Incidence Of Cesarean Section Research Articles

Robotic-assisted laparoscopic versus abdominal and laparoscopic myomectomy: A systematic review and meta-analysis.

Myomectomy is the preferred treatment for women with uterine fibroids and fertility requirements. There are three modalities are used in clinical practice for myomectomy: abdominal myomectomy (AM), laparoscopic myomectomy (LM), and robot-assisted laparoscopic myomectomy (RLM). To compare the perioperative and postoperative outcomes of RLM, AM, and LM. We searched PubMed, Web of Science, Embase, and Clinical Trials for relevant literature published between January 2000 and January 2023. We included all studies reporting peri- and postoperative outcomes of myomectomy in patients with uterine myomas. Surgical treatments were classified as RLM, LM, or AM. Two or more authors selected studies independently, assessed risk of bias, and extracted data. We derived mean difference (MD) or odds ratio (OR) with 95% confidence intervals (CIs) for each outcome, subgrouping trials by the patient characteristics and myoma characteristics. We used the I2 statistic to quantify heterogeneity and the random-effects model for meta-analysis when appropriate. We used the funnel plot to assess the publication bias. A total of 32 studies with 6357 patients were included, of which 1982 women had undergone RLM. The operating time was significantly longer (MD = 43.58, 95% confidence interval [CI]: 25.22-61.93, P < 0.001), and the incidence of cesarean section after myomectomy was significantly lower (OR = 0.27, 95% CI: 0.10-0.78, P = 0.02) in RLM than in LM. Compared with AM, the operation time, blood loss, blood transfusion rate, complication rate, total cost, length of hospital stay, and pregnancy rate of patients with RLM were significantly different. The safety and effectiveness of RLM are superior to those of AM but inferior to those of LM.

Clinical Significance of Supraventricular Tachycardia During Pregnancy in HealthyWomen.

Supraventricular tachycardias (SVT) are the most frequently encountered arrhythmias in pregnancy with unclear clinical significance. This study sought to report the prevalence, describe the management, and explore the association between SVT and adverse obstetric outcomes. Cohort study of primiparous and multiparous women without history of Cesarean section (CS), and with structurally normal hearts admitted in labor. The study group consisted of women with at least 1 SVT episode during pregnancy, and the control group was randomly selected in a 4:1 ratio. Of 141,769 women meeting the inclusion criteria, SVT diagnosis was confirmed in 122. A total of 76 (age 33.2 ± 4.8 years) had at least 1 symptomatic and documented episode during pregnancy. In women with a known SVT diagnosis before pregnancy, medical therapy was not associated with a lower risk of SVT recurrence (OR: 1.07; 95%CI: 0.41-2.80). However, catheter ablation before pregnancy was associated with significantly lower risk of SVT recurrence (OR: 0.09; 95%CI: 0.04-0.23). Women with SVT during pregnancy had higher incidence of CS (39.5% vs 27.0%; P=0.03), and preterm labor (PTL) (30.3% vs 8.6%; P< 0.001). Adjusting for age and parity, SVT during pregnancy was an independent predictor of CS (OR: 1.80; 95%CI: 1.03-3.10), particularly planned CS (OR: 2.89; 95%CI: 1.06-7.89) and PTL (OR: 4.37; 95%CI: 2.30-8.31). SVT during pregnancy is associated with increased risk for CS and PTL in healthy women. History of SVT should be sought as early as preconception counseling, and a multidisciplinary approach is warranted for both prevention and management of SVT occurrence.

PROFILE OF INDUCED LABOUR IN UNCOMPLICATED PREGNANCIES WITH UNFAVOURABLE MODIFIEDS BISHOP SCORE IN A TERTIARY CARE CENTRE

