Prediction of vaginal birth after cesarean for labor dystocia by sonographic estimated fetal weight

2021 ◽  
Author(s):  
Gabriel Levin ◽  
Abraham Tsur ◽  
Lee Tenenbaum ◽  
Nizan Mor ◽  
Michal Zamir ◽  
...  
Keyword(s):  
Vaginal Birth ◽  
Fetal Weight ◽  
Vaginal Birth After Cesarean ◽  
Labor Dystocia ◽  
Estimated Fetal Weight

scholarly journals Recent Research Questions the Values of Routine Intervention

2003 ◽  
Vol 12 (3) ◽  
pp. 46-49 ◽  
Author(s):  
Mary Lou Moore
Keyword(s):  
Epidural Anesthesia ◽  
Fetal Monitoring ◽  
Vaginal Birth ◽  
Fetal Weight ◽  
Vaginal Birth After Cesarean ◽  
Electronic Fetal Monitoring ◽  
Research Questions ◽  
Routine Procedures

Under appropriate circumstances, intervention in labor and birth can be valuable, even lifesaving. But interventions can also become routine procedures. This paper reviews three recent studies in which the focus of research is common interventions: electronic fetal monitoring and epidural anesthesia. A fourth study reviewed here examines the effect of previous vaginal birth and fetal weight on the success of vaginal birth after cesarean.

scholarly journals Effect of stage of initial labor dystocia on vaginal birth after cesarean success

2015 ◽  
Vol 213 (6) ◽  
pp. 861.e1-861.e5 ◽  
Author(s):  
Adam Korrick Lewkowitz ◽  
Sanae Nakagawa ◽  
Mari-Paule Thiet ◽  
Melissa Greer Rosenstein
Keyword(s):  
Vaginal Birth ◽  
Vaginal Birth After Cesarean ◽  
Labor Dystocia

scholarly journals Epidural analgesia at trial of labor after cesarean (TOLAC): a significant adjunct to successful vaginal birth after cesarean (VBAC)

2018 ◽  
Vol 46 (3) ◽  
pp. 261-269 ◽  
Author(s):  
Sorina Grisaru-Granovsky ◽  
Maayan Bas-Lando ◽  
Lior Drukker ◽  
Fred Haouzi ◽  
Rivka Farkash ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Uterine Rupture ◽  
Mode Of Delivery ◽  
Similar Rate ◽  
Vaginal Birth ◽  
Neonatal Outcomes ◽  
Vaginal Birth After Cesarean ◽  
Trial Of Labor ◽  
Labor Dystocia ◽  
Significant Covariates

Abstract Introduction: Epidural analgesia has been considered a risk factor for labor dystocia at trial of labor after cesarean (TOLAC) and uterine rupture. We evaluated the association between exposure to epidural during TOLAC and mode of delivery and maternal-neonatal outcomes. Materials and methods: A single center retrospective study of women that consented to TOLAC within a strict protocol between 2006 and 2013. Epidural “users” were compared to “non-users”. Primary outcome was the mode of delivery: repeat in-labor cesarean or vaginal birth after cesarean (VBAC). Secondary outcomes were maternal/neonatal morbidities. Univariate/multivariate analyses for associations between epidural and mode of delivery were adjusted for significant covariates/mediators. Results: Of a total of 105,471 births registered, 9464 (9.0%) were eligible for TOLAC; 7149 (75.5%) women consented to TOLAC, among which 4081 (57.1%) had epidural analgesia. The in labor cesarean rate was significantly lower for the epidural “users” 8.7% vs. “non-users” 11.8%, P<0.0001, with a parallel increased rate of instrumental delivery. Uterine rupture rates were comparable: 0.4% and 0.29%, respectively (P=0.31). The adjusted multivariate model showed that epidural “users” were more likely to experience a VBAC, odds ratio (OR) 4.58 [3.67; 5.70]; P<0.0001 with a similar rate of adverse maternal-neonatal outcomes. Conclusion: Epidural analgesia at TOLAC may emerge as a safe and significant adjunct for VBAC.

