Risk Of Vaginal Birth Research Articles

Effect of pelvic floor muscle exercise with postural advice on improving quality of life among pregnant mothers in bangladesh: a randomized controlled trial

BackgroundPelvic floor muscle exercise has gained recognition as a valuable adjunct for promoting maternal well-being and optimizing childbirth outcomes. This study aimed to evaluate the effectiveness of pelvic floor muscle exercise in enhancing the likelihood of improving quality of life pregnant mothers in Bangladesh.Methods/DesignThis was a randomized controlled trial in which 66 pregnant womenwere divided into control and intervention groups. The control group received conventional treatment, while the intervention group received the Pelvic Floor Muscles Exercise program with a posture explaining booklet. Both groups received supervised 30-min sessions five days a week for six weeks. The WHOQOL-BREF questionnaire measured pregnancy health and quality of life. Both descriptive (median and inter quartile range, IQR) and inferential statistics (Mann–whitney U test and Wilcoxon signed- ranked test) used to analyse the data by SPSS 25.0 software with 95% Confidence interval.ResultsThe intervention group mothers averaged gestional age was 32.4 (31.7 to 35.2) weeks, while the control group averaged 32.7 (32.3 to 36.2) weeks. According to the intergroup analysis, both groups had significantly improved health-related quality of life (p < 0.05). According to the intragroup analysis, participants who received pelvic floor muscle exercise with postural advice had better outcomes than did those who received only usual care with postural advice (p < 0.05).ConclusionPelvic floor muscle exercise may improve quality of life and the risk of vaginal birth. Healthcare professionals should include pelvic floor muscle exercises in standard prenatal care to help expectant mothers achieve positive childbirth and reduce postnatal problems.Trial registration: Clinical Trial Registry of India: (CTRI/2023/10/059091) (Date: 25/10/2023).

Predictors and Risks of Vaginal Birth after Cesarean Section: Insights from a Regional Referral Hospital in Uganda

Vaginal birth after cesarean section (VBAC) remains a topic of significant interest due to its potential benefits and associated risks. This retrospective cohort study aimed to identify predictors and risks associated with VBAC compared to elective repeat cesarean section (ERCD) among women delivering at Jinja Regional Referral Hospital in Uganda. We analyzed data from 384 women who had a previous cesareansection and delivered at the hospital between 2022 and 2023. Socio-demographic, obstetric, and medical characteristics were assessed for their association with successful VBAC using logistic regression. Risks of maternal morbidities between VBAC and ERCD groups were compared using Chi-square tests. The study found that BMI &lt;35 kg/m², birth weight &lt;3500g, spontaneous onset of labor, previous safe vaginal birth, and absence of diabetes mellitus were significant predictors of successful VBAC. Women undergoing TOLAC had a higher incidence of uterine rupture (p = 0.030), thromboembolism (p &lt; 0.001), and blood transfusion requirement (p &lt; 0.001) compared to ERCD. However, hysterectomy, hemorrhage, viscus injury, and pelvic floor trauma did not significantly differ between the two groups. Our findings highlight important predictors and risks associated with VBAC compared to ERCD in a regional referral hospital setting. Understanding these factors can aid clinicians in counseling women on their delivery options and managing potential risks associated with VBAC. Further research is warranted to explore strategies for optimizing VBAC outcomes while minimizing associated morbidities. Keywords: Maternal, Morbidity, Labor, Cesarean Section, Elective Repeat Cesarean Delivery, Jinja, Hospital

Vaginal birth core information set: study protocol for a Delphi study to achieve a consensus on a ‘core information set’ for vaginal birth

IntroductionStudies have shown that women are often underinformed about potential benefits and risks of vaginal birth. This is in contrast to other modes of birth, such as caesarean birth, for...

Follow up of women after obstetric anal sphincter injuries (OASI)-What is the role of anorectal testing?

To evaluate the benefit of performing anorectal studies on all women following primary obstetric anal sphincter injury (OASI) repair over performing them on symptomatic women only. Women who attended perineal clinic between 2007 and 2020 underwent symptom assessment and anorectal studies at 6 weeks and 6 months postpartum. Anorectal studies including endo anal ultrasound (EAUS) and anal manometry (AM) were performed. The anorectal studies of symptomatic women who were the case group, were compared with asymptomatic women who were the control group. A total of 1348 women were seen in the perineal clinic over 13 years. A total of 454 (33.7%) women were symptomatic. A total of 894 (66.3%) women were asymptomatic. A total of 313 (35%) asymptomatic women had two abnormal anorectal studies, 274 (31%) had abnormal AM alone, and 86 (9.6%) had abnormal EAUS alone. A total of 221 (24.7%) asymptomatic women had normal anorectal studies. Almost 70% of women were asymptomatic 6 months following primary OASI repair. Most had at least one abnormal anorectal study result. Selectively performing anorectal tests on symptomatic women would not identify asymptomatic women at risk of future faecal incontinence following further vaginal birth. Without anorectal study results, women would not receive accurate counseling about the risks of vaginal birth. Anorectal studies should be offered to all women following OASI where resources allow.

The correlations of method between the first and the subsequent childbirth at PKU Muhammadiyah Yogyakarta hospital in 2016

The birth of elective Caesarean Sectio leads to a 3-fold risk than the risk of vaginal birth, whereas emergency Sectio Caesarean birth causes a 9-fold risk than the risk of vaginal delivery. This research uses analytic observational design. The data retrieval uses a retrospective time approach. The sample in this research is taken with purposive sampling technique (January 1 st 2016 to December 31 th 2016), were 195 patients. This study, using secondary data. Data analysis used Chi Square. With significance level 0,05 obtained result of P Value equal to 0,000 (P Value &lt;0.05) and value of closeness (Phi) equal to 0,612. Therefore it can be concluded there is a relationship between the first labor with the next labor at PKU Muhammadiyah Yogyakarta Hospital in 2016 with the strong relationship.

