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Background: Early initiation of breast feeding and feeding exclusively for six months have great implication for the survival, well-being and growth of new borne. Factors such as maternal age, occupation, religion, spouse age, spouse occupation, parity, antenatal care (ANC) attendance, mode of delivery (MOD) and birth order are significantly associated with exclusive breast feeding (EBF) Methodology: The study is a descriptive cross-sectional study conducted among nursing mothers attending child health clinic in General Hospital Bonny, in Bonny Island, Rivers State, Nigeria. All eligible nursing mother who presented at the clinic were enlisted for the study. Enlistment of eligible participants was done on every child welfare clinic day. Data was collected using a pretested, interviewer administered, structured questionnaire which was adapted and prepared in English Language. Categorical data was analyzed using multinomial logistic regression model with statistical significance set at 0.05. Result: Results from this study identified significant association between EBF and some maternal variables such as age, occupation and religion. Spouse age and occupation were significantly associated with EBF. ANC attendance, gestational age, MOD, parity and birth order were also significant variables associated with EBF. Conclusion: Maternal variables such as age, occupation, religion, parity, MOD, ANC attendance including spouse age and occupation significantly influence EBF of new borne.
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Breast Feeding , Occupations , Parity , Infant, Small for Gestational Age , Child Health , Breastfeeding and Complementary Feeding , MothersABSTRACT
Objective:To explore the feasibility of prenatal ultrasound in predicting delivery mode of full-term primipara.Methods:The study prospectively enrolled primiparas with gestational age ≥37 weeks, singleton, cephalic and no contraindications to vaginal delivery who underwent routine prenatal examination in the Third Affiliated Hospital of Sun Yat-sen University from September 2020 to February 2021.In addition to routine fetal ultrasound examination, the transperineal ultrasound examination was performed to assess the angle of progression (AOP), head perineum distance (HPD), the angle of pubic arch and the anteroposterior diameter, left and right diameter, area and perimeter of levator ani hiatus of pregnant women in different states were measured; Cervical length (CL) was examined by transvaginal ultrasound. The delivery mode was tracked, and the indicators related to natural delivery were screened out. Receiver operating characteristic (ROC) curve was used to evaluate the effectiveness of relevant indicators in predicting natural delivery.Results:A total of 142 cases were included in this study, including 112 cases of natural delivery and 30 cases of manual intervention delivery. There were no significant differences in age, gestational weeks, biparietal diameter, head circumference, body mass index (BMI) and neonatal weight between the natural delivery group and the manual intervention delivery group (all P>0.05). Multivariate regression analysis showed that AOP was associated with natural delivery( OR=1.048, P=0.008). ROC curve analysis showed that the area under the curve was 0.648 with AOP 96.92° as the node, and the specificity and positive predictive values were 83.33% and 0.909 1 respectively. Conclusions:It is feasible to predict the mode of delivery by prenatal ultrasound in full-term primiparas. AOP is related to the mode of delivery, which can provide more reference information for clinical practice.
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Background: The objective of this study was to analyse the current obstetric practice regarding breech presentation, document the incidence, perinatal outcome and the factors influencing perinatal outcome in breech deliveries.Methods: It was a retrospective observational study including 252 cases of breech presentation during January 2018 to December 2019 in a tertiary teaching institute in Vidarbha region of Maharashtra.Results: Total number of breech deliveries 252 (incidence is 2.5%). Caesarean section for breech presentation 95 (37.6%). With vaginal deliveries the Apgar score at 5 min below 7 were among 48 out of 157 breech deliveries whereas with LSCS it was only amongst 7 out of 95 deliveries. The maximum percentage of perinatal mortality is seen with birth weight below 2000 gm. Maximum mortality is seen prior to 32 weeks and in babies who delivered by vaginal route. Respiratory distress with prematurity and severe birth asphyxia are the common causes of perinatal deaths. Total 32 (12.69%) babies were transferred to NICU. 20.38% of the total vaginal breech deliveries and 5.26% of the total LSCS were transferred to NICU. Out of total 32 NICU admissions 22 are for the preterm babies and babies with birth weight below 2000 gm.Conclusions: The perinatal outcome does not depend only on the mode of delivery, it is also affected by the weight of the baby, its maturity, associated congenital anomalies, equipped neonatal intensive care unit and also substantially on the expertise of the obstetrician and the neonatologist.
