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Ultrasound in labor

Jeffrey P Wilkinson, Angela M Bengtson, Ennet Chipungu, Rachel J Pope, Bonus Makanani, Margaret Moyo, Mwawi Mwale, Jennifer H Tang
Objective: Obstetric fistula (OF) is a morbid condition caused by prolonged obstructed labor. Women with OF experience profound injury and have high rates of infertility and poor obstetric outcomes. We examined endovaginal ultrasound parameters in women with and without OF. Design/Setting/Sample/Methods: This cross-sectional study enrolled women evaluated at the Fistula Care Centre in Lilongwe, Malawi. Eligibility criteria included age 18-45, prior pregnancy, and a uterus on ultrasound...
2018: Obstetrics and Gynecology International
Mitko Kocarev, Fouzia Khalid, Fatima Khatoon, Roshan Fernando
PURPOSE OF REVIEW: Neuraxial labor analgesia remains the most effective and one of the most commonly utilized methods for pain relief during labor. This narrative review article is a summary of the literature published in 2017 on neuraxial analgesia for labor. RECENT FINDINGS: From a total of 41 identified articles, 13 were included in the review. The topics have been structured into three categories: initiation of neuraxial analgesia, maintenance of neuraxial analgesia, and neuraxial analgesia and obstetric outcomes...
March 14, 2018: Current Opinion in Anaesthesiology
Vanessa Bueno-Lopez, Carmen Fuentelsaz-Gallego, Manel Casellas-Caro, Ana Maria Falgueras-Serrano, Silvia Crespo-Berros, Ana Maria Silvano-Cocinero, Carolina Alcaine-Guisado, Manuela Zamoro Fuentes, Elena Carreras, Carmen Terré-Rull
BACKGROUND: Fetal occiput posterior position in labor is associated with more painful and prolonged labor, and an increase in both maternal and fetal morbidity. The aim of this study is to assess whether the modified Sims position on the side of the fetal spine increases the rotation to occiput anterior position in women with epidural analgesia and a fetus in persistent occiput posterior (POP) position. METHODS: This is an open, randomized controlled, clinical trial...
March 14, 2018: Birth
F Bellussi, L Alcamisi, G Guizzardi, D Parma, G Pilu
OBJECTIVES: to investigate the usefulness of visual biofeedback by transperineal ultrasound to improve the pushing coaching during the active second stage of labor in nulliparous women. METHODS: a randomized controlled trial of low risk nulliparous women in the active second stage of labor. Patients were allocated either to coaching aided by visual demonstration of the progress of the fetal head by transperineal ultrasound (sonographic coaching, Group A) or to classical coaching (Group B)...
March 13, 2018: Ultrasound in Obstetrics & Gynecology
Arata Hibi, Kazumasa Mogi
Portal vein thrombosis is a rare but life-threatening complication during pregnancy and postpartum period. Color Doppler ultrasound is useful for prompt diagnosis. Although the risk of complications should be considered, successful pregnancy with comorbid portal vein thrombosis is possible with appropriate anticoagulation therapy and close monitoring.
March 2018: Clinical Case Reports
Noam Smorgick, Avital Mittler, Ido Ben-Ami, Ron Maymon, Zvi Vaknin, Moty Pansky
OBJECTIVE: To investigate whether women who were surgically treated for retained products of conception (RPOC) by either suction curettage or hysteroscopy are at risk for recurrent RPOC on their subsequent pregnancies. STUDY DESIGN: Retrospective analysis of 442 women surgically treated for RPOC following delivery or abortion by suction curettage (N = 63, 14.3%) or hysteroscopy (N = 379, 85.7%). Information on subsequent pregnancies and their outcomes was available for 161 (36...
March 5, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Ahmed M Maged, Ehab M Soliman, Ali A Abdellatif, Mohamed Nabil, Omar I Said, Mohamed N Mohesen, Ayman N Raslan, Sahar M Y Elbaradie
BACKGROUND: Fetal head attitude has a substantial impact on labor progress and outcome. Fetal head deflexion is basically diagnosed by digital vaginal examination during labor. OBJECTIVES: To assess the effect of the fetal occiput-spine angle (OSA) measured through transabdominal ultrasound during the first stage of labor on the progress and outcome of labor. MATERIAL AND METHODS: A prospective cohort study conducted on 400 women with term uncomplicated singleton pregnancy with occipitoanterior position during active labor...
