Academic literature on the topic 'Labor (Obstetrics) Complications Victoria Statistics'

One of the most severe complications during childbirth is the separation of the tattoo from the vaginal arches (from the sleeve). Hugenberger was the first to draw attention to the ruptures of the vaginal fornix and gave them the name colpaporrhexis . They occur much less frequently than ruptures of the uterus, which is evident from the following: Belousov (1910) collected only about 100 cases, and that, apparently, exclusively from Russian literature; in a major work on this issue, Brindeau and Lerne land stated that the frequency of this kind of complications of labor is difficult to establish, since statistics on this issue do not exist. Obviously, the specific nature of this severe complication is characteristic of Russian obstetrics. Indeed, the statistics of Shchetkin and Belousov is based mainly on domestic casuistry (Guggenberger, Syromyatnikov, Vernits, Lvov, Poroshin, Kutova, Brunoit. E).

Objectives: In Nigeria, the number of professional midwives available for care of pregnant women and their babies is inadequate; hence, most pregnant women are attended to by Traditional Birth Attendants (TBAs). Studies show that TBAs have poor knowledge of how to identify obstetrics complications. Aim: To determine the effectiveness of a training program on enhancing the knowledge of TBAs in the identification of some selected labor emergencies. Materials and Methods: An experimental research design was conducted with probability sampling to select sample size (n = 111 TBAs). A modified, structured questionnaire from TBAs knowledge on identification of labor emergencies (TBAs-TPKI) was used for data collection. Data collected were analyzed using Statistical Packages for the Social Science (SPSS) software. Descriptive statistics were used to provide answers to the six research questions of the study while inferential statistics of paired t-test was used to test the hypothesis of the study at 0.05 level of significance. Results: The results show that the mean score on knowledge identification on prolonged labor increased from 4.88±2.54 to 11.56±1.48; obstructed labor from 4.18±2.18 to 5.73±1.26, cord presentation from 2.44 ±1.27 to 5.78 ± 0.74, cord prolapse from 2.79±1.45 to 6.60±0.84, placenta abruptio from3.83±1.99 to 9.08±1.16 and postpartum hemorrhage from 3.48±1.82 to 8.26±1.05. The overall mean score of TBAs on knowledge of identification increased from 21.59 ± 11.26 to 51.19 ± 6.54 post-intervention. There was a significant difference between pre- and post-intervention mean scores of knowledge of TBAs on the identification of all the selected labor emergencies (t = 32.208, p = 0.00). Conclusions: The Ministry of Health in each state should organize regular training for TBAs to target early identification of obstetrics emergencies in order to reduce maternal mortality in Nigeria.

BACKGROUND: The rapid increase in the frequency of caesarean sections has led to the emergence of a special group of patients with a uterine scar who want to give birth through the natural birth canal. Repeated operative delivery is associated with high risks of both intraoperative and postoperative complications, therefore, every year the number of women with a uterine scar who prefer natural childbirth is growing. AIM: The aim of this study was to create a model that allows, based on a comprehensive assessment of risk factors, for predicting the outcome of childbirth in women with a history of abdominal childbirth. MATERIALS AND METHODS: We carried out a retrospective analysis of 173 birth histories of women with a uterine scar after a previous caesarean section, delivered in the Chita City Maternity Hospital in 20212022. Three groups of individuals were designed for the study: Group 1 included 110 women delivered by caesarean section in a planned manner; Group 2 comprised 20 women delivered by caesarean section during childbirth, while Group 3 consisted of 43 women who gave birth through the natural birth canal. The groups were comparable in terms of nationality, age, material and social conditions of the patients. On the eve of delivery, all patients underwent general clinical and obstetric ultrasound examination, with the anamnesis details clarified. The data obtained were processed statistically using the IBM SPSS Statistics version 25.0. RESULTS: Using binary logistic regression, a model was developed to predict the outcome of childbirth through the natural birth canal in women with a uterine scar, which takes into account statistically significant indicators such as gestational age, estimated fetal weight, parity, and the presence of chronic endometritis and weakness of labor activity in history. The sensitivity of the developed prognostic model is 0.86, the specificity being 0.70. The area under the ROC curve is 0.87 (95% confidence interval 0.780.96; p 0.001). CONCLUSIONS: The comprehensive analysis of risk factors allows for predicting the outcome of natural childbirth in women with a uterine scar, which in the future will optimize the tactics of their delivery and prevent the development of complications in childbirth for the mother and fetus.

