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Christianne J.m. De Groot - One of the best experts on this subject based on the ideXlab platform.
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Balloon catheter for induction of labor in women with one previous Cesarean and an unfavorable cervix
Acta obstetricia et gynecologica Scandinavica, 2019Co-Authors: Claartje M. A. Huisman, Mieke L.g. Ten Eikelder, Kelly Mast, Katrien Oude Rengerink, Marta Jozwiak, Frederique M. Van Dunne, Johannes J. Duvekot, Jim Van Eyck, Ingrid P.m. Gaugler-senden, Christianne J.m. De GrootAbstract:Introduction: When women with a previous Cesarean Section and an unfavorable cervix have an indication for delivery, the choice is to induce labor or to perform a Cesarean Section. This study aims to assess the effectiveness and safety of a balloon catheter as a method of induction of labor in women with one previous Cesarean Section and an unfavorable cervix compared with an elective Repeat Cesarean Section. Material and methods: We performed a prospective cohort study in 51 hospitals in the Netherlands on term women with one previous Cesarean Section, a live singleton fetus in cephalic position, an unfavorable cervix and an indication for delivery. We recorded obstetric, maternal and neonatal characteristics. We compared the outcome of women who were induced with a balloon catheter with the outcome of women who delivered by elective Repeat Cesarean Section. Main outcomes were maternal and neonatal morbidity. Mode of delivery was a secondary outcome for women who were induced. Adjusted odds ratios (aOR) were calculated using logistic regression, adjusted for potential confounders. Results: Analysis was performed on 993 women who were induced and 321 women who had a Repeat Cesarean Section (August 2011 until September 2012). Among the women who were induced, 560 (56.4%) delivered vaginally and 11 (1.1%) sustained a uterine rupture. Composite adverse maternal outcome (uterine rupture, severe postpartum hemorrhage or postpartum infection) occurred in 73 (7.4%) in the balloon and 14 (4.5%) women in the Repeat Cesarean Section group (aOR 1.58, 95% confidence interval [CI] 0.85-2.96). Composite adverse neonatal outcome (Apgar score
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Balloon catheter for induction of labor in women with one previous Cesarean and an unfavorable cervix
'Wiley', 2019Co-Authors: Huisman C.m.a., Eikelder, M.l. Ten, Mast K., Rengerink K. Oude, Jozwiak M., Dunne F. Van, Duvekot J.j., Eyck J. Van, Christianne J.m. De GrootAbstract:Item does not contain fulltextINTRODUCTION: When women with a previous Cesarean Section and an unfavorable cervix have an indication for delivery, the choice is to induce labor or to perform a Cesarean Section. This study aims to assess the effectiveness and safety of a balloon catheter as a method of induction of labor in women with one previous Cesarean Section and an unfavorable cervix compared with an elective Repeat Cesarean Section. MATERIAL AND METHODS: We performed a prospective cohort study in 51 hospitals in the Netherlands on term women with one previous Cesarean Section, a live singleton fetus in cephalic position, an unfavorable cervix and an indication for delivery. We recorded obstetric, maternal and neonatal characteristics. We compared the outcome of women who were induced with a balloon catheter with the outcome of women who delivered by elective Repeat Cesarean Section. Main outcomes were maternal and neonatal morbidity. Mode of delivery was a secondary outcome for women who were induced. Adjusted odds ratios (aOR) were calculated using logistic regression, adjusted for potential confounders. RESULTS: Analysis was performed on 993 women who were induced and 321 women who had a Repeat Cesarean Section (August 2011 until September 2012). Among the women who were induced, 560 (56.4%) delivered vaginally and 11 (1.1%) sustained a uterine rupture. Composite adverse maternal outcome (uterine rupture, severe postpartum hemorrhage or postpartum infection) occurred in 73 (7.4%) in the balloon and 14 (4.5%) women in the Repeat Cesarean Section group (aOR 1.58, 95% confidence interval [CI] 0.85-2.96). Composite adverse neonatal outcome (Apgar score <7 at 5 minutes or umbilical pH <7.10) occurred in 57 (5.7%) and 10 (3.2%) neonates, respectively (aOR 1.40, 95% CI 0.87-3.48). Women who were induced had a shorter postpartum admission time (2.0 vs 3.0 days (P < 0.0001)). CONCLUSIONS: In women with a previous Cesarean Section and a need for delivery, induction of labor with a balloon catheter does not result in a significant increase in adverse maternal and neonatal outcomes as compared with planned Cesarean Section
Baha Sibai - One of the best experts on this subject based on the ideXlab platform.
