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https://www.readbyqxmd.com/read/28231607/position-in-the-second-stage-of-labour-for-women-with-epidural-anaesthesia
#1
REVIEW
Marion Kibuka, Jim G Thornton
BACKGROUND: Epidural analgesia for pain relief in labour prolongs the second stage of labour and results in more instrumental deliveries. It has been suggested that a more upright position of the mother during all or part of the second stage may counteract these adverse effects. This is an update of a Cochrane review first published in 2013. OBJECTIVES: To assess the effects of different birthing positions (upright and recumbent) during the second stage of labour, on important maternal and fetal outcomes for women with epidural analgesia...
February 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28222694/knowledge-of-obstetric-danger-signs-and-associated-factors-among-reproductive-age-women-in-raya-kobo-district-of-ethiopia-a-community-based-cross-sectional-study
#2
Nigus Bililign, Tesfahun Mulatu
BACKGROUND: Knowledge of danger signs of obstetric complications during pregnancy, labour, and postnatal period is the first essential step for appropriate and timely referral. This study aimed to investigate predictors of knowledge about obstetric danger signs during pregnancy, delivery, and postpartum period among mothers of reproductive age women who gave birth in the last 12 months. METHODS: A quantitative community based cross-sectional study was employed during March 2016...
February 21, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28222428/neonatal-and-maternal-short-term-outcome-parameters-in-instrument-assisted-vaginal-delivery-compared-to-second-stage-cesarean-section-in-labour-a-retrospective-11-year-analysis
#3
Moritz Polkowski, Elna Kuehnle, Cordula Schippert, Sudip Kundu, Peter Hillemanns, Ismini Staboulidou
BACKGROUND: This study is aimed at comparing the neonatal and maternal short-term outcomes after instrumental-assisted vaginal delivery and cesarean section (CS) in labour. METHODS: This retrospective study over a period of 11 years included singleton pregnancies above 34 + 0 gestational weeks, giving birth either by instrumental-assisted delivery or CS in labour. Maternal and neonatal outcome parameters were analysed using t test or linear regression. RESULTS: A total of 1,971/2,571 deliveries were included for analysis: 149 forceps-, 393 vacuum-assisted deliveries and 1,420 CS in labour...
February 22, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28219313/trial-of-labour-after-caesarean-tolac-is-associated-with-increased-risk-for-instrumental-delivery
#4
Rotem Inbar, Shali Mazaaki, Anat Kalter, Itai Gat, Eyal Sivan, Eyal Schiff, Israel Hendler
: We compared the rates of instrumental delivery in a cohort of nulliparous women at term (n = 19,416), to primiparous women who attempted labour after prior caesarean (TOLAC) (n = 1747). The rate of instrumental deliveries was higher in the TOLAC group compared to nulliparous gravidas (17.3 vs. 15% respectively, p = 0.001). The difference was more prominent for women who eventually had successful vaginal delivery (TOLAC: 23.9% vs. CONTROLS: 17.1%, p < 0...
January 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28213060/prediction-of-cesarean-delivery-in-the-term-nulliparous-woman-results-from-the-prospective-multi-center-genesis-study
#5
Naomi Burke, Gerard Burke, Fionnuala Breathnach, Fionnuala Mcauliffe, John J Morrison, Michael Turner, Samina Dornan, John R Higgins, Amanda Cotter, Michael Geary, Peter Mcparland, Sean Daly, Fiona Cody, Pat Dicker, Elizabeth Tully, Fergal D Malone
BACKGROUND: In contemporary practice many nulliparous women require intervention during childbirth such as operative vaginal delivery or Cesarean delivery (CD). Despite the knowledge that the rising CD rate is associated with increasing maternal age, obesity and larger infant birthweight, we lack a reliable method to predict the requirement for such potentially hazardous obstetric procedures during labor and delivery. This issue is important as there are higher rates of morbidity and mortality associated with unplanned CD performed in labor compared to scheduled Cesarean deliveries...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28208944/the-effect-of-fetal-gender-on-the-delivery-outcome-in-primigravidae-women-with-induced-labours-for-all-indications
#6
Angeliki Antonakou, Dimitrios Papoutsis
INTRODUCTION: There is increasing evidence of a gender-related phenomenon where the presence of a male fetus may have an adverse effect on the outcome of pregnancy. AIM: The aim of this study was to investigate the effect of fetal gender on the delivery outcome in primigravidae women with induced labours. MATERIALS AND METHODS: This was an observational cohort study of primigravidae women who had Induction Of Labour (IOL) for all indications during a two-year period...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28199373/prevalence-of-maternal-hiv-infection-and-knowledge-on-mother-to-child-transmission-of-hiv-and-its-prevention-among-antenatal-care-attendees-in-a-rural-area-in-northwest-cameroon
#7
Carlson-Babila Sama, Vitalis F Feteh, Maxime Tindong, John T Tanyi, Nestor Mbinkar Bihle, Fru F Angwafo
BACKGROUND: In 2010, an estimated 141 new HIV infections occurred per day in Cameroon and reports suggest an upsurge of these rates by 2020 if current trends continue. Mother-to-child transmission (MTCT) of HIV is a major public health challenge, and maternal knowledge on HIV transmission during pregnancy and its prevention is important in curtailing paediatric HIV acquisition. OBJECTIVES: We aimed at establishing the prevalence of maternal HIV infection as well as assessing knowledge on HIV, MTCT and prevention of MTCT (PMTCT) of HIV among pregnant women in a rural area of Cameroon...