Somatic morbidity in parturient and puerperant women, mainly diabetes mellitus and anemia remains an urgent problem of the modern obstetrics due to the multiple negative effect on both maternal and newborn health. Dynamic analysis of this morbidity makes it possible to identify priorities in preventive activities to ensure effective coordination of the multidisciplinary team of highly qualified specialists. Purpose. To study dynamics in somatic morbidity complicating labor in the Russian Federation. Material and methods. The analysis was carried out according to the form of statistical observation No. 32 «Information on medical care for pregnant, parturient and puerperant women» and on the basis of data from the collections «Main indicators of maternal and child health, performance of mother and child services in the Russian Federation» for 2016-2020, using methods of descriptive statistics, calculation of the increase and decrease rates of indicators, as well as prognostic options for diseases. Results. In 2016-2020 Russia registered increased morbidity among parturient and puerperant women with diabetes (+ 170.33%; 31.88 ‰ - 86.18 ‰), venous complications (+ 27.33%; 19.9 ‰ - 24.30 ‰) and anemia (+ 5.65%; 247.68 ‰ - 261.70 ‰). Diseases of the cardiovascular system (-15.76%; 57.11 ‰ - 48.10 ‰) and urinary tract infections (-7.44%; 51.13 ‰ - 47.30 ‰) tend to decrease. According to the calculated forecasts, a similar trend will remain until 2025. At the same time, there are pronounced regional differences in indicators with multidirectional nature of the dynamics. Conclusion. Dynamic analysis of morbidity makes it possible to identify priorities for preventive activities. However, the existing reporting forms contain a narrow list of pathologies, not fully reflecting diseases that significantly affect mother and child health.

Aim: conduct a systematic analysis of pregnancy development, investigate clinical and laboratory data affecting development of labor abnormalities in women residing in the Belgorod region. Materials and Methods. From 2014 to 2018, 484 women were examined and divided into 2 groups: main group consisted of those who had childbirth complicated with labor abnormalities (n = 344), whereas control group consisted of women lacking complications during delivery (n = 140). The following methods were used in the study: questionnaires, general clinical methods, biochemical blood tests in pregnant and postpartum women, populational statistics as well as methods of standard and multivariate statistics. Results. In the second half of pregnancy in women with labor abnormalities revealed higher rate of moderate preeclampsia (34.30 ± 2.56 % vs. 10.71 ± 2.61%; p < 0.05), polyhydramnios (11.34 ± 1.71 % vs. 5.71 ± 1.96 %; p < 0.05), chronic intrauterine hypoxia (29.6 ± 2.46 % vs. 12.86 ± 2.83 %; p < 0.05), chronic utero-placental insufficiency (60.47 ± 2.64 % vs. 20.00 ± 3.38 %; p < 0.05), sexually transmitted infections (3.78 ± 1.03 % vs. 0.71 ± 0.71 %; p < 0.05), acute respiratory viral infection (8.72 ± 1.52 % vs. 3.57 ± 1.57 %; p < 0.05) as well as a combination of several types of pathology (8.72 ± 1.52 % vs. 13.57 ± 2.89 %; p < 0.05). Laboratory parameters in women with labor abnormalities compared with control antepartum group were noted to have significantly decreased count of red blood cells (3.89 ± 0.38×1012/L vs. 3.99 ± 0.40×1012/L; p = 0.006), eosinophils (0.95 ± 0.69×109/L vs. 1.20 ± 0.67×109/L; p = 0.026) and platelets (226.29 ± 62.71×109/L vs. 245.44 ± 60.32×109/L; p = 0.0003). Blood biochemical parameters in women with labor abnormalities vs. control group were featured with significantly decreased level of bilirubin (6.76 ± 3.16 μmol/L vs. 9.88 ± 3.60 μmol/L; p < 0.05) and alanine aminotransferase (13.94 ± 10.08 U/L vs. 19.41 ± 14.40 U/L; p = 0.004). Analyzing coagulation parameters in the main group showed significantly reduced fibrinogen level (4.30 ± 1.00 g/L) compared with control group (4.71 ± 1.14 g/L; p < 0.05) as well as elevated international normalized ratio (1.07 ± 0.11 vs. 1.03 ± 0.10; p = 0.001). Conclusion. Our study data found that pregnant women with labor abnormalities had altered clinical and laboratory parameters observed as early as in the second half of gestation, which may be used to calculate an individual risk of such labor complication.

