Operative Childbirth Research Articles

“An Undesired Life Event”: A retrospective interview study of Swedish women’s experiences of Caesarean Section in the 1970s and 1980s.”

BackgroundGiving birth is a transformative event. Memories of the birth often remain in a woman’s mind for the rest of her life. Key aspects of a mother's overall birth experience include concerns about the safety and health of the baby, and the first contact the mother has with her child. To the best of our knowledge, research has not yet been published relating to the ways in which women undergoing caesarean sections in the 1970s and 1980s experienced the birth of their baby and whether or not their mode of delivery has affected their reproductive health and their relationship to their child. ObjectiveTo describe women’s experience of undergoing a caesarean section in the 1970s and 1980s in Sweden. DesignA qualitative method using semi-structured questions and content analysis. ParticipantsTwenty-two women were interviewed who underwent caesarean section during the 1970s and 1980s in Sweden. ResultsThe overarching theme surrounding women’s experience of having undergone a caesarean section 30–40 years ago is that it is described as “undesired life event”. Four categories were established: vaginal birth as the norm; a total loss of control; acceptance and contact with the child. ConclusionUndergoing a caesarean section during the 1970s and 1980s was considered to be an undesired life events. The interlocuters who participated in this study had little knowledge about operative childbirth and were poorly prepared for a complicated birth and postpartum care. The women did not suffer any long-term physiological harm yet were harmed psychologically until they came to terms with their negative experience and reached acceptance of it.

The impact of major depressive disorder and antidepressant medication before and during pregnancy on obstetric and neonatal outcomes: A nationwide population-based study

ObjectiveTo investigate the impact of major depressive disorder (MDD) and antidepressant medication before and during pregnancy on obstetric and neonatal outcomes. Study designA national register‐based cohort study of pregnant women born in Sweden, and their first child born in 2012–2015 (n = 262 329). Women diagnosed with MDD and who had redeemed an antidepressant one year before becoming pregnant (“before pregnancy”) and women who were diagnosed with MDD and who had redeemed an antidepressant both before and during pregnancy (“before and during pregnancy”) were compared with each other and with women who had neither been diagnosed with MDD nor been prescribed antidepressants (population controls). ResultsIn comparison to population controls, the “before pregnancy” and the “before and during pregnancy” groups had increased likelihoods of operative childbirth (aOR = 1.19, 95 % CI 1.12−1.27, aOR = 1.38, 95 % CI 1.28−1.48 respectively), and with an increased likelihood for the child being admitted to a neonatal intensive care unit (NICU) (aOR = 1.51, 95 % CI 1.17−1.95, aOR = 1.55, 95 % CI 1.14−2.11). Children born to mothers in the “before and during pregnancy” group had an increased likelihood of preterm birth (aOR = 1.72, 95 % CI 1.52−1.95,), while children to mothers in the “before pregnancy” group had an increased likelihood of low birthweight (aOR = 1.15, 95 % CI 1.00−1.33) compared to population controls. Women in the “before and during pregnancy” group had an increased likelihood for hyperemesis during pregnancy (aOR = 1.93, 95 % CI = 1.60–2.32), having an operative childbirth (aOR = 1.17, 95 % CI = 1.06–1.29) or a preterm birth (aOR = 1.53, 95 % CI = 1.28–1.81) compared to the “before pregnancy” group. ConclusionsWomen with MDD and antidepressant medication prior to becoming pregnant are at increased risk for adverse obstetric and neonatal outcomes compared to women without an MDD. Continuation of antidepressant medication during pregnancy somewhat increased the risk for adverse obstetric and neonatal outcomes.

The Adolescent Birth Experience: A Comparison of Three Diverse Groups.

Recognized risk factors influencing the birth experience and subsequent poor mental health are not addressed among childbearing adolescents, especially minority teens. Our study purpose was to compare birth experiences of three adolescent groups by prevalence and influence of selected risk factors as moderated by racial/ethnic background. Using a birth rating scale and the Impact of Event Scale, birth perception and stress were examined among an equal number of Black, White, and Hispanic adolescents. Surveys completed at 72 hours postpartum showed Black adolescents most at risk for a negative birth experience. Contributing risk factors included depression, trauma, parity, and operative childbirth. Risk factors occur before and after birth; therefore, childbirth educators can promote a positive birth experience via perinatal assessments and interventions.

The results of efferent therapy by woman with HIV infection, with amniotic fluid outflow at 23 weeks with growth retardation syndrome of 2 fetus

In the article presents data on the management of a 48-year-old patient with HIV infection, urogenital infection with pregnancy, which occurred as a result of IVF, with premature effusion of amniotic fluid at 23 weeks of pregnancy with the syndrome of growth retardation of 2 fetus in monochoric diamniotic twins. After the discharge of the amniotic fluid, the patient was treated for six days in an infectious hospital, then transferred to the perinatal center, where blood tests noted moderatemanifestations of endotoxicosis, increased levels of aminotransferases and an inflammatory reaction of the body. The course of treatment included detoxification methods (plasmapheresis, hemosorption, photomodification of blood with ultraviolet, laser rays), which contributed to the normalization of blood tests, prolongation of pregnancy for another three weeks in the absence of septic complications after operative childbirth in the mother and in newborn girls. At birth, 1 childs weight, body length and Apgar score were 750 g., 29 sm. and3/5points, respectively, in 2 children 590 g., 30 sm. and1/3points, respectively. The children required treatment from resuscitators, at the second stage of nursing, from rehabilitation specialists.