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Background: Breech presentation is the commonest of all mal presentations. Vaginal delivery of breech presentation at term is associated with a much higher perinatal mortality and morbidity than that of vertex presentation.Methods: This prospective study was carried out in the department of obstetrics and gynaecology, S. S. G. Hospital, Baroda for a period of six months from 1st May 2019 to 31st October 2019. Out of a total number of 4476 deliveries, 159 were breech pregnancy. It included all the women admitted in labour room or ward who delivered with clinical or ultrasound diagnosis of breech presentation after 20 weeks of gestation.Results: In the present study incidence of breech pregnancy was 3.6%. Authors observed the highest incidence of breech pregnancy in the age group of 20 to 25 years. Maximum (62.9%) cases delivered after 37 weeks of gestation. In our study 62.3% cases were primigravida and 37.7% were multigravida. Majority of cases (77.4%) delivered by caesarean section. Among all the babies born 50.6% were having birth weight of less than 2.5 kg.Conclusions: Authors need to study and analyse all cases of breech pregnancy individually to decide the management and mode of delivery depending on cases to case basis and expertise of the staff available. Delivery of breech foetus should be conducted by experience obstetrician after appropriate consent from pregnant women and her relatives.
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Background: Meconium staining of amniotic fluid (MSAF) is a significant risk factor for the subsequent development of meconium aspiration syndrome (MAS), respiratory distress and eventual respiratory failure in neonates. To learn more about the risk factors and outcomes associated with MSAF, a prospective case control study was conducted. The objective of the study was to study various maternal risk factors associated with MSAF and to study the outcome of neonates born through MASF and to compare the perinatal outcome in patients with thick and thin meconium stained amniotic fluid.Methods: A hospital based prospective case control study was conducted comparing pregnant women with meconium stained (cases) amniotic fluid with pregnant women having clear liquor (control), 200 in each arm. Singleton pregnancies complicated with MASF were included in the cases group on the basis of predefined inclusion criteria. Various risk factors, mode of delivery, outcome of neonates and perinatal outcome in babies born through thick and thin meconium stained amniotic fluid was studied.Results: Out of 200 patients who had MSAF 114 patients (57%) had thick meconium stained liquor while remaining 86 patients (43.00%) had thin meconium stained amniotic fluid. Post-maturity, pregnancy induced hypertension; oligohydramnios and prolonged labor were found to be statistically significant risk factors for MSAF. Nonreactive non-stress test and Need for cesarean section was more common in women with MSAF as compared to women with clear liquor (p <0.05). Common morbidities in neonates were Birth asphyxia (15%) followed by meconium aspiration syndrome (10%) and hypoxic ischemic encephalopathy (15%).Conclusions: Meconium stained amniotic fluid is more commonly associated with post-maturity, pregnancy induced hypertension, oligohydramnios and prolonged labor low APGAR score and higher incidence of birth asphyxia and NICU admissions. Appropriate management of neonates with meconium aspiration syndrome is crucial to prevent neonatal mortality.
