ABSTRACT
BACKGROUND: It has been recognized that preterm labor is related to short cervical length and that poor progress in labor is a major indication for cesarean section at term. We therefore hypothesize that long cervix is not associated with increased risk of cesarean delivery during labor at term. OBJECTIVES: The objective is to determine the relationship between cervical length at mid-pregnancy and mode of delivery and preterm delivery. MATERIALS AND METHODS: Trans-vaginal ultrasonographic scan measurement of cervical length was done for 281 pregnant women at a mean gestational age of 22 weeks. These women were followed up till delivery and the mode of delivery and the cervical length were analyzed for associations. RESULTS: Cesarean section due to poor progress in labor at term constituted 11.7%. The cesarean section for the highest quartile cervical length (40-67 mm) was 50% (P value 0.0018 for trend). Of the 33 women whose mode of delivery was cesarean section due to poor progress 18 (54.5%) had cervical length of more than 40 cm. The likelihood ratio of cesarean section due to poor progress of labor at term among women at the upper quartile cervical length is 10.28 (P value 0.0013) CONCLUSION: Long cervical length at mid-pregnancy predicts the possibility of cesarean delivery early in pregnancy. Hence, cervical length in mid-pregnancy can be of value in predicting the mode of delivery in early pregnancy.
Subject(s)
Cervix Uteri/diagnostic imaging , Delivery, Obstetric , Cesarean Section , Female , Humans , Male , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, Second , UltrasonographyABSTRACT
OBJECTIVE: Cesarean section (C/S) is still being perceived as an abnormal means of delivery by many antenatal women in Nigeria. This study aims to determine the perceptions of antenatal clients in the southeastern Nigeria on C/S. MATERIALS AND METHODS: The study was conducted using a structured questionnaire administered to 300 consenting pregnant clients attending the antenatal clinic. The data were analyzed and presented in a simple frequency table. RESULTS: The average C/S rate in the hospital was 16.6%. Only 4 (1.4%) viewed C/S as very good and elected to undergo C/S. Thirty-four (12.3%) considered C/S as bad and would reluctantly undergo the procedure. Two hundred and twenty-five (81.2%) would accept C/S if their life or that of their fetus is in great danger. CONCLUSION: This study affirms previous suspicion that a significant proportion of antenatal clients are averse to C/S and the negative cultural perception of the people to C/S reinforced this aversion.
Subject(s)
Cesarean Section/psychology , Health Knowledge, Attitudes, Practice , Patient Acceptance of Health Care/statistics & numerical data , Adolescent , Adult , Cross-Sectional Studies , Culture , Female , Hospitals, Teaching , Humans , Middle Aged , Nigeria , Pregnancy , Surveys and Questionnaires , Young AdultABSTRACT
AIM: The goal of this study was to identify risk factors associated with umbilical cord prolapse and to document the perinatal outcome of cases of cord prolapse. MATERIALS AND METHODS: During the period of the study (from July 1, 2001 and June 30, 2007), forty-six cases of umbilical cord prolapse were identified from the labor ward record and analyzed retrospectively. Associations between cord prolapse and potential risk factors were evaluated by means of the odds ratio. RESULTS: During the period of the study, 46 cases of cord prolapse were encountered out of 10,080 deliveries which was 0.46% of all deliveries. Of the 46 fetuses with umbilical cord prolapse 32.6% had a fetal weight of less than 2.5 kg compared with 15.2% for fetuses in control group (P<0.012). The umbilical cord prolapse occurred in association with breech presentation eleven times (23.9%) and transverse presentation seven times (15.2%). The occurrence of breech presentation among the control cases was 4.3% (P<0.00031), and that of transverse lie was 4.4% (P<0.02007). Among the women that had cord prolapse, 47.8% had unbooked pregnancies compared with the control group with 14.5% (P<0.0000033). Multiparity accounted for 78.3% in the cord prolapse cases and 68.1% in the controls (P=0.19). The perinatal mortality rate was 413/1000. (41.3%), compared to the perinatal mortality of 58/1000 for the control group. CONCLUSIONS: Our findings in this study has confirmed an association between increased risk of umbilical cord prolapse and abnormal fetal presentation, low birth weight and unbooked status. It is therefore suggested that pregnant women should be encouraged to register early in pregnancy for antenatal care and this will enhance the early identification of these risk factors and an appropriate management instituted to reduce perinatal mortality.
Subject(s)
Fetal Diseases , Pregnancy Outcome , Umbilical Cord , Adult , Apgar Score , Female , Fetal Diseases/epidemiology , Hospitals, Teaching , Humans , Infant, Newborn , Infant, Very Low Birth Weight , Labor Presentation , Nigeria , Obstetric Labor Complications/epidemiology , Obstetric Labor Complications/etiology , Parity , Perinatal Care , Perinatal Mortality , Pregnancy , Prolapse , Retrospective Studies , Risk Factors , Young AdultABSTRACT
Aim: The goal of this study was to identify risk factors associated with umbilical cord prolapse and to document the perinatal outcome of cases of cord prolapse. Materials and Methods: During the period of the study (from July 1; 2001 and June 30; 2007); forty-six cases of umbilical cord prolapse were identified from the labor ward record and analyzed retrospectively. Associations between cord prolapse and potential risk factors were evaluated by means of the odds ratio. Results: During the period of the study; 46 cases of cord prolapse were encountered out of 10;080 deliveries which was 0.46of all deliveries. Of the 46 fetuses with umbilical cord prolapse 32.6had a fetal weight of less than 2.5 kg compared with 15.2for fetuses in control group (P0.012). The umbilical cord prolapse occurred in association with breech presentation eleven times (23.9) and transverse presentation seven times (15.2). The occurrence of breech presentation among the control cases was 4.3(P0.00031); and that of transverse lie was 4.4(P0.02007). Among the women that had cord prolapse; 47.8had unbooked pregnancies compared with the control group with 14.5(P0.0000033). Multiparity accounted for 78.3in the cord prolapse cases and 68.1in the controls (P=0.19). The perinatal mortality rate was 413/1000. (41.3); compared to the perinatal mortality of 58/1000 for the control group. Conclusions: Our findings in this study has confirmed an association between increased risk of umbilical cord prolapse and abnormal fetal presentation; low birth weight and unbooked status. It is therefore suggested that pregnant women should be encouraged to register early in pregnancy for antenatal care and this will enhance the early identification of these risk factors and an appropriate management instituted to reduce perinatal mortality