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306: Maternal and perinatal outcomes in trial of labor after one prior Cesarean delivery versus elective Repeat Cesarean Section in gestational diabetes
American Journal of Obstetrics and Gynecology, 2014Co-Authors: Oscar A. Viteri, Sean C. Blackwell, Hind N. Moussa, Baha SibaiAbstract:306 Maternal and perinatal outcomes in trial of labor after one prior Cesarean delivery versus elective Repeat Cesarean Section in gestational diabetes Oscar Viteri, Sean Blackwell, Hind Moussa, Baha Sibai UT Health University of Texas Medical School at Houston, Department of Obstetrics, Gynecology and Reproductive Sciences, Houston, TX OBJECTIVE: The absolute and relative risks associated with a trial of labor (TOL) in woman with gestational diabetes (GDM) attempting vaginal birth after a Cesarean (VBAC) as compared to elective Repeat Cesarean (ERCD) are uncertain. Our objective is to compare maternal and perinatal outcomes between women undergoing a TOL and those who have an ERCD. STUDY DESIGN: Secondary analysis of a prospective observational study conducted at 19 academic centers of all women with singleton, vertex gestation and a diagnosis of GDM, who had one prior documented low transverse CD. Patients with contraindications for a TOL were excluded. Maternal and perinatal outcomes were compared between those with and without a TOL. RESULTS: Among 4988 women with GDM in the CD registry, 2161 met the inclusion criteria. TOL was attempted by 948 (44%) with 555 (58%) ending in successful VBAC; and 1203 (56%) women underwent an ERCD. There were no differences between groups in mean gestational age at delivery, however the mean birth weight was higher in ERCD than TOL (3480 g vs 3370 g). Table below compares maternal and perinatal outcomes overall. In addition, compared to ERCD those who had failed TOL had higher rates of chorioamnionitis (9% vs 0.6%, p
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306 maternal and perinatal outcomes in trial of labor after one prior Cesarean delivery versus elective Repeat Cesarean Section in gestational diabetes
American Journal of Obstetrics and Gynecology, 2014Co-Authors: Oscar A. Viteri, Sean C. Blackwell, Hind N. Moussa, Baha SibaiAbstract:306 Maternal and perinatal outcomes in trial of labor after one prior Cesarean delivery versus elective Repeat Cesarean Section in gestational diabetes Oscar Viteri, Sean Blackwell, Hind Moussa, Baha Sibai UT Health University of Texas Medical School at Houston, Department of Obstetrics, Gynecology and Reproductive Sciences, Houston, TX OBJECTIVE: The absolute and relative risks associated with a trial of labor (TOL) in woman with gestational diabetes (GDM) attempting vaginal birth after a Cesarean (VBAC) as compared to elective Repeat Cesarean (ERCD) are uncertain. Our objective is to compare maternal and perinatal outcomes between women undergoing a TOL and those who have an ERCD. STUDY DESIGN: Secondary analysis of a prospective observational study conducted at 19 academic centers of all women with singleton, vertex gestation and a diagnosis of GDM, who had one prior documented low transverse CD. Patients with contraindications for a TOL were excluded. Maternal and perinatal outcomes were compared between those with and without a TOL. RESULTS: Among 4988 women with GDM in the CD registry, 2161 met the inclusion criteria. TOL was attempted by 948 (44%) with 555 (58%) ending in successful VBAC; and 1203 (56%) women underwent an ERCD. There were no differences between groups in mean gestational age at delivery, however the mean birth weight was higher in ERCD than TOL (3480 g vs 3370 g). Table below compares maternal and perinatal outcomes overall. In addition, compared to ERCD those who had failed TOL had higher rates of chorioamnionitis (9% vs 0.6%, p<0.001), and higher rate of readmission (3% vs 1.8%, P 1⁄4 0.16). There was 1 maternal death in the ERCD cohort. CONCLUSION: In women with gestational diabetes the overall rate of successful VBAC is only 58%. We found no differences in either adverse maternal or perinatal outcomes between those who underwent TOL and those who had ERCD. These findings suggest that VBAC is as safe in GDM as it is in normal pregnancies, but the success rate is lower.
