scholarly journals First-trimester maternal serum vitamin D and mode of delivery

2012 ◽  
Vol 108 (11) ◽  
pp. 1972-1975 ◽  
Author(s):  
Makrina D. Savvidou ◽  
Mahlatse Makgoba ◽  
Pedro T. Castro ◽  
Ranjit Akolekar ◽  
Kypros H. Nicolaides
Keyword(s):  
Vitamin D ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
First Trimester ◽  
Maternal Serum ◽  
Emergency Caesarean Section ◽  
Maternal Vitamin ◽  
Vitamin D Levels

Low maternal vitamin D levels have been associated with adverse pregnancy outcome. A recent study has suggested that low maternal vitamin D levels at the time of delivery are also associated with an almost fourfold increase in caesarean section risk. The aim of the present study was to investigate whether there is a difference in maternal serum 25-hydroxyvitamin D (25(OH)D) levels at 11–13 weeks' gestation according to the mode of delivery. Maternal serum 25(OH)D levels were measured at 11–13 weeks' gestation in 995 singleton pregnancies resulting in the birth of phenotypically normal neonates at term. The measured 25(OH)D levels were adjusted for maternal age, BMI, racial origin, smoking, method of conception and season of blood testing, and the adjusted levels (multiple of the median; MoM) were compared between those who subsequently delivered vaginally and those that delivered by caesarean section. Delivery was vaginal in 79·6 % of cases, by emergency caesarean section in 11·6 % and by elective caesarean section in 8·8 %. The median 25(OH)D level in our population was 46·82 (interquartile range (IQR) 27·75–70·13) nmol/l. The adjusted maternal median 25(OH)D levels in the emergency and elective caesarean section groups (0·99, IQR 0·71–1·46 MoM and 0·96, IQR 0·73–1·27 MoM, respectively) were not significantly different from the vaginal delivery group (0·99, IQR 0·71–1·33 MoM; P = 0·53 and P = 0·81, respectively). First-trimester maternal serum 25(OH)D levels are similar between women who subsequently have a vaginal delivery and those who deliver by elective or emergency caesarean section.

scholarly journals A Study of Relationship Between Maternal Vitamin D Status and Mode of Delivery in a Tertiary Care Military Hospital

2020 ◽  
Author(s):  
Gurpreet Kaur Dhillon ◽  
Suneeta Singh ◽  
Harpreet Singh Dhillon ◽  
Shibu Sasidharan
Keyword(s):  
Vitamin D ◽  
Cesarean Section ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Serum Vitamin ◽  
Maternal Serum ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
The Relationship

Abstract Background: Vitamin D deficiency has been shown to be related to multiple adverse pregnancy related outcomes. An observational study was undertaken to study the relationship between maternal serum vitamin D levels during peripartum period and outcome in the form of mode of delivery.Methods: This study was done in a tertiary care centre on 569 patients to study the relationship between maternal serum vitamin D levels and mode of delivery categorized into vaginal delivery (VD), (including assisted delivery) and Lower Segment Cesarean Section (LSCS). The primary objective of this project was to assess the vitamin D levels in maternal serum and to study its relationship, if any, with mode of delivery. Results: A total of 569 samples of maternal and neonatal serum were analyzed for serum 25(OH)D levels. 464 (81.54%) mothers had Vitamin D sufficient (VDS) levels ≥30ng/ml and 105 (18.45%) had vitamin D deficient (VDD) levels <30ng/ml. Out of total 569 newborns; LSCS and spontaneous Vaginal Delivery were 152 (26.71%) and 417 (73.28%) respectively. The incidence of LSCS was 19.61% in the vitamin D sufficient group as compared to 58.09% in the vitamin D deficient group (p<0.0005). The mean cord blood 25(OH) D levels of the neonates born by vaginal delivery was 14.05ng/ml (SD 3.86, range 8.2-27) whereas those born by LSCS was 12.11 ng/ml (SD 3.18, range 7.9-22), which was significantly lower (p<0.00000042).Conclusion: The rates of Cesarean section deliveries was 2.96 times higher in mothers who had deficient Vitamin D levels. Also the levels of mean cord blood vitamin D was higher in vaginally delivered newborns.

scholarly journals Maternal Vitamin D and Newborn Telomere Length

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2012
Author(s):  
Lisa Daneels ◽  
Dries S. Martens ◽  
Soumia Arredouani ◽  
Jaak Billen ◽  
Gudrun Koppen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cord Blood ◽  
Telomere Length ◽  
First Trimester ◽  
Maternal Serum ◽  
Adverse Outcomes ◽  
Dietary Vitamin ◽  
Maternal Vitamin ◽  
Vitamin D Intake ◽  
Diet Supplements