Background: Induction of Labor is a non-spontaneous initiation of uterine contractions before onset of spontaneous labour that results in progressive dilatation with effacement of cervix and further descent of the presenting part of fetus, leading to safe vaginal delivery of the baby. ACOG has an extensive list of recommendations on delivery timing for various complicated and uncomplicated pregnancies. Pharmacological methods are most commonly deployed for induction in patients with poor bishopÂ’s score. The aim of this study is to determine maternal and perinatal outcome in induced labour in medically uncomplicated pregnancies. Methods: This is a hospital based retrospective observational study conducted for a duration of 11 months on 422 patients admitted in our labour room with unfavourable modified bishops score given induction of labour for various reasons after ruling out any contraindication for vaginal delivery. Results: In our study of 422 participants, majorities was term pregnancies (93.36%) and were induced by dinoprostone gel. Most common indication for IOL was postdated pregnancy (36.49%) and 67.3% patients underwent vaginal delivery. 27.7% of all vaginal deliveries required additional doses of dinoprostone. Most common indication for emergency caesarian section was FIOL (63.77%). All neonates were born alive and 32.46% neonates got admitted in NICU, most common indication being neonatal jaundice.42.42% cases developed complication of induction most common being MSL(17.54%). Conclusion: Induction of labor is beneficial and safe even in uncomplicated pregnancies. Although there is increased incidence of caesarian section, induction should be performed once risk of continuing pregnancy outweighs risk of termination.

Differences in neonatal outcomes between normal and preeclampsia complicated pregnancies

This study aims to explore potential variations in neonatal outcomes between pregnancies without complications and those complicated by preeclampsia within a tertiary gynecology and obstetrics center in Serbia. By focusing on neonatal outcomes, the research seeks to provide a nuanced understanding of how preeclampsia may impact the health and well-being of newborns in this specific medical setting. The investigation will shed light on any distinctive patterns or disparities in outcomes, contributing valuable insights to the broader understanding of maternal and neonatal health within the context of preeclampsia in the Serbian healthcare system. Material and MethodThis case-control study included 50 preeclampsia patients and 50 healthy normotensive pregnant women followed up in the Clinic for Gynecology and Obstetrics, Clinical Center of Serbia. Neonatal outcomes in both groups were monitored until discharge from the hospital. Appropriate statistical tests were applied for experimental and clinical data analysis. ResultsCesarean Section was significantly more frequent in preeclampsia than in the normal pregnancy group. The mean gestational age of birth and Apgar scores were significantly lower in newborns of preeclamptic mothers than in healthy control (p < 0.001). Hospitalization was longer after preeclampsia-complicated pregnancies than uncomplicated controls. Admission to the neonatal intensive care unit, along with perinatal complications such as perinatal asphyxia, respiratory distress syndrome, neonatal convulsions, intracranial hemorrhage, jaundice, anemia, and infection, were significantly more common in the preeclampsia group than in the controls (p < 0.001). In the whole study group, only one newborn from a pregnancy complicated with early and severe preeclampsia had a lethal outcome. Discussion and ConclusionsThe incidence of Cesarean sections exhibited a noteworthy increase in pregnancies complicated by preeclampsia, contrasting with a reduction in both gestational age and Apgar Scores when compared to the group with normal pregnancies. This investigation underscores a significant elevation in overall morbidity rates among newborns born to mothers grappling with preeclampsia in comparison to those born from uncomplicated pregnancies. The findings emphasize the multifaceted impact of preeclampsia on perinatal outcomes, underscoring the importance of comprehensive care strategies to address the unique challenges posed by this complication during pregnancy.

Clinical Efficacy and Nursing Efficiency Analysis of Jiuwei Zhusheng Decoction in Promoting Cervical Ripening in the Perinatal Midwifery Holistic Care

To evaluate the clinical efficacy of Jiuwei Zhusheng Decoction (JWZSD) and perinatal midwifery holistic nursing care in promoting cervical ripening, we conducted a randomized controlled trial involving 80 primiparous and full-term pregnant women with indications for labor induction. The participants were divided into a control group (n = 40) receiving intravenous oxytocin for labor induction and a study group (n = 40) receiving oral administration of JWZSD. Additionally, 30 female Wistar pregnant rats were randomly assigned to the blank group, oxytocin group, and traditional Chinese medicine (TCM) group to compare relevant indicators. In the clinical study, both groups showed significant increases in Bishop scores after treatment. However, the study group demonstrated significantly greater improvements compared to the control group. Moreover, the study group exhibited higher rates of clinical effectiveness and successful vaginal delivery than the control group. In the animal experiment, both the oxytocin and TCM groups displayed disorganized and relaxed cervical connective tissue with evident interstitial edema when compared to the blank group. Furthermore, rats in the TCM group exhibited significantly elevated serum levels of interleukin-8 (IL-8), matrix metalloproteinase-9 (MMP-9), prostaglandin E2 (PGE2), and cyclooxygenase-2 (COX-2) compared to those in the oxytocin group. The combination of JWZSD and perinatal midwifery holistic nursing care for labor induction can effectively enhance cervical ripening and reduce the incidence of cesarean section, potentially through the regulation of IL-8, MMP-9, COX-2, and PGE2 expression. However, further investigations are required to elucidate the underlying mechanisms.

