scholarly journals The Costs and Their Determinant of Cesarean Section and Vaginal Delivery: An Exploratory Study in Chongqing Municipality, China

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Zhifei He ◽  
Zhaohui Cheng ◽  
Tailai Wu ◽  
Yan Zhou ◽  
Junguo Chen ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Cesarean Section ◽  
Vaginal Delivery ◽  
Influencing Factors ◽  
Chi Square ◽  
Delivery Modes ◽  
Chongqing Municipality ◽  
Vaginal Deliveries ◽  
Tertiary Hospitals ◽  
Chi Square Test

Objectives. This study aims to analyze the cesarean section (CS) rates and vaginal delivery rates in tertiary hospitals of China, explore the costs of two different deliveries, and examine the relative influencing factors of the costs in both CS and vaginal deliveries. Methods. 30,168 anonymized obstetric medical cases were selected from three sample tertiary hospitals in Chongqing Municipality from 2011 to 2013. Chi-square test was used to compare the distributions of CS and vaginal deliveries under different indicators. Mann–Whitney test and Kruskal-Wallis test were adopted to analyze the differences under different items. Multiple linear regression was used to determine the influencing factors of the costs of different delivery modes. Results. (1) The rates of CS were 69%, 65.5%, and 59.2% in the three sample tertiary hospitals in Chongqing from 2011 to 2013. (2) The costs and the length of stay of CS were greater than those of vaginal delivery, which had significant differences (P<0.005). (3) The areas, length of stay, age, medical insurance, and modes of delivery were the influencing factors of both CS and vaginal delivery costs. Discussion. The high CS rates in China must be paid significant attention. The indicators of two modes of delivery should be regulated strictly. CS rate reduction and saving medical resources will be the benefits if vaginal delivery is chosen by pregnant women.

scholarly journals Cesarean Vs Vaginal Delivery : An Institutional Experience

2018 ◽  
Vol 56 (209) ◽  
pp. 535-539
Author(s):  
Shanta Sharma ◽  
Indra Dhakal
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Categorical Variables ◽  
Maternal Complications ◽  
Chi Square ◽  
Normal Delivery ◽  
Vaginal Deliveries ◽  
Chi Square Test ◽  
Institutional Experience ◽  
Prolonged Labor

  Introduction: According to the WHO, 15% of deliveries have precise indication for cesarean section where it is mandatory for the preservation of maternal and/or fetal health. Increasing rates of Lower Segment Caesarean Sections puts foreword various question that, whether a LSCS need to be reflected as a normal delivery in this twenty first century. There are conflicting reports regarding the safety of caesarean sections. While a significant number of cesarean delivery are performed for obstetrical indications, some are simply due to maternal request and may incur several risks for the child. Not much study has compared the complications of caesarean section with those of vaginal birth. Objective of this study is to find out and compare the common complications of cesarean section with vaginal deliveries on mothers. Methods: A descriptive study was conducted in two selected hospitals of Rupandehi district, Nepal. Data was collected as per pretested structured proforma from 550 respondents randomly and analyzed by using SPSS, MANOVA and Chi-square test to determine associations between categorical variables. Results: In total of 550 mothers, 408 (74.2%) had vaginal delivery and 142 (25.8%) had cesarean delivery.The common maternal complications were postpartum hemorrhage 116 (21.1%), prolonged labor 47 (8.5%) and wound infection 42 (7.6%). Conclusions: The result of the study shows that the maternal complications were higher among LSCS compared to vaginal delivery.

scholarly journals Perbedaan Pola Menyusui Bulan Pertama Ibu Melahirkan Seksio Sesarea Dibandingkan Melahirkan Normal di Rumah Sakit Sayang Bayi

2018 ◽  
Vol 5 (3) ◽  
pp. 126
Author(s):  
Winda Nurmayani ◽  
Madarina Julia ◽  
Shinta Prawitasari
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Sampling Technique ◽  
Total Sample ◽  
Chi Square ◽  
Exact Test ◽  
Vaginal Deliveries

