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Operative Vaginal Delivery (operative + vaginal_delivery)
Selected AbstractsOperative vaginal delivery and episiotomyBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2008DJ Murphy No abstract is available for this article. [source] Author response to: Operative vaginal delivery and episiotomyBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2008JW De Leeuw No abstract is available for this article. [source] The optimal mode of delivery for the haemophilia carrier expecting an affected infant is caesarean deliveryHAEMOPHILIA, Issue 3 2010A. H. JAMES Summary., While a majority of affected infants of haemophilia carriers who deliver vaginally do not suffer a head bleed, the outcome of labour cannot be predicted. A planned vaginal delivery puts a woman at risk of an abnormal labour and operative vaginal delivery, both of which predispose to intracranial haemorrhage. Furthermore, vaginal delivery does not eliminate the risk to the haemophilia carrier herself. Overall, maternal morbidity and mortality from planned vaginal delivery are not significantly different from those from planned caesarean delivery. Caesarean delivery is recommended or elected now in conditions other than haemophilia carriage, where the potential benefits are not nearly as great. Additionally, vaginal delivery of the haemophilia carrier poses medical/legal risks if the infant is born with cephalohaematoma or intracranial haemorrhage. Caesarean delivery allows for a planned, controlled delivery. Caesarean delivery reduces the risk of intracranial haemorrhage by an estimated 85% and the risk can be nearly eliminated by performing elective caesarean delivery before labour. Therefore, after a discussion of the maternal and foetal risks with planned vaginal delivery versus planned caesarean delivery, haemophilia carriers should be offered the option of an elective caesarean delivery. [source] Adolescent primiparas: Changes in obstetrical risk between 1983,1987 and 1999,2005JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2008Willibald Zeck Abstract Aims:, Teenage pregnancies have always been considered at increased risk for obstetric complications. Deliveries in adolescent primiparas in the 5-year time periods 1983,1987 and 1999,2005 were compared against each other, the general population and against primiparas aged 20,29 years in order to reveal trends and differences in obstetric outcome. Methods:, A total of 186 primiparas delivering at an age of 17 or less between October 1999 and October 2005 were compared with 353 adolescent primiparas delivered between 1983 and 1987. Type of delivery and complications such as low birthweight, pre-eclampsia, breech presentation and third stage complications were studied. Results:, The percentage of adolescents in the overall obstetric population decreased. The cesarean section rate remained the same in the adolescents while increasing in the general population. Rates of low birthweight and operative vaginal delivery increased in the adolescent group and overall. Third stage complications (abnormally adherent or incomplete placentas) decreased in both groups. There were no intrauterine fetal deaths in adolescent pregnancies in either time period. Other obstetric variables were unchanged in the adolescent as well as in the general population between 1999 and 2005. When comparing the adolescents' outcome with the outcome of the 20,29-year-old primiparas between 1999 and 2005, it was noted that the rates of abstracted obstetric variables were higher in the population of the 20,29-year-olds. Conclusions:, The obstetric outcome of adolescent pregnancies has remained favorable over the last 18 years. We do not consider adolescence as an obstetrical risk. We suggest that adolescent pregnancy is more a public health issue than a clinical problem. [source] Does delayed child-bearing increase the risk of levator injury in labour?AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2007Hans P. DIETZ Abstract Background:, Levator trauma is common in parous women. We have recently found a relationship with age at first vaginal delivery in women seen before and after childbirth. Aims:, To examine women presenting with symptoms of pelvic floor disorders for such an association. Methods:, Eight hundred and one women were prospectively seen for an interview, clinical examination (including for levator integrity and function in 789 cases), multichannel urodynamic testing and pelvic floor ultrasound (including 3D imaging in 350 cases). Findings were tested for association with maternal age at first vaginal delivery, parity and operative vaginal delivery using logistic regression. Results:, Mean age was 55.3 years (range 17,90), with 79% complaining of stress urinary incontinence and 28% of symptoms of prolapse. Median