BACKGROUND: Prelabour rupture of the membranes (PROM) is a common obstetric pathology, the incidence of which reaches 20%. There is evidence that PROM is the main risk factor not only for abnormal labor, but also for postpartum hypotonic bleeding. Meanwhile, the etiology and pathogenesis of this complication have not been finally determined until now. AIM: The aim of this study was to create a model that allows for predicting PROM, based on a comprehensive assessment of risk factors. MATERIALS AND METHODS: Based on the data collected in the Regional Clinical Hospital Perinatal Center, Chita, Russia in 2018-2021, the prospective analysis of 213 cases of labor was carried out. The total sample was divided into two study groups: group 1 included 142 cases of labor with timely rupture of membranes; group 2 included 71 cases of labor, complicated by PROM. The groups were comparable in terms of nationality, age, material and social living conditions of women, frequency of genital pathology, gestational age and gender distribution of newborns. On the eve of labor (1-2 days), all patients underwent a general clinical examination and clarification of the anamnesis. Ultrasound examination was carried out both the day before and during labor in order to clarify fetal position. Statistical processing of the results was carried out using the IBM SPSS Statistics Version 25.0 program. RESULTS: Risk factors for PROM are: the presence of posterior view of the occipital presentation (RR = 2.67 (95 % CI 1.13-6.31), p = 0.02) and varicose veins (RR = 3.2 (95 % CI 1.09-9.43), p = 0.04), distantia cristarum more than 28.5 cm (RR = 1.99 (95 % CI 1.12-3.54), p = 0.02), distantia trochanterica more than 30.5 cm (RR = 2.15 (95 % CI 1.09-4.23), p = 0.03), and conjugata externa more than 20.5 cm (RR = 1.84 (95 % CI 1.01-3.37), p = 0.046). Oligohydroamnion is a protective factor in relation to PROM (RR = 0.31 (95 % CI 0.11-0.85), p = 0.02). This predictive model, which takes into account such factors as the type of fetal head presentation, the presence of oligohydramnios and varicose veins, and the size of distantia cristarum, allows for predicting PROM with much effect. CONCLUSIONS: The comprehensive assessment of risk factors, despite its simplicity and availability, allows for predicting the timeliness of rupture of the membranes with an accuracy of 71.0%. Application of the developed model makes it possible to identify a risk group subject to preventive preinduction, which in the future will help to reduce the frequency of abnormal labor and associated complications.

