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https://www.readbyqxmd.com/read/29768964/effects-of-combined-spinal-epidural-analgesia-on-first-stage-of-labor-a-cohort-study
#1
Silvia Poma, Luigia Scudeller, Chiara Verga, Giorgio Mirabile, Barbara Gardella, Federica Broglia, Maria Ciceri, Marinella Fuardo, Simona Pellicori, Maddalena Gerletti, Silvia Zizzi, Elena Masserini, Maria Paola Delmonte, Giorgio Antonio Iotti
BACKGROUND: Neuraxial anesthesia is considered as the gold standard in the control labor of pain. Its variants are epidural analgesia and combined spinal-epidural analgesia. Few studies, as yet, have investigated the duration of labor as a primary outcome. Some authors have suggested that combined spinal-epidural analgesia may reduce labor duration but at the moment the benefit of shortening labor is uncertain. The main aim of this study was to compare combined spinal-epidural with epidural analgesia in terms of their effect on duration of stage I labor, maternal, and neonatal outcomes...
May 17, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29764452/risk-factors-for-korean-women-to-develop-an-isthmocele-after-a-cesarean-section
#2
I Y Park, M R Kim, H N Lee, Y Gen, M J Kim
BACKGROUND: The increase in number of cesarean section (CS) operations has resulted in an increase in cases of isthmocele development. The objective of this study is to determine the risk factors for isthmocele development after CS. METHODS: Isthmocele measurements were taken for 404 women with a history of at least one low transverse CS. The following potential risk factors were investigated: patient's age at CS, cause of CS, weeks of gestation at CS, premature rupture of membrane (PROM), phase of labor, type suture (single/double layer), operation time, uterine flexion (anteversion/retroversion), and blood transfusion during operation...
May 15, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29763609/cervical-ripening-balloon-with-and-without-oxytocin-in-multiparas-a-randomized-controlled-trial
#3
Alison M Bauer, Justin R Lappen, Kimberly S Gecsi, David N Hackney
BACKGROUND: The optimal method for induction of labor for multiparous women with an unfavorable cervix is unknown. OBJECTIVE: To determine if induction of labor with simultaneous use of oxytocin and a cervical ripening balloon, compared with sequential use, increases the likelihood of delivery within 24 hours in multiparous women. STUDY DESIGN: We performed a randomized controlled trial between November 2014 and June 2017. Eligible participants were multiparous women with a vertex presenting, non-anomalous singleton gestation ≥ 34 weeks undergoing induction of labor...
May 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29755833/risk-factors-for-umbilical-cord-prolapse-at-the-time-of-artificial-rupture-of-membranes
#4
Tetsuya Kawakita, Chun-Chih Huang, Helain J Landy
Objective  The aim of the study was to examine the association between cervical exam at the time of artificial rupture of membranes (AROM) and cord prolapse. Study Design  We conducted a retrospective cohort study using the data from the Consortium on Safe Labor. We included women with cephalic presentation and singleton pregnancies at ≥ 23 weeks' gestation who underwent AROM during the course of labor. Multivariable logistic regression was used to calculate the adjusted odds ratio (aOR) with 95% confidence interval (95% CI), controlling for prespecified covariates...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29743028/investigating-determinants-for-patient-satisfaction-in-women-receiving-epidural-analgesia-for-labour-pain-a-retrospective-cohort-study
#5
Daryl Jian An Tan, Rehena Sultana, Nian Lin Reena Han, Alex Tiong Heng Sia, Ban Leong Sng
BACKGROUND: Epidural analgesia is a popular choice for labour pain relief. Patient satisfaction is an important patient-centric outcome because it can significantly influence both mother and child. However, there is limited evidence in the correlations between clinical determinants and patient satisfaction. We aim to investigate clinical covariates that are associated with low patient satisfaction in parturients receiving labour neuraxial analgesia. METHODS: After institutional ethics approval was obtained, we conducted a retrospective cohort study using electronic and corresponding hardcopy records from 10,170 parturients receiving neuraxial analgesia between the periods of January 2012 to December 2013 in KK Women's and Children's Hospital in Singapore...