March 7, 2018: Journal of Maternal-fetal & Neonatal Medicine
José Morales-Roselló, Asma Khalil, Victoria Fornés-Ferrer, Alfredo Perales-Marín
OBJECTIVE: To study the accuracy of the cerebroplacental ratio (CPR) for the detection of intrapartum fetal compromise (IFC) in fetuses growing over the 10th centile. METHODS: This was a prospective study of 569 nonsmall fetuses attending the day hospital unit of a tertiary hospital that underwent an ultrasound examination at 36-40 weeks, and were delivered within 4 weeks of examination. IFC was defined as a composite of: abnormal intrapartum fetal heart rate or intrapartum fetal scalp pH < 7...
March 7, 2018: Journal of Maternal-fetal & Neonatal Medicine
Caterina Pizzicaroli, Carlotta Montagnoli, Ilaria Simonelli, Maria Grazia Frigo, Herbert Valensise, Mario Filippo Segatore, Giovanni Larciprete
PURPOSE: The aim of the study was to evaluate the progression and rotation of the fetal head during the second stage of labor using translabial ultrasound and to compare ultrasonographic data obtained in nulliparous women both receiving and not receiving neuraxial analgesia. METHODS: The 49 patients enrolled in the study were divided into two groups according to receiving or not receiving neuraxial analgesia. Every half hour from full dilation to delivery, the ultrasonographic translabial parameters of Angle of Progression, Head Symphysis Distance, and Midline Angle were obtained and recorded by a single operator...
February 28, 2018: Journal of Ultrasound
Alaa Eldin A Youssef, Ahmed F Amin, Mohamed Khalaf, Marwa S Khalaf, Mohammed K Ali, Ahmed M Abbas
OBJECTIVE: The current study aims to evaluate a simple method for sonographic measurement of the fetal biacromial diameter for prediction of fetal macrosomia in term pregnancy. MATERIALS AND METHODS: The current study was a single center prospective observational study conducted in a tertiary University Hospital from January 2015 to May 2017. We included all consecutive term (37-42 weeks) pregnant women presented to the labor ward for delivery. Ultrasound parameters were measured as biparietal diameter, head circumference, transverse thoracic diameter, mid arm diameter, abdominal circumference, femur length, estimated fetal weight and amniotic fluid index...
February 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
L Ghesquière, C Garabedian, C Coulon, P Verpillat, T Rakza, B Wibaut, A Delsalle, D Subtil, P Vaast, V Debarge
The main cause of fetal anemia is maternal red blood cell alloimmunization (AI). The search of maternal antibodies by indirect antiglobulin test allows screening for AI during pregnancy. In case of AI, fetal genotyping (for Rh-D, Rh-c, Rh-E and Kell), quantification (for anti-rhesus antibodies) and antibody titration, as well as ultrasound monitoring, are performed. This surveillance aims at screening for severe anemia before hydrops fetalis occurs. Management of severe anemia is based on intrauterine transfusion (IUT) or labor induction depending on gestational age...
February 21, 2018: Journal of gynecology obstetrics and human reproduction
Salvatore Butticè, Antonio Simone Laganà, Salvatore Giovanni Vitale, Christopher Netsch, Yiloren Tanidir, Francesco Cantiello, Laurian Dragos, Michele Talso, Esteban Emiliani, Rosa Pappalardo, Tarik Emre Sener
OBJECTIVE: Clinical presentation of ureteral stones during pregnancy is generally with renal colic pain. The aim of this study is to present our experience in the management of renal colic during pregnancy in emergency settings. MATERIALS AND METHODS: 208 pregnant patients who presented to emergency department with renal colic pain and underwent ureteroscopy (URS) due to failed conservative therapy were enrolled in the study. Urinary tract stones were diagnosed either with ultrasound (US) examination or during URS...
December 31, 2017: Archivio Italiano di Urologia, Andrologia
Mohammad Ghasem Hanafi, Aliakbar Sahraeizadeh
INTRODUCTION: The objective is to assess if fetal halogen light stimulation can reduce the time needed to obtain a normal biophysical profile (BPP). METHODS: Patients scheduled for a BPP and who satisfied the inclusion criteria were prospectively randomized to halogen light stimulation and no stimulation groups. The study group was exposed to handheld halogen light for 10 s whenever fetal breathing, movement, or tone was absent through the first 5 min of BPP. The time required to achieve complete BPP score was recorded...
