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Breech Delivery

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101. Adverse obstetric outcomes in pregnant women with uterine fibroids in China: A multicenter survey involving 112,403 deliveries. Full Text available with Trip Pro

18 to 22 weeks. Obstetric outcomes include cesarean delivery, breech presentation, preterm delivery, placenta previa, placental abruption, premature rupture of membranes and neonatal birthweight. Univariate analyses and multivariate logistic regression analyses were performed.Of 112,403 women who underwent routine obstetric survey, 3,012 (2.68%) women were identified with at least 1 fibroid. By univariate and multivariate analyses, the presence of uterine fibroids was significantly associated (...) with cesarean delivery (Adjusted odds radio [AOR] 1.8, 95% confidence interval [CI] 1.7-2.0), breech presentation (AOR 1.3, 95% CI 1.2-1.5) and postpartum hemorrhage (AOR 1.2, 95% CI 1.1-1.4). The size of uterine fibroids and location in uterus had important effect on the mode of delivery. The rates of PPH were significantly higher with increasing size of the uterine fibroid (P<0.001). And the location of fibroid (intramural, submucosal or subserosal) also have a statistically significant impact on the risk

2017 PLoS ONE

102. Rates, indications, and outcomes of caesarean section deliveries: A comparison of tribal and non-tribal women in Gujarat, India. Full Text available with Trip Pro

Rates, indications, and outcomes of caesarean section deliveries: A comparison of tribal and non-tribal women in Gujarat, India. Even though the caesarean section is an essential component of comprehensive obstetric and newborn care for reducing maternal and neonatal mortality, there is a lack of data regarding caesarean section rates, its determinants and health outcomes among tribal communities in India.The aim of this study is to estimate and compare rates, determinants, indications (...) and outcomes of caesarean section. The article provides an assessment on how the inequitable utilization can be addressed in a community-based hospital in tribal areas of Gujarat, India.Prospectively collected data of deliveries (N = 19923) from April 2010 to March 2016 in Kasturba Maternity Hospital was used. The odds ratio of caesarean section was estimated for tribal and non-tribal women. Decomposition analysis was done to decompose the differences in the caesarean section rates between tribal and non

2017 PLoS ONE

103. In which groups of pregnant women can the caesarean delivery rate likely be reduced safely in the USA? A multicentre cross-sectional study. Full Text available with Trip Pro

In which groups of pregnant women can the caesarean delivery rate likely be reduced safely in the USA? A multicentre cross-sectional study. To identify obstetrical subgroups in which (1) the caesarean delivery (CD) rate may be reduced without compromising safety and (2) CD may be associated with better perinatal outcomes.A multicentre cross-sectional study.19 hospitals in the USA that participated in the Consortium on Safe Labor.228 562 pregnant women in 2002-2008.Maternal and neonatal safety (...) was measured using the individual Weighted Adverse Outcome Score.Women were divided into 10 subgroups according to a modified Robson classification system. Generalised estimated equation model was used to examine the relationships between mode of delivery and Weighted Adverse Outcome Score in each subgroup.The overall caesarean rate was 31.2%. Repeat CD contributed 29.5% of all CD, followed by nulliparas with labour induction (15.3%) and non-cephalic presentation (14.3%). The caesarean rates in induced

2018 BMJ open

104. Delivery of the second twin: influence of presentation on neonatal outcome, a case controlled study. Full Text available with Trip Pro

Delivery of the second twin: influence of presentation on neonatal outcome, a case controlled study. Spontaneous vaginal twin delivery after 32nd week of gestation is safe when first twin presenting cephalic. Aim of this study is to identify obstetric factors influencing the condition of second twin and to verify whether non-cephalic presentation and vaginal breech delivery of the second twin is safe.This is a retrospective case controlled cohort study of 717 uncomplicated twin deliveries ≥32 (...) after ECS had significant better umbilical artery UA pH (p < 0.001) and better Apgar compared to UPC (p = 0.002). Variables for a fetal population "at risk" for adverse neonatal outcome after vaginal delivery (UA pH < 7.20, Apgar 5´ < 9) were associated with higher gestational age (p = 0.001), longer twin-twin interval (p = 0.05) and vacuum extraction of twin A (p = 0.04). Non-cephalic presentation of second twins was not associated (UA pH < 7.20 OR 1.97, CI 95% 0.93-4.22, p = 0.07, Apgar 5´ < 9