May 9, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29739262/comparison-of-prostaglandin-and-mechanical-cervical-ripening-in-the-setting-of-small-for-gestational-age-neonates
#6
Robert M Rossi, Carri R Warshak, Heather R Masters, Jodi K Regan, Sara A Kritzer, Kristin P Magner
OBJECTIVE: To determine whether cervical ripening with misoprostol (MP) is associated with higher rates of cesarean delivery (CD) (CD) compared to dinoprostone (DP) or Pitocin/Foley balloon (PFB) in infants found to be small for gestational age (SGA). STUDY DESIGN: Single center institution based cohort study of all inductions between 2008-2012 where birth weight was found to be as SGA (< 10th percentile). Maternal demographic, obstetric, and labor characteristics were compared between SGA births where cervical ripening with MP, Mode compares MP to referent group (DP), or PFB was used as the primary agent...
May 8, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29728142/intermittent-fetal-heart-rate-monitoring-using-a-fetoscope-or-hand-held-doppler-in-rural-tanzania-a-randomized-controlled-trial
#7
Paschal Francis Mdoe, Hege L Ersdal, Estomih R Mduma, Jeffrey M Perlman, Robert Moshiro, Peter T Wangwe, Hussein Kidanto
BACKGROUND: Neonatal mortality is a global challenge, with an estimated 1.3 million intrapartum stillbirths in 2015. The majority of these were found in low resource settings with limited options to intrapartum fetal heart monitoring devices. This trial compared frequency of abnormal fetal heart rate (FHR) detection and adverse perinatal outcomes (i.e. fresh stillbirths, 24-h neonatal deaths, admission to neonatal care unit) among women intermittently assessed by Doppler or fetoscope in a rural low-resource setting...
May 4, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29727248/quantitative-fetal-fibronectin-and-cervical-length-in-symptomatic-women-results-from-a-prospective-blinded-cohort-study
#8
Lisa D Levine, Katheryne L Downes, Julie A Romero, Hope Pappas, Michal A Elovitz
OBJECTIVES: Our objectives were to determine whether quantitative fetal fibronectin (fFN) and cervical length (CL) screening can be used alone or in combination as prognostic tests to identify symptomatic women at highest or lowest risk for spontaneous preterm birth (sPTB). METHODS: A prospective, blinded cohort study of women presenting with a singleton gestation to our triage unit between 22-33w6d with preterm labor symptoms was performed. Women with ruptured membranes, moderate/severe bleeding, and dilation > 2 cm were excluded...
May 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29725244/cervical-dilatation-curves-of-spontaneous-deliveries-in-pregnant-japanese-females
#9
Yusuke Inde, Akihito Nakai, Atsuko Sekiguchi, Masako Hayashi, Toshiyuki Takeshita
Background: Although cervical dilatation curves are crucial for appropriate management of labor progression, abnormal labor progression and obstetric interventions were included in previous and widely-used cervical dilatation curves. We aimed to describe the cervical dilatation curves of normal labor progression in pregnant Japanese females without abnormal labor progression and obstetric interventions. Methods: We completed retrospective obstetric record reviews on 3172 pregnant Japanese females (parity = 0, n = 1047; parity = 1, n = 1083; parity ≥ 2, n = 1042), aged 20 to 39 years old at delivery, with pregravid body mass indices of less than 30...
2018: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29712877/characterization-of-collagen-microstructural-organization-of-human-cervical-tissue
#10
Jia Hao, Wang Yao, William-Barton Ryan Harris, Joy Y Vink, Kristin Myers, Eve Donnelly
The cervix shortens and softens as its collagen microstructure remodels in preparation for birth. Altered cervical tissue collagen microstructure can contribute to a mechanically weak cervix and premature cervical dilation and delivery. To investigate the local microstructural changes associated with anatomic location and pregnancy, we used second harmonic generation microscopy to quantify the orientation and spatial distribution of collagen throughout cervical tissue from 4 pregnant and 14 non-pregnant women...