Discrepancy Analysis between Clinical Versus Ultrasound Estimated Fetal Weight and Actual Birth Weight at 3rd Trimester

2019 ◽  
Vol 11 (1) ◽  
pp. 32-38
Author(s):  
Naznin Rashid Shewly ◽  
Menoka Ferdous ◽  
Hasina Begum ◽  
Shahadat Hossain Khan ◽  
Sheema Rani Debee ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Fetal Weight ◽  
P Value ◽  
Weight Estimation ◽  
Third Trimester ◽  
Mortality And Morbidity ◽  
Fetal Weight Estimation ◽  
Obstetric Management ◽  
Estimated Fetal Weight

Background: In obstetric management fetal weight estimation is an important consideration when planning the mode of delivery in our day to day practice. In Bangladesh low birth weight is a major public health problem & incidence is 38% - 58%. Neonatal mortality and morbidity also yet high. So accurate antenatal estimation of fetal weight is a good way to detect macrosomia or small for date baby. Thus to improve the pregnancy outcome and neonatal outcome decreasing various chance of neonatal mortality and morbidity antenatal fetal weight prediction is an invaluable parameter in some situation where to identify the at risk pregnancy for low birth weight become necessary. Reliable method for prenatal estimation of fetal weight two modalities have got popularity - Clinical estimation and another one is ultrasonic estimation. This study was designed to determine the accuracy of clinical versus ultrasound estimated fetal weight detecting the discrepancy with actual birth weight at third trimester. So that we can verify more reliable and accurate method. Objectives: To find out more accurate and reliable modality of fetal weight estimation in antenatal period during obstetric management planning. To compare clinical versus ultrasound estimated fetal weight & to determine discrepancy of both variable with actual birth weight. Method: This prospective, cross sectional analytical study was carried out in Dhaka Medical College Hospital from January 2006 to December 2006. By purposive sampling 100 pregnant women fulfilling inclusion criteria were included in my study in third trimester (29wks-40wks). In clinical weight estimation procedure SFH (Symphysio Fundal Height) was measured in centimeter. On pervaginal finding whether vertex below or above the ischial spine was determined. By Johnson’s formula fetal weight in grams was estimated. Then by ultrasound scan different biometric measurements were taken and finally by Hadlock’s formula fetal weight was estimated. Eventually actual birth weight was taken after birth by Globe Brand weighing machine. Accuracy of both modalities were compared and which one was more reliable predictor was determined by statistical analysis. Results: After data collection were analyzed by computer based software (SPSS). There was gradual and positive relationship between symphysiofundal height and estimated birth weight. Discrepancy between clinical and actual birth weight at third trimester was statistically significant – Paired Student’s ‘t’ test was done where p value was <0.001. Whereas discrepancy between sonographically estimated fetal weight with actual birth weight was not statistically significant (by paired ‘t’ test where p value was >0.05). That implies discrepancy between ultrasound estimated fetal weight and actual birth weight was significantly less than that of clinically estimated fetal weight. 14% clinically and 46% sonographically estimated fetal weight were observed within £ 5% of actual birth weight. 31% clinical and 42% sonographically estimates observed within 6% to 10% of actual birth weight and 55% clinical and 12% sonographically estimate were >10% of actual birth weight. That is about 88% sonographical versus 45% clinical estimates were within 10% of actual birth weight. Conclusion: There is no doubt about importance of fetal weight in many obstetric situations. Clinical decisions at times depends on fetal weight. Whether to use oxytocin, to use forceps or vacuum for delivery or extend of trial or ended by Caesarian section immediately or no scope of trial to be largely depend on fetal size and weight. So more accurate modality for antenatal fetal weight estimation has paramount importance. In my study sonographically estimated weight have more accuracy than that of clinical estimate in predicting actual birth weight. Sonographically estimated fetal weight is more reliable, accurate and reproducible rather than other modality. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 32-38

scholarly journals Swedish intrauterine growth reference ranges for estimated fetal weight

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Linda Lindström ◽  
Mårten Ageheim ◽  
Ove Axelsson ◽  
Laith Hussain-Alkhateeb ◽  
Alkistis Skalkidou ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Postnatal Growth ◽  
Fetal Weight ◽  
Hierarchical Regression ◽  
Reference Ranges ◽  
Hierarchical Regression Model ◽  
Gestational Week ◽  
Prospective Longitudinal ◽  
Estimate Fetal Weight ◽  
Estimated Fetal Weight

AbstractFetal growth restriction is a strong risk factor for perinatal morbidity and mortality. Reliable standards are indispensable, both to assess fetal growth and to evaluate birthweight and early postnatal growth in infants born preterm. The aim of this study was to create updated Swedish reference ranges for estimated fetal weight (EFW) from gestational week 12–42. This prospective longitudinal multicentre study included 583 women without known conditions causing aberrant fetal growth. Each woman was assigned a randomly selected protocol of five ultrasound scans from gestational week 12 + 3 to 41 + 6. Hadlock’s 3rd formula was used to estimate fetal weight. A two-level hierarchical regression model was employed to calculate the expected median and variance, expressed in standard deviations and percentiles, for EFW. EFW was higher for males than females. The reference ranges were compared with the presently used Swedish, and international reference ranges. Our reference ranges had higher EFW than the presently used Swedish reference ranges from gestational week 33, and higher median, 2.5th and 97.5th percentiles from gestational week 24 compared with INTERGROWTH-21st. The new reference ranges can be used both for assessment of intrauterine fetal weight and growth, and early postnatal growth in children born preterm.