The impact of a trial of labor after cesarean versus elective repeat cesarean delivery: A meta-analysis.

The increasing global incidence of cesarean section has prompted efforts to reduce cesarean delivery rates. A trial of labor after cesarean (TOLAC) has emerged as an alternative to elective repeat cesarean delivery (ERCD) for women with a prior cesarean delivery. However, the available evidence on the comparative outcomes of these 2 options remains inconsistent, primarily due to varying advantages and risks associated with each. Our meta-analysis aims to compare the maternal-neonatal results in TOLAC and ERCD in women with prior cesarean deliveries. A comprehensive search was performed in PubMed, Embase, Cochrane library databases up to September,2022 to identity studies evaluating perinatal outcomes in women who underwent TOLAC compared to ERCD following a previous cesarean delivery. The included studies were subjected to meta-analysis using RevMan 5.3 software to assess the overall findings. A total of 13 articles were included in this meta-analysis. Statistically significant differences were identified in the rate of uterine rupture (OR = 2.01,95%CI = 1.48-2.74, P < .00001) and APGAR score < 7 at 5 minutes (OR = 2.17,95%CI = 1.69-2.77, P < .00001) between the TOLAC and ERCD groups. However, no significant differences were observed in the rates of hysterectomy, maternal blood transfusion, postpartum infection, postpartum hemorrhage and neonatal intensive care unit (P ≥ .05) admission between the 2 groups. Our analysis revealed that TOLAC is associated with a higher risk of uterine rupture and lower incidence APGAR score < 7 at 5 minutes compared to ERCD. It is vital to consider predictive factors when determining the appropriate mode of delivery in order to ensure optimal pregnancy outcomes. Efforts should be made to identify the underlying causes of adverse outcomes and implement safety precautions to select suitable participants and create safe environments for TOLAC.

The Incidence and Indications of Caesarean Sections in King George Hospital (KGH), Visakhapatnam

The Incidence and Indications of Caesarean Sections in King George Hospital (KGH), Visakhapatnam

Gestational weight gain and its association with maternal and neonatal outcomes among pregnant women with normal pre-pregnancy body mass index from a Middle Eastern country

BackgroundInappropriate gestational weight gain (GWG) is one of the leading health problems during pregnancy. Little is known about the association of GWG with the pregnancy outcomes among Middle Eastern pregnant women. PurposeTo examine the relationship between GWG and maternal and neonatal outcomes among pregnant women with normal pre-pregnancy BMI. MethodsThis retrospective cohort study was conducted in Oman among 763 healthy women with normal pre-pregnancy BMI between August 1, 2021, and June 30, 2022. Maternal and neonatal outcomes were retrieved from participants’ medical records using a standardized form. The analytical tools included descriptive statistics and the chi-square test. ResultsDescriptive statistics showed 22.6 % and 21.4 % of the study participants gained weight above or below the guidelines, respectively. The findings from the chi-square test showed a significant association between total GWG and the incidence of emergency caesarean section (p < .01), gestational diabetes mellitus (p < .01), and gestational hypertension (p < .01), macrosomia (p < .01), small for gestational age (p < .01), large for gestational age (p < .01), low birth weight (p < .01), intrauterine growth retardation (p < .01), and preterm birth (p < .01). Conclusion and implications for practiceOur study found that inappropriate gestational weight gain (GWG) contributes to several adverse maternal and neonatal outcomes. We recommend that Ministries of Health in Middle East and North Africa area includes GWG as a risk factor for pregnancy-related adverse outcomes. Midwives should closely monitor and manage GWG to ensure optimal pregnancy outcomes. In addition, midwives should encourage mothers to maintain GWG within the recommended range using various strategies such as continuous counselling and motivational health promotion interventions.

Perioperative Exercise Testing in Pregnant and Non-Pregnant Women of Reproductive Age: A Systematic Review.

