Background: Studies on either postnatal quality of life in general or studies that compare quality of life in new mothers after different mode of delivery are limited. An investigation on health related quality of lif...Background: Studies on either postnatal quality of life in general or studies that compare quality of life in new mothers after different mode of delivery are limited. An investigation on health related quality of life measures in women after different type of delivery showed that women who had vaginal delivery had better health related quality of life compared to those who had caesarean section. However, the best method of delivery, vaginal or caesarean for postpartum quality of life is a difficult question as it is a matter of controversy both from professional’s perspectives and from women’s experience during childbirth. Objective: To compare postpartum quality of life in primiparous women after vaginal delivery versus caesarean section. Methods: Prospective cross-sectional study was conducted at the department of Obstetrics and Gynecology, Salmaniya medical complex in Kingdom of Bahrain. 500 primiparous women who gave birth either vaginally or by cesarean section answered a questionnaire designed to include general information, questions from short form health survey questionnaire (SF-36) and specific questions regarding postnatal related symptoms. Results: Body pain, fatigue, wound pain, headache and backache were significantly higher in cesarean section group as compared to vaginal delivery group (p-value Conclusion: Cesarean delivery has negatively affected the quality of life (QOL) of primiparous women. More studies with larger sample sizes should be conducted to examine the effects of cesarean delivery on QOL in both primiparous and multiparas within a shorter period after delivery. .展开更多
<strong>Objective:</strong><span><span style="font-family:Verdana;"> Misoprostol vaginal insert (MVI) is proven to induce labor by a </span><span style="font-family:Verd...<strong>Objective:</strong><span><span style="font-family:Verdana;"> Misoprostol vaginal insert (MVI) is proven to induce labor by a </span><span style="font-family:Verdana;">continuously release of PGE1. Previous reports showed that MVI reduced</span><span style="font-family:Verdana;"> induction to delivery time as well as active labor time but it also increased uterine tachysystole. Here we attempted to clarify whether MVI is safe and </span><span style="font-family:Verdana;">efficient for women with pregnancies >40 weeks in a single institute.</span> <b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This study was performed in Lutheran Hospital Bergisch Gladbach, Germany 2014-2019. A total of 304 women between 40 + 0 to 42 + 0 weeks underwent labor induction with MVI. Outcomes were</span></span><span style="font-family:Verdana;">:</span><span><span style="font-family:Verdana;"> 1) maternal: time from insertion </span><span style="font-family:Verdana;">to delivery, interventions, mode of delivery, and uterine tachysystole, 2)</span><span style="font-family:Verdana;"> neo</span></span><span style="font-family:Verdana;">-</span><span><span style="font-family:Verdana;">natal: cord blood pH, APGAR scores, and admission to a neonatal clinic. This </span><span style="font-family:Verdana;">study ended unexpectedly due to the withdrawal of MVI (Misodel<span style="white-space:nowrap;"><sup>TM</sup></span>) in</span><span style="font-family:Verdana;"> September 2019. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">75.7% (n = 230) of women gave birth within 24 hours after MVI placement. 72.2% (n = 140) nulliparous women and 81.8% (n = 90) </span><span style="font-family:Verdana;">parous women delivered within 24 hours. In two cases emergency CS was</span><span style="font-family:Verdana;"> required. 67.8% (n = 206) of women delivered vaginal. 2.3% (n = 7) of cord pH levels were below 7.10. 3.3% (n = 10) of newborns were transmitted to a neonatal clinic. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">MVI is an efficient method to induce labor for </span><span style="font-family:Verdana;">pregnant women beyond 40 + 0 weeks. However, considering various</span><span style="font-family:Verdana;"> compli</span><span style="font-family:Verdana;">cations observed (uterine tachysystole and fetal distress leading to a high</span><span style="font-family:Verdana;"> number of CS), we cannot universally advocate the use of MVI.</span></span>展开更多