2018 BMC Pregnancy and Childbirth

105. Management of Labor and Delivery After Fetoscopic Repair of an Open Neural Tube Defect. (Abstract)

were induced and 20 labored spontaneously. Of the latter, five were augmented. Of 26 laboring patients, 17 delivered vaginally and nine underwent urgent cesarean delivery (35%, 95% CI 17-56%; seven nonreassuring fetal heart tracings and two breech). There were no cases of uterine rupture or dehiscence. Most (94%, 95% CI 80-99%) had normal 5-minute Apgar scores; one neonate (3%, 95% CI 0-15%) had acidosis but normal Apgar scores.Our data regarding trial of labor, use of low-dose oxytocin (...) Management of Labor and Delivery After Fetoscopic Repair of an Open Neural Tube Defect. To report labor, delivery, and neonatal outcomes in a cohort of women delivering neonates who had undergone fetoscopic neural tube defect repair.We conducted a retrospective cohort study from April 2014 to January 2018. All patients met Management of Myelomeningocele Study eligibility criteria. We included patients with completed second-trimester fetoscopic neural tube defect repair (laparotomy, uterine

2018 Obstetrics and Gynecology

106. Neonatal morbidity associated with vaginal delivery of non-cephalic second twins. (Abstract)

. The primary outcome was a composite of intrapartum mortality and neonatal mortality and morbidity. Neonatal outcomes of second twins born ≥32 weeks of gestation after vaginal delivery of the first cephalic or breech twin were compared according to the noncephalic or cephalic second twin presentation. Multivariable logistic regression models controlled for potential confounders. Subgroup analyses were conducted according to the breech or transverse presentation of the noncephalic second twin (...) , and gestational age at delivery, before or after 37 weeks of gestation.Among 3903 second twins enrolled in the study, 2384 (61.1%) were in cephalic and 1519 (38.9%) in noncephalic presentations, of whom 999 (25.6%) were in breech and 520 (13.3%) in transverse presentation. Composite neonatal mortality and morbidity did not differ between the noncephalic and cephalic group (47/1519 [3.1%] vs 59/2384 [2.5%]; adjusted odds ratio, 1.23; 95% confidence interval, 0.81-1.85). No significant difference between groups

2018 American Journal of Obstetrics and Gynecology

107. Cesarean Delivery in the United States 2005 - 2014: A Population-Based Analysis Using the Robson Ten Group Classification System. Full Text available with Trip Pro

, were used to classify all women included into 1 of 10 groups.The overall cesarean rate was 31.6%. Group-3 births (singleton, term, cephalic multiparas in spontaneous labor) were most common, while group-5 births (those with a previous cesarean) accounted for the most cesarean deliveries increasing from 27% of all cesareans in 2005 through 2006 to >34% in 2013 through 2014. Breech pregnancies (groups 6 and 7) had cesarean rates >90%. Primiparous and multiparous women who had a prelabor cesarean (...) Cesarean Delivery in the United States 2005 - 2014: A Population-Based Analysis Using the Robson Ten Group Classification System. Cesarean delivery has increased steadily in the United States over recent decades with significant downstream health consequences. The World Health Organization has endorsed the Robson 10-Group Classification System as a global standard to facilitate analysis and comparison of cesarean delivery rates.Our objective was to apply the Robson 10-Group Classification

2018 American Journal of Obstetrics and Gynecology

108. PICO Negative Pressure Wound Therapy in Obese Women Undergoing Elective Cesarean Delivery.

with a 24 - 41 weeks gestational age pregnancy scheduled for cesarean delivery for any routine indication (repeat procedure, breech presentation, abnormal placentation, uterine anomaly, maternal medical condition, or elective) Surgical skin site preparation with chlorhexidine gluconate solution (ChloraPrep©) Received preoperative surgical prophylaxis antibiotics as per protocol Surgical incision that can be covered completely by the NPWT skin system Pre-operatively assessed to undergo a procedure (...) PICO Negative Pressure Wound Therapy in Obese Women Undergoing Elective Cesarean Delivery. PICO Negative Pressure Wound Therapy in Obese Women Undergoing Elective Cesarean Delivery. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more

2018 Clinical Trials

109. Neonatal Morbidity After Management of Vaginal Noncephalic Second-Twin Delivery by Residents. (Abstract)

Poisson regression models and propensity score matching to control for indication bias and potential confounders, including the maternity unit status. We performed subgroup analyses according to gestational age at delivery, before or after 37 weeks of gestation, and to the noncephalic second twin presentation, breech or transverse.Among 1,376 noncephalic second-twin deliveries, 545 (39.6%) were initially managed by a resident and 831 (60.4%) by a senior obstetrician. Residents failed to deliver (...) Neonatal Morbidity After Management of Vaginal Noncephalic Second-Twin Delivery by Residents. To assess neonatal mortality and morbidity according to whether a resident or senior obstetrician initially managed vaginal delivery of noncephalic second twins.The JUmeaux MODe d'Accouchement study was a national, prospective, population-based, cohort study of twin deliveries in 176 maternity units in France, where active management of second-twin delivery is recommended. The primary outcome of our