Women have classically been excluded from the development of normal data and reference ranges, with pregnant women experiencing further neglect. The incidence of Caesarean section in pregnant women, and of general operative management in young women (both pregnant and non-pregnant), necessitates the formal development of healthy baseline data in these cohorts to optimise their perioperative management. This systematic review assesses the representation of young women in existing reference ranges for several functional exercise tests in common use to facilitate functional assessment in this cohort. Existing reference range data for the exercise tests the Six Minute Walk Test (6MWT), the Incremental Shuttle Walk Test (ISWT) and Cardiopulmonary Exercise Testing (CPET) in young women of reproductive age were assessed using the MEDLINE (Ovid) database, last searched December 2023. Results were comparatively tabulated but not statistically analysed given underlying variances in data. The role of exercise testing in the perioperative period as an assessment tool, as well as its safety during pregnancy, was evaluated using 65 studies which met inclusion criteria. There is a significant lack of baseline data regarding these tests in this population, especially amongst the pregnant cohort, which limits the application of exercise testing clinically.

PREGNANCY OUTCOME IN ADVANCED MATERNAL AGE IN COMPARISON WITH YOUNGER PREGNANT WOMEN – A COMPARATIVE STUDY IN CENTRAL REFERRAL HOSPITAL, GANGTOK, SIKKIM

Objectives: The aim of the study was to compare maternal and neonatal outcome in pregnancy in advanced maternal age (&gt;35 years) in comparison with pregnancy outcome in younger mothers of age 20–34 years. Methods: This was a retrospective and comparative study conducted in the Department of Obstetrics and Gynecology of Central Referral Hospital, Gangtok, Sikkim. Institutional ethical committee approved the study. One thousand three hundred and thirty-five women were included in this study. Data of these mothers were retrieved from the MRD records and reviewed. Pregnancy outcomes were studied in terms of antenatal, intranatal, and postpartum complications. Each adverse obstetrical outcome was assessed if it has made a significant association with maternal age. Perinatal outcome was also compared. Results: The mean maternal age was significantly higher in Group A (38.2±0.66) as compared to Group Y (25.85±4.41) and the difference was found to be statistically highly significant (p&lt;0.0001). LSCS rate was more in advanced maternal age group as compared to patients &lt;35 years and the difference was statistically significant (p=0.0009). Comparison for both the groups for gestational diabetes, gestational hypertension, anemia, preterm labor, prelabor rupture of membranes, and postpartum hemorrhage shows these pathologies to be more common in Group A. In Group A, the common causes of LSCS were patient request (41.39%) followed by FGR with abnormal Doppler (26.01%) whereas in Group Y common indications for LSCS included previous LSCS (36.56%) patient request (27.56%). Group A had a higher incidence of low birth weight (52 vs. 65, p&lt;0.0001), large-for-gestational-age babies (&gt;4 kg) (15 vs. 12, p&lt;0.0001), NICU admission due to low APGAR score (35 vs. 42, p&lt;0.0001), and pre-term births (43 vs. 10, p&lt;0.0001). Conclusion: Advanced maternal age pregnancies are associated with increased incidence of maternal medical disorders, cesarean section, and postpartum haemorrhage as well as adverse perinatal outcome.

Effect of Early Amniotomy on Delivery Outcome with/without Cervical Ripening: A Systematic Review and Meta-Analysis.

Although shorter labors are the benefits of Early Amniotomy (EA), it may lead to risks such as non-reassuring fetal testing and cesarean delivery. Also, the effect of cervical ripening to induce labor before amniotomy is unknown. This systematic review and meta-analysis evaluated the effect of EA on the delivery outcome with or without cervical ripening. Bibliographic search was conducted without time limit until June 2020. PubMed, Scopus SID Magiran, Cochrane Library Science website, and ISI databases were searched with English and Farsi keywords, including amniotomy, delivery, induced, and pregnancy outcome. The meta-analysis on ten clinical trials showed that the incidence of cesarean section was lower (0.89% VS 0.94; relative risk, 0.85; 95% confidence interval, 0.55-1.30) compared to the group without cervical ripening, and the time to induce labor was approximately 55 minutes (mean difference, 0.91 hour; 95% confidence interval, -1.43 to - 0.33). If EA is performed in women after cervical ripening, the incidence of cesarean section will not increase, and the duration of labor will be reduced. A shorter delivery time is associated with perinatal benefits and greater maternal satisfaction. Furthermore, EA with cervical ripening may reduce monitoring time in busy hospitals with limited medical staff.

Caesarean section delivery rates and associated factors in a faith-based referral hospital in Ghana: A retrospective analysis.