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Aims and Objectives: The aim of the study was to study the perinatal outcome of the second twin with respect to mode of delivery.Materials and Methods: Consecutive pregnant women having twin pregnancies beyond 28 weeks of gestation admitted tothe department of the institute during the period from April 2016–May 2017 were included in the study.Results: A total of 50 cases were enrolled in the study. Vaginal, ventouse/forceps, and lower segment cesarean section (LSCS) werethe different modes of delivery consisting of 48%, 2%, and 50% of cases, respectively. Perinatal loss of the second twins was higher inLSCS group consisting of 61.11% of cases. Perinatal loss of the second twins was 100% for monochorionic monoamniotic pregnancieswhereas 33.33% for monochorionic diamniotic and 29.03% for dichorionic diamniotic pregnancies. The delivery time interval of <10 minbetween the first and second twin had the higher second twin perinatal loss, i.e., 37.14% and less poor APGAR score, i.e., 57.14% incomparison to time interval of 10–30 and >30 min groups but statistically insignificant. For second twin, vertex presentation had higherpoor APGAR score compared to non-vertex presentation, i.e., 65.63% versus 55.56%. Poor APGAR score was found to be higher incesarean section, outlet forceps and vaginal mode of deliveries consisting of 60%, 100%, and 62.5%, respectively. In overall, 64% ofsecond twins and 84% of first twins were alive, and the difference had P = 0.034. About 62% of second twins and 34% of first twinswere having poor APGAR score of <7, and the difference had P = 0.005. About 67.44% and 76.92% of second twins were found tobe alive higher in maternal age group of ≥20 years and multigravida group, respectively, having P < 0.05. About 64.52% and 100% ofsecond twins were alive higher in <37 weeks gestational age group and birth weight of second twin ≥2500 kg groups, respectively, withP < 0.05. Second twins were having higher alive in vertex-non-vertex presentation, vaginal mode of delivery for both the twins, DCDAgroup and intertwin delivery interval of 10–30 min groups consisting of 71.43%, 72%, 70.97%, and 77.78%, respectively, with P > 0.05.Conclusion: The perinatal mortality of 2nd twin is higher than that of 1st twin in terms of monochorionic, prematurity, and lowbirth weight. Intensive labor monitoring, safe delivery, and improved neonatal care facilities appear to be the major areas toimprove the perinatal outcome.
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Background: To study the association between cervical favorability at admission and maternal, perinatal outcome. To study the association between mode of delivery and maternal, perinatal outcome in eclampsia.Methods: This was a retrospective cohort study carried out in a tertiary hospital. All women (92) admitted with antepartum eclampsia from April 2015 to April 2016, with >32 weeks gestation, reassuring foetal heart and no other complications were included in the study. They were divided into two cohorts delivery, maternal and perinatal outcomes were compared between the two groups.Results: Group with favourable cervix achieved higher vaginal deliveries. Perinatal mortality and morbidity were significantly higher in patients with unfavourable cervix (mortality 39.6% and 20.5% respectively, p: 0.046: morbidity 25.6% and 7.8% respectively, p: 0.033), more so in vaginal delivery (RR 2.355). However there was no significant difference in maternal morbidity. Higher induction-to-delivery interval was the major contributory factor.Conclusions: Perinatal outcome was worse in patients with unfavourable cervix at induction. This can be attributed to increased induction to delivery time and vaginal route of delivery. Prolonged induction should be avoided in eclampsia.
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Background: A parallel rise in the rate of obesity in women in reproductive age; and cesarean section as outcome of pregnancy is noticed in the last years in our society. It is unknown whether this dual rise is related or not. The impact is more evident on primigravida patients, so authors perform this study to assess the impact of obesity on the outcome of pregnancy in primigravida patients in a major obstetrics hospital.Methods: A prospective controlled study was conducted in Ibn Al-Balady obstetrics hospital. It included 121 primigravida patients who were divided into 3 groups according to WHO BMI categories: normal, overweight, and obese. The mode of delivery of these patients is recorded and was assessed in relation to BMI.Results: About 17% of the patients were obese and they needed more emergency CS as a mode of delivery than normal BMI patients (p<0.01). They also had longer second stage of labor (p<0.01) and delivered babies with higher birth weight that the normal group (p<0.05).Conclusions: Obesity constitutes a growing challenge on the outcome of pregnancy, duration of second stage of labor and baby birth weight in primigravida patients. Women who are getting pregnant for the first time should be advised to lower their BMI as a safety measure to avoid emergency cesarean section.
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Abstract Objective To access the benefits or harms of an exercise program, based on the current American College of Obstetricians and Gynecologists guidelines, on the mode of delivery, duration and onset of labor. Methods A study performed at the Hospital Senhora da Oliveira between October 2015 and February 2017. This was a quasi-experimental study involving 255 women divided into two groups: an intervention group engaged in a controlled and supervised exercise program during pregnancy (n = 99), and a control group that did not participate in the exercise program (n = 156). Data were collected in two stages: during the 1st trimester biochemical screening (before the beginning of the program), through a written questionnaire, and after delivery, from the medical files of the patients. The significance level in the present study was 5% (p = 0.05). Results The control group had higher odds of induced labor (odds ratio [OR] 2.71; 95% confidence interval [CI]: 1.42-5.17; p = 0.003), when compared with women who underwent the intervention. No differences were found between the groups in instrumental vaginal deliveries, cesarean rate, time until the beginning of the active phase, duration of the active phase, and duration of the second stage of labor. Conclusion The implementation of a controlled and supervised exercise program in pregnancy was associated with significantly lower odds of induced deliveries.