Nutrition is important during pregnancy for offspring health. Gestational vitamin D intake may prevent several adverse outcomes and might have an influence on offspring telomere length (TL). In this study, we want to assess the association between maternal vitamin D intake during pregnancy and newborn TL, as reflected by cord blood TL. We studied mother–child pairs enrolled in the Maternal Nutrition and Offspring’s Epigenome (MANOE) cohort, Leuven, Belgium. To calculate the dietary vitamin D intake, 108 women were asked to keep track of their diet using the seven-day estimated diet record (EDR) method. TL was assessed in 108 cord blood using a quantitative real-time PCR method. In each trimester of pregnancy, maternal serum 25-hydroxyvitamin D (25-OHD) concentration was measured. We observed a positive association (β = 0.009, p-value = 0.036) between newborn average relative TL and maternal vitamin D intake (diet + supplement) during the first trimester. In contrast, we found no association between average relative TL of the newborn and mean maternal serum 25-OHD concentrations during pregnancy. To conclude, vitamin D intake (diet + supplements), specifically during the first trimester of pregnancy, is an important factor associated with TL at birth.

scholarly journals Vaginal Delivery versus Elective Caesarean Section for Breech Presentation - Experience in Institute of Child and Mother Health (ICMH)

2019 ◽  
Vol 31 (1) ◽  
pp. 23-26
Author(s):  
Mahe Jabeen ◽  
Sabiha Shimul ◽  
Ummay Salma ◽  
Jebunnesa
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Neonatal Outcome ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Cost Of Care ◽  
Increased Risk

Introduction: Compared with a fetus with cephalic presentation, a breech fetus faces increased risk during labour and delivery of asphyxia from cord compression and of traumatic injury during delivery of the shoulders and head. Caesarean section avoids most of this risk. The purpose of this study was to evaluate the feasibility of vaginal delivery of uncomplicated singleton breech presentation by evaluating early neonatal morbidity and mortality as well as maternal morbidity following vaginal and caesarean delivery for breech presentation. Materials and Methods: This is a cross sectional comparative study.104 women with singleton breech presentation at term in labour were included consequetively in labour ward of Institute of Child and Mother Health (ICMH). Informed consent was taken from them. Neonatal and maternal outcome were recorded and statistical analysis was done using SPSS version 22. Results: APGAR at 5 min and Neonatal Intensive Care Unite (NICU) admission were not affected by mode of delivery. Long term neonatal outcome is similar in either mode of delivery. Maternal morbidity and duration of hospital stay is increased in caesarean births. Conclusion: Neonatal outcome did not depend on mode of delivery though maternal morbidity and cost of care is increased following Caesarean Section. Proper selection of cases and by improving skill & confidence in new generation obstetrician, vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to a woman in a tertiary care centre. Medicine Today 2019 Vol.31(1): 23-26

In pregnant bitches, is elective caesarean section more effective than vaginal delivery at improving puppy survival?

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Mullika Borisoot
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Research Question ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Clinical Expertise ◽  
Bottom Line ◽  
Safe Delivery ◽  
Definitive Answer ◽  
Emergency Caesarean

PICO question In pregnant bitches due to whelp, is elective caesarean section more effective than vaginal delivery to improve puppy survival?   Clinical bottom line Category of research question The category of the research question is regarding the incidence of puppy mortalities as a result of vaginal delivery, emergency caesarean section and elective caesarean section. The number and type of study designs reviewed Two retrospective articles were reviewed and critically appraised; one retrospective study with high single canine breed bias and one study on different canine breeds but limited support in directly answering the PICO question. Strength of evidence The studies selected both had strong uses of experimental designs but together provided weak evidence to determine a definitive answer to the PICO question. Outcomes reported The outcomes from both retrospective studies suggests that the mortality rates of newborn puppies can be reduced if pregnant bitches are scheduled ahead for elective caesareans, in comparison to undergoing an emergency caesarean section when complications develop, particularly in breeds with higher risks of dystocia. Therefore, there is some evidence to support that it may be advantageous to consider the breed, age and overall health of the bitch during pregnancy to determine whether elective caesarean sections, for the safe delivery of puppies, should be considered. Conclusion There are currently insufficient studies, literatures and evidence in veterinary medicine for caesarean sections to become a routine procedure in first opinion practices. Future prospective studies should be conducted and include the optimum anaesthetic protocols with the lowest associated risks for the pregnant bitch and puppies.   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

scholarly journals Personal Preference of Mode of Delivery. What do Urogynaecologists choose? Preliminary Results of the DECISION Study

2017 ◽  
Vol 77 (11) ◽  
pp. 1182-1188 ◽  
Author(s):  
Julia Bihler ◽  
Ralf Tunn ◽  
Christl Reisenauer ◽  
Jan Pauluschke-Fröhlich ◽  
Philipp Wagner ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Risk Stratification ◽  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Online Questionnaire ◽  
Personal Attitude ◽  
Uncomplicated Pregnancy ◽  
Study Participants