Background: exclusive breastfeeding should be provided until 6 months of age, but the fact proves that the pattern of breastfeeding has decreased. The pattern of the first month lactation is a critical period for the survival of the subsequent breastfeeding, so it is necessary to make efforts to maintain the duration of breastfeeding because the success of the first month breastfeeding will increase mothers’ confidence to continue breastfeeding.Objective: To determine differences in the pattern of the first month breastfeeding in mothers who gave birth by cesarean section compared to those by vaginal delivery in Rumah Sakit Sayang Bayi (Baby Friendly Hospital)Method: Type of research is comparative observational  with a prospective cohort design using a quantitative approach. The research was conducted in Baby Friendly Hospital of RSUD (General Hospital) Mataram City. Total sample 120 consisted of 60 mothers giving birth the caesarean section and 60 mothers vaginal delivery. The independent variable of giving birth by Cesarean Section and vaginal delivery, dependent variable pattern the first month of breastfeeding and external variables age, parity, employment, the incidence of antepartum and postpartum. The sampling technique using consecutive sampling. Analysis of the data used is univaribel, bivariate using Chi-square and Fisher's exact test and multivariable logistic regression and stratification testResult and Discussion: There was no significant correlation between the mode of delivery and the patterns of the first month breastfeeding by including a variable of employment with a value of OR (95% CI) = 1.6 (0.63 to 4.17) and there was a decrease in the value of OR (95% CI ) from 2.5 (1.05 to 5.94) to 1.6 (0.63 to 4.17); there was also no  significant correlation when involving the variable of the incidence of ante partum and post partum with the value of OR (95% CI) = 1.7 (0.45 to 6.26) and OR (95% CI) = 2.3 (0.96 to 5.53), respectively.Conclusion: : There is no difference patterns of breastfeeding mothers first month who gave birth cesarean section compared to normal birth. Caesarean section would affect the pattern of the first month breastfeeding if cesarean section deliveries occurred at housewives and mothers who did not experience the incidence of ante partum. Keywords: pattern of breastfeeding; vaginal deliveries; caesarean section; breast milk; 

scholarly journals Complications among Mothers and New Born Due to Delivery Process in Rupandehi District Nepal

2018 ◽  
Vol 16 (2) ◽  
pp. 190-194
Author(s):  
Shanta Sharma ◽  
Indra Dhakal
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Descriptive Study ◽  
Lower Segment ◽  
Chi Square ◽  
Normal Delivery ◽  
Child Birth ◽  
New Born ◽  
Lower Segment Cesarean Section ◽  
Chi Square Test

Background: Child birth is a universally celebrated occasion, yet everyday for thousands of women child birth is experienced not as a joyful event as it should be, but as a private hell that may even end in death. The objective of this study is to determine the complications of normal delivery and cesarean section on the mothers and new born.Methods: A descriptive study was conducted in two selected hospitals of Rupandehi district, Nepal. Data was collected as per pretested structured proforma from 550 respondents who were the mothers and new born delivered normally and through cesarean section randomly till the completion of sample size and analyzed by using SPSS, MANOVA and Chi-square test to determine associations between categorical variables.Results: In a total of 550 deliveries,25.8% were cesarean delivery, 42.7% motherssuffered from delivery related complications, common were PPH (21.1%), prolonged labour (8.5%) and wound infection (7.6%). 35.5% of newborn had complications, common were respiratory distress (6.3%) and neonatal jaundice (4.2%).Conclusions: Delivery related complications were higher among Lower segment cesarean section compared to vaginal delivery in mothers and newborn.Keywords: Cesarean section; child birth; maternal complication; new born; vaginal delivery.

scholarly journals Outcome of pregnancy in women with previous one cesarean section

2018 ◽  
Vol 7 (8) ◽  
pp. 3257
Author(s):  
Manish Mittal ◽  
Meenakshi Kandoria ◽  
Rajeev Sood ◽  
Monica Chauhan ◽  
Rohini Rao ◽  
...  
Keyword(s):  
Cesarean Section ◽  
P Value ◽  
Perinatal Complications ◽  
Chi Square ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Vaginal Deliveries ◽  
Mother And Child ◽  
Chi Square Test ◽  
Gandhi Medical College