Background: Trial of labour after Caesarean section (TOLAC) refers to an attempt at vaginal delivery after a previous caesarean section. Outcome is influenced by a number of factors which are important in patient’s s...Background: Trial of labour after Caesarean section (TOLAC) refers to an attempt at vaginal delivery after a previous caesarean section. Outcome is influenced by a number of factors which are important in patient’s selection. Objectives: The aim of this study was to find out the incidence and feto-maternal outcome of the practice of Trial of labour after Caesarean section. Methodology: This is a retrospective study of cases of vaginal birth after Caesarean section Data were retrieved from the case notes of patients who attempted vaginal birth after Caesarean section from January 1, 2013 to December 31, 2017, a period of five years. Result: There were 10,669 deliveries, 3179 of which were through Caesarean section. This gave a Caesarean section rate of 29.8%. A total of 217 patients attempted vaginal birth after Caesarean section and 83 ended up as repeat Caesarean section (38.2%) while 138 (61.8%) had successful vaginal birth after Caesarean section. Patients with previous vaginal delivery, age range 25 - 29 years and interdelivery interval of greater than or equal to 2 years were more successful at achieving vaginal birth after Caesarean section. The leading indications for the repeat Caesarean section include cephalopelvic disproportion (45.8%), poor progress of labour (19.3%) and hypertensive disorders of pregnancy (8.4%). Conclusion: Vaginal birth after Caesarean section was successful in most of the parturients that attempted it in this study especially in patients within the age range of 25 - 29 years, those that have had previous vaginal delivery and with interdelivery interval of greater than or equal to 2 years.展开更多
目的研究剖宫产史对人工授精助孕临床妊娠率的影响。方法回顾性分析2012年2月—2022年6月在厦门大学附属妇女儿童医院生殖医学科接受夫精人工授精(artificial insemination by husband,AIH)治疗的至少有1次活胎分娩史的不孕患者336例,共...目的研究剖宫产史对人工授精助孕临床妊娠率的影响。方法回顾性分析2012年2月—2022年6月在厦门大学附属妇女儿童医院生殖医学科接受夫精人工授精(artificial insemination by husband,AIH)治疗的至少有1次活胎分娩史的不孕患者336例,共560个周期,其中瘢痕子宫组203个周期,阴道分娩组357个周期。比较2组年龄、身体质量指数(body mass index,BMI)、输卵管盆腔因素、内膜异位症占比、治疗方案及助孕结果等。结果2组的年龄、高龄占比(>35岁)、不孕年限、输卵管盆腔因素、内膜异位症占比比较,差异无统计学意义(P>0.05)。瘢痕子宫组患者BMI为(22.30±3.27)kg/m^(2),高于阴道分娩组的(21.67±2.76)kg/m^(2)(P<0.05)。瘢痕子宫组BMI>23 kg/m^(2)的比例为36.9%,高于阴道分娩组的29.7%,差异无统计学意义(P=0.078)。瘢痕子宫组诱导排卵方案占比为53.7%(109/203),高于经阴道分娩组的44.3%(158/357),差异有统计学意义(P<0.05)。瘢痕子宫组临床妊娠率为15.3%,阴道分娩组为16.5%,差异无统计学意义(P=0.853)。结论通过适当的干预与筛选,可以提高有剖宫产史妇女的宫腔内人工授精临床妊娠率。展开更多
目的探讨脉冲泵椎管内分娩镇痛失败中转剖宫产的麻醉方式。方法120例脉冲泵椎管内分娩镇痛失败中转剖宫产产妇为研究对象,按随机数字表法分为A、B、C三组,各40例。A组实施腰硬联合麻醉,B组使用分娩镇痛留置的导管行硬膜外麻醉,C组实施...目的探讨脉冲泵椎管内分娩镇痛失败中转剖宫产的麻醉方式。方法120例脉冲泵椎管内分娩镇痛失败中转剖宫产产妇为研究对象,按随机数字表法分为A、B、C三组,各40例。A组实施腰硬联合麻醉,B组使用分娩镇痛留置的导管行硬膜外麻醉,C组实施气管插管全身麻醉(全麻)。比较三组围麻醉期并发症发生率,入室至切皮时间及麻醉至胎儿取出时间,新生儿出生时、出生1 min和出生5 min Apgar评分。结果C组围麻醉期高血压、低血压、恶心呕吐发生率显著低于A组和B组(P<0.05);三组围麻醉期误吸发生率比较差异无统计学意义(P>0.05)。C组入室至切皮时间和麻醉至胎儿取出时间分别为(8.2±1.6)、(5.3±0.7)min,均短于A组的(15.7±2.6)、(12.2±2.5)min和B组的(15.6±2.7)、(11.5±2.3)min(P<0.05)。C组新生儿出生时、出生1 min和出生5 min Apgar评分分别为(7.8±1.4)、(8.6±0.4)、(9.1±0.7)分,均显著高于A组的(7.0±0.7)、(7.4±0.6)、(8.0±0.5)分和B组的(7.1±0.8)、(7.5±0.6)、(8.1±0.5)分(P<0.05)。结论气管插管全麻用于脉冲泵椎管内分娩镇痛分娩失败中转剖宫产者,具有并发症少,快速娩出胎儿,减少新生儿窒息风险等优势。展开更多
文摘Background: Studies on either postnatal quality of life in general or studies that compare quality of life in new mothers after different mode of delivery are limited. An investigation on health related quality of life measures in women after different type of delivery showed that women who had vaginal delivery had better health related quality of life compared to those who had caesarean section. However, the best method of delivery, vaginal or caesarean for postpartum quality of life is a difficult question as it is a matter of controversy both from professional’s perspectives and from women’s experience during childbirth. Objective: To compare postpartum quality of life in primiparous women after vaginal delivery versus caesarean section. Methods: Prospective cross-sectional study was conducted at the department of Obstetrics and Gynecology, Salmaniya medical complex in Kingdom of Bahrain. 500 primiparous women who gave birth either vaginally or by cesarean section answered a questionnaire designed to include general information, questions from short form health survey questionnaire (SF-36) and specific questions regarding postnatal related symptoms. Results: Body pain, fatigue, wound pain, headache and backache were significantly higher in cesarean section group as compared to vaginal delivery group (p-value Conclusion: Cesarean delivery has negatively affected the quality of life (QOL) of primiparous women. More studies with larger sample sizes should be conducted to examine the effects of cesarean delivery on QOL in both primiparous and multiparas within a shorter period after delivery. .