Resumo Objetivo Avaliar o efeito de um programa de exercícios na gravidez (baseado nas recomendações do American College of Obstetricians and Gynecologists) na via, duração e início do trabalho de parto. Métodos Estudo realizado no Hospital Senhora da Oliveira entre outubro de 2015 e fevereiro de 2017. Trata-se de um estudo quasi-experimental com 255 grávidas, divididas em dois grupos: grupo de intervenção, constituído por mulheres que participaram de um programa controlado e supervisionado de exercícios físicos (n = 99), e um grupo de controle, formado por grávidas que não participaram do programa de exercícios (n = 156). Os dados foram colhidos em dois momentos: durante o rastreio bioquímico do primeiro trimestre (antes do início do programa), através de um questionário escrito, e após o parto, através da consulta do processo clínico da paciente. O nível de significância estatística adotado neste projeto foi de 5% (p = 0,05). Resultados O grupo controle apresentou maior probabilidade de indução do trabalho de parto (razão de chances [RC] 2,71; intervalo de confiança [IC] 95%: 1,42-5,17; p = 0,003) quando comparado com o grupo de intervenção. Não foram encontradas diferenças estatisticamente significativas entre os dois grupos em relação à via de parto, tempo até início da fase ativa, duração da fase ativa e duração do segundo estadio do trabalho de parto. Conclusão A implementação de um programa de exercícios controlado e supervisionado na gravidez foi associada a uma probabilidade significativamente menor de indução do trabalho de parto.
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Humans , Female , Pregnancy , Adult , Prenatal Care/methods , Labor, Obstetric/physiology , Exercise Therapy/methods , Labor, Induced/statistics & numerical data , Pregnancy Outcome , Case-Control StudiesABSTRACT
Objective@#To explore the choice of re-pregnancy delivery mode after cesarean section.@*Methods@#From January 2015 to December 2017, a retrospective study was performed on 576 pregnant women who received re-pregnancy after cesarean section in National Nuclear Corporation 416 Hospital and randomly selected 40 cases of vaginal birth after cesarean delivery(VBAC), 40 cases of cesarean section after trial of labor after cesarean delivery(TOLAC) and 40 cases of elective repeat cesarean delivery(ERCD) for comparative analysis.The postpartum hemorrhage, neonatal Apgar score, hospitalization time, hospitalization expenses and complication were compared.@*Results@#All the 159 pregnant women chose transvaginal trials and 112 had successful vaginal delivery.The success rate of delivery was 70.4%.Compared with the other two groups, the VBAC group had less postpartum hemorrhage [(172.50±59.86)mL, (281.25±192.05)mL, (260.00±125.68)mL], less average hospital stay [(3.9±0.9)d, (5.7±1.5)d, (4.6±0.7)d] and lower medical expenses [(6 491.79±1 104.78), (11 871.96±1 784.30), (10 724.69±1 843.63)], and the differences were statistically significant (F=7.086, 26.243, 123.488; P=0.001, 0.000, 0.000). The neonatal Apgar score, incidence rates of complications (incomplete uterine rupture, postpartum hemorrhage, urinary retention, thrombotic disease and neonatal conversion) had no statistically significant differences between the two groups (all P>0.05). The TOLAC failed to change to the cesarean section group compared with the ERCD group, the average hospitalization cost was more [(11 871.96±1 784.30)CNY, (10 724.69±1 843.63)CNY], the average hospitalization days was longer [(5.7±1.5)d, (4.6±0.7)d], the difference was statistically significant (P=0.000, 0.005). The postpartum hemorrhage volume, neonatal Apgar score, complications had no statistically significant differences between the two groups(all P>0.05).@*Conclusion@#It is safe and feasible to perform vaginal trials under close monitoring without vaginal trials.It is safe and feasible to perform vaginal trials under strict monitoring.Even if the vaginal trial fails to change to cesarean section, it will not increase the occurrence of serious complications.Infant outcomes are good.
