregnancy were included in the study. Thirty age, parity and gestational age matched controls were selected. Total bile acids and alanine transaminases (ALT) were measured in each study subject. Results: The sensitivity and specificity for both total bile acids and ALT were calculated. Our study results showed a comparable sensitivity and specificity for both tests in patients with ICP. The rise in bile acids and ALT was statistically significant in ICP. The level of transaminases increased in proportion to total bile acids. Also, our study found an increased risk of preterm delivery, low birth weight and delivery by cesarean section in patients with ICP. Conclusion: It is concluded that ALT can be used alternatively to total bile acids for the diagnosis of intrahepatic cholestasis of jaundice. Total bile acids are expensive and only a few laboratories in Pakistan are offering this service, making its access limited to general population. Whereas ALT is a cost effective and common test, its results are readily available with an additional benefit that no fasting sample is required. Hence, it is a more appropriate diagnostic test for ICP in our resource constraint setup. Key Words: Bile acids, Liver enzymes, Cholestasis, Pregnancy, Aminotransaminase
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Ebrahimi, Soudabe, Maryam Niknami, Fateme Rafat, and Ehsan Kazemnezhad Leili. "A Comparative Study on Adverse Pregnancy Outcomes in Pregnant Women with Different Age." Journal of Holistic Nursing And Midwifery 31, no. 1 (January 1, 2021): 9–16. http://dx.doi.org/10.32598/jhnm.31.1.2017.
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Introduction: Delayed childbearing is increasing. Increased maternal age has been associated with increased risk of pregnancy complications. On the other hand, the adolescent pregnancy has traditionally been considered high-risk, especially in developing countries. Objective: This study aimed to compare the adverse pregnancy outcomes in different age groups of pregnant women. Materials and Methods: The analytical study with cross-sectional design was conducted on 345 pregnant women referred to one of the maternity hospitals in Rasht, Iran in 2018 who were selected by sequential sampling method. They were followed from gestational age >37 weeks until delivery in 3 groups: <19 years, 19-35 years and >35 years. The data collection tool was a two-part researcher-made questionnaire which surveys demographic, fertility, and socioeconomic information and adverse maternal and neonatal outcomes. The collected data were analyzed using descriptive and inferential statistics (Chi-square test, Fisher’s exact test, Kruskal-Wallis test, ANOVA, Bonfrroni test, Spearman correlation test, and multiple linear regression analysis). Results: The highest prevalence of maternal diabetes mellitus (29.7%) and cesarean section (72.46%) were reported in the age group >35 years. The highest frequency of premature rupture of membranes (18.8%) and abnormal fetal presentation (13.8 %) were reported in age groups <19 years and 19-35 years, respectively. Among maternal outcomes, maternal diabetes, abnormal fetal presentation, premature rupture of membranes and delivery by cesarean section were significantly different between three groups (P<0.05). There was a significant difference between maternal age and neonatal outcomes in ages groups <19 years and 19-35 years (P<0.05). Multiple linear regression model showed that the maternal age <19 years was a predictor of adverse neonatal outcomes. The group <19 years reported more adverse outcomes than the age group 19-35 years (β=0.282, 95% CL: 0.002-0.561, P=0.049). Conclusion: All age groups of pregnant women faced some pregnancy outcomes. Due to Iran’s new plan to encourage childbearing, prenatal screening, and receiving more prenatal care, we recommend pregnant women to participate in childbirth preparation training courses.
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Wie, Jeong Ha, Se Jin Lee, Sae Kyung Choi, Yun Sung Jo, Han Sung Hwang, Mi Hye Park, Yeon Hee Kim, et al. "Prediction of Emergency Cesarean Section Using Machine Learning Methods: Development and External Validation of a Nationwide Multicenter Dataset in Republic of Korea." Life 12, no. 4 (April 18, 2022): 604. http://dx.doi.org/10.3390/life12040604.
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This study was a multicenter retrospective cohort study of term nulliparous women who underwent labor, and was conducted to develop an automated machine learning model for prediction of emergent cesarean section (CS) before onset of labor. Nine machine learning methods of logistic regression, random forest, Support Vector Machine (SVM), gradient boosting, extreme gradient boosting (XGBoost), light gradient boosting machine (LGBM), k-nearest neighbors (KNN), Voting, and Stacking were applied and compared for prediction of emergent CS during active labor. External validation was performed using a nationwide multicenter dataset for Korean fetal growth. A total of 6549 term nulliparous women was included in the analysis, and the emergent CS rate was 16.1%. The C-statistics values for KNN, Voting, XGBoost, Stacking, gradient boosting, random forest, LGBM, logistic regression, and SVM were 0.6, 0.69, 0.64, 0.59, 0.66, 0.68, 0.68, 0.7, and 0.69, respectively. The logistic regression model showed the best predictive performance with an accuracy of 0.78. The machine learning model identified nine significant variables of maternal age, height, weight at pre-pregnancy, pregnancy-associated hypertension, gestational age, and fetal sonographic findings. The C-statistic value for the logistic regression machine learning model in the external validation set (1391 term nulliparous women) was 0.69, with an overall accuracy of 0.68, a specificity of 0.83, and a sensitivity of 0.41. Machine learning algorithms with clinical and sonographic parameters at near term could be useful tools to predict individual risk of emergent CS during active labor in nulliparous women.