Background: Worldwide rise in cesarean section (CS) rate during the last three decades has been the cause of alarm and needs an in-depth study. The purpose of this study was to determine the outcome of pregnancy in women with previous one cesarean section and maternal and perinatal complications. It also aimed at identifying the factors, which can influence the outcome of trial of labour (TOL).Methods: The prospective study was conducted in the department of Obstetrics and Gynaecology, Kamla Nehru hospital for mother and child, Indira Gandhi Medical College, Shimla, from June 2013 to May 2014 which included all women undergoing trial for vaginal birth after a previous cesarean who were more than 34 weeks, singleton viable fetus of appropriate size with cephalic presentation with inter delivery interval more than 18 months. Collected data was analysed by Student T-test and Chi-square test was used where required, for statistical analysis using Epi info 7 software. P value <0.05 was considered significant.Results: Out of 152 subjects given trial of labour, 107 (70.39%) subjects had successful VBAC and 45 (29.61%) had repeat emergency cesarean section. The maternal morbidity in emergency cesarean section group and vaginal delivered group was seen in 14 (31%), 8 (7.47%) subjects respectively. No significant perinatal morbidity was observed. VBAC rate was significantly more in women who had prior vaginal deliveries, especially in those with previous VBAC.Conclusions: In carefully selected cases, trial of labour (TOL) after a prior cesarean is safe and often successful. A prior vaginal delivery, particularly, a prior VBAC are associated with a higher rate of successful TOL.

scholarly journals CONTROL OF POST-SURGICAL PAIN

2010 ◽  
Vol 17 (03) ◽  
pp. 400-404
Author(s):  
ALI MIR MANSOURI ◽  
FARNOUSH FARZI ◽  
SHIRIN KHALKHALIRAD ◽  
Katayoon Haryalchi ◽  
Abas Sediginejad
Keyword(s):  
Pain Relief ◽  
Cesarean Section ◽  
Pain Control ◽  
Nausea And Vomiting ◽  
Chi Square ◽  
Double Blind ◽  
Analgesic Effects ◽  
Emergency Cesarean ◽  
Surgical Pain ◽  
Chi Square Test

Introduction: There are many complications for patients with post cesarean section relative pain. So it delays in discharging or increasing in hospital stay. The objective of this study was a comparison between Tramadol and Meperidine according to pain relief or other possible complications in post cesarean section pain control. Materials and Methods: This study was a double blind clinical trial. It arranged for 240 parturients who scheduled for emergency cesarean section with pain after surgery in spite of spinal anesthesia. All patients were in ASA class I. They were divided randomly in two groups .Meperidine (M) and Tramadol (T) groups with 120 patients in each group. After beginning of pain in post anesthesia care unit (VAS> or = 4), in group (T) tramadol 1.5 mg/kg and in group (M) meperidine  .5 mg/kg were injected intravenously. Apart from pain, other drug complications such as shivering, blood pressure changes, itching, nausea and vomiting, drowsiness were recorded one and two hours after injection. Data were analyzed by chi-square test. Results: Relative frequency rate (RFR) of 50% decrease in pain score one hour after intravenous injection was 56.7% in group (T) and 69.2% in group (M) ( P = 0.054). RFR for respiratory depression after one hour was 5.8% in (M) group and 0 in (T) group (P = 0.007). RFR for nausea after one hour was 39.2% in (T) group and 23.3% in (M) group (P = 0.008). RFR for vomiting after one hour was 23.3% in (T) group and 13.3% in (M) group (P= 0.045). RFR for drowsiness after one hour was 25% in (M) group and 3.3% in (T) group (P=0.007). There was no statistically significant relationship after 2nd hour for pain relief, nausea, vomiting and drowsiness between two groups. There was no difference between two groups in RFR for shivering, blood pressurechanges and itching in both two groups. Conclusion: This study illustrates both remedies Meperidine and Tramadol which were effective for pain relief and shivering after cesarean section. But according to high incidence of nausea and vomiting with Tramadol and more analgesic effects of Meperidine than Tramadol, administration of Meperidine is better than Tramadol after cesarean section for pain control.

scholarly journals ULTRASOUND PREDICTABILITY OF LOWER UTERINE SEGMENT CESAREAN SECTION SCAR THICKNESS

2020 ◽  
pp. 9-11
Author(s):  
Madhu Kumari ◽  
Kumari Bibha ◽  
Abha Sinha ◽  
Debarshi Jana
Keyword(s):  
Cesarean Section ◽  
Gestational Age ◽  
Statistical Significance ◽  
P Value ◽  
Chi Square ◽  
Medical College ◽  
Chi Square Test ◽  
Uterine Scar ◽  
Age Range ◽  
The Given