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Pregnancy with heart disease is one of the important causes of maternal mortality.Assessment and management of such patients before pregnancy,during pregnancy and during childbirth play an important role in reducing maternal mortality and improving maternal and infant outcomes.This article summarizes the risk assessment of pregnancy with heart disease and the choice of delivery mode at home and abroad in order to provide reference for clinical workers in diagnosis,treatment and management of pregnancy with heart disease.
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Objective To explore the choice of re - pregnancy delivery mode after cesarean section. Methods From January 2015 to December 2017,a retrospective study was performed on 576 pregnant women who received re-pregnancy after cesarean section in National Nuclear Corporation 416 Hospital and randomly selected 40 cases of vaginal birth after cesarean delivery(VBAC),40 cases of cesarean section after trial of labor after cesarean delivery(TOLAC) and 40 cases of elective repeat cesarean delivery(ERCD) for comparative analysis.The postpartum hemorrhage,neonatal Apgar score, hospitalization time, hospitalization expenses and complication were compared. Results All the 159 pregnant women chose transvaginal trials and 112 had successful vaginal delivery.The success rate of delivery was 70.4%.Compared with the other two groups,the VBAC group had less postpartum hemorrhage [(172.50 ± 59.86) mL,(281.25 ± 192.05 ) mL, ( 260.00 ± 125.68 ) mL],less average hospital stay [(3.9 ± 0.9)d,(5.7 ± 1.5) d, (4.6 ± 0.7) d] and lower medical expenses [(6 491.79 ± 1 104.78), (11 871.96 ± 1 784.30),(10 724.69 ± 1 843.63 )], and the differences were statistically significant ( F =7. 086,26. 243, 123.488;P=0.001,0.000,0.000).The neonatal Apgar score,incidence rates of complications ( incomplete uterine rupture,postpartum hemorrhage,urinary retention,thrombotic disease and neonatal conversion) had no statistically significant differences between the two groups ( all P>0.05).The TOLAC failed to change to the cesarean section group compared with the ERCD group,the average hospitalization cost was more [(11 871.96 ± 1 784.30) CNY, (10 724.69 ± 1 843.63)CNY],the average hospitalization days was longer [(5.7 ± 1.5) d,(4.6 ± 0.7) d],the difference was statistically significant (P=0.000,0.005).The postpartum hemorrhage volume,neonatal Apgar score, complications had no statistically significant differences between the two groups( all P>0.05).Conclusion It is safe and feasible to perform vaginal trials under close monitoring without vaginal trials. It is safe and feasible to perform vaginal trials under strict monitoring.Even if the vaginal trial fails to change to cesarean section,it will not increase the occurrence of serious complications.Infant outcomes are good.
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Background@#Multiple gestations, including twin gestations are commonly associated with adverse maternal, perinatal and neonatal outcomes compared with singleton pregnancies. Its incidence has shown a significant increase over the last decades. A retrospective cohort study was made at the Department of Obstetrics and Gynecology by review of medical records of twin pregnancies and their neonates. @*Objective@#The purpose of this study is to describe and compare the outcomes of twin gestation against singleton pregnancies, in terms of the following: the presentation of the twin gestation, chorionicity, the mode and timing of delivery and fetomaternal complications. This study aimed to determine whether an association exists between the twin gestation and adverse perinatal outcomes.@*Methodology@#The study included singletons and twin gestations admitted at a tertiary government hospital admitting section within a ten-year period, 2006-2015. Confirmation of diagnosis of multiple pregnancies was obtained by ultrasound. This retrospective cohort study conducted at a tertiary government hospital included 228 singletons and 110 twin gestations in a ten-year period.@*Results@#Results showed women with twin pregnancies had a higher incidence of preterm labor and delivery. Compared to singleton pregnancies, complications of prematurity are not uncommon in twin gestations. This should encourage prenatal and antenatal care in women who have twin gestations.@*Conclusion@#The incidence of preterm labor and delivery for twin gestation, relative to singletons, was high in the study. Twin gestations are 3-4 times more likely to present with preterm labor relative to singletons.