The global incidence of caesarean section (CS) deliveries has exceeded the recommended threshold set by the World Health Organization. This development is a matter of public health concern due to the cost involved and the potential health risk to the mother and the neonate. We sought to investigate the prevalence, indications, maternal and neonatal outcomes and determinants of CS in private health facilities in Ghana. A retrospective cross-sectional analysis was conducted using data from women who delivered at the Holy Family Hospital from January to February 2020 using descriptive and inferential statistics, with a significance level set at p<0.05. The prevalence of CS was 28.70%. The primary indications of C/S include previous C/S, foetal distress, breech presentation, pathological CTG and failed induction. Significant associations were found between CS and breech presentation (AOR = 4.60; 95%CI: 1.22-17.38) p<0.024, previous CS history (AOR = 51.72, 95% CI: 11.59-230.70) p<0.00, and neonates referred to NICU (AOR = 3.67, 95% CI: 2.10-6.42) p<0.00. The prevalence of caesarean section (CS) deliveries was higher than the WHO-recommended threshold. Major indications for CS included previous CS, fetal distress, and failed induction. Significant risk factors for CS were previous CS history, breech presentation, and neonates referred to NICU.

Faktor Risiko Persalinan Seksio Sesarea

This study aims to determine the risk factors for cesarean section delivery. The method used is an analytic observational study with a case-control design, namely comparing the case group and the control group. The results showed that the risk factor associated with cesarean section delivery was the age of the mother (ρ=0.004; OR=0.368; 95% CI=0.191-0.710). Old labor with values (ρ=0.019; OR=0.206; 95%CI95%CI=0.57-0.748). Placental condition with values (ρ=0.023; OR=9.828; 95% CI=1.220-79.166). Preeclampsia with a value (ρ=0.004; OR=3.667; 95% CI=1.554-8.653). History of caesarean section delivery (ρ=0.000; OR=8.556; 95% CI=3.736-19.591). Risk factors for caesarean section delivery that have a relationship are maternal age, prolonged labor, placental conditions, preeclampsia, and history of caesarean section delivery. while the risk factors that have no relationship are pelvic conditions, abnormal location, macrosomia, number of fetuses, fetal distress, premature rupture of membranes, preterm labor, and preterm labor. In conclusion, knowing the factors of caesarean section is expected to reduce the incidence of cesarean section for the welfare of the mother and fetus by promoting health and providing health services according to the needs of the mother and fetus from an early age so as not to have complications in labor and pregnancy. &#x0D; &#x0D; Keywords: Risk Factors, Childbirth, Caesarean Section

Comparison of Perinatal Complications in Macrosomic İnfants of Diabetic and Nondiabetic Mothers

Introduction: Metabolic, congenital disorders, and complications seen in infants of diabetic mothers (IDM) are well defined in the literature. We aimed to compare perinatal problems in macrosomic IDM and infants of mothers without diabetes.&#x0D; Methods: We included all macrosomic infants admitted to neonatal intensive care unit (NICU) at two centers between 2017-2020. Birth history, anthropometric measurements, gestational age, metabolic and cardiac problems were compared between macrosomic IDMs and infants of non-DMs. The p-value less than 0.05 was considered statistically significant.&#x0D; Results: 156 (37 IDM, and 119 non-IDM) macrosomic newborns were included in the study. While the incidence of hypoglycemia, need for mechanical ventilation, respiratory distress syndrome, ventricular septal defect (VSD) and persistent pulmonary hypertension (PPH) were statistically similar, the incidence of cesarean section (p=0.002), myocardial hypertrophy (p=0.001), and polycythemia (p=0.019) was higher in the IDM group. While the incidence of respiratory problems and VSD was similar in both groups, myocardial hypertrophy was found in approximately in one fourth (22.2%) of the non-diabetic group.&#x0D; Conclusion: Macrosomic non-IDMs have a similar risk for perinatal-postnatal complications as macrosomic IDMs and should be evaluated accordingly.

Impact of Physical Activity Interventions on High-Risk Pregnancies: A Systematic Review and Meta-Analysis.

