Efficacy analysis of blood inflammation and liver function indexes in ICP diagnosis and delivery mode prediction / 重庆医学

Objective To observe the changes of laboratory blood indexes in patients with intrahepatic cholestasis of pregnancy(ICP),and analyze the value of blood inflammation indexes and liver function indexes in the diagnosis of ICP and the prediction of delivery mode.Methods A total of 251 patients diagnosed with ICP in this hospital from January 2021 to December 2022 were selected as the ICP group,and another 200 healthy pregnant women were selected as the control group.The patients with ICP were further divided into the severe ICP group(n=47)and the mild ICP group(n=204),the vaginal delivery group(n=113)and the cesarean section group(n=138)according to the severity of ICP and delivery mode.Mann-Whitney U test was used for comparison of parameters between groups,and Spearman method was used for correlation analy-sis.Receiver operating characteristic(ROC)curves were used to evaluate the efficacy of laboratory indicators in diagnosing ICP and predicting delivery mode.Results Neutrophil/lymphocyte ratio(NLR)[6.01(4.45,8.37)vs.3.36(4.12,3.51)]and aspartate transaminase(AST)level[20.00(16.00,33.00)U/L vs.15.00(13.00,18.00)U/L]in the ICP group were significantly higher than those in the control group(P＜0.05),and NLR in the severe ICP group was significantly higher than that in the mild ICP group[4.93(3.87,7.35)vs.4.14(3.12,5.17),P＜0.05].Correlation analysis showed that NLR was positively correlated with AST level(r=0.279,P＜0.001)and ICP severity(r=0.139,P=0.028)in patients with ICP.The area under ROC curve(AUC)of NLR combined with AST for ICP diagnosis was 0.882(95％CI:0.851-0.913).In ad-dition,cholinesterase(CHE)[6 020.00(5 499.50,6 703.50)U/L vs.5 341.50(4 651.75,6 259.25)U/L]and prealbumin(PA)[199.00(177.71,225.20)mg/Lvs.169.17(139.18,204.40)mg/L]levels in the va-ginal delivery group were significantly higher than those in the cesarean section group(P＜0.05),and the AUC of CHE combined with PA for predicting vaginal delivery in ICP patients was 0.727(95％CI:0.664-0.789).Conclusion NLR and AST have potential value in the diagnosis of ICP,and CHE and PA have poten-tial value in predicting delivery mode of ICP patients.

Correlates of exclusive breast feeding among nursing mothers attending child health clinic at a general hospital in Rivers State Nigeria

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.

Preliminary study of prenatal ultrasound in predicting delivery mode of full-term primipara / 中华超声影像学杂志

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.

Evaluating the factors influencing perinatal outcome in breech presentation

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.

A prospective observational study of breech pregnancy in a tertiary care centre

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.

A study of maternal risk factors and the perinatal outcome in meconium stained amniotic fluid in central referral hospital

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.

​Perinatal Outcome of the Second Twin with Respect to Mode of Delivery – A Prospective Analysis

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.

Does cervical favourability and mode of delivery affect the maternal and perinatal outcome in eclampsia?: a cohort study

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.

Effect of obesity on the outcome of pregnancy in primigravida patients: an Iraqi experience

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.

Exercise in pregnancy: the impact of an intervention program in the duration of labor and mode of delivery / Exercício na gravidez: impacto de um programa de intervenção na duração do trabalho de parto e via de parto

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.

Clinical analysis of delivery mode of 576 cases of re-pregnancy after cesarean section / 中国基层医药

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.

Clinical analysis of delivery mode of 576 cases of re-pregnancy after cesarean section / 中国基层医药

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.

Pregnancy risk and mode of delivery in pregnant women with heart disease / 中国实用妇科与产科杂志

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.

Analysis of the Effects of Different Delivery Methods on the Levator Ani Muscle of the Pelvic Floor by Transperineal Three - dimensional Ultrasound and TUI Imaging / 现代医院

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.

A comparison of maternal and perinatal outcomes and mode of delivery of twin and singleton gestations in tertiary government hospital during a 10-year period / Philippine Journal of Obstetrics and Gynecology

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.

The literature review of women′s decison on mode of delivery and its related factors / 中国实用护理杂志

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.

Influence of partograph tracing on management of labour

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

Effect of limited on pregnancy outcome analysis of different delivery mode for fetal growth / 中国现代医生

Objective To study and research on different delivery methods on full-term fetal growth restriction preg-nancy outcomes of pregnant women,pregnant women for fetal growth restriction provided reasonable way of delivery. Methods Chose 60 cases of full-term fetal growth restriction of pregnant women in our hospital from Jan 2010 to Aug 2014, pregnant women of different delivery way the incidence of adverse pregnancy outcomes and different incidence of cesarean section indications of adverse pregnancy outcomes were analyzed. Results Sitty cases of pregnant Twenty-five cases of natural childbirth in women, the incidence of adverse pregnancy outcomes was 24.0%(6/25﹚,cesarean section 35 cases [20.0%(7/35﹚], the incidence of adverse pregnancy outcomes was not significant(P>0.05﹚; For fe-tal distress or oligohydramnios cesarean section indications of pregnant women in 7 cases [42.9%(3/7﹚], the inci-dence of adverse pregnancy outcomes with other factors as the cesarean section indications 28 cases of pregnant women 14.3%(4/28﹚,the incidence of adverse pregnancy outcomes compared with significant difference (P<0.05﹚;Did not have adverse pregnancy outcome of fetal average weight of (2513.5±154.6) g,fetal adverse pregnancy outcome was signifi-cantly high er than (2331.7 ±192.4) g. Conclusion Different ways childbirth in general will not affect pregnancy out-comes in pregnant women who full-term fetal growth restriction significantly affect,limit is mainly neonatal birth weight,fetal outcomes for suspected fetal distress or oligohydramnios full-term fetal growth restriction pregnant women should be advised to choose a cesarean section delivery.

The impact of maternal health education on the mode of delivery and pregnancy outcomes / 中国现代医生

Objective To investigate the impact of maternal health education on the mode of delivery and pregnancy outcome. Methods All 385 pregnant women had been chosen, were randomly divided into observation group of 194 cases and control group of 191 cases,of which 24 cases exit off observation group,27 cases exit off the control group,included the observation group of 170 cases and the control group of 164 cases, the observation group used stages of maternal health education, control group used conventional health education. Results The evaluation of health knowl-edge scores in observation group were significantly higher, the number of prenatal significantly more than the control group,complete check-rate rate were significantly higher(P<0.05).The vaginal delivery rate in observation group were significantly higher than control group,cesarean section own volition choose the ratio in observation group were signifi-cantly lower than the control group(P<0.05). The incidence of adverse pregnancy outcomes between groups were signifi-cantly different(χ2=4.242,P<0.05),in which the observation group gestational diabetes,preterm birth were significantly higher incidence of postpartum hemorrhage, lactation period were significantly less than the control group, nursing satisfaction were significantly higher(P<0.05). Conclusion Maternal health education helps to improve maternal health and prenatal knowledge of the number of times to reduce the cesarean section rate, reduce the incidence of adverse pregnancy outcomes.

Effect of education in pregnant women’s school on primipara mode of delivery and puerperal behavior / 现代临床护理

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.