Factors Influencing Mode of Delivery: A Case-Control Study

The primary objective of this investigation was to scrutinize the prepregnancy conditions and lifestyles of 2046 women residing in Liuzhou City, with the aim of delineating the determinants of delivery methods. Evidently, the study unearthed substantial correlations between prepregnancy body mass index, educational attainment, exposure to passive smoking, medical history, and other variables with the mode of delivery. Furthermore, a predictive nomogram model was formulated to accurately forecast the likelihood of cesarean section. These discernments equip pertinent authorities with the means to institute targeted screening and supportive measures for women contemplating pregnancy based on these identified factors. Moreover, provision of services such as prepregnancy counseling and clinical risk assessments could be instrumental in curbing the incidence of cesarean section.

Relationship between age of pregnant women with gestational diabetes mellitus and mode of delivery and neonatal Apgar score

BACKGROUND Gestational diabetes mellitus(GDM)refers to abnormal glucose tolerance during pregnancy,and it is often accompanied by obvious changes in glucose and lipid metabolism,and associated with adverse pregnancy outcomes.The incidence of fetal distress,polyhydramnios,puerperal infection,premature delivery,and macrosomia in pregnant women with GDM are higher than in those without GDM.AIM To analyze the relationship between age of pregnant women with GDM and mode of delivery and neonatal Apgar score.METHODS A total of 583 pregnant women with GDM who delivered in the Department of Obstetrics at our hospital between March 2019 and March 2022 were selected.Among them,377 aged<35 years were selected as the right age group and 206 aged>35 years were selected as the older group.The clinical data of the two groups were collected,and the relationship between age of the pregnant women with GDM and mode of delivery,maternal and neonatal outcomes,and neonatal Apgar score were compared.In the older group,159 women were classed as the adverse outcome group and 47 as the good outcome group according to whether they had adverse maternal and infant outcomes.The related factors of adverse maternal and infant outcomes were analyzed through logistic regression.RESULTS The number of women with assisted pregnancy,≤37 wk gestation,≥2 pregnancies,one or more deliveries,and no pre-pregnancy blood glucose screening in the older group were all higher than those in the right age group(P<0.05).The natural delivery rate in the right age group was 40.85%,which was higher than 22.33%in the older group(P<0.05).The cesarean section rate in the older group was 77.67%,which was higher than 59.15%in the right age group(P<0.05).The older group had a higher incidence of polyhydramnios and postpartum hemorrhage,and lower incidence of fetal distress than the right age group had(P<0.05).There was no significant difference in neonatal weight between the two groups(P>0.05).The right age group had higher Apgar scores at 1 and 5 min than the older group had(P<0.05).Significant differences existed between the poor and good outcome groups in age,education level,pregnancy mode,≤37 wk gestation,number of pregnancies,and premature rupture of membranes(P<0.05).Logistic regression showed that age,education level and premature rupture of membranes were all risk factors affecting the adverse outcomes of mothers and infants(P<0.05).CONCLUSION Delivery mode and Apgar score of pregnant women with GDM are related to age.Older age increases the adverse outcome of mothers and infants.

Pregnancy and delivery after augmentation cystoplasty:A case report and review of literature

BACKGROUND Augmentation cystoplasty,first described by Mikulicz in 1899 involves segments of bowel,stomach or mega-ureter to increase bladder capacity in those with inadequate bladder function or lack of detrusor compliance.The most widely used bowel segment is a detubularised patch of ileum.When ileum is not suitable for augmentation,sigmoid colon is the alternative.However,only eight pregnancies after sigmoidocystoplasty have been reported without detail and clinicians may be uncertain about the effects of sigmoidocystoplasty on reproductive health and pregnancy.CASE SUMMARY We followed the patient from gestational week 32+3 until 6 wk after delivery.During pregnancy,our patient suffered urinary tract infection twice and had to undergo percutaneous nephrostomy drainage due to progressive hydronephrosis.Despite a dense adhesion between the uterus and neobladder,we were able to deliver a healthy baby by cesarian section in the presence of the attending urologist.CONCLUSION Augmentation cystoplasty-afflicted women can have a healthy reproductive life.Certain perioperative measures may be advisable to avoid serious surgical complications.

Fetal Outcome and Mode of Delivery in a Patient with Meconium-Stained Amniotic Fluid

Background: Meconium stained amniotic fluid (MSAF), especially observed before term, is considered a sign of fetal jeopardy. Although many studies characterized this condition and associated it with delivery mode, data is lacking in this area, Saudi Arabia. Thus, we attempted to study it. Methods: All data were retrieved from pregnant patients with MSAF who delivered at King Abdul, Saudi Arabia, from January 2015 to December 2018. Results: 758 showed MSAF, of which 83% had vaginal delivery, whereas remaining 17% had an emergency caesarean section. Of them, 32 (4.2%) infants developed meconium aspiration syndrome, and 7 (21.8%) were admitted to the NICU. Conclusion: It was reconfirmed that MSAF is associated with a newborn risk, especially meconium aspiration syndrome. Patients had a higher rate for emergent caesarean section and baby admission to NICU. These data may be useful to make health/reproductive-health poly-making in this area.

Impact of Epidural Analgesia in Labour on Neonatal and Maternal Outcomes

Aim: To evaluate the effect of epidural analgesia during labour on neonatal-maternal outcomes. Methods: A retrospective cohort study of nulliparous parturients who gave birth in Vasternorrland County, Sweden, over a 2-year period between 2015 and 2016. Neonatal outcomes (Apgar score at 5 min and umbilical cord arterial blood gases), maternal outcomes (perineal injury, total bleeding volume and maternal satisfaction with birth) and labour parameters (mode of delivery and the durations of labour and postpartum hospital stay) were evaluated. Results: The study cohort consisted of 1449 women with singleton pregnancies. Patients were divided into two groups according to whether during labour they were administered epidural analgesia using bupivacaine and sufentanil (EDA group, n = 615) or not (non-EDA group, n = 834). The rate of assisted vaginal delivery was significantly higher in the EDA group than in the non-EDA group (15.6% and 11.3%, respectively, p < 0.05), whereas the rates of caesarean section were similar. The duration of the active phase of labour was significantly longer in the EDA group than in the non-EDA group (489 ± 217 min versus 371 ± 210 min, respectively, p < 0.001). The Apgar score at 5 min and umbilical cord blood pH were lower and the base deficit greater in the EDA group (p < 0.001, p < 0.001 and p < 0.01, respectively). Bleeding volume was similar between the groups after adjusting for gestational age. Women in the EDA group were more satisfied with their labour experience, as measured by the visual analogue scale (p Conclusion: The results of this study suggest that EDA affects delivery and neonatal-maternal outcomes negatively, but increases the mother’s satisfaction with labour.