Objective: The objective of this study is to find out association between scar thickness, assessed sonographically, and intraoperative findings (IOF). Study Design: Descriptive study. Place and Duration of Study: Department of Obstetrics and Gynecology, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar from June 2019 to May 2020. Methodology: A total of 70 pregnant patients were included in this study. Transabdominal ultrasound was done for scarred uteri. Sonographic findings were co-related with introperative findings. All the given data were entered on SPSS version 23. Age was expressed as mean ± SD. Parity, gestational age, and interval between cesarean sections were expressed as frequencies with percentages. Statistical analysis was done by using Chi-square test for categorical data for association between sonographic scar thickness and intraoperative findings. The statistical significance was set at p-value <0.05. Results: The age range of the patients was 20- 36 years with a mean of 27.91 ±3.690 years. Gestational age at the time of cesarean section was between 27-40 weeks of gestation with a mean of 37 ±2.126 weeks. The interval from previous cesarean was 10 months at the minimum, and 6 years at the maximum with a mean of 2.29 ±1.0 months. Mean scar thickness was 2.5 mm. Association between scar thickness (<1-3 mm) and intaoperative findings of dehiscence and rupture showed a p-value of <0.001. Conclusion: Sonographic assessment of a uterine scar has a practical application to determine the thickness of previous scar, and assess its integrity.

scholarly journals Anandamide Exerts a Differential Effect on Human Placenta Before and After the Onset of Labor

2021 ◽  
Vol 12 ◽  
Author(s):  
Paula Accialini ◽  
Cyntia Abán ◽  
Tomás Etcheverry ◽  
Mercedes Negri Malbrán ◽  
Gustavo Leguizamón ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Endocannabinoid System ◽  
Cesarean Sections ◽  
Vaginal Deliveries ◽  
Before And After ◽  
Elective Cesarean ◽  
Main Components ◽  
Relevant Finding

The onset of labor involves the action of multiple factors and recent reports have postulated the endocannabinoid system as a new regulator of this process. Our objective was to study the role of anandamide, one of the main endocannabinoids, on the regulation of placental molecules that contribute to the onset of labor at term. Placental samples were obtained from patients with laboring vaginal deliveries and from non-laboring elective cesarean sections. Vaginal delivery placentas produced higher prostaglandins levels than cesarean section samples. Besides, no differences were observed in NOS basal activity between groups. Incubation of vaginal delivery placentas with anandamide increased prostaglandins concentration and decreased NOS activity. Antagonism of type-1cannabinoid receptor (CB1) did not alter the effect observed on NOS activity. Conversely, incubation of cesarean section placentas with anandamide reduced prostaglandins levels and enhanced NOS activity, the latter involving the participation of CB1. Furthermore, we observed a differential expression of the main components of the endocannabinoid system between placental samples, being the change in CB1 localization the most relevant finding. Our results suggest that anandamide acts as a modulator of the signals that regulate labor, exerting differential actions depending on CB1 localization in laboring or non-laboring term placentas.

scholarly journals Workplace Violence Against Healthcare Professionals in Thai Tertiary Hospitals

2021 ◽  
Author(s):  
Sophida Kueanongkhun ◽  
Siriwan Grisurapong ◽  
Kitirat Techatraisak ◽  
Thomas E. Guadamuz
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Workplace Violence ◽  
Healthcare Workers ◽  
Qualitative Data ◽  
Physical Violence ◽  
Chi Square ◽  
Racial Harassment ◽  
Tertiary Hospitals ◽  
Chi Square Test

Abstract Background: Thailand lacks evidence of the current prevalence of workplace violence (WPV) at tertiary hospitals. This study aimed to examine the prevalence of, perpetrators of, and factors associated with WPV against healthcare workers in excellent tertiary hospitals in Thailand.Methods: This was a mixed-methods study. A questionnaire was individually administered by an interviewer to 220 healthcare workers using a tablet with an online platforms, and the completion rate was 100%. The study was conducted from July 2018 to March 2019. Pearson’s chi-square test was used to examine the variables related to any violence according to individual and work data. Odds ratios with 95% confidence intervals were used to assess risk factors for exposure to violence using a logistic regression model. Thirty participants provided additional qualitative data that were used for thematic analysis.Results: The findings revealed that in the past 12 months, 63.6% of the participants experienced violence at their workplaces. The most common type of violence reported was verbal violence (56.4%), followed by physical violence (24.1%), bullying (16.4%), sexual harassment (4.1%), and racial harassment (3.6%). Multivariable logistic regression revealed that the correlates of violence at hospitals included being male (OR = 4.28, 95% CI 1.50–12.19), working in an outpatient department (OR = 2.55, 95% CI 1.42–4.58), and having direct contact with clients (OR = 3.12, 95% CI 1.25–7.73). The qualitative data revealed 5 major themes.Conclusion: There is a high prevalence of violence against all healthcare workers at excellent tertiary hospitals in Thailand. Policymakers need to be aware of the roots and risk factors for all types of WPV. The results could also contribute to the development of appropriate policies, interventions for conflicts based on intergenerational gaps, reporting, investigation processes, preventive measures, and zero-tolerance protocols for all healthcare workers.

