Background: American college of obstetricians and gynecologists and the American academy of family physicians recommended that pregnant women with a single previous caesarean delivery and a low-transverse incision should be offered a trial of labour. This study was planned to measure safety and efficacy of elective Foley’s induction as a method of induction in previous one caesarean section.Methods: This was a prospective study of 150 women with previous caesarean section who were candidates for TOLAC admitted in labour room. Induction of labour via Foley’s catheter was done in group A whereas group B had a spontaneous onset of labour in previous caesarean section cases. Augmentation was done, if required.Results: There was spontaneous expulsion of Foley’s catheter in 88% out of which 65.15% patients delivered vaginally and 34.84% were delivered by caesarean section. Out of 12% where Foley’s catheter had to be removed after 12 hours manually, 88.89% were delivered by caesarean section.Conclusions: A change in Bishop score after induction with Foley’s catheter in previous caesarean section leads to higher chances of successful vaginal delivery. The likelihood of successful vaginal delivery increases with increase in FLAMM score.
Background: Amniotic fluid index (AFI) is commonly used to estimate amniotic fluid volume. A proper AFI is between 10 and 24 centimetres. If it is below 5 cm, it is can represent oligohydramnios, and in case AFI is above 24 cm, it can represent polyhydramnios. This study was undertaken to determine whether measuring AFI at term is useful in the prediction of perinatal outcome.Methods: A prospective study of 250 pregnant women with gestational age between 37 and 42 weeks was conducted at Sola Civil Hospital. AFI was measured in each patient using the Phelan’s technique and the perinatal outcome was studied. The results were analysed and presented in the form of tables and graphs.Results: Total 250 patients were studied. Out of them, 33 patients (13.2%) had AFI <=5, 215 (86%) had AFI between 6 and 24; and 2 patients (0.8%) had AFI >=25.19 out of 33 (57.57%) patients with AFI <= 5, had to undergo caesarean section, out of which, 12 caesarean sections (63.15%) were taken for non-reassuring foetal status. 36.27% (78/215) of patients with AFI between 6 and 24 underwent caesarean section, out of which 38.46% (30/78) underwent caesarean section for non-reassuring foetal status.Conclusions: In the presence of oligohydramnios, the rates of LSCS due to foetal distress, the occurrence of low Apgar score and of low birth weight are higher than in patients with normal liquor at term. Thus, measuring the amniotic fluid index at term can be helpful in the prediction of perinatal outcome.
The gestational age at which the delivery occurs is important in determining the perinatal outcome. In this study, the foetal outcome was analysed according to the gestational age in weeks in spontaneous vaginal delivery occurring between 36 completed weeks to 40 completed weeks of gestation. To study the foetal outcome according to the weeks of gestation in spontaneous vaginal delivery occurring between 36 completed weeks to 40 completed weeks of gestation. A retrospective study of women who spontaneously delivered vaginally, at gestational age between 36 completed weeks to 40 completed weeks from 1 July 2019 to 30 September 2019 was conducted at GMERS Medical College and Hospital, Sola.Total 390 cases were studied.Foetal outcome in terms of birth weight, APGAR score at 1 minute, and NICU admissions were noted and analysed according to the weeks of gestation at delivery, and entered into a database.The results were analysed and presented in the form of tables and graphs. The average birth weight increased with increase in the weeks of gestation at the time of the spontaneous delivery. The average birth weight of neonates born in 36th, 37th and 38th week was 2.314Kg, 2.623Kg and 2.704Kg, respectively. 14.28% of the babies born in the 36th week of gestation were admitted to the NICU. 4.705% and 4.347% of the babies born in the 37thand 38th week of gestation respectively, were admitted to the NICU.The Mean APGAR score of the neonates born in 36th, 37th, 38th and 39th week were 8.714, 9.235, 9.347, and 9.645, respectively. Thus, the mean APGAR score increased by the weeks of gestation at the time of the spontaneous delivery. Unnecessary induction of labour or elective LSCS before 39 weeks should be discouraged. In case of elective deliveries, unless there is a health risk to the mother or baby, it is best to wait to deliver until reaching full term at 39 weeks.
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