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MorbidityABSTRACT
Objective To investigate the effect of different delivery methods on the levator ani muscle of the pelvic floor by transperineal three-dimensional ultrasound and TUI imaging. Methods 200 cases of pregnant women from August2014 to August 2016 in our hospital were divided into selective cesarean section group (n = 85) and vaginal delivery group (n= 115). The vaginal group, according to the intraoperative lateral segmentation, was further divided into vaginal lateral incision group (n = 65) and vaginal delivery without lateral incision group (n = 50). At the same time, select 80 cases of nulliparous women (volunteers) as control group, relevant indicators by three-dimensional imaging and TUI imaging technique. Results The vaginal delivery without lateral incision group, lateral incision group vaginal delivery and cesarean section group levator hiatus diameter, anteroposterior diameter, perimeter and area were significantly higher than the control group(P＜0.05), and vaginal delivery side cut was significantly higher than the other three groups (P＜0.05), vaginal delivery in two sub-group and cesarean section group of levator ani muscle thickness were significantly lower than the control group(P＜0.05), vaginal delivery in two sub groups were significantly lower than that in the cesarean section group (P＜0. 05); vaginal delivery group of levator ani muscle injury rate was significantly higher than that in the cesarean section group (P＜0. 05); There was no significant difference in the rate of levator ani muscle injury in vaginal delivery group (P＞0.05). Conclusion Compared with cesarean section, vaginal delivery is more obvious in changing the morphology and integrity of levator ani muscle, and vaginal delivery is more obvious than that of vaginal incision.
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Decision on mode of delivery (MOD) is a process involved by both clients and health care providers, based on specific clinical situations and women′s values. To help each woman obtain the best MOD is crucial for obstetric health professionals to provide women-centered high quality of care. There is a steep upward trend in cesarean sections in China due to the introduced advanced technologies, overused antenatal monitoring methods, flexible indications for cesarean sections, delayed childbearing ages and people′s misconceptions, etc.. Recently the conditional and comprehensive two-child policy have been implemented in China, which might initiate changes in fertility and birth intentions of many families, and in subsequent decisions on MOD. This review illustrates the pros and cons of MOD, decision process on MOD, influencing factors and strategies to promote decision on MOD, in order for the obstetric professionals to provide evidence-based best care for women and their families in the process of decision-making.
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Introduction: The partograph, a graphic recording of labour and features in the mother and fetus has been used since 1970 to detect labour that is not progressing normally. The partograph serves early warning system and assist in early decision of transfer, augmentation and termination of labour. It also increases the quality and regularity of observing mother and fetus in labour. Material and methods: It was a prospective observational study conducted in the Department of Obstetrics and Gynaecology at Dhiraj General Hospital, Pipariya, Waghodiya during the period of 6 months. Total 100 patients were enrolled in my study. Plotting on partogram was started at cervical dilation > 4 cm dilation on alert line. Induction was done in needed cases. Augmentation was done as per requirement. Results: 48% cases were Primigravida and 52% cases were multigravida. Mean gestational age was 38.8 weeks. In 88% cases delivered spontaneous and 12% cases required induction of labour. 18.2% of spontaneous onset patients crossed the alert line as compared to 66.66%in the induced group. 72.7% patients in spontaneous group had vaginal delivery, 23.86% had LSCS and 3.4% had instrumental delivery. 25% patients in induced group had vaginal delivery, 75% had LSCS. 96% neonate had no morbidity. Conclusion: The proper use of partograph and application of the right decision at the right time that we can achieve the best for maternal and neonatal outcome
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Objective To investigate the effect of education in pregnant women’s school on primipara mode of delivery and puerperal behavior.Methods Two hundred and twenty cases who delivered in our hospital and paid postpartum visits were divided into observation group and control group equally according to whether they had attended the pregnant women’s school.The observation group included those having attended the school and the control those who had not.The two groups were compared in terms of primipara mode of delivery and puerperal behavior.Results The rates of maternal vaginal delivery and cesarean section rate in observation group were 71.8%and 28.2%,both significantly higher than those of the control group(52.7%and 47.3%)(P<0.01).The rate of caesarean section due to social factors in the observation group was significantly lower than that of the control group(P<0.05).Besides,the observation group had higher rates of puerperiumal shampoo, showering, eating vegetables and fruits,brushing,use of air-conditioners than the control group did(all P<0.01).Conclusions Prenatal maternal health education in the pregnant women’s school affects puerperous behavior.It suggests that prenatal parturients actively participate in related education on maternal health care,which can help establish a good pregnancy and puerperium maternal behavior,reduce maternal cesarean section and thus help them live through puerperium.
