ABSTRACT
Background: Globally, the rate of cesarean delivery is increasing rapidly over the past years. Aim: The study was conducted to investigate the incidence and the predictors for cesarean delivery in nulliparous women at Khartoum Hospital, Sudan. Methods: A prospective cross-sectional hospital-based study was conducted where all parturient nulliparous women delivered in the period between February to April 2012 were included. Socio-demographic characteristics were gathered through structured questionnaires. Maternal anthropometric measures, birth weight, gender and mode of delivery were recorded and compared between those who delivered vaginally and by emergency cesarean delivery. Results: A total of 533 parturient women were enrolled, of these, 147(27.6%) were emergency cesarean delivery. The cesarean delivery rate in nulliparous increased significantly with increased maternal, age ˃ 30 years (OR=2.4, 95% CI= 1.1─5.2, P= 0.032), decreased maternal height < 150 cm (OR=2.4, 95% CI=1.4─4.1, P=0.002), and in increase BMI ≥ 30 Kg/m 2 (OR=2.2, 95% CI=1.1─4. 9, P=0.046) and increase in birth weight > 3750g (OR=2.7, 95% CI=1.1─6.4, P=0.026). There was no association between cesarean delivery rate, mid-upper arm circumference and fetal gender. Conclusion: There was a high incidence of cesarean delivery among nulliparous women especially among elder, obese women, short statue women and with a fetal birth weight > 3750g.
ABSTRACT
Background: As a woman’s age increases, infertility also increases. Women with cervical insufficiency seek pregnancy at advanced age. Objectives: This study quantifies pregnancy outcome in women with cervical incompetence according to maternal age. Methods: A register-based study conducted between May 1, 2010 to April 30, 2011 at MCH, Qassim, KSA. During this period, 8723 deliveries and 52 cases with cervical insufficiency were identified. Patients were divided according to maternal age into group 1 less than 35 years of age or group 2 at or greater than 35 years of age. Results: Out of these 52, 38(73.1%) comprised Group1 and 14 (26.9%) comprised group 2. Patients in group 2, were older, (40 vs. 27 years, P=0.00), of high gravidity (17 vs. 4, P=0.00), had less previous history of ERCP (14.3% vs.31.6% P=0.002), were likely delivered by caesarean section (0.002) and were less likely developed PROM (P=0.047). However, both groups (G1 and G2) were similar in gestational age at delivery (36.6 vs. 36.6 weeks, P=0.95), the abortion rate, [8(21.1%) vs. 2(14.3%), P=0.58], and the rate of preterm delivery, 3(10.3%) vs. 2(16.7%) respectively (P=0.57). Conclusion: pregnancy outcome in women with cervical incompetence and advanced maternal age is not influenced by maternal age.