Estimated fetal weight and severe neonatal outcomes in preterm prelabor rupture of membranes

2020 ◽  
Vol 48 (7) ◽  
pp. 687-693 ◽  
Author(s):  
Jose R. Duncan ◽  
Katherine M. Dorsett ◽  
Michael M. Aziz ◽  
Zoran Bursac ◽  
Mario A. Cleves ◽  
...  
Keyword(s):  
Characteristic Curve ◽  
Neonatal Outcomes ◽  
Fetal Weight ◽  
Clinical Tool ◽  
Logistic Regression Models ◽  
Clinical Variables ◽  
Prognostic Accuracy ◽  
Prediction Probability ◽  
Prelabor Rupture Of Membranes ◽  
Estimated Fetal Weight

AbstractObjectivesOur aim was to study the association of clinical variables obtainable before delivery for severe neonatal outcomes (SNO) and develop a clinical tool to calculate the prediction probability of SNO in preterm prelabor rupture of membranes (PPROM).MethodsThis was a prospective study from October 2015 to May 2018. We included singleton pregnancies with PPROM and an estimated fetal weight (EFW) two weeks before delivery. We excluded those with fetal anomalies or fetal death. We examined the association between SNO and variables obtainable before delivery such as gestational age (GA) at PPROM, EFW, gender, race, body mass index, chorioamnioitis. SNO was defined as having at least one of the following: respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, neonatal sepsis, or neonatal death. The most parsimonious logistic regression models was constructed using the best subset selection model approach, and receiver operator curves were utilized to evaluate the prognostic accuracy of these clinical variables for SNO.ResultsWe included 106 pregnancies, 42 had SNO (39.6%). The EFW (area under the receiver operating characteristic curve [AUC]=0.88) and GA at PPROM (AUC=0.83) were significant predictors of SNO. The addition of any of the other variables did not improve the predictive probability of EFW for the prediction of SNO.ConclusionsThe EFW had the strongest association with SNO in in our study among variables obtainable before delivery. Other variables had no significant effect on the prediction probability of the EFW. Our findings should be validated in larger studies.

scholarly journals How birth outcomes among a cohort of Guatemalan women with a history of prior cesarean vary by mode or birth across different interpregnancy intervals

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Margo S. Harrison ◽  
Ana Garces ◽  
Lester Figueroa ◽  
Jamie Westcott ◽  
Michael Hambidge ◽  
...  
Keyword(s):  
Mode Of Delivery ◽  
Secondary Analysis ◽  
Vaginal Birth ◽  
Global Network ◽  
Vaginal Birth After Cesarean ◽  
Cesarean Birth ◽  
Dilation And Curettage ◽  
History Of ◽  
Interpregnancy Intervals ◽  
Hospital Births

Abstract Objectives Our objectives were to analyze how pregnancy outcomes varied by cesarean birth as compared to vaginal birth across varying interpregnancy intervals (IPI) and determine if IPI modified mode of birth. Methods This secondary analysis used data from a prospective registry of home and hospital births in Chimaltenango, Guatemala from January 2017 through April 2020, through the Global Network for Women’s and Children’s Health Research. Bivariate comparisons and multivariable logistic regression were used to answer our study question, and the data was analyzed with STATA software v.15.1. Results Of 26,465 Guatemalan women enrolled in the registry, 2794 (10.6%) had a history of prior cesarean. 560 (20.1%) women delivered by vaginal birth after cesarean with the remaining 2,233 (79.9%) delivered by repeat cesarean. Repeat cesarean reduced the risk of needing a dilation and curettage compared to vaginal birth after cesarean, but this association did not vary by IPI, all p-values > p = 0.05. Repeat cesarean delivery, as compared to vaginal birth after cesarean, significantly reduced the likelihood a woman breastfeeding within one hour of birth (AOR ranged from 0.009 to 0.10), but IPI was not associated with the outcome. Regarding stillbirth, repeat cesarean birth reduced the likelihood of stillbirth as compared to vaginal birth (AOR 0.2), but again IPI was not associated with the outcome. Conclusion Outcomes by mode of delivery among a Guatemalan cohort of women with a history of prior cesarean birth do not vary by IPI.

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