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Objective A retrospective analysis was conducted to explore the impact of LEEP knife treatment of cervical intraepithelial neoplasia (CIN) on women's pregnancy outcomes and modes of delivery.Methods Fifty-eight women were recruited as the experimental group from our hospital.They accepted LEEP surgery for treatment of CIN during 2009 and became pregnant before December 2011.Sixty pregnant women without history of LEEP surgery were randomly selected as the control group from January 2010 to December 2011.A retrospective analysis of the study groups was conducted to investigate the pregnancy situations,two-wire receiver modes of delivery and pregnancy outcome of participants.Results There was no significant difference between the two groups on rates of abortion,vaginal delivery and cesarean section (P ＞ 0.05).The experimental group had significantly higher rates of preterm birth than control group (12.07％ vs.1.67％,x2 =5.049,P ＜ 0.05).No significant difference was observed between the two groups on rates of premature rupture of membranes,cervical laceration,postpartum hemorrhage,low birth weight and neonatal asphyxia(P ＞ 0.05).Conclusion LEEP knife treatment of CIN has no significant effect on mode of delivery or pregnancy outcome,but may increase the incidence of preterm birth.Management of pregnant women with history of CIN and LEEP surgery should be strengthened.
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In this study fecal microflora of human infants born through vaginal delivery (VB) and through cesarean section (CB) were investigated using culture-independent 16S rDNA cloning and sequencing approach. The results obtained clearly revealed that fecal microbiota of VB infants distinctly differ from those in their counterpart CB infants. The intestinal microbiota of infants delivered by cesarean section appears to be more diverse, in terms of bacteria species, than the microbiota of vaginally delivered infants. The most abundant bacterial species present in VB infants were Acinetobacter sp., Bifidobacterium sp. and Staphylococcus sp. However, CB infant’s fecal microbiota was dominated with Citrobacter sp., Escherichia coli and Clostridium difficile. The intestinal microbiota of cesarean section delivered infants in this study was also characterized by an absence of Bifidobacteria species. An interesting finding of our study was recovery of large number of Acinetobacter sp. consisting of Acinetobacter pittii (former Acinetobacter genomic species 3), Acinetobacter junii and Acinetobacter baumannii in the VB infants clone library. Among these, Acinetobacter baumannii is a known nosocomial pathogen and Acinetobacter pittii (genomic species 3) is recently recognized as clinically important taxa within the Acinetobacter calcoaceticus–Acinetobacter baumannii (ACB) complex. Although none of the infants had shown any sign of clinical symptoms of disease, this observation warrants a closer look.
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Under the hygiene hypothesis, children born by cesarean section (CS) may consequently have an increased risk of asthma and other allergic diseases. CS has been shown to have a delayed and altered development in establishment of gut flora and altered cytokine production. Concerns about the relations between CS and the risk of children's asthma are rising due to the growing number of CS performed in many countries. However, finding the concrete evidence to correlate CS with higher risk of asthma is still controversial. There were significant covariate imbalance between groups of children born by CS vs. vaginal delivery that include the number of maternal age, gestational age, birth weight, complication during pregnancy, complication during labor, socioeconomic status, a parental history of atopy, and maternal smoking history. And there were considerable heterogeneity in methods and study subjects between the studies of delivery by CS and the offspring's risk of asthma and other allergic diseases. Therefore, as we proceed into the further study, researchers must refer to the literatures and look for the best way proving their hypothesis that are based on the methodological subject group. Of which should be accordance with the research purposes. Also, researchers have to search for identifying the core biological mechanism in order to know whether there is a causal relationship exists between the CS and asthma.