Vaginal Delivery

2017

Operative vaginal deliveries are accomplished by applying direct traction on the fetal skull with forceps or by vacuum extractor [1]. There is periodic and vocal demand to delete assisted vaginal delivery, however clinical experience suggests that leaving all to natural forces or the scalpel will not accomplish this goal [2]. Assisted vaginal delivery is an integral part of obstetric care worldwide. It may be performed as infrequently as in 1.5% of deliveries or as often as in 15% [3].

Obstetrical & Gynecological Survey, 1997

Objective. To reveal factors influencing the prospect for vaginal delivery in very prolonged pregnancy. Material and methods. Thirty-six nulliparae and 14 multiparae delivered beyond 43 weeks followed a routine surveillance protocol. Labor was induced on strict indications (n=ll; oligohydramnios, large fetus, hypertension) and on 'soft' indications (n=24; favorable cervix, emotional stress). Statistics. Receiver operating characteristic curves were obtained for maternal stature and birthweight with regard to mode of delivery. Student's unpaired t-test, Mann-Whitney U test, and Fisher's exact test were used with a two-tailed p<0.05 considered statistically significant. Results. Labor started spontaneously within three days in >50% of cases managed expectantly. All multiparae had nonoperative vaginal deliveries. Of nulliparae, 89% delivered vaginally if spontaneous labor and 56% if induced. Failure to progress was the most common reason for operative delivery. A maternal height of 1160 cm, a very unripe cervix, and a birthweight >4250 g were unfavorable factors in induced nulliparae. No case of perinatal mortality, severe birth asphyxia, meconium aspiration, or shoulder dystocia occurred. Fetal meconium release, fetal distress in labor, and birth asphyxia did not significantly differ with regard to parity or mode of labor. Conclusions. The prospect for vaginal delivery was strongly associated with parity. All multiparae had nonoperative vaginal deliveries, irrespective of spontaneous or induced labor. In nulliparae, a spontaneous onset was favorable but a maternal height of 1160 cm, a very unripe cervix, and a birthweight >4250 g were unfavorable factors. In uncomplicated pregnancy with favorable factors spontaneous labor can be awaited for a few days.

INTRODUCTION -Operative vaginal delivery refers to a delivery in which the operator uses forceps or a vacuum device to extract the fetus from the vagina, with or without the assistance of maternal pushing. The decision to use an instrument to deliver the fetus balances the maternal, fetal, and neonatal impact of the procedure against the alternative options of cesarean birth or expectant management.

Innovative Publication, 2017

Objective: To study and analyse the vaginal birth with previous caesarean section and its out come Methods: A study of 100 cases of post caesarean pregnancies with induction of labour carried out. Trial is given with one previous lower segment caesarean section with no obstetric contraindication and scoring system to predict the success in trail of labour with the inclusion criteria including singleton pregnancy presenting with vertex, with adequate pelvis without any antenatal complications. The exclusion criteria included classical or unknown uterine scar type, past history of uterine rupture, past history of corporeal surgery, severe myopia complicated by retinal detachment, incompatible with safe vaginal delivery and multiple pregnancy. Results: In our study we found that out of 100 cases, 61% had viganial delivery and 39% underwent caesarean section. Out of 61 cases delivered vaginally, 45 cases had FTND with episiotomy, 07 FTND without episiotomy, 04 FTND with first degree perianal tear, 11 cases were by outlet forceps with episiotomy and 5 cases were delivered by low forceps. Conclusion: conclude that predicting the score for VBAC and giving trial of labour helps in decreasing the number of repeat caesarean sections in selected cases where there is no contraindication for vaginal delivery. The high probability of success and minimum risk of uterine rupture, favours the use of trial for vaginal delivery in women with previous caesarean section.