The correlations of method between the first and the subsequent childbirth at PKU Muhammadiyah Yogyakarta hospital in 2016

The birth of elective Caesarean Sectio leads to a 3-fold risk than the risk of vaginal birth, whereas emergency Sectio Caesarean birth causes a 9-fold risk than the risk of vaginal delivery. This research uses analytic observational design. The data retrieval uses a retrospective time approach. The sample in this research is taken with purposive sampling technique (January 1 st 2016 to December 31 th 2016), were 195 patients. This study, using secondary data. Data analysis used Chi Square. With significance level 0,05 obtained result of P Value equal to 0,000 (P Value &lt;0.05) and value of closeness (Phi) equal to 0,612. Therefore it can be concluded there is a relationship between the first labor with the next labor at PKU Muhammadiyah Yogyakarta Hospital in 2016 with the strong relationship.

Women\u2019s decision-making processes and the influences on their mode of birth following a previous caesarean section in Taiwan: a qualitative study

BackgroundVaginal birth after caesarean (VBAC) is an alternative option for women who have had a previous caesarean section (CS); however, uptake is limited because of concern about the risks of uterine rupture. The aim of this study was to explore women’s decision-making processes and the influences on their mode of birth following a previous CS.MethodsA qualitative approach was used. The research comprised three stages. Stage I consisted of naturalistic observation at 33-34 weeks’ gestation. Stage II involved interviews with pregnant women at 35-37 weeks’ gestation. Stage III consisted of interviews with the same women who were interviewed postnatally, 1 month after birth. The research was conducted in a private medical centre in northern Taiwan. Using a purposive sampling, 21 women and 9 obstetricians were recruited. Data collection involved in-depth interviews, observation and field notes. Constant comparative analysis was employed for data analysis.ResultsEnsuring the safety of mother and baby was the focus of women’s decisions. Women’s decisions-making influences included previous birth experience, concern about the risks of vaginal birth, evaluation of mode of birth, current pregnancy situation, information resources and health insurance. In communicating with obstetricians, some women complied with obstetricians’ recommendations for repeat caesarean section (RCS) without being informed of alternatives. Others used four step decision-making processes that included searching for information, listening to obstetricians’ professional judgement, evaluating alternatives, and making a decision regarding mode of birth. After birth, women reflected on their decisions in three aspects: reflection on birth choices; reflection on factors influencing decisions; and reflection on outcomes of decisions.ConclusionsThe health and wellbeing of mother and baby were the major concerns for women. In response to the decision-making influences, women’s interactions with obstetricians regarding birth choices varied from passive decision-making to shared decision-making. All women have the right to be informed of alternative birthing options. Routine provision of explanations by obstetricians regarding risks associated with alternative birth options, in addition to financial coverage for RCS from National Health Insurance, would assist women’s decision-making. Establishment of a website to provide women with reliable information about birthing options may also assist women’s decision-making.

The effect of birth weight on vaginal birth after cesarean delivery success rates

Objective: The purpose of this study was to evaluate the effect of increasing birth weight on the success rates for a trial of labor in women with one previous cesarean delivery. Study Design: To evaluate the effect of increasing birth weight for women who undergo a trial of labor, the medical records of women who had attempted a vaginal birth after cesarean delivery (VBAC) from 1995 through 1999 in 16 community and university hospitals were reviewed retrospectively by trained abstractors. Information was collected about demographics, medical history, obstetric history, neonatal birth weight, complications, treatment, and outcome of the index pregnancy. The analysis was limited to women with singleton gestations with a history of 1 previous cesarean delivery. Because women with previous vaginal deliveries have higher vaginal birth after cesarean delivery success rates, the women were divided into four risk groups on the basis of their birth history. Groups were defined as women with no previous vaginal deliveries (group 1), women with a history of a previous vaginal birth after cesarean delivery (group 2), women with a history of a vaginal delivery before their cesarean delivery (group 3), and a group of women with a vaginal delivery both before and after the previous cesarean delivery (group 4). Results: There were 9960 women with a singleton gestation and a history of one previous cesarean delivery. The overall vaginal birth after cesarean delivery success rate for the cohort was 74%. The overall vaginal birth after cesarean delivery success rates for groups 1, 2, 3, and 4 were 65%, 94%, 83%, and 93%, respectively. An analysis of neonatal birth weights of <4000 g, 4000 to 4249 g, 4250 to 4500 g, and >4500 g in group 1 showed a reduction in vaginal birth after cesarean delivery success rates from 68%, 52%, 45%, and 38%, respectively. In the remaining groups, there was no success rate below 63% for any of the birth weight strata. For group 1, vaginal birth after cesarean delivery success rates were decreased when the indication for the previous cesarean delivery was cephalopelvic disproportion or failure to progress or when the treatment was either an induction or augmentation of labor. The uterine rupture rate was higher in women for group 1 with birth weights of ≥4000 g (relative risk, 2.3; P <.001). Conclusion: Women with macrosomic fetuses and a history of a previous vaginal delivery should be informed of the favorable vaginal birth after cesarean delivery success rates. Given the risks of vaginal birth after cesarean delivery, those women with no history of a vaginal delivery should be counseled that the success rates may be <50% when the neonatal birth weight exceeds 4000 g and that the success rates may be even lower if the indication for the previous cesarean delivery was cephalopelvic disproportion or failure to progress or if the treatment requires either induction or augmentation of labor. The uterine rupture rate was 3.6% in women for group 1 with a birth weight ≥4000 g. (Am J Obstet Gynecol 2003;188:824-30.)