文摘<strong>Objective:</strong><span><span style="font-family:Verdana;"> Misoprostol vaginal insert (MVI) is proven to induce labor by a </span><span style="font-family:Verdana;">continuously release of PGE1. Previous reports showed that MVI reduced</span><span style="font-family:Verdana;"> induction to delivery time as well as active labor time but it also increased uterine tachysystole. Here we attempted to clarify whether MVI is safe and </span><span style="font-family:Verdana;">efficient for women with pregnancies >40 weeks in a single institute.</span> <b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This study was performed in Lutheran Hospital Bergisch Gladbach, Germany 2014-2019. A total of 304 women between 40 + 0 to 42 + 0 weeks underwent labor induction with MVI. Outcomes were</span></span><span style="font-family:Verdana;">:</span><span><span style="font-family:Verdana;"> 1) maternal: time from insertion </span><span style="font-family:Verdana;">to delivery, interventions, mode of delivery, and uterine tachysystole, 2)</span><span style="font-family:Verdana;"> neo</span></span><span style="font-family:Verdana;">-</span><span><span style="font-family:Verdana;">natal: cord blood pH, APGAR scores, and admission to a neonatal clinic. This </span><span style="font-family:Verdana;">study ended unexpectedly due to the withdrawal of MVI (Misodel<span style="white-space:nowrap;"><sup>TM</sup></span>) in</span><span style="font-family:Verdana;"> September 2019. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">75.7% (n = 230) of women gave birth within 24 hours after MVI placement. 72.2% (n = 140) nulliparous women and 81.8% (n = 90) </span><span style="font-family:Verdana;">parous women delivered within 24 hours. In two cases emergency CS was</span><span style="font-family:Verdana;"> required. 67.8% (n = 206) of women delivered vaginal. 2.3% (n = 7) of cord pH levels were below 7.10. 3.3% (n = 10) of newborns were transmitted to a neonatal clinic. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">MVI is an efficient method to induce labor for </span><span style="font-family:Verdana;">pregnant women beyond 40 + 0 weeks. However, considering various</span><span style="font-family:Verdana;"> compli</span><span style="font-family:Verdana;">cations observed (uterine tachysystole and fetal distress leading to a high</span><span style="font-family:Verdana;"> number of CS), we cannot universally advocate the use of MVI.</span></span>
文摘Background: Trial of labour after Caesarean section (TOLAC) refers to an attempt at vaginal delivery after a previous caesarean section. Outcome is influenced by a number of factors which are important in patient’s selection. Objectives: The aim of this study was to find out the incidence and feto-maternal outcome of the practice of Trial of labour after Caesarean section. Methodology: This is a retrospective study of cases of vaginal birth after Caesarean section Data were retrieved from the case notes of patients who attempted vaginal birth after Caesarean section from January 1, 2013 to December 31, 2017, a period of five years. Result: There were 10,669 deliveries, 3179 of which were through Caesarean section. This gave a Caesarean section rate of 29.8%. A total of 217 patients attempted vaginal birth after Caesarean section and 83 ended up as repeat Caesarean section (38.2%) while 138 (61.8%) had successful vaginal birth after Caesarean section. Patients with previous vaginal delivery, age range 25 - 29 years and interdelivery interval of greater than or equal to 2 years were more successful at achieving vaginal birth after Caesarean section. The leading indications for the repeat Caesarean section include cephalopelvic disproportion (45.8%), poor progress of labour (19.3%) and hypertensive disorders of pregnancy (8.4%). Conclusion: Vaginal birth after Caesarean section was successful in most of the parturients that attempted it in this study especially in patients within the age range of 25 - 29 years, those that have had previous vaginal delivery and with interdelivery interval of greater than or equal to 2 years.