Ginekologia Polska

Objectives: To compare a perinatal outcome in breech presentation depending on different modes of vaginal breech delivery (VBD). Material and methods: Over the course of 13 years (2005-2018), perinatal outcome of newborns was compared among 98 singleton pregnancies (64 term pregnancies and 34 preterm pregnancies) completed with VBD divided into six groups depending on the mode of delivery used (Bracht, Müller, Thiessen, classical arm release, Mauriceau-Levret-Veit-Smellie (MLVS), and Vermelin´s spontaneous vaginal delivery). Also, maternal demographic parameters were observed. Results: Of 98 singleton pregnancies, the most frequently used mode was Thiessen (35.71%), followed by MLVS technique (25.51%), Bracht (22.45%), Vermelin (13.27%), classical arm release (2.04%) and Müller (1.02%). Newborns with Apgar score ≤ 7 at 5 min. were transferred to the neonatal intensive care unit (NICU), which included 15.31% of newborns (total 15 newborns: 1 term and 14 preterm newborns). The incidence of episiotomy was 63.27%. Seventy-point five percent of women included in the study were ≤ 35 years of age, and 37.76% were multiparas. Delivery was induced in 7.14% cases. Conclusions: Less-traumatizing actions during VBD have less harmful consequences and better perinatal outcome. Lower Apgar score was noted with the aggressiveness of the mode of VBD.

The Professional Medical Journal, 2010

Objective: It is to compare neonatal morbidity in terms of birth trauma, respiratory distress syndrome, APGAR score in Primigravida with breech presentation delivered vaginally and emergency cesarean section. Design: Cross-sectional comparative study. Place and Duration of Study: Obstetrics and Gynaecology Unit-I, Bahawal Victoria Hospital, Bahawalpur from 1-5-2007 to 30-4-2008. Patients and Method: The study was carried out on all Primigravida with breech presentation reported through emergency in labour deliveredvaginally and by emergency cesarean section. The variable analyzed were birth trauma, respiratory distress syndrome and APGAR score at 1 and 5 minutes. Students-t test was used for comparison between means and chi square test for comparison between percentages. Significance was taken at P&lt;0.05. Results: It was found that mean APGAR score at 1 and 5 minutes is 7.31 and 9.066 in vaginal and 8.533 and 9.644 incesarean group. Respiratory distress syndrome is more in cesarea...

International Health

Background To observe prevalence, characteristics and outcomes associated with operative vaginal birth (OVB). Methods We compared spontaneous vaginal birth with OVB. Results Of 993 women, 759 (76.4%) experienced vaginal birth; 716 were spontaneous (94.3%), 14 (1.8%) underwent forceps-assisted birth and 29 (3.8%) had vacuum assistance. In a multivariable model of OVB (forceps and vacuum), compared with a midwife, general practitioners (OR 5.6, p = 0.04) and integrated emergency surgical officers (OR 42.8, p = 0.001) were more likely to attend. Women experiencing OVB were more likely to receive local anesthesia (OR 3.0, p = 0.009). Conclusion OVB is used sparingly but safely at Mizan-Tepi University Teaching Hospital.

The New Indian Journal of OBGYN, 2021

Objectives: To study the maternal and neonatal outcome in patients undergoing instrumental vaginal delivery (vacuum & forceps delivery) at a tertiary care teaching hospital. Methods: This retrospective study was carried out in patients undergoing instrumental vaginal delivery during the study period. Results: In present study total 266 patients were included. 1.39 % instrumental vaginal deliveries were noted. Most common age group in present study was 21-25 years in both groups (39 %-vacuum, 41%-forceps). Instrumental vaginal deliveries were common in patients with 37-40 weeks of gestation. In present study most common indication for Instrumental vaginal delivery (vacuum & forceps) was delayed second stage (32 %) followed by fetal distress (26 %) & medical disorders (18 %). In present study, 3 fresh still births and 3 early neonatal deaths were noted, common indication was fetal distress in second stage of labour. We noted cervical lacerations (15%), PPH requiring blood transfusion (13%) , vaginal lacerations (10%), extension of episiotomy (5%) & perineal injuries (2%) as maternal complications. Neonatal jaundice was most common neonatal complication in present study (9 %-vacuum, 15%-forceps). Conclusion: Instrumental vaginal delivery remains useful procedure if applied judiciously by a trained obstetrician. It helps to improve neonatal and maternal outcome, also helps to reduce caesarean delivery rate.

Lancet Global Health, 2019

Link to publication in VU Research Portal citation for published version (APA) Nolens-van der Horst, B. J. (2019). Reintroduction of vacuum extraction in a tertiary referral hospital in Uganda. General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal ? Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.

Medicolegal Issues in Obstetrics and Gynaecology, 2018