February 22, 2018: Journal of Medical Ultrasonics
Christopher Flatley, Sailesh Kumar
OBJECTIVE: In high-risk pregnancies combining the cerebro-placental ratio (CPR) with the estimated fetal weight (EFW) improves the identification of vulnerable fetuses. The purpose of this study was to assess the CPR and EFW's ability to predict adverse obstetric and perinatal outcomes in a low-risk pregnancy, when measured late in gestation. METHODS: This was a retrospective study of women who birthed at Mater Mothers Hospitals, Brisbane, Australia between 2010 and 2015...
February 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
Bradley de Vries, Rajit Narayan, Kevin McGeechan, Stanley Santiagu, Ramesh Vairavan, Minke Burke, Hala Phipps, Jon Hyett
INTRODUCTION: Cesarean section rates continue to increase globally. Prediction of intrapartum cesarean section could lead to preventive measures. Our aim was to assess the association between sonographically measured cervical length at 37 weeks of gestation and cesarean section among women planning a vaginal birth. The population was women with a low-risk pregnancy or with gestational diabetes. MATERIAL AND METHODS: This was a prospective cohort study conducted in a tertiary referral hospital in Sydney, Australia...
February 16, 2018: Acta Obstetricia et Gynecologica Scandinavica
Kaouther Dimassi, Ines Bouriel, Amel Triki, Ali Mrabet, Mohamed Faouzi Gara
BACKGROUND: Preterm delivery is the major cause of adverse outcomes in twin pregnancy.  A shortened cervix at 20-24 weeks of amenorrhea is a good predictor of preterm birth in asymptomatic patients. However, there are no recommendations for serial cervical length measurements for these high risk pregnancies. OBJECTIVES: To evaluate the benefits from monthly cervical length monitoring in asymptomatic twin pregnancies. METHODS: This was a prospective study...
March 2017: La Tunisie Médicale
C Verhaeghe, E Parot-Schinkel, P E Bouet, S Madzou, F Biquard, P Gillard, P Descamps, G Legendre
BACKGROUND: The frequency of posterior presentations (occiput of the fetus towards the sacrum of the mother) in labor is approximately 20% and, of this, 5% remain posterior until the end of labor. These posterior presentations are associated with higher rates of cesarean section and instrumental delivery. Manual rotation of a posterior position in order to rotate the fetus to an anterior position has been proposed in order to reduce the rate of instrumental fetal delivery. No randomized study has compared the efficacy of this procedure to expectant management...
February 14, 2018: Trials
Shai Shrot, Clark T Johnson, W Christopher Golden, Ahmet A Baschat, Janine E Bullard, Aylin Tekes, Andrea Poretti, Emily Dunn, Thierry A G M Huisman
BACKGROUND AND PURPOSE: Persistent hyperextension of the fetal craniocervical junction or neck is one of several fetal positions commonly observed on prenatal imaging. Underlying fetal structural etiologies such as fetal neck masses and iniencephaly can be detected as causes of hyperextension. Caesarean delivery is considered in cases of vaginal delivery or obstructed labor for fear of cervical spinal cord injury. In this case series, we describe the prenatal magnetic resonance imaging (MRI) findings and their potential role in obstetric management and discuss postnatal outcomes in fetuses demonstrating prenatal imaging findings of persistent extreme hyperextension of the neck...
February 5, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Vajiheh Marsoosi, Reihaneh Pirjani, Mohamad Asghari Jafarabadi, Mina Mashhadian, Saeedeh Ziaee, Ashraf Moini
Background: Preterm labor is a major cause of perinatal morbidity and mortality and it might be predicted by assessing the cervical change. Objective: To assess the association between absence of cervical gland area (CGA) and spontaneous preterm labor (SPTL). Materials and Methods: This prospective cohort study was performed on 200 singleton pregnant women with a history of SPTL, second-trimester abortion in the previous pregnancy or lower abdominal pain in current pregnancy...
November 2017: International Journal of Reproductive Biomedicine (Yazd, Iran)
Burcin Karamustafaoglu Balci, Gokhan Goynumer
PURPOSE: The presence of echogenic amniotic fluid at term gestation on sonography is uncommon. The aim of our study was to investigate the incidence of echogenic amniotic fluid at term pregnancy, and to determine how often echogenic amniotic fluid was associated with meconium. METHODS: All singleton pregnant women at term who were admitted to our labor unit and who delivered within 24 h of the ultrasound scan were included in the study. For each woman, gestational age, maternal age, gravidity, parity, the character of the amniotic fluid on ultrasound at admission (clear or echogenic), birth weight, and the character of the amniotic fluid on artificial or spontaneous rupture of membranes or on cesarean section (clear/with vernix/meconium-stained) were recorded...
January 23, 2018: Archives of Gynecology and Obstetrics
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