Carmen D. Dirksen - One of the best experts on this subject based on the ideXlab platform.
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Practice variation of vaginal birth after Cesarean and the influence of risk factors at patient level: a retrospective cohort study
Acta obstetricia et gynecologica Scandinavica, 2017Co-Authors: Emy Vankan, E. N. C. Schoorel, Sander M. J. Van Kuijk, Ben-willem Mol, Jan G. Nijhuis, Robert Aardenburg, Marleen Alink, Karin De Boer, Friso M.c. Delemarre, Carmen D. DirksenAbstract:Introduction Large practice variation exists in mode of delivery after Cesarean Section, suggesting variation in implementation of contemporary guidelines. We aim to evaluate this practice variation and to what extent this can be explained by risk factors at patient level. Material and methods This retrospective cohort study was performed among 17 Dutch hospitals in 2010. Women with one prior Cesarean Section without a contraindication for a trial of labor were included. We used multivariate logistic regression analysis to develop models for risk factor adjustments. One model was derived to adjust the elective Repeat Cesarean Section rates; a second model to adjust vaginal birth after Cesarean rates. Standardized rates of elective Repeat Cesarean Section and vaginal birth after Cesarean per hospital were compared. Pseudo-R2 measures were calculated to estimate the percentage of practice variation explained by the models. Secondary outcomes were differences in practice variation between hospital types and the correlation between standardized elective Repeat Cesarean Section and vaginal birth after Cesarean rates. Results In all, 1068 women had a history of Cesarean Section, of whom 71% were eligible for inclusion. A total of 515 women (67%) had a trial of labor, of whom 72% delivered vaginally. The elective Repeat Cesarean Section rate at hospital level ranged from 6 to 54% (mean 29.8, standard deviation 11.8%). Vaginal birth after Cesarean rates ranged from 50 to 90% (mean 71.8%, standard deviation 11.1%). More than 85% of this practice variation could not be explained by risk factors at patient level. Conclusion A large practice variation exists in elective Repeat Cesarean Section and vaginal birth after Cesarean rates that can only partially be explained by risk factors at patient level.
Maureen Hack - One of the best experts on this subject based on the ideXlab platform.