scholarly journals Delivery of Twin Gestation (≥ 32.0 Weeks): The Vaginal Route as a Practicable and Safe Alternative to Cesarean Section

2020 ◽  
Vol 80 (10) ◽  
pp. 1033-1040
Author(s):  
Anne Dathan-Stumpf ◽  
Katharina Winkel ◽  
Holger Stepan
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Neonatal Outcomes ◽  
University Hospital ◽  
Delivery Mode ◽  
Safe Alternative ◽  
Vaginal Deliveries ◽  
Twin Pregnancies ◽  
Second Twin

Abstract Objective The appropriate delivery mode for twins is discussed controversially in the literature. The aim of this study was to investigate delivery modes and short-term neonatal outcomes of twin pregnancies delivered in University Hospital Leipzig. Material and Methods A total of 274 twin pregnancies (32.0 to 39.4 weeks of gestation) delivered between 2015 and 2017 were analyzed retrospectively with regard to the planned and final delivery mode as well as neonatal outcomes. The inclusion and exclusion criteria for vaginal delivery were comparable to those of the Twin Birth Study. Results The spontaneous birth rate for births planned as vaginal deliveries was 78.5%; the rate of secondary cesarean section was 19.4%. The final total cesarean rate was 58.8%, and the rate of vaginal deliveries was 41.2%. Vertex or non-vertex position of the second twin had no significant effect on neonatal outcome or mean delivery interval between the birth of the first and second twin. Chorionicity, neonatal weight and gender had no significant impact on delivery mode. However, successful vaginal delivery was associated with higher gestational age and both fetuses in vertex position. The combined neonatal outcome for both twins was significantly worse if they were delivered by cesarean section compared to spontaneous birth. In addition, the leading twin in monochorionic/diamniotic (MC/DA) pregnancies was intubated more frequently after cesarean delivery and had significantly lower Apgar scores. Conclusion Vaginal delivery in twin pregnancies is a practicable and safe option in specific defined conditions and when the appropriate infrastructure and clinical experience is available.

scholarly journals Retrospective evaluation of attempted vaginal deliveries in dichorionic twin pregnancies

2020 ◽  
Author(s):  
Sabine Enengl ◽  
Peter Oppelt ◽  
Simon-Hermann Enzelsberger ◽  
Philip Sebastian Trautner ◽  
Omar Shebl ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Time Interval ◽  
Apgar Scores ◽  
Outcome Parameters ◽  
Retrospective Data Analysis ◽  
Vaginal Deliveries ◽  
Mode Of Birth ◽  
Twin Pregnancies ◽  
Second Twin

Abstract Purpose Numbers of planned cesarean deliveries are increasing in twin pregnancies, despite the lack of evidence for this approach, and the second twin is thought to be at risk for a poorer outcome. The aim of this study was to examine whether twins have a poorer outcome if an attempted vaginal delivery is changed to a cesarean section or combined delivery. Methods This retrospective data analysis included all women with dichorionic twin pregnancies attempting vaginal delivery over a 10-year period. Outcome parameters for the first and second twins relative to their mode of birth were compared. A correlation model between the interdelivery time interval and Apgar scores was calculated. Subgroup analyses assessing the birth mode of the first and second twins were conducted. Results A total of 248 women were enrolled in the study. The second twins had significantly lower values for outcome parameters, such as umbilical artery cord pH and Apgar scores in comparison with the first twins (P < 0.01). The subgroup analysis of birth modes in first and second twins showed a significantly poorer outcome in the cesarean section and combined delivery group (P < 0.05). The interdelivery time interval was significantly longer in the second twin cesarean section group (P < 0.01). There was no significant correlation between the interdelivery time intervals and Apgar scores (P > 0.05). Conclusion Although outcome parameters were significantly lower in second twins and twins born via secondary cesarean section, the clinical relevance of this appears to be negligible.

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