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Elad Mei-Dan, Elizabeth V Asztalos, Andrew R Willan, Jon F R Barrett
BACKGROUND: This secondary analysis for the Twin Birth Study, an international, multicenter trial, aimed to compare the cesarean section rates and safety between methods of induction of labor in twin pregnancies. METHODS: Women with twin pregnancies where the first twin was in a cephalic presentation and who presented for labor induction, were non-randomly assigned to receive prostaglandin or amniotomy and/or oxytocin. Main outcome measures were the rates of unplanned cesarean section and neonatal and maternal mortality or serious morbidity...
January 6, 2017: BMC Pregnancy and Childbirth
Michael Beckmann, Rachel Thompson, Yvette Miller, Samantha J Prosser, Vicki Flenady, Sailesh Kumar
OBJECTIVE: To describe and examine the EXIT (EXperiences of Induction Tool), and report on the experience of women undergoing PGE2 vaginal gel IOL, who were participants in a randomized controlled trial comparing early amniotomy with repeat-PGE2. STUDY DESIGN: Following an evening dose of PGE2 vaginal gel, 245 women with live singleton term pregnancies were randomized to amniotomy or repeat-PGE2. Women's experience of IOL was a secondary outcome measure, assessed using the self-report EXIT administered by phone at 7-9days post-partum...
December 28, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Aizhan D Kyzayeva, Aigul B Kudamanova
BACKGROUND: Over the last 10 years, the evidential practice has been developing in Kazakhstan. The clinical protocols of diagnostics and treatment were implemented in the country since 2007. We analyzed the normal birth practice in Kazakhstan. MATERIALS AND METHODS: Obstetricians and midwives were subject to the questionnaire survey in four large Maternity Hospitals of Almaty. RESULTS: Totally, 72 midwives and 50 obstetricians took part in the questionnaire survey...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Heléne E K Sundelin, Olof Stephansson, Kari Johansson, Jonas F Ludvigsson
INTRODUCTION: An increased risk of preterm birth in women with joint hypermobility syndrome or Ehlers-Danlos syndrome is suspected. MATERIAL AND METHODS: In this nationwide cohort study from 1997 through 2011, women with either joint hypermobility syndrome or Ehlers-Danlos syndrome or both disorders were identified through the Swedish Patient Register, and linked to the Medical Birth Register. Thereby, 314 singleton births to women with joint hypermobility syndrome/Ehlers-Danlos syndrome before delivery were identified...
January 2017: Acta Obstetricia et Gynecologica Scandinavica
Laurice Bou Nemer, Dawn Kalin, Desiree Fiorentino, Jorge J Garcia, Christopher M Estes
OBJECTIVE: To develop and evaluate a simulation laboratory designed to stimulate learning and increase medical students' preparedness for an obstetrics and gynecology clinical clerkship. METHODS: Ninety-seven medical students participated in the games during their obstetrics and gynecology clerkship in 1 year. Using the resident-as-teacher model, students rotated through seven stations, each with a simulated obstetric task. Points were awarded at each station, and the student with the highest score won...
October 2016: Obstetrics and Gynecology
Zarko Alfirevic, Edna Keeney, Therese Dowswell, Nicky J Welton, Nancy Medley, Sofia Dias, Leanne V Jones, Gillian Gyte, Deborah M Caldwell
BACKGROUND: More than 150,000 pregnant women in England and Wales have their labour induced each year. Multiple pharmacological, mechanical and complementary methods are available to induce labour. OBJECTIVE: To assess the relative effectiveness, safety and cost-effectiveness of labour induction methods and, data permitting, effects in different clinical subgroups. METHODS: We carried out a systematic review using Cochrane methods. The Cochrane Pregnancy and Childbirth Group's Trials Register was searched (March 2014)...
August 2016: Health Technology Assessment: HTA
Alessandro Svelato, Mariarosaria Di Tommaso, Roberta Spinoso, Antonio Ragusa
We read with great interest "Avoiding the first caesarean section - results of structured organizational and cultural changes" by Blomberg (1). We understand Blomberg's attention toward the complex issue of dystocia, and we would like to ask the author some questions: How long did labor last in patients who were subject to augmentation of labor and for those who were not subject to augmentation? Was there a difference in the duration of the labor for the two groups? Did they use a partogram? When did they start partogram compilation? In which percentage of patients were oxytocin and amniotomy used? This article is protected by copyright...
August 12, 2016: Acta Obstetricia et Gynecologica Scandinavica
Ashley N Battarbee, Anna Palatnik, Danielle A Peress, William A Grobman
OBJECTIVE: To evaluate the association between early amniotomy after ripening with a Foley balloon catheter and duration of labor induction. METHODS: In this retrospective matched cohort study, 546 nulliparous women with a singleton viable gestation undergoing cervical ripening with a Foley balloon catheter were compared based on timing of amniotomy after catheter removal: early (defined as artificial rupture of membranes less than 1 hour after Foley removal) compared with no artificial rupture of membranes in the first hour...