April 30, 2018: Reproduction: the Official Journal of the Society for the Study of Fertility
https://www.readbyqxmd.com/read/29712501/the-feasibility-and-accuracy-of-ultrasound-assessment-in-the-labor-room
#11
S Usman, M Wilkinson, H Barton, C C Lees
OBJECTIVE: Vaginal examination is widely used to assess the progress of labor; however, it is subjective and poorly reproducible. We aim to assess the feasibility and accuracy of transabdominal and transperineal ultrasound compared to vaginal examination in the assessment of labor and its progress. METHODS: Women were recruited as they presented for assessment of labor to a tertiary inner city maternity service. Paired vaginal and ultrasound assessments were performed in 192 women at 24-42 weeks...
April 30, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29702988/enteritis-as-initial-manifestation-of-systemic-lupus-erythematosus-in-early-pregnancy-a-case-report
#12
Anna Maria Bellou, Dominik Bös, Guido Kukuk, Ulrich Gembruch, Waltraut Maria Merz
RATIONAL: Lupus enteritis is a rare, severe complication of systemic lupus erythematosus (SLE). We report of a patient who presented with enteritis as manifestation of new-onset SLE during the first trimester of pregnancy. PATIENTS CONCERNS: The 23-year nulliparous patient was admitted to a district hospital with abdominal pain, nausea, vomiting and bloody diarrhea at a gestational age (GA) of 10 weeks. Her symptoms improved with symptomatic treatment and she was discharged a few days later...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29701868/devices-for-measuring-cervical-dilation-during-labor-systematic-review-and-meta-analysis
#13
Margherita Brancadoro, Selene Tognarelli, Franco Fambrini, Antonio Ragusa, Arianna Menciassi
Importance: Measurement of cervical dilation is one of the major indicators of labor progression. At present, the criterion standard for this evaluation is digital examination, which results are sometimes inaccurate and extremely dependent on the subject (ie, obstetrician or midwife) experience. Objective: In this systematic and meta-analysis review, the authors have gathered the vast majority of the instruments used for measuring cervical dilation and their clinical application; main features, potentialities, and the most significant constraints are underlined for each device...
April 2018: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29693012/management-of-cesarean-scar-pregnancy-a-single-institution-retrospective-review
#14
P Giampaolino, N De Rosa, I Morra, A Bertrando, A Di Spiezio Sardo, B Zizolfi, C Ferrara, L Della Corte, G Bifulco
Objective: Cesarean scar pregnancy (CSP) is a rare condition that occurs when the pregnancy implants in a cesarean scar. An early diagnosis and a proper management are fundamental to prevent maternal complications. We review and discuss the different treatment employed in our unit to reduce morbidity, preserve fertility, and predict possible complications. Methods: The reported treatment has been expectant management, operative hysteroscopy approach, and intramuscular injection of 50 mg methotrexate (MTX), followed by cervical dilation and manual vacuum aspiration (D&S) with a Karman cannula under ultrasound guidance, uterine artery embolization (UAE), and manual vacuum aspiration under ultrasound guidance and uterine artery embolization before surgical laparotomic resection...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29689580/normal-cervical-effacement-in-term-labor
#15
Janine S Rhoades, Molly J Stout, Candice Woolfolk, Methodius G Tuuli, George A Macones, Alison G Cahill
OBJECTIVE:  To estimate the natural history of cervical effacement in labor. STUDY DESIGN:  This is a retrospective cohort study of term, vertex, singletons who reached 10 cm of cervical dilation from 2010 to 2014. Interval-censored regression was used to estimate the median number of hours between changes in effacement (measured in centimeters of the residual cervix) and to estimate the median effacement at a given cervical dilation. Analysis was stratified by parity and labor type...