2018 Obstetrics and Gynecology

110. Safe Prevention of the Primary Cesarean Delivery

that contemporary labor progresses at a rate substantially slower than what was historically taught. Additionally, improved and standardized fetal heart rate interpretation and management may have an effect. Increasing women’s access to nonmedical interventions during labor, such as continuous labor and delivery support, also has been shown to reduce cesarean birth rates. External cephalic version for breech presentation and a trial of labor for women with twin gestations when the first twin is in cephalic (...) for breech presentation at term: the international randomized Term Breech Trial. Term Breech Trial Collaborative Group. . ** Data from Gregory KD, Jackson S, Korst L, Fridman M. Cesarean versus vaginal delivery: whose risks? Whose benefits? . It is difficult to isolate the morbidity caused specifically by route of delivery. For example, in one of the few randomized trials of approach to delivery, women with a breech presentation were randomized to undergo planned cesarean delivery or planned vaginal

2014 American College of Obstetricians and Gynecologists

111. Randomised controlled trial: Caesarean delivery for twin gestation at 32?38?weeks does not lead to improved clinical outcomes for neonates or mothers

. 1 , 2 Although some observational studies have suggested that there may be decreased risk of adverse perinatal outcomes with CD, clear benefits of routine CD for twin gestation have not been established, especially when the primary provider is experienced in breech extraction of the second twin. 3 This large multicentre trial aimed to avoid the biases of observational studies in order to answer the question of optimal delivery mode for twin gestation. Methods This was a randomised, unblinded (...) Randomised controlled trial: Caesarean delivery for twin gestation at 32?38?weeks does not lead to improved clinical outcomes for neonates or mothers Caesarean delivery for twin gestation at 32–38 weeks does not lead to improved clinical outcomes for neonates or mothers | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies

2014 Evidence-Based Medicine

112. Twin Vaginal Delivery: Innovate or Abdicate. (Abstract)

surveyed a group of practicing obstetricians to explore potential barriers to the vaginal birth of twins with a focus on delivery of the noncephalic second twin. Among 107 responding providers, only 57% would deliver a noncephalic second twin by breech extraction. Providers who preferred breech extraction had a higher rate of maternal-fetal medicine subspecialty training (26.2% vs 4.3%; P<.01) and were more likely to be in an academic practice environment (36.1% vs 10.9%; P<.01) and to practice in high (...) %; P<.01). In an adjusted analysis, the 46% of providers with a perceived need for more training were far less likely to prefer breech extraction for delivery of a noncephalic second twin (adjusted odds ratio, 0.38; 95% confidence interval, 0.16-0.95). Furthermore, 57% of providers who would not offer their patient breech extraction would be willing to consult a colleague for support with a noncephalic twin delivery. These results suggest that scientific evidence and society opinion are likely

2017 American Journal of Obstetrics and Gynecology

113. Membrane Sweeping Versus Transcervical Foley Catheter for Induction of Labour in Women With Previous Caesarean Delivery

Membrane Sweeping Versus Transcervical Foley Catheter for Induction of Labour in Women With Previous Caesarean Delivery Membrane Sweeping Versus Transcervical Foley Catheter for Induction of Labour in Women With Previous Caesarean Delivery - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum (...) number of saved studies (100). Please remove one or more studies before adding more. Membrane Sweeping Versus Transcervical Foley Catheter for Induction of Labour in Women With Previous Caesarean Delivery The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03326557 Recruitment Status : Completed First

2017 Clinical Trials

114. Maternal body mass index as a predictor for delivery method. Full Text available with Trip Pro

Maternal body mass index as a predictor for delivery method. High maternal body mass index (BMI) is associated with complications during pregnancy and delivery such as gestational diabetes, hypertensive disorders, perineal injuries and macrosomia. The aim of this study was to assess the association between maternal BMI and delivery method in non-breech, singleton deliveries, after 36 weeks of gestation, in women with no more than one previous cesarean section, in Oslo University Hospital (...) , Ullevål.This retrospective register study used data from the hospital obstetrical database in 2011-2012, forming a cohort of 8821 women. Women were categorized into five different BMI classes and stratified into subgroups according to parity and previous cesarean delivery. Mode of delivery was categorized to spontaneous delivery, instrumental vaginal delivery, planned cesarean section and emergency cesarean section.Incidence of emergency cesarean delivery increased with increasing maternal BMI. Among

2017 Acta Obstetricia et Gynecologica Scandinavica

115. Predictors of Cephalic Vaginal Delivery Following External Cephalic Version: An Eight-Year Single-Centre Study of 447 Cases Full Text available with Trip Pro

Predictors of Cephalic Vaginal Delivery Following External Cephalic Version: An Eight-Year Single-Centre Study of 447 Cases Introduction. Our study aims to investigate and evaluate (1) rates of success of ECV for breech presentation at term at the Royal Women's Hospital in comparison to international standards; (2) mode of delivery following ECV; (3) factors influencing success rates of ECV at the Royal Women's Hospital. Methods. An audit of all women who underwent ECV between the years 2007 (...) %. Of the patients undergoing ECV, 29% proceeded to normal vaginal delivery. Predictors of successful ECV included low BMI, multiparity, and AFI more than 16 (P < 0.05). The only predictor of cephalic vaginal delivery following ECV was multiparity. Negative predictors of cephalic delivery were low AFI and nulliparity. Conclusions. The success rate of ECV at the Women's Hospital, Melbourne, is in line with global standards.