文摘目的研究剖宫产史对人工授精助孕临床妊娠率的影响。方法回顾性分析2012年2月—2022年6月在厦门大学附属妇女儿童医院生殖医学科接受夫精人工授精(artificial insemination by husband,AIH)治疗的至少有1次活胎分娩史的不孕患者336例,共560个周期,其中瘢痕子宫组203个周期,阴道分娩组357个周期。比较2组年龄、身体质量指数(body mass index,BMI)、输卵管盆腔因素、内膜异位症占比、治疗方案及助孕结果等。结果2组的年龄、高龄占比(>35岁)、不孕年限、输卵管盆腔因素、内膜异位症占比比较,差异无统计学意义(P>0.05)。瘢痕子宫组患者BMI为(22.30±3.27)kg/m^(2),高于阴道分娩组的(21.67±2.76)kg/m^(2)(P<0.05)。瘢痕子宫组BMI>23 kg/m^(2)的比例为36.9%,高于阴道分娩组的29.7%,差异无统计学意义(P=0.078)。瘢痕子宫组诱导排卵方案占比为53.7%(109/203),高于经阴道分娩组的44.3%(158/357),差异有统计学意义(P<0.05)。瘢痕子宫组临床妊娠率为15.3%,阴道分娩组为16.5%,差异无统计学意义(P=0.853)。结论通过适当的干预与筛选,可以提高有剖宫产史妇女的宫腔内人工授精临床妊娠率。
文摘目的探讨脉冲泵椎管内分娩镇痛失败中转剖宫产的麻醉方式。方法120例脉冲泵椎管内分娩镇痛失败中转剖宫产产妇为研究对象,按随机数字表法分为A、B、C三组,各40例。A组实施腰硬联合麻醉,B组使用分娩镇痛留置的导管行硬膜外麻醉,C组实施气管插管全身麻醉(全麻)。比较三组围麻醉期并发症发生率,入室至切皮时间及麻醉至胎儿取出时间,新生儿出生时、出生1 min和出生5 min Apgar评分。结果C组围麻醉期高血压、低血压、恶心呕吐发生率显著低于A组和B组(P<0.05);三组围麻醉期误吸发生率比较差异无统计学意义(P>0.05)。C组入室至切皮时间和麻醉至胎儿取出时间分别为(8.2±1.6)、(5.3±0.7)min,均短于A组的(15.7±2.6)、(12.2±2.5)min和B组的(15.6±2.7)、(11.5±2.3)min(P<0.05)。C组新生儿出生时、出生1 min和出生5 min Apgar评分分别为(7.8±1.4)、(8.6±0.4)、(9.1±0.7)分,均显著高于A组的(7.0±0.7)、(7.4±0.6)、(8.0±0.5)分和B组的(7.1±0.8)、(7.5±0.6)、(8.1±0.5)分(P<0.05)。结论气管插管全麻用于脉冲泵椎管内分娩镇痛分娩失败中转剖宫产者,具有并发症少,快速娩出胎儿,减少新生儿窒息风险等优势。