A technique variant for the use of the vacuum extractor with episiotomy to reduce maternal injuries

Vulvovaginal tears during childbirth are a relevant factor of morbidity and are often more extensive in case of forceps or vacuum application. Although it is not routinely recommended, episiotomy is the primary mean to reduce the maternal lesion and is commonly used in case of operative delivery, also if sometimes is not able to avoid lacerations. Episiotomy technique as any procedure can be improved. This study suggests a new procedure that has been applied and can significantly reduce maternal vaginal tears during operative childbirth with vacuum extraction.

“Slow” Cesarean Section by Inconsistent Corporal Scar (Clinical Case)

Introduction. Increasing the initial number of caesarean delivery operations involves certain risks when planning and carrying subsequent pregnancies. Despite the trend towards operative childbirth being gradually being replaced by natural, the frequency of recurrent caesarean is higher than the prevailing rate due to scar inconsistency and the presence of a “classic” (corporal) scar on the uterus. The use of corporal access to date is gradually being replaced by less traumatic access. The operation of “slow” caesarean section is considered as an alternative approach to surgical delivery.Purpose and objectives. To analyse the operation of “slow” caesarean section in the presence of corporal scars on the uterus.Materials and methods. The resulted clinical case of incomplete rupture of the uterus by corporal scar in the second pregnancy at a period of 38 weeks. Corporal scarring as a result of caesarean operations in the case of interruption of first pregnancy at a period of 22–23 weeks.Results. The patient was discharged in a satisfactory condition on the 5th day with the child. Postoperative period without complications; results of analyses performed prior to discharge within normal limits.Discussion. The conducted corporal incision at the first pregnancy was inexpedient due to presenting increased risks in subsequent pregnancies. For the termination of pregnancy in the second trimester, it was necessary to consider therapeutic methods, the operations of a minor caesarean section or a caesarean section in the lower segment of the uterus.Conclusion. Conducting “slow” caesarean section has the following advantages over classic caesarean section: soft adaptation of the foetus to environmental conditions, purification of the mucous oropharynx of the foetus, establishing a stronger bond between the mother and her future child. In future, we plan to conduct a clinical evaluation of children delivered through a “slow” caesarean section.

An Experience of Intravaginal Auto Lymphocyte Therapy in Treatment of Female Patients with Infertility: A Case Report

Aim : Application of a new method – intravaginal auto lymphocyte therapy in treatment of female infertility. Place and Duration of Study: I.M. Sechenov, First Moscow State Medical University, the study was performed in 2010. Results: A case report concerning treatment of a female patient with infertility by use of a new method of intravaginal administration of auto lymphocytes is presented. To prepare the patient to infertility treatment with help of intravaginal fertilization (IVF), 5 performances of intravaginal auto lymphocyte therapy were made. A pregnancy resulted simultaneously after the treatment course and finished by operative childbirth. Conclusion: In the case presented here the method of intravaginal auto lymphocyte therapy demonstrated its efficiency in treatment of infertility. We hope that in immediate future this method will provide us with a possibility to improve female infertility treatment results.

A Pervasive Visual–Haptic Framework for Virtual Delivery Training

Thanks to the advances of voltage regulator (VR) technologies and haptic systems, virtual simulators are increasingly becoming a viable alternative to physical simulators in medicine and surgery, though many challenges still remain. In this study, a pervasive visual-haptic framework aimed to the training of obstetricians and midwives to vaginal delivery is described. The haptic feedback is provided by means of two hand-based haptic devices able to reproduce force-feedbacks on fingers and arms, thus enabling a much more realistic manipulation respect to stylus-based solutions. The interactive simulation is not solely driven by an approximated model of complex forces and physical constraints but, instead, is approached by a formal modeling of the whole labor and of the assistance/intervention procedures performed by means of a timed automata network and applied to a parametrical 3-D model of the anatomy, able to mimic a wide range of configurations. This novel methodology is able to represent not only the sequence of the main events associated to either a spontaneous or to an operative childbirth process, but also to help in validating the manual intervention as the actions performed by the user during the simulation are evaluated according to established medical guidelines. A discussion on the first results as well as on the challenges still unaddressed is included.

Aspects médico-légaux de l’extraction instrumentale

The aim of this data analysis on medical liability in professional guidelines on instrumental delivery, is to point out the most common difficulties to which obstetricians are exposed, and to discuss some aspects confronted to literature. Firstly, instrumental delivery is replaced in whole labour ward activity by unpublished results of a national enquiry on instrumental delivery concerning 239 337 deliveries during the year 2007. Then, the analysis of 61 data from legal claims in relation with instrumental deliveries between 1995 and 2007, to allow educational lessons. At last, few specific aspects of judicial expert opinion are confronted to literature and discussed: the effects of debriefing after operative childbirth; discussion on decision making and decision-to-delivery intervals. This chapter is concluded by different points on risk management in labour ward, mainly with potential interest of auditable standards and training with computer assisted simulation.

A midwife led debriefing session after operative childbirth did not reduce postpartum depression

(2000) BMJ 321, 1043. Small R, Lumley J, Donohue L, et al. . Randomised controlled trial of midwife led debriefing to reduce maternal depression after operative childbirth. . Oct 28;...

A midwife-led debriefing session after operative childbirth did not reduce postpartum depression

A midwife-led debriefing session after operative childbirth did not reduce postpartum depression

Randomised controlled trial of midwife led debriefing to reduce maternal depression after operative childbirth

Objective: To assess the effectiveness of a midwife led debriefing session during the postpartum hospital stay in reducing the prevalence of maternal depression at six months postpartum among women giving...