2017: PloS One
https://www.readbyqxmd.com/read/28197352/vulvovaginal-infralevator-haematoma-mimicking-the-second-stage-of-labour
#8
J O Awoleke, O M Ipinnimo
Even though they are quite uncommon, puerperal genital haematomas can be associated with serious maternal morbidity. Key findings are significant perineal pain and, depending on the location, visible swelling. However, attention can be drawn to its progression by the rare occurrence of persistent painful "bearing down" efforts, even after the successful delivery of the baby. The final size of this haematoma and the rare presentation make it truly uncommon. The primary goals of treatment include the prevention of further blood loss, minimizing tissue damage, relieving pain, and reducing the risk of infection...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28195653/duration-of-second-stage-of-labour-at-term-and-pushing-time-risk-factors-for-postpartum-haemorrhage
#9
Emelie Looft, Marija Simic, Mia Ahlberg, Jonathan M Snowden, Yvonne W Cheng, Olof Stephansson
BACKGROUND: Prolonged labour is associated with increased risk of postpartum haemorrhage (PPH), but the role of active pushing time and the relation with management during labour remains poorly understood. METHODS: A population-based cohort study from electronic medical record data in the Stockholm-Gotland Region, Sweden. We included 57 267 primiparous women with singleton, term gestation, livebirths delivered vaginally in cephalic presentation in 2008-14. We performed multivariable Poisson regression to estimate the association between length of second stage, pushing time, and PPH (estimated blood loss >500 mL during delivery), adjusting for maternal, delivery, and fetal characteristics as potential confounders...
March 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28194892/decision-making-at-the-borderline-of-viability-who-should-decide-and-on-what-basis
#10
Lynn Gillam, Dominic Wilkinson, Vicki Xafis, David Isaacs
Parents and medical staff usually agree on the management of preterm labour at borderline viability, when there is a relatively high risk of long-term neurodevelopmental problems in survivors. If delivery is imminent and parents and staff cannot agree on the best management, however, who should decide what will happen when the baby is delivered? Should the baby be resuscitated? Should intensive care be initiated? Three ethicists, one of whom is also a neonatologist, discuss this complex issue.
February 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28191626/intermittent-auscultation-ia-of-fetal-heart-rate-in-labour-for-fetal-well-being
#11
REVIEW
Ruth Martis, Ova Emilia, Detty S Nurdiati, Julie Brown
BACKGROUND: The goal of fetal monitoring in labour is the early detection of a hypoxic baby. There are a variety of tools and methods available for intermittent auscultation (IA) of the fetal heart rate (FHR). Low- and middle-income countries usually have only access to a Pinard/Laënnec or the use of a hand-held Doppler device. Currently, there is no robust evidence to guide clinical practice on the most effective IA tool to use, timing intervals and length of listening to the fetal heart for women during established labour...
February 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28183709/consequences-of-delivery-at-home-in-a-woman-without-prenatal-care
#12
Nakul Kumar, Lisa Gilbert, Terry Ellis, Sandeep Krishnan
This is a case report of a 39-year-old multigravida woman without allopathic prenatal care who, after three previous caesarean sections, attempted to deliver her fourth child at home with the help of a direct entry midwife. During labour, fetal movement and fetal heart tones became undetectable, at which time the patient was referred by the midwife to the hospital. The patient was diagnosed with uterine rupture, bladder rupture and fetal demise; she was rushed to emergency surgery. The patient's lack of allopathic prenatal care, attempt of vaginal birth after three previous caesarean sections, coupled with her desire for delivery at home, led to her complicated course...
February 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28179699/referral-pattern-of-emergencies-in-obstetrics-implications-for-defining-scope-of-services-and-policy
#13
Rahat Najam Qureshi, Rozina Sikandar, Zahra Hoodbhoy, Raffat Bano, Nigar Jabeen
OBJECTIVE: To analyse referral pattern of high-risk obstetric cases from secondary to tertiary care hospitals and to assess their maternal and neonatal outcomes. METHODS: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised all referred obstetric cases from secondary-level hospitals to tertiary-level care within and outside the Hospital between January 2011 and December 2014. Day and time of referral, reason for referral as well as maternal and neonatal outcomes were collected...