Pregnant women with absolute contraindications may be advised against physical activity throughout pregnancy. In this context, bed rest elevates the short-term risk of neonatal complications, thereby exacerbating negative long-term effects on childhood development. The aim of the current study was to investigate the impact of various physical activity interventions during bed rest or activity restriction in pregnancy on factors such as birth weight, preterm birth, maternal hypertension, gestational age at delivery, and the incidence of cesarean sections. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was designed. The protocol was registered in the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD42022370875). Nine studies, with a total sample of 3173 women, from six countries on four continents were included. There were significant differences in the relationship between bed rest status and birth weight (Z = 2.64; p = 0.008) (MD = 142.57, 95% CI = 36.56, 248.58, I2 = 0%, Pheterogeneity = 0.45) favourable to active groups. No significant differences were found in other analyzed outcomes. Pregnant women who experience this problem must maintain a minimum of daily activity to alleviate these physiological complications and the medical field must understand the consequences of physical inactivity during pregnancy.

Effects of novel coronavirus Omicron variant infection on pregnancy outcomes: a retrospective cohort study from Guangzhou.

Since 2022, Omicron has been circulating in China as a major variant of the novel coronavirus, but the effects of infection with Omicron variants on pregnant women and newborns are unknown. The purpose of this study was to determine the clinical characteristics of Omicron infection during pregnancy and its effect on pregnancy outcomes. This study retrospectively analyzed the data of 93 confirmed cases of novel coronavirus infection and 109 non-infected patients admitted to the isolation ward of Guangdong Maternal and Child Health Hospital from December 1, 2022 to January 31, 2023, and statistically analyzed the clinical features of Omicron variant infection during pregnancy and its impact on pregnancy outcomes. Further effects of underlying diseases on Omicron infection in pregnant women were analyzed. The incubation period of COVID-19 infection was 0.99±0.86 days, 94.38% of patients had fever or other respiratory symptoms, the lymphocyte count in the infected group was lower than that in the uninfected group, and the lymphocyte count was further reduced in the patients with pregnancy complications or complications. Compared with the uninfected group, APTT and PT were prolonged, platelet count and fibrinogen were decreased in the infected group, all of which had statistical significance. COVID-19 infection during pregnancy increased the rate of cesarean section compared to uninfected pregnant patients, and COVID-19 infection in gestational diabetes resulted in a 4.19-fold increase in cesarean section rate. There was no statistically significant difference in gestational age between the two groups. The incidence of intrauterine distress, turbidity of amniotic fluid and neonatal respiratory distress were higher in the infection group. No positive cases of neonatal COVID-19 infection have been found. The patients infected with omicron during pregnancy often have febrile respiratory symptoms with lymphocyopenia, but the incidence of severe disease is low. Both Omicron infection and gestational diabetes further increase the incidence of cesarean section, and this study found no evidence of vertical transmission of Omicron.

Effect of pre-pregnancy body mass index and gestational weight gain on fetal outcome

Fetaldevelopment and growth in uterus is most critical. Most commonly used indicator is birth weight for determining well-being of infant. Body mass index (BMI) of mother before pregnancy, pregnancy weight gain, and other factors related to behavior, socio-cultural as well as genetics influence the birth weight. To study effect of pre-pregnancy BMI and gestational weight gain on fetal outcomeHospital-based follow-up study was carried out among 189 antenatal women. Gestational age, weight, height, BMI and fetal growth were recorded. Regular sonography was carried out to rule out fetal congenital abnormalities and fetal well-being. Daily fetal movement count, fetal heart rate monitoring was carried out daily. Estimation of the “total pregnancy weight gain” was done by subtracting last measured weight before delivery from weight recorded at first visit in first trimester. Birth weight of the neonate was recorded within 24 hours of delivery. BMI before pregnanacy was normal in Majority (75.1%). Underweight women earlier to conception had either normal Gestational weight gain (GWG) or less than normal GWG. Their babies also had significantly low average birth weight compared to either normal weight females or overweight and obese before conception. Overweight and obese females before conception had higher incidence of gestational diabetes (GDM) and cesarean section. Normal weight females before conception had higher incidence of Pregnancy induced hypertension.Being underweight before conception is a risk factor for low birth weight babies whereas being overweight and obese before pregnancy is a risk factor for GDM.