Abstract Introduction Currently, almost every third child in Germany is delivered by caesarean section. Apart from straightforward and clear indications for caesarean section which account for approx. 10%, the large proportion of relative indications in particular needs to be critically reviewed if the current C-section rate is to be effectively lowered. It is more than doubtful, however, whether this can be a realistic goal in Germany, especially in the context of international developments. All studies on this topic demonstrate that the personal attitude of the obstetric team has a considerable influence on the pregnant womanʼs personally preferred mode of delivery. Therefore, in the first part of the DECISION study, the personal preferences of urogynaecologists were evaluated regarding the best suitable mode of delivery. Material and Methods All 432 delegates at the 9th German Urogynaecology Congress in Stuttgart in April 2017 were invited to participate in an online questionnaire study. The questionnaire was developed especially for this study. Results Of the 432 registered delegates, 189 (43.8%) participated in the survey. 84.7% (n = 160) of the study participants would prefer a vaginal delivery, in an otherwise uncomplicated pregnancy. Only 12.2% (n = 23) opted for an elective caesarean section. The main reasons stated for this decision were concerns about incontinence (87.5%) and pelvic floor trauma (79.2%). Amongst the study participants, 83.6% would like to be part of a risk stratification system presented in the questionnaire which, with the aid of specific parameters, is intended to allow early identification of a population with a high risk of developing pelvic floor disorders. There was also great interest in postpartum pelvic floor recovery (97.8%) and an associated optional pessary therapy (64.4%). The type of delivery already experienced (vaginal delivery vs. primary caesarean section) and parity also reveals to have a significant influence on the personal preferred mode of delivery as well. Conclusions Urogynaecologists prefer vaginal delivery for themselves. There is a great interest to participate in a risk stratification process in order to approach childbirth in an individualized and risk-adapted manner.

scholarly journals Perinatal determinants of D-dimer levels in a cross-sectional study of low risk pregnant women

2016 ◽  
Vol 9 (2) ◽  
pp. 78-82
Author(s):  
NM Murphy ◽  
AS Khashan ◽  
DI Broadhurst ◽  
O Gilligan ◽  
K O’Donoghue ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
D Dimer ◽  
In Pregnancy

Background To examine perinatal determinants of the antenatal levels of D-dimers. Methods Cross-sectional study of 760 low risk pregnant women recruited into five gestational groups. Variables examined in antenatal groups included maternal age, body mass index, parity, smoking, family history venous thromboembolism (VTE) and previous use of the oral contraceptive pill (OCP). Onset of labour and mode of delivery were also examined in the post-natal group. Results D-dimer levels in group 4 (38–40 + 6) were significantly lower in the women with a history of taking the OCP when compared to those that had not taken it in the past ( P = 0.027). In the day 2 post-natal group, the median level of D-dimer was significantly higher in primparous when compared to multiparous women ( P = 0.015). The median D-dimer levels were significantly lower in the elective Caesarean section group in comparison to spontaneous onset ( P = 0.003) and induction of labour ( P = 0.016). When the mode of delivery was examined, the median D-dimer levels were significantly lower in those that had an elective Caesarean section when compared to normal vaginal delivery ( P = 0.008) and instrumental vaginal delivery ( P = 0.007). Women post elective Caesarean section had a significantly lower D-dimer than those after emergency Caesarean section ( P = 0.008). Discussion There are some significant differences in D-dimer levels when certain perinatal determinants are examined. This work is potentially beneficial to the future diagnosis of VTE in pregnancy as it supports previously published recommended D-dimer levels for the diagnosis of VTE in pregnancy.

scholarly journals Evaluation of Maternal and Fetal Stress Hormones During the Process of Birth

2018 ◽  
Vol 24 (2) ◽  
pp. 65
Author(s):  
Burcu Kisa Karakaya ◽  
Ozlem Moraloglu ◽  
Rahime Bedir Findik ◽  
Necati Hancerliogullari ◽  
Hatice Celik ◽  
...  
Keyword(s):  
Stress Response ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Umbilical Cord ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Normal Vaginal Delivery ◽  
Singleton Pregnancy ◽  
Beta Endorphin ◽  
Tertiary Center

