Labor Onset, Oxytocin Use, and Epidural Anesthesia for Vaginal Birth after Cesarean Section and Associated Effects on Maternal and Neonatal Outcomes in a Tertiary Hospital in China

Wu, Shaowen; He, Dongyi; Zhang, Weiyuan

doi:10.4103/0366-6999.229897

Cited by 9 publications

(8 citation statements)

References 22 publications

(24 reference statements)

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“…Another possible explanation might be because using a similar standard protocol for induction of labor as the majority of the reports were from similar settings (limited resource countries). However, the current study finding is lower than the studies conducted in different countries like Ethiopia (80.3%) [26], China(76.9%) [33], Pakistan (82%) [34], Saudi Arabia(84%) [31], India (86.32%) [35] and Nigeria (82.2%) [36]. The possible justification for this discrepancy might be due to differences in socio-demographic characteristics of the study participants, the nature of study designs, and methods of data collections techniques.…”

Section: Plos Onecontrasting

confidence: 93%

Outcome of induction and associated factors among induced labours in public Hospitals of Harari Regional State, Eastern Ethiopia: A two years’ retrospective analysis

et al. 2021

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Background Induction of labor (IOL) is an essential intervention to reduce adverse maternal and neonatal outcomes. It is also improved pregnancy outcomes, especially in resource-limited countries, where maternal and perinatal mortality is unacceptably high. However, there is a scarcity of evidence regarding the outcome of induction of labor and its predictors in low-income countries like Sub-Saharan Africa. Therefore, this study was aimed at assessing the outcome of induction of labor and associated factors among mothers who underwent labor induction in public Hospitals of Harari Regional State, Estern Ethiopia. Methods A facility-based cross-sectional study was conducted from 1 to 30 March, 2019 in Harari Regional State, Eastern Ethiopia. A total of 717 mothers who underwent induction of labor in public Hospitals of Harari Regional State, Eastern Ethiopia from January 2017 to December 2018 were enrolled in the study. Data were collected using a pretested structured questionnaire. The collected data were entered into Epi-data version 3.1 and exported to SPSS version 24 (IBM SPSS Statistics, 2016) for further analysis. A multivariable logistic regression analysis was performed to estimate the effects of each predictor variable on the outcome of induction of labor after controlling for potential confounders. Statistical significance was declared at p-value <0.05. Results Overall, the prevalence of success of induction of labor was 65% [95% CI (61.5, 68.5)]. Pre-eclampsia/eclampsia was found to be the most common indication for induction of labor (46.70%) followed by pre-labor rupture of fetal membrane (33.5%). In the final model of multivariable analysis, predictors such as: maternal age < 24 years old [AOR = 1.93, 95%CI(1.14, 3.26)], nulliparity[AOR = 0.34, 95%CI(0.19, 0.59)], unfavorable Bishop score [AOR = 0.06, 95%CI(0.03, 0.12)], intermediate Bishop score [AOR = 0.08, 95%CI(0.04, 0.14)], misoprostol only method [AOR = 2.29, 95%CI(1.01, 5.19)], nonreassuring fetal heart beat pattern [AOR = 0.14, 95%CI (0.07, 0.25)] and Birth weight 3500 grams and above[AOR = 0.32, 95% CI (0.17, 0.59)] were statistically associated with the successful outcome of induction of labor. Conclusion The prevalence of successful of induction of labor was relatively low in this study area because only two-thirds of the mothers who underwent induction of labor had a successful of induction. Therefore, this result calls for all stakeholders to give more emphasis on locally available induction protocols and guidelines. In addition, pre-induction conditions must be taken into consideration to avoid unwanted effect of failed induction of labour.

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Section: Plos Onecontrasting

confidence: 93%

Outcome of induction and associated factors among induced labours in public Hospitals of Harari Regional State, Eastern Ethiopia: A two years’ retrospective analysis

et al. 2021

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“…Sufentanil is a new generation of potent synthetic opioid analgesic drug with better analgesic effect and less adverse reactions. With these advantages, its use has been on the rise in recent years . The clinical application of dexmedetomidine is also growing in recent years.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine versus sufentanil with high‐ or low‐concentration ropivacaine for labor epidural analgesia: A randomized trial