December 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28176333/selective-versus-routine-use-of-episiotomy-for-vaginal-birth
#14
REVIEW
Hong Jiang, Xu Qian, Guillermo Carroli, Paul Garner
BACKGROUND: Some clinicians believe that routine episiotomy, a surgical cut of the vagina and perineum, will prevent serious tears during childbirth. On the other hand, an episiotomy guarantees perineal trauma and sutures. OBJECTIVES: To assess the effects on mother and baby of a policy of selective episiotomy ('only if needed') compared with a policy of routine episiotomy ('part of routine management') for vaginal births. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register (14 September 2016) and reference lists of retrieved studies...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28169021/supplemental-parenteral-nutrition-in-intensive-care-patients-a-cost-saving-strategy
#15
Lorenzo Pradelli, Séverine Graf, Claude Pichard, Mette M Berger
BACKGROUND & AIMS: The Swiss supplemental parenteral nutrition (SPN) study demonstrated that optimised energy provision combining enteral nutrition (EN) and SPN reduces nosocomial infections in critically ill adults who fail to achieve targeted energy delivery with EN alone. To assess the economic impact of this strategy, we performed a cost-effectiveness analysis using data from the SPN study. METHODS: Multivariable regression analyses were performed to characterise the relationships between SPN, cumulative energy deficit, nosocomial infection, and resource consumption...
January 25, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28166782/caesarean-deliveries-in-china
#16
Xin Wang, Susan Hellerstein, Lei Hou, Liying Zou, Yan Ruan, Weiyuan Zhang
BACKGROUND: The caesarean section rate has risen rapidly in China. The purpose of this retrospective study was to estimate caesarean section rates and indications by hospital facility level in Mainland China to investigate reasons contributing to the high rate. METHODS: This cross-sectional hospital-based study collected data from 39 hospitals in three geographical regions in China, covering 14 different provinces, municipalities, and autonomous regions, including 20 tertiary health hospitals and 19 secondary hospitals...
February 6, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28166080/stress-induced-gastric-ulcers-presenting-as-massive-rectal-bleeding-in-a-newborn
#17
A Joshi, P S Shrestha, S Dangol, N C Shrestha, P Poudyal, A Shrestha A
Severe gastrointestinal bleeding in newborn period is a serious but uncommon phenomenon that has a broad differential diagnosis. Primary duodenal ulcers are rare in children but stress induced ulceration in stomach occurs more often in neonatal period due to birth asphyxia, prolonged labour, cesarean deliveries, instrumentations, respiratory distress syndrome and sepsis. These present as acute onset of gastrointestinal bleeding commonly as altered gastric aspirate, hematemesis or malena. We report a case of a neonate with stress induced gastric bleeding following birth asphyxia who presented with massive gastrointestinal bleed manifesting as hematemesis and massive rectal bleeding...
April 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/28163844/effect-of-entonox-on-reducing-the-need-for-pethidine-and-the-relevant-fetal-and-maternal-complications-for-painless-labor
#18
Alireza Sharifian Attar, Atefe Shirinzadeh Feizabadi, Lida Jarahi, Laya Shirinzadeh Feizabadi, Shima Sheybani
BACKGROUND: Pain relief during labour is one of the major concerns in obstetrics; severe labor pain causes fear of the next pregnancy, and interferes with the mother's family relationship. OBJECTIVE: The aim of this study was to evaluate the analgesic effects of Entonox during labor on reducing the need for pethidine (Meperidine) and fetal-maternal complications. METHODS: This double-blind randomized clinical trial was conducted on pregnant women who were candidates for vaginal delivery in Educational Hospitals of Mashhad University of Medical Sciences, Iran between January 2014 and November 2015...
December 2016: Electronic Physician
https://www.readbyqxmd.com/read/28159130/early-discharge-following-birth-what-characterises-mothers-and-newborns
#19
Ingrid M S Nilsson, Hanne Kronborg, Christopher H Knight, Katrine Strandberg-Larsen
BACKGROUND: Early postnatal discharge has increased over the past 50 years and today we lack the knowledge on who is discharged early that would allow us to improve quality of postnatal care. The aim of this study was to describe maternal and infant predictors for early postnatal discharge in a country with equal access to health care. METHODS: An observational study of 2786 mothers, recruited in pregnancy was conducted from April 2013 to August 2014 in four of the five regions in Denmark...
March 2017: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
https://www.readbyqxmd.com/read/28153654/reduction-of-total-labour-length-through-the-addition-of-parenteral-dextrose-solution-in-induction-of-labor-in-nulliparous-results-of-dextrons-prospective-randomized-controlled-trial
#20
Josianne Paré, Jean-Charles Pasquier, Antoine Lewin, William Fraser, Yves-André Bureau
BACKGROUND: Prolonged labor is a significant cause of maternal and fetal morbidity and very few interventions are known to shorten labor course. Skeletal muscle physiology suggests that glucose supplementation might improve muscle performance in case of prolonged exercise and this situation is analogous to the gravid uterus during delivery. Therefore, it seemed imperative to evaluate the impact of adding carbohydrate supplements on the course of labor. OBJECTIVE(S): To provide evidence as to whether IV glucose supplementation during labor induction in nulliparous women can reduce total duration of active labor...
January 28, 2017: American Journal of Obstetrics and Gynecology
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