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Neonatal Morbidity After Elective Repeat Cesarean Section and Trial of Labor
PEDIATRICS, 1997Co-Authors: B. Hook, Robert Kiwi, Saeid B. Amini, Avroy A. Fanaroff, Maureen HackAbstract:OBJECTIVE To evaluate neonatal outcomes after an elective Repeat Cesarean Section (ERCS) compared with a trial of labor (TOL). POPULATION AND METHOD All mothers who underwent previous Cesarean Section and delivered singleton infants at term gestation were identified during a 1-year period. Neonatal outcomes were compared between infants delivered by ERCS (n = 497) and those delivered by TOL (n = 492), and between infants delivered by a successful (n = 336) and a failed (n = 156) TOL. A cohort of mothers and their term infants delivered by routine vaginal delivery were also identified. RESULTS Infants delivered by ERCS had an increased rate of transient tachypnea compared with infants born by TOL (6% vs 3%). Compared with routine vaginal deliveries, the adjusted odds ratio of developing any respiratory problem after an ERCS was 2.3 (95% confidence interval [CI]: 1.4, 3.8), and for developing transient tachypnea was 2.6 (CI: 1.5, 4.5). In addition, two infants delivered by ERCS developed respiratory distress syndrome. Infants delivered after a TOL had increased rates of suspected and proven sepsis (5% vs 2% and 1% vs 0.1%, respectively). Compared with a successful TOL, the infants delivered by Cesarean Section after a failed TOL had more neonatal morbidity and had a longer hospital stay (4.8 +/- 2 vs 3.1 +/- 2 days). The odds ratio for developing any respiratory illness after a failed TOL was 2.1 (95% CI: 1.1, 4.1), for suspected sepsis was 4.8 (95% CI: 2.6, 9.0), and for proven sepsis was 19.3 (95% CI: 2.0, 187). Neonatal outcomes after a successful TOL were similar to routine vaginal births. CONCLUSION Infants born by ERCS are at increased risk for developing respiratory problems compared with those born by TOL. However, TOL is associated with increased rates of suspected and proven sepsis. This appears to be limited to infants delivered by Cesarean Section after a failed TOL.
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Neonatal morbidity after elective Repeat Cesarean Section and trial of labor.
Pediatrics, 1997Co-Authors: B. Hook, Robert Kiwi, Saeid B. Amini, Avroy A. Fanaroff, Maureen HackAbstract:To evaluate neonatal outcomes after an elective Repeat Cesarean Section (ERCS) compared with a trial of labor (TOL). All mothers who underwent previous Cesarean Section and delivered singleton infants at term gestation were identified during a 1-year period. Neonatal outcomes were compared between infants delivered by ERCS (n = 497) and those delivered by TOL (n = 492), and between infants delivered by a successful (n = 336) and a failed (n = 156) TOL. A cohort of mothers and their term infants delivered by routine vaginal delivery were also identified. Infants delivered by ERCS had an increased rate of transient tachypnea compared with infants born by TOL (6% vs 3%). Compared with routine vaginal deliveries, the adjusted odds ratio of developing any respiratory problem after an ERCS was 2.3 (95% confidence interval [CI]: 1.4, 3.8), and for developing transient tachypnea was 2.6 (CI: 1.5, 4.5). In addition, two infants delivered by ERCS developed respiratory distress syndrome. Infants delivered after a TOL had increased rates of suspected and proven sepsis (5% vs 2% and 1% vs 0.1%, respectively). Compared with a successful TOL, the infants delivered by Cesarean Section after a failed TOL had more neonatal morbidity and had a longer hospital stay (4.8 +/- 2 vs 3.1 +/- 2 days). The odds ratio for developing any respiratory illness after a failed TOL was 2.1 (95% CI: 1.1, 4.1), for suspected sepsis was 4.8 (95% CI: 2.6, 9.0), and for proven sepsis was 19.3 (95% CI: 2.0, 187). Neonatal outcomes after a successful TOL were similar to routine vaginal births. Infants born by ERCS are at increased risk for developing respiratory problems compared with those born by TOL. However, TOL is associated with increased rates of suspected and proven sepsis. This appears to be limited to infants delivered by Cesarean Section after a failed TOL.
Babita Thapa - One of the best experts on this subject based on the ideXlab platform.