vaginal parity was 2 (range 0,12); mean age at first vaginal delivery was 24 (range 14,39). Levator defects were found in 170 women (21.6%), 24% of the vaginally parous. Defects were more common on the right (86%) than left (45%) (P < 0.0001). Women with levator trauma had a higher mean age (25.5 (SD 5.2) vs 23.5 (SD 4.5) years, P < 0.0001). Regression modelling confirmed findings, demonstrating an increase in the odds of levator trauma of approximately 10% for every year of delay in child-bearing. Vaginal operative delivery was associated with a near-doubling of the odds of trauma. Conclusions:, Increased maternal age is a risk factor for intrapartum pelvic floor trauma. The global trend towards delayed child-bearing may result in an increased prevalence of pelvic floor disorders in coming decades. [source] Hypertension during pregnancy in South Australia, Part 2: Risk factors for adverse maternal and/or perinatal outcome , results of multivariable analysisAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 5 2004Sophie A. VREEBURG Abstract Objective:, To identify factors associated with adverse pregnancy outcomes among women with hypertension during pregnancy Design:, A population-based retrospective multivariable analysis using the South Australian perinatal data collection. Methods:, Perinatal data on 70 386 singleton births in 1998,2001 were used in multivariable analyses on three groups: all women combined, all hypertensive women and women with pregnancy hypertension only, in order to identify independent risk factors for requirement for level II/III care, preterm birth, small for gestational age (SGA) birth and maternal length of stay greater than 7 days. Results:, The risks for the four morbidities were all increased among women with hypertension compared with normotensive women. Those with pre-existing hypertension had the lowest risk (with odds ratios (OR) 1.26,2.90). Pregnancy hypertension held the intermediate position (OR 1.52,5.70), while superimposed pre-eclampsia was associated with the highest risk (OR 2.00,8.75). Among women with hypertension, Aboriginality, older maternal age, nulliparity and pre-existing or gestational diabetes increased the risk for level II/III nursery care, preterm birth and prolonged hospital stay. Smokers had shorter stays, which may be related to their decreased risk of having a Caesarean section or operative vaginal delivery. Asian women, Aboriginal women, smokers and unemployed women had an increased risk for having an SGA baby, while women with pre-existing or gestational diabetes had a reduced risk. Conclusions:, Among hypertensive pregnant women, nulliparity, older maternal age, Aboriginality, unemployment and diabetes are independent risk factors for one or more major adverse pregnancy outcomes. Smoking does not always worsen the outcome for hypertensive women except for SGA births. [source] Continuity of Caregivers for Care During Pregnancy and ChildbirthBIRTH, Issue 3 2000E.D. Hodnett A substantive amendment to this systematic review was last made on 17 May 1999. Cochrane reviews are regularly checked and updated if necessary. ABSTRACT Background: Social support may include advice or information, tangible assistance, and emotional support. Objectives: The objective of this review was to assess the effects of continuous support during labour (provided by health care workers or lay people) on mothers and babies. Search strategy: I searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: April 1999. Selection criteria: Randomised trials comparing continuous support during labour with usual care. Data collection and analysis: Trial quality was assessed. Study authors were contacted for additional information. Main results: Fourteen trials, involving more than 5000 women, are included in the Review. The continuous presence of a support person reduced the likelihood of medication for pain relief, operative vaginal delivery, Caesarean delivery, and a 5-minute Apgar score less than 7. Continuous support was also associated with a slight reduction in the length of labour. Six trials evaluated the effects of support on mothers' views of their childbirth experiences; while the trials used different measures (overall satisfaction, failure to cope well during labour, finding labour to be worse than expected, and level of personal control during childbirth), in each trial the results favoured the group who had received continuous support. Reviewers' conclusions: Continuous support during labour from caregivers (nurses, midwives, or lay people) appears to have a number of benefits for mothers and their babies and there do not appear to be any harmful effects. Citation: Hodnett ED. Caregiver support for women during childbirth (Cochrane Review). In: The Cochrane Library, Issue 1, 2000. Oxford: Update Software. [source] | ||||||||||