<p><strong>Objective:</strong> This study aims to determine whether mode of delivery is associated with the endocrine stress response in mother and newborn.</p><p><strong>Study Design:</strong> This prospective observational study was conducted with 86 women with a normal singleton pregnancy who delivered healthy infants between 37 and 41 weeks of gestation in a tertiary center. Study groups included; (1) women undergoing normal vaginal delivery with epidural anesthesia, (2) women undergoing vaginal delivery with immersion in water for pain relief during labor, (3) women delivered through elective caesarean section without labor. After delivery, thyroid stimulating hormone, cortisol, insulin, prolactin and Beta-endorphin levels were measured in maternal and umbilical cord serum and their relationships between modes of delivery were investigated.</p><p><strong>Results:</strong> It was found that the concentrations of cortisol and beta-endorphin after vaginal delivery with immersion in water group in both mothers and infants were higher than other two modes of delivery and these differences were statistically significant. Umbilical cord concentration of cortisol was the lowest in the caesarean section group.</p><p><strong>Conclusions:</strong> Maternal and fetal stress response was found to be associated with the mode of delivery and labor.</p>

The evaluation of cord blood interleukin-1β levels in normal and caesarean deliveries

2014 ◽  
Vol 33 (12) ◽  
pp. 1193-1198 ◽  
Author(s):  
A Gedikbaşi ◽  
Ö Salihoğlu ◽  
A Çankaya ◽  
V Arica ◽  
CH Akkuş ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cord Blood ◽  
Vaginal Delivery ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Blood Levels ◽  
Hypoxic Stress ◽  
Foetal Distress ◽  
Normal Delivery ◽  
Term Neonates

Objective: The aim of this prospective study was to establish the cord blood interleukin 1β (IL-1β) levels and asphyxia enzymes in term newborns and their relationship between delivery modes. We investigated whether cord blood level of IL-1β could be used as a reliable marker for detecting hypoxic stress and to determine the optimal cut-off level for IL-1β. Methods: The study was designed prospectively. Cord blood samples were obtained at the time of delivery from 75 noninfected full-term neonates for the purpose of measuring cord blood levels of IL-1β. Women were classified into three groups according to the mode of delivery (20 vaginal delivery, 29 urgent caesarean section (with foetal distress) and 26 elective caesarean section). All cases were followed-up by hospitalization. Umbilical cord sampling was carried out for IL-1β, umbilical artery gas parameters and other asphyxia enzymes at the time of delivery. Cord blood IL-1β was measured by enzyme-linked immunosorbent assay. The perinatal outcomes of the cases were recorded after birth. Demographic characteristics, neonatal outcomes and laboratory findings were compared in all the three groups. Results: IL-1β levels showed statistically significant difference between groups ( p < 0.01). The relationship was found between IL-1β cord blood levels and the mode of delivery. IL-1β levels of urgent caesarean section group were significantly higher than elective caesarean section and normal delivery group ( p:0.001 and p:0.001, respectively). Normal delivery levels were significantly higher than the elective caesarean group ( p:0.001). Conclusion: Urgent section (foetal distress) and vaginal delivery (labour) were each associated with elevated IL-1β cord blood levels in noninfected full-term neonates, while only elective caesarean section was associated with decreased IL-1β levels. For the evaluation of newborns at high risk for perinatal hypoxic stress, cord blood IL-1β levels may lead the way. On the other hand, the mode of delivery may be associated with the effects on the immune system. Further investigations with larger patient groups are required to confirm our results.

scholarly journals Factors Affecting the Pregnancy Outcome in Patients with Previous One Caesarean Section

2014 ◽  
Vol 26 (1) ◽  
pp. 01-03
Author(s):  
Kazi Shahnaz Begum ◽  
Neyamat Ullah Khan ◽  
Farhana Akter
Keyword(s):  
Caesarean Section ◽  
Post Partum ◽  
Early Report ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Case Series ◽  
Emergency Caesarean Section ◽  
Factors Affecting ◽  
Emergency Caesarean ◽  
Case Series Study

This case series study was designed to determine the factors affecting the pregnancy out come in patients with previous one caesarean section. The study was conducted at Marie Stopes Clinic Primium-1 Dhanmondi from July 01, 2012 to January 31, 2013. A total of 150 patients with previous one caesarean section who presented at term were included in the study. The data were collected through proforma and subjected to statistical analysis. Out of 150 patients, 81 (54%) patients had trial of scar and the remaining 69 (46%) patients underwent repeat elective caesarean section. Among those who had trial of scar only 35 (43.2%) patients achieved successful vaginal delivery and remaining 46 (56.8%) had emergency caesarean section. Common indication for repeat emergency caesarean section was non progress of labour (47.8%). It was frequent in women who reported late to hospital after the onset of labour and in women who did not seek antenatal booking in pregnancy. Maternal complications like post partum hemorrhage, scar dehiscence, wound infection and febrile illness were more in those who had emergency caesarean section. There was no maternal mortality in the study. Perinatal outcome was not affected by the mode of delivery. There were two perinatal deaths which occurred in non-booked patients who underwent emergency caesarean section. Most of the women in our study had repeat caesarean section for failed progress. Regular antenatal check up and early report to hospital after the onset of labour can reduce the rate of repeat caesarean section. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21300 Medicine Today 2014 Vol.26(1): 01-03

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