Ways to reduce the incidence of cesarean sections according to the Robson classification

Introduction and Aim: Cesarean sections (CS) are a medically indicated and effective method for reducing maternal and perinatal mortality. The incidence of CS has increased in developed as well as developing countries over the past few decades. The objective of this study is to analyze the distribution of births according to the Robson classification and to assess ways to reduce the frequency of CS. Methods: This is a retrospective study based on records of the delivery histories of 18,125 female patients in the maternity department of the Kyrgyz Research Center for Human Reproduction, conducted using Robson classification. Results: However, the parameters also showed a statistically significant decrease in the highest number of patients in group 3 by -18.9% (from 40.6% to 32.9%) and group 1 by -9.9% (from 29.2% to 26.3%) in 2022 compared to 2016, p&lt;0.001. Despite their low specific weights, the 6, 7, 8, 9, and 10 groups showed a significant increase despite their small numbers. Conclusion: Despite their low proportion but massive increase in indicators, the small number of groups 6, 7, 8, 9, and 10 may contribute to perinatal mortality and morbidity, highlighting the need for rigorous monitoring and control of pregnant women in these groups.

Abstract 12902: Supraventricular Tachycardia During Pregnancy is Independently Associated With Adverse Obstetrical Outcomes

Introduction: Supraventricular tachycardias (SVT) are the most frequently encountered arrhythmias in pregnancy, however, their clinical significance is unclear. Hypothesis: We report the prevalence, describe the management and explore the association between SVT and adverse obstetric outcomes in women with structurally normal hearts. Methods: This is a case-control study of primiparous and multiparous women without history of cesarean section (CS), and no known cardiac diagnosis admitted in labor to one of 8 Northwell Health hospitals between January 2015 and August 2022. The study group consisted of women with at least one SVT episode during pregnancy and the control group was randomly selected in a 4:1 ratio. Multivariate analysis was used to examine the association between occurrence of SVT during pregnancy and incidence of cesarean section (CS), preterm labor (PTL), and length of stay (LOS). Results: Of 141,769 women meeting the inclusion criteria, SVT diagnosis was confirmed in 122. Of those, 76 (age 33.2±4.8 years) had at least 1 symptomatic episode during pregnancy. For the women with known SVT diagnosis prior to pregnancy, medical therapy with any antiarrhythmic agent was not associated with reduction of SVT recurrence during pregnancy (OR 1.07, 95% CI 0.41-2.80 p=0.89). On the contrary, catheter ablation prior to pregnancy was associated with significant reduction of SVT recurrence (OR 0.09, 95% CI 0.04-0.23, p&lt;0.0001). Women with SVT during pregnancy had a higher incidence of CS (39.5% vs 27.0%. p=0.03), and PLT (30.3% vs 8.6%, p&lt;0.001) compared to the control group. After adjusting for age and parity, SVT during pregnancy was independent predictor of CS, particularly elective CS (OR 2.89 95% CI 1.06-7.89) and PTL (OR 4.37 95%CI 2.30-8.31). Conclusions: SVT occurs in about 1 in every 1,000 women during pregnancy and is associated with higher rates of CS, particularly scheduled, and PLT. Any history of SVT should be sought and addressed during preconception counselling and SVT episodes during pregnancy should be approached in a multidisciplinary way to mitigate the risk of CS and associated complications.

Maternal and Perinatal Outcomes Amongst Nulliparous Singleton Pregnancies Electively Induced at 39Weeks: A Prospective Observational Study.

Given the uncertainty of inducing beyond 39weeks, we intended to study the maternal and neonatal mortality and morbidity associated with planned elective induction of labour (eIOL) at 390/7 to 396/7weeks. To study the maternal and perinatal outcomes, after eIOL, at 390/7 to 396/7weeks, amongst nulliparous singleton pregnancies, followed up for the duration of their hospital stay. All consecutive nulliparous, singleton gestations, undergoing eIOL, at 390/7 to 396/7weeks, with no plan for caesarean section (CS) or contraindication for vaginal delivery were prospectively recruited. The primary outcome studied was the incidence of CS and neonatal intensive care requirement, and the secondary outcomes studied were induction-delivery interval, incidence of chorioamnionitis, postpartum haemorrhage, meconium aspiration syndrome (MAS), APGAR ≤ 7 at 1min and neonatal mortality. Amongst the total 304 mothers electively induced at 390/7 to 396/7weeks, 80 (26.3%) mothers underwent CS and 48 (15.8%) neonates required intensive care. Fifteen (4.9%) babies required respiratory support at birth. The mean induction-delivery interval was 19h 42min ± 10h. There were 9(3%) cases of PPH and no reported cases of chorioamnionitis. Eleven (3.6%) babies had an APGAR < / = 7 at 1min and 9 (2.9%) had MAS, but there was no maternal or neonatal mortality. Induction of labour at 39weeks in low-risk nulliparous women did not result in a lower frequency of CS or adverse perinatal outcomes.