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Bhattari, Saraswoti Kumari Gautam, M. Dahal, and M. R. Budha. "Status of Maternity Services in Karnali Academy of Health Sciences." Journal of Karnali Academy of Health Sciences 1, no. 2 (October 6, 2018): 14–17. http://dx.doi.org/10.3126/jkahs.v1i2.24131.
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Introduction: Access to proper medical attention and hygienic conditions during delivery can reduce the risk of complications and infections for the mother and baby. Health facility-based delivery is considered a critical strategy to improve maternal health. This study aimed to identify the status of maternity service in Karnali Academy of Health Science (KAHS), Jumla.
Methods: A hospital based retrospective study was done in maternity ward of KAHS teaching hospital, Jumla. Total 855 women admitted in maternity ward with obstetrical problem and labour pain were included in the study from July 16, 2017 to July 16, 2018. Sampling technique was census and cases were selected from record section. Data was analyzed by using descriptive statistics.
Results: There were total 855 obstetrical cases with labour pain and other obstetrical conditions. Among them 673 (78.71%) cases were in labour pain, 543 (80.68%) had spontaneous vaginal delivery, 104 (15.45%) had cesarean section. Among the 678 neonates; 650 (95. 87%) were live born baby, 28 (4.12%) were still birth, 13 (1.91%) died in neonatal period. Furthermore, among 855 obstetric cases 109 (12.74%) had obstetrical complications, and 116 (13.56%) received specific obstetrical management for complications.
Conclusions: Though there was no any maternal death in the KAHS nearly 2% neonatal death was found. Therefore, special management facility should be improved for the survival of neonates in future.
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Iqbal, Adnan, Hafiz Muhammad Javed, Khaleel Ahmad, Muhammad Adeel Ashfaq, Mahnoor Rafique Butt, and Marrium Khalid. "Phenylephrine Boluses Vs Noradrenaline Boluses for Hypotension after Spinal Anesthesia in LSCS." Pakistan Journal of Medical and Health Sciences 16, no. 7 (July 30, 2022): 775–77. http://dx.doi.org/10.53350/pjmhs22167775.
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Background: Hypotension is a frequent complication highly associated with spinal anesthesia during lower segment cesarean section that imposed adverse effects related to maternal as well as fetal. Purpose: The purpose: of this study is to lighten the comparison of vasopressor (Phenylephrine boluses vs. noradrenaline boluses) use to treat hypotension after spinal anesthesia in LSC patients Study design: randomized double-blind study design. Method: This randomized double-blind study was performed at the department of anesthesia, critical care, and pain medicine at Aziz Bhatti Shaheed Teaching Hospital, Gujrat Pakistan, and was conducted from Jun 2020 to Jun 2021. The patients aged between 20 to 40 years who went through lower segment cesarean section were part of this study. A total of 60 patients were divided into two groups namely groups A and B. Group A contain 30 patients in the same way group occupied with 30 patients and by using a random allocation procedure or protocol, the randomized number was assigned to all patients via the computer-generated system. Group A received phenylephrine and Group B received noradrenaline. Results: Statically analysis was performed using SPSS software. In the case of group A, the mean arterial pressure was measured at 115.03 ± 8.69, heart rate, beats/min was measured at 65.72 ± 9.46, and bradycardia was found in 14 (46.6%) patients out of 30 of group A with a mean value of beats 43.65 ± 3.23, hypotension was found in 4.31 ± 2.11 cases and to treat its repeated episodes with phenylephrine boluses was used 4.21 ± 1.21. In the case of group B, the mean arterial pressure was measured at 121± 9.86, heart rate, beats/min was measured at 80.42± 8.01, and bradycardia was found in 8 (26.6%) patients out of 30 of group B with a mean value of beats 45.23± 2.13, hypotension was found in 2.21± 1.03 cases and to treat its repeated episodes with noradrenaline boluses was used 3.98± 1.32 and all the variables was found with significant results. Conclusion: We conclude that noradrenaline shows ameliorated response to handle the hypotension situation after spinal anesthesia as compared to phenylephrine. Keywords: Spinal anesthesia, phenylephrine bolus, noradrenaline bolus, lower segment cesarean section (LSCS)