April 24, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29689578/peripartum-morbidity-after-cesarean-delivery-for-arrest-of-dilation-at-4-to-5-cm-compared-with-6-to-10-cm
#16
Joshua D Dahlke, Jeffrey D Sperling, Phinnara Has, Todd R Lovgren, Brendan D Connealy, Dwight J Rouse
OBJECTIVE:  Given that recent consensus guidelines established to decrease cesarean delivery (CD) rates use 6 cm to define the onset of the active phase of labor, our objective was to evaluate maternal and neonatal outcomes after CD for the indication of arrest of dilation at 4 to 5 cm compared with ≥ 6 cm. STUDY DESIGN:  We performed a secondary analysis using data from the Maternal Fetal-Medicine Units Network Cesarean Registry. We included nulliparous women with term, singleton, vertex gestations who underwent primary CD for arrest of dilation...
April 24, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29686882/pyosalpinges-after-hysterosalpingography-in-a-patient-with-lower-genital-tract-infection-and-managed-by-laparoscopic-surgery-in-a-resource-low-tertiary-hospital-case-report-and-literature-review
#17
Thomas Obinchemti Egbe, Fidelia Mbi Kobenge, Metogo Mbengono Junette Arlette, Eugene Belley-Priso
Background: Pyosalpinges (a complication of pelvic inflammatory disease) is infection of the fallopian tubes and the morbidity associated with it has major health implications. We are reporting a case of pyosalpinges diagnosed after hysterosalpingography and managed by laparoscopic surgery at the Douala General Hospital, Cameroon. Case presentation: A 29-year-old single woman, an assistant nurse of the Douala tribe in Cameroon. She is G1P0010 and came to our attention because of secondary infertility of three years duration...
2018: Fertility Research and Practice
https://www.readbyqxmd.com/read/29683909/acog-committee-opinion-no-734-the-role-of-transvaginal-ultrasonography-in-evaluating-the-endometrium-of-women-with-postmenopausal-bleeding
#18
(no author information available yet)
Cancer of the endometrium is the most common type of gynecologic cancer in the United States. Vaginal bleeding is the presenting sign in more than 90% of postmenopausal women with endometrial carcinoma. Clinical risk factors for endometrial cancer, including but not limited to age, obesity, use of unopposed estrogen, specific medical comorbidities (eg, polycystic ovary syndrome, type 2 diabetes mellitus, atypical glandular cells on screening cervical cytology), and family history of gynecologic malignancy also should be considered when evaluating postmenopausal bleeding...
May 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29683904/acog-committee-opinion-no-734-summary-the-role-of-transvaginal-ultrasonography-in-evaluating-the-endometrium-of-women-with-postmenopausal-bleeding
#19
(no author information available yet)
Cancer of the endometrium is the most common type of gynecologic cancer in the United States. Vaginal bleeding is the presenting sign in more than 90% of postmenopausal women with endometrial carcinoma. Clinical risk factors for endometrial cancer, including but not limited to age, obesity, use of unopposed estrogen, specific medical comorbidities (eg, polycystic ovary syndrome, type 2 diabetes mellitus, atypical glandular cells on screening cervical cytology), and family history of gynecologic malignancy also should be considered when evaluating postmenopausal bleeding...
May 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29683307/maternity-care-update-labor-and-delivery
#20
Andrew Smith, Wendy B Barr, Erin Bassett-Novoa, Nicholas LeFevre
Labor is defined as contractions with cervical change and active labor starts when the cervix is dilated 6 cm. Updated labor curves and definitions should be used to define labor dystocia. Oxytocin and amniotomy have important roles in the management of labor dystocia. Structured intermittent fetal monitoring should be considered for women with low-risk pregnancies but continuous electronic fetal monitoring still is used most commonly. Moderate fetal heart rate variability is the most reliable marker of fetal well-being...
April 2018: FP Essentials
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