IntroductionInduction of labour has been common intervention in modern obstetrics. This study is aimed to determine the distribution of practice and outcomes related to induction of labour in Mid-Western Regional Hospital in Nepal. MethodsThis is a retrospective cross-sectional study conducted at Mid-Western Regional Hospital in Surkhet, Nepal. Secondary data were collected from patients’ records of the hospital dating from 16 July 2016 to 15 July 2017. All women who underwent induction of labour with oral misoprostol were included in this study. For induction of labour, maximum five doses of 50 microgram oral misoprostol was administered in every four hours. Descriptive summary statistics such as frequency and percentages were calculated.ResultsOut of total 3,694 pregnant women who delivered in MWRH, 10.5% (n = 387) were induced by oral misoprostol. Majority of labour induced women were in the age group of 20 – 24 years (52.9%), 37 – 42 weeks of gestation (69.5%), and multi-gravida (49.9%). Majority (77.0%) who underwent induction of labour had vaginal delivery. Among total induction of labour, 88.9% had healthy babies. Majority of new borns had APGAR score of six or more in both one minute (87.9%) and five minutes (93.6%). More than half of the new borns (54.5%) had birth weight of 3000 – 3500 grams. Most of the induced cases (97.4%) were free of complications. Only 1.3% of cases had post-partum haemorrhage. ConclusionsInduction of labour using oral misoprostol is a common practice in Mid-Western Regional hospital in Nepal and majority (77.0%) who underwent induction of labour had vaginal delivery.

Objective We aimed to assess the risk of developing gestational diabetes mellitus (GDM) in women with a normal A1C (<5.7) compared with those with an A1C in the pre-diabetic range (5.7–6.4). Study Design This study comprises of a retrospective cohort of non-anomalous singleton pregnancies with maternal body mass index (BMI) ≥40 at a single institution from 2013 to 2017. Pregnancies with multiple gestation, late entry to care, type 1 or 2 diabetes, and missing diabetes-screening information were excluded. The primary outcome was development of GDM. Secondary outcomes included fetal growth restriction, macrosomia, gestational age at delivery, large for gestational age, delivery BMI at delivery, total weight gain in pregnancy, induction of labor, shoulder dystocia, and cesarean delivery. Bivariate statistics were used to compare demographics, pregnancy complications, and delivery characteristics of women who had an early A1C < 5.7 and A1C 5.7 to 6.4. Multivariable analyses were used to estimate the odds of the primary outcome. Results Eighty women (68%) had an early A1C <5.7 and 38 (32%) had a A1C 5.7 to 6.4. Women in the lower A1C group were less likely to be Black (45 vs. 74%, p = 0.01). No differences in other baseline demographics were observed. The median A1C was 5.3 for women with A1C < 5.7 and 5.8 for women with A1C 5.7 to 6.4 (p < 0.001). GDM was significantly more common in women with A1C 5.7 to 6.4 (3.8 vs. 24%, p = 0.002). Women with pre-diabetic range A1C had an odd ratio of 11.1 (95% CI 2.49–48.8) for GDM compared with women with a normal A1C. Conclusion Women with class III obesity and a pre-diabetic range A1C are at an increased risk for gestational diabetes when compared with those with a normal A1C in early pregnancy. Key Points

Background Intrahepatic cholestasis of pregnancy has poor feto-maternal outcomes. To date there has been sparse publications regarding impact of intrahepatic cholestasis in feto-maternal outcomes in our setting. Therefore, we aimed to study the feto-maternal outcome in patients with intrahepatic cholestasis of pregnancy.Material and Methods A hospital based prospective cross-sectional study carried out in department of Obstetrics and Gynecology of Nobel Medical College, Biratnagar, Nepal from 1st January 2014 to 30th December 2015 in women who presented with pruritus in third trimester of pregnancy and having deranged liver function tests. All the cases were followed from admission to discharge. Socio-demographic, clinico-laboratory profile and feto-maternal outcomes were recorded in a preformed structured proforma. Descriptive statistics was used to present the data.Results Among 6,780 women admitted for delivery, 80 had cholestasis of pregnancy with incidence of 1.15%. 83% were of 18-35 years and 65% were primigravida. Most distressing symptom was generalized pruritus (75.0 %). The cesarean delivery rate was 46.25% and labor induction rate was (47.5%). Fetal complications were seen in majority of cases that included meconium aspiration syndrome 26 (32.5%), intrapartum fetal distress 21 (26.25%) and requirement of: intensive care 38 (48.75%). There were 7 perinatal and 3 neonatal deaths.Conclusion Intrahepatic cholestasis of pregnancy seems fairly common among pregnant women. It may be responsible for a large number of perinatal and neonatal deaths especially after 36 weeks of gestation. A large prospective study is needed to address the problems in time.Journal of Nobel Medical College Volume 5, Number 1, Issue 8, January-July 2016, 20-25