Cheng

Zhang

et al. 2019

J of Obstet and Gynaecol

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Aim: To study analgesic effects of dexmedetomidine or sufentanil, both combined with ropivacaine, in epidural analgesia during labor. Methods: We recruited 160 primigravidae with full-term pregnancy who received epidural anesthesia during labor and randomized them into four groups to receive epidural administration of ropivacaine combined with sufentanil (RS 1 and RS 2 groups) or with dexmedetomidine (RD 1 and RD 2 groups). Systolic blood pressure, diastolic blood pressure and heart rate before anesthesia (T 1 ), 15 min after anesthesia induction (T 2 ), on delivery (T 3 ) and 2 h postpartum (T 4 ), together with visual analogue scale scores, Bromage scores, Ramsay scores, adverse reactions during analgesia and urinary retention at 6 and 24 h postpartum were recorded; the pH, PCO 2 and PO 2 of umbilical cord arterial blood and Apgar scores at 1, 5 and 10 min after childbirth were assessed. Results: RS 1 group had significantly lower systolic blood pressure, diastolic blood pressure and heart rate than RD 1 group at T 2 and T 3 (all P < 0.05), but not at T1. At T 2 and T 3 , the other three groups were lower than RS 2 group in visual analogue scale and Ramsay scores (all P < 0.05). After childbirth, RD 2 group had significantly higher PO 2 result than other three groups (P < 0.05). At 6 h postpartum, RD 2 group had significantly fewer cases of urinary retention than RD 1 and RS 1 groups (both P < 0.05). Conclusion: A relatively low concentration of ropivacaine, combined with dexmedetomidine, is better in analgesia during labor.

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“…It’s worth noting that half of all unnecessary caesareans occur in Brazil and China [ 1 ]. This has aroused a significant global concern due to the economic burden and the increased complications after CS, especially in China after the implementation of “universal two-child policy” [ 2 , 3 ]. Women following a CS opt to have a second child either by repeated cesarean section (RCS) or vaginal birth after cesarean section (VBAC) [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…This has aroused a significant global concern due to the economic burden and the increased complications after CS, especially in China after the implementation of “universal two-child policy” [ 2 , 3 ]. Women following a CS opt to have a second child either by repeated cesarean section (RCS) or vaginal birth after cesarean section (VBAC) [ 3 ]. Due to the surgical indication of uterine scar, the phrase ‘once a cesarean, always a cesarean’ has always been repeatedly supported [ 2 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Labor characteristics and intrapartum interventions in women with vaginal birth after cesarean section

Lan

Pan

Chen

et al. 2022

BMC Pregnancy Childbirth

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Background With the development of China’s two-child-policy, vaginal birth after cesarean section (VBAC) has aroused public concern. It is important to understand the labour characteristics and intrapartum management of women attempting VBAC to enhance the rates of successful VBAC. The purpose of our research was to investigate the differences in the characteristics of labor, intervention measures and perinatal outcomes between women who had a VBAC and primiparas or multiparas not undergoing VBAC, providing clinical references of intrapartum management for women who are planning a VBAC. Material and methods This observational retrospective study enrolled all women who laboured spontaneously and who had a VBAC (n = 139) at the Second Affiliated Hospital of Wenzhou Medical University in China between 2016 and 2019. They were allocated into VBAC group A (the previous cesarean section was performed before dilation of the cervix) and VBAC group B (the previous cesarean section was performed after dilation of the cervix). The primipara control group included 149 primiparae, and the multipara control group included 155 multiparae with second vaginal birth. Durations of labor, intervention measures and perinatal outcomes were compared among the groups. Results The durations of labor, intrapartum interventions and maternal and neonatal outcomes in VBAC group A were similar to those of the VBAC group B. However, all women who had a VBAC and those in VBAC group A had shorter first, second and the total stages of labor than primiparae. All women with VBAC and those in VBAC group B had longer second stage of labor, but shorter third stage of labor than multiparae. Oxytocin, labor analgesia and artificial rupture of membranes were administered less often in women with VBAC than in primiparae, while phloroglucinol was administered more often in women with VBAC than in multiparae. Women who had a VBAC were more likely to receive episiotomy and had higher incidences of postpartum hemorrhage than primipara and multipara women. Conclusions Labor characteristics, intrapartum interventions and perinatal outcomes in women who had a VBAC with cervical dilation were similar to those in women who had a VBAC without cervical dilation before the previous cesarean section, but differed significantly from those of multiparae and primiparae who did not undergo VBAC.

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Labor Onset, Oxytocin Use, and Epidural Anesthesia for Vaginal Birth after Cesarean Section and Associated Effects on Maternal and Neonatal Outcomes in a Tertiary Hospital in China

Cited by 9 publications

References 22 publications

Outcome of induction and associated factors among induced labours in public Hospitals of Harari Regional State, Eastern Ethiopia: A two years’ retrospective analysis

Outcome of induction and associated factors among induced labours in public Hospitals of Harari Regional State, Eastern Ethiopia: A two years’ retrospective analysis

Dexmedetomidine versus sufentanil with high‐ or low‐concentration ropivacaine for labor epidural analgesia: A randomized trial

Labor characteristics and intrapartum interventions in women with vaginal birth after cesarean section

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