2017 Obstetrics and gynecology international

116. Intraabdominal Chloroprocaine During Cesarean Delivery for Pain Control

doctor may contact the study research staff using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 18 Years to 50 Years (Adult) Sexes Eligible for Study: Female Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Pregnant women with a singleton or multiple pregnancies, vertex or breech presentation presenting to our labor and delivery unit for an elective cesarean section will be eligible for participation. Exclusion (...) Intraabdominal Chloroprocaine During Cesarean Delivery for Pain Control Intraabdominal Chloroprocaine During Cesarean Delivery for Pain Control - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Intraabdominal

2017 Clinical Trials

117. Blinded ultrasonic fetal biometry at 36 weeks and the risk of emergency caesarean delivery: a prospective cohort study of 3,047 low risk nulliparous women. Full Text available with Trip Pro

Blinded ultrasonic fetal biometry at 36 weeks and the risk of emergency caesarean delivery: a prospective cohort study of 3,047 low risk nulliparous women. To compare the association between risk of emergency Cesarean delivery (CD) and non-customized vs customized ultrasound estimated fetal weight (EFW) at 36 weeks' gestation, determine whether addition of ultrasound EFW to a model based on maternal characteristics alone improved prediction of emergency CD, assess the screening performance (...) ' gestation. Both the women and their clinicians were blinded to fetal biometry results. Emergency CD was defined as delivery by Cesarean section in pregnancies in which the date of delivery had not been prearranged. Additional candidate predictors of emergency CD evaluated were maternal age, height, body mass index (BMI), weight gain, fetal abdominal circumference growth velocity and fetal sex. External validation of the predictive model was performed using routinely collected data from 55 337 births

2017 Ultrasound in Obstetrics and Gynecology

118. Takotsubo Syndrome After Cardiopulmonary Resuscitation During Emergency Cesarean Delivery. (Abstract)

Takotsubo Syndrome After Cardiopulmonary Resuscitation During Emergency Cesarean Delivery. Takotsubo syndrome is a rare, stress-related, and reversible form of acute heart failure primarily affecting postmenopausal women. It is characterized by left ventricular dysfunction with a classic apical and midventricular wall motion abnormality (apical ballooning).A 28-year-old woman, gravida 2 para 1, at 30 4/7 weeks of gestation was admitted with fetal bradycardia, a fully dilated cervix, and breech (...) presentation. During emergency cesarean delivery, the patient had intraoperative cardiac arrest. Resuscitation was successful. Twelve hours postoperatively, after demonstrating symptoms of acute heart failure, she was diagnosed with Takotsubo syndrome.Peripartum Takotsubo syndrome must be differentiated from peripartum cardiomyopathy. Cesarean delivery and sympathomimetic medications can increase the risk of occurrence. Early recognition and interdisciplinary management are essential in the prevention

2017 Obstetrics and Gynecology

119. Description of inter-institutional referrals after admission for labor and delivery: a prospective population based cohort study in rural Maharashtra, India. Full Text available with Trip Pro

Description of inter-institutional referrals after admission for labor and delivery: a prospective population based cohort study in rural Maharashtra, India. In 2008, the Indian government introduced financial assistance to encourage health facility deliveries. Facility births have increased, but maternal and neonatal morbidity and mortality have not decreased raising questions about the quality of care provided in facilities and access to a quality referral system. We evaluated the potential (...) role of inter-institutional transfers of women admitted for labor and delivery on adverse maternal and neonatal outcomes in an ongoing prospective, population-based Maternal and Newborn Health Registry in Central India.Pregnant women from 20 rural Primary Health Centers near Nagpur, Maharashtra were followed throughout pregnancy and to day 42 post-partum. Inter- institutional referral was defined as transfer of a woman from a first or second level facility where she was admitted for labor

2017 BMC health services research

120. WITHDRAWN: Caesarean delivery for the second twin. (Abstract)

WITHDRAWN: Caesarean delivery for the second twin. The optimal mode of birth for a second twin in breech position is controversial, with support for both caesarean and vaginal birth.The objective of this review was to assess the effects of caesarean birth compared with vaginal birth of a second twin not presenting cephalically.The Cochrane Pregnancy and Childbirth Group's Trials Register and bibliographies up to 31 January 2007.Randomised trials of caesarean birth compared with vaginal birth

2011 Cochrane

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