Despite the successes of modern obstetrics and perinatology, stillbirth occupies one of the leading places inthe structure of perinatal morbidity and mortality. Today, every 5-6 women lose a pregnancy, and the majority of spontaneous miscarriages occur in the 1st trimester of pregnancy.The aim of the study is to examine the peculiarities of the course of the gestation period, childbirth and the condition of newborns in patients with a threat of early termination of pregnancy.Materials and methods. We carried out a retrospective analysis of 100 individual charts of pregnant and parturient women with a threat of abortion in the 1st trimester of pregnancy (the main group). In 40 patients (subgroup I), the threat of termination of pregnancy was accompanied by bleeding, in 60 – the threat of termination without bleeding was diagnosed (subgroup II).The control group consisted of 50 pregnant women with the physiological course of the first trimester of pregnancy. Statisticalanalysis was performed according to generally accepted methods of variational statistics. Reliability was assessed by Student's t-test.Differences were considered significant at a significance level of p≤0.05.The conduct of research was approved by the Ethics Committee of the BSMU, which is confirmed by the protocol of the Commission on Biomedical Ethics regarding the observance of moral and legal rules for conducting medical scientific research.Processing of personal data was carried out after receiving the patient's informed consent.Results and their discussion. The research groups were representative in terms of residence, social status, and education. Menstrual and reproductive anamnesis data in the main and control groups also did not differ significantly. The rate of spontaneous abortions and terminations of pregnancy according to medical indications was significantly higher in women with threatened termination of pregnancy both with and without bleeding compared to controls. Patients of the main group had a significantly higher history of both gynecological diseases and extragenital pathology.Pregnant women with retrochorial hematoma and bleeding accounted for 70%, in 30% of women in the 1st trimester of pregnancy, in the presence of bloody secretions, retrochorial hematoma was not diagnosed. The percentage of asymptomatic retrochorial hematomas was 15%. Anomalous location of the chorion in the 1st trimester of pregnancy was diagnosed much more often in the 1st and 2nd subgroups.The analysis of the further course of pregnancy in women with episodes of miscarriage in the early stages of gestation showed that in the main group the level of perinatal complications, such as the threat of premature birth (30%), placental dysfunction (38%), preeclampsia (11%), fetal distress (20%), SZRP (19%) was significantly higher. Accordingly, the rates of premature birth (13%), fetal distress (25%), and labor anomalies (10%) were higher in childbirth.When analyzing the condition of children at birth, the level of moderate asphyxia in the main group was higher than in the control group (8±2.7% and 0%, respectively). The average weight of full-term newborns in the study group was significantly lower (3020.0±21.4) than that of children in the control group (3685.0±28.1 g) (p<0.05).Conclusions.Pregnant women with a threat of miscarriage in the first trimester of pregnancy are a high-risk group for the occurrence of perinatal complications.The level of complications in the II and III trimesters of pregnancy is significantly higher if the threat of early termination of pregnancy was accompanied by bleeding.In pregnant women with bleeding earlier (up to 8 weeks), compared to patients with bleeding at 9-13 weeks, the frequency of threatened miscarriage in the II trimester of pregnancy, premature birth, placental dysfunction, preeclampsia, and SZRP was significantly higher.