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Status of Scar in Repeat Cesarean Section in a Tertiary Hospital
Journal of Lumbini Medical College, 2016Co-Authors: Subha Shrestha, Raju Prasad Shakya, Buddhi Kumar Shrestha, Narinder Kaur, Babita ThapaAbstract:Introduction: In modern Obstetrics, with rising trends of primary Cesarean Section (CS) for fetal and maternal interests, pregnancy over the scarred uterus is a challenge to all treating obstetricians. Despite the method of suturing of the Cesarean scar, its fate in next pregnancy is still not measurable. Objective of this study was to evaluate the status of previous Cesarean scar during Repeat Cesarean Section (RCS) and calculate the maternal morbidity in those cases in a tertiary hospital. Methods: It was a descriptive, retrospective study conducted at department of Obstetrics of Lumbini Medical College Teaching Hospital. The study was conducted from 15th July 2014 to 14thJuly 2015. The data were retrieved from the department of Medical Records. Women undergoing RCS were enrolled. The status of scar was evaluated in terms of intact scar, scar rupture, scar dehiscence, thin lower uterine segment, scar placenta previa, and adhesions as indicator of scar integrity. Results: There were 534 (25.4%) CS among 2,098 deliveries during the study period. Ninety one (17.04%) of them were RCS. Elective RCS were 73.6% (n=67), and emergency RCS were 26.4% (n=24). Eighty two (90.1%) women had RCS once and nine (9.9%) had RCS for second time. Scar was intact in 22 (91.6%), scar dehiscence in one (8.3%), scar with adhesions in one (8.3%) among emergency RCS and intact in 53 (91.3%) and scar with adhesions in five (8.7%) among elective RCS. There was no scar dehiscence and no scar rupture in two RCS women. Adhesions were documented twice higher in women whose primary CS was undertaken outside our hospital. Placenta previa and placenta accreta each were found in two cases. Conclusion : Most of the scars of Repeat Cesarean Section were healthy with no scar rupture. We can consider trial of labor for scarred uterus with strict vigilance and in need, CS is always an option. DOI: https://doi.org/10.22502/jlmc.v4i1.84 J. Lumbini. Med. Coll. Vol 4, No 1, Jan-June 2016, page: 42-45
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Status of Scar in Repeat Cesarean Section in a Tertiary Hospital
Lumbini Medical College, 2016Co-Authors: Subha Shrestha, Buddhi Kumar Shrestha, Narinder Kaur, Raju Shakya, Babita ThapaAbstract:Introduction: In modern Obstetrics, with rising trends of primary Cesarean Section (CS) for fetal and maternal interests, pregnancy over the scarred uterus is a challenge to all treating obstetricians. How better the Cesarean scar is sutured, its exact fate in next pregnancy is still not measurable. Objective of this study was to evaluate the status of previous Cesarean scar during Repeat Cesarean Section (RCS) and calculate the maternal morbidity in those cases in a tertiary hospital. Methods: It was a descriptive, retrospective study conducted at department of Obstetrics of Lumbini Medical College Teaching Hospital. The study was conducted from 15th July 2014 to 14th July 2015. The data were retrieved from the department of Medical Records. Women undergoing RCS were enrolled. The status of scar was evaluated in terms of intact scar, scar rupture, scar dehiscence, thin lower uterine segment, scar placenta previa, and adhesions as indicator of scar integrity. Results: There were 534 (25.4%) CS among 2,098 deliveries during the study period. Ninety one (17.04%) of them were RCS. Elective RCS were 73.6% (n=67), and emergency RCS were 26.4% (n=24). Eighty two (90.1%) women had RCS once and 9 (9.9%) had RCS for second time. Scar was intact in 22 (91.6%), scar dehiscence in 1 (8.3%), scar with adhesions in 1 (8.3%) among emergency RCS and intact in 53 (91.3%) and scar with adhesions in 5 (8.7%) among elective RCS. Among nine women of two RCS, three (37.5%) had thin scar, five (62.5%) had well formed scar, seven (87.5%) had intact scar, and one (12.5%) had scar with adhesion. There was no scar dehiscence and no scar rupture in two RCS women. Adhesions were documented twice higher in women whose primary CS was undertaken outside our hospital. Placenta previa and placenta accreta each were found in two cases. Conclusion: Most of the scars of Repeat Cesarean Section were healthy with no scar rupture. We can consider trial of labor for scarred uterus with strict vigilance and in need, CS is always at option