September 2016: Obstetrics and Gynecology
Joanna Ivars, Charles Garabedian, Patrick Devos, Denis Therby, Sabine Carlier, Philippe Deruelle, Damien Subtil
OBJECTIVE: Our objectives were to confirm the predictiveness of parity for successful labor induction and propose an improvement in the Bishop's score to take parity into account and simultaneously simplify the original Bishop score. STUDY DESIGN: Retrospective study of 326 deliveries induced by oxytocin and amniotomy before prostaglandins between January 1, 1987, and June 30, 1988. We conducted a univariate and then a multivariate analysis of the relation between successful labor induction - defined by vaginal delivery- and the components of Bishop's score and parity...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
F Sierra, D Reitz, S Ermisch, G Heller, S Schmidt
We report a case of pathological foetal Doppler velocity, specifically the absence of end diastolic flow in the umbilical artery (AEDV/REDV), suspected diabetic pregnancy and mesangioproliferative glomerulonephritis, at 32 weeks of gestation. The foetal heart rate tracings were evaluated using a computerised cardiotocogram (Oxford Sonicaid system 8002 Chichester, England) 1 for 20-30 min parallel to the routine cardiotocogram. The ultrasound control at 33 weeks of gestation showed oligohydramnion, foetal centralisation and reduced interval foetal growth...
August 2016: Zeitschrift Für Geburtshilfe und Neonatologie
Jane Sandall, Hora Soltani, Simon Gates, Andrew Shennan, Declan Devane
BACKGROUND: Midwives are primary providers of care for childbearing women around the world. However, there is a lack of synthesised information to establish whether there are differences in morbidity and mortality, effectiveness and psychosocial outcomes between midwife-led continuity models and other models of care. OBJECTIVES: To compare midwife-led continuity models of care with other models of care for childbearing women and their infants. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (25 January 2016) and reference lists of retrieved studies...
April 28, 2016: Cochrane Database of Systematic Reviews
Z Alfirevic, E Keeney, T Dowswell, N J Welton, N Medley, S Dias, L V Jones, D M Caldwell
OBJECTIVES: To compare the clinical effectiveness and cost-effectiveness of labour induction methods. METHODS: We conducted a systematic review of randomised trials comparing interventions for third-trimester labour induction (search date: March 2014). Network meta-analysis was possible for six of nine prespecified key outcomes: vaginal delivery within 24 hours (VD24), caesarean section, uterine hyperstimulation, neonatal intensive care unit (NICU) admissions, instrumental delivery and infant Apgar scores...
August 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Yu V Korenovsky, O V Remneva
The aim of this study was to determine reference values of matrix metalloproteinase-1 (MMP-1), MMP-2, MMP-9 and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in the amniotic fluid at the first stage of labor in physiological pregnancy. 89 women at the first stage of term labor have been examined. Samples of amniotic fluid were taken at the first period of labor by vaginal amniotomy. Concentrations ofMMP-1, MMP-2, MMP-9, and TIMP-1 were investigated in amniotic fluid by ELISA kits. We have determined normal concentration ranges for MMP-1, MMP-2, MMP-9, TIMP-1, and ratios of concentrations of MMPs and TIMP-1 (MMP-1/TIMP-1, MMP-2/TIMP-1, MMP-9/TIMP-1) in the amniotic fluid at the first period of labor in physiological pregnancy...
January 2016: Biomedit︠s︡inskai︠a︡ Khimii︠a︡
Livinus N Onah, Cyril C Dim, Uchenna I Nwagha, Benjamin C Ozumba
BACKGROUND: Early amniotomy is common in obstetric practice but, its effectiveness has not been proven. OBJECTIVES: To determine the effects of early amniotomy on the duration of labour, and other maternal / neonatal outcomes of uncomplicated pregnancies in Enugu, South-east Nigeria. METHODS: A randomized controlled study of 214 consenting term pregnant women at the University of Nigeria Teaching Hospital Enugu, Nigeria. Intervention group received amniotomy early in active labour while the control group had their membranes conserved...
December 2015: African Health Sciences
Antonio Ragusa, Salvatore Gizzo, Marco Noventa, Enrico Ferrazzi, Sara Deiana, Alessandro Svelato
PURPOSE: Dystocia is the leading indication for primary caesarean sections. Our aim is to compare two approaches in the management of dystocia in labor in nulliparous women with a singleton fetus in cephalic presentation at term in spontaneous or induced labor. METHODS: Prospective cohort study. Four hundred and nineteen consecutive patients were divided into two groups: the standard management group (SM), in acceleration of labor was commenced at the "action line" in the case of arrested or protracted labor, and the comprehensive management group (CM) in which arrested or protracted labor was considered as a warning sign promoting further diagnostic assessment prior to considering intervention...
October 2016: Archives of Gynecology and Obstetrics
Michael Beckmann, Katharina Merollini, Sailesh Kumar, Vicki Flenady
BACKGROUND: In a randomized controlled trial of two policies for induction of labor (IOL) using Prostaglandin E2 (PGE2) vaginal gel, women who had an earlier amniotomy experienced a shorter IOL-to-birth time. OBJECTIVE: To report the cost analysis of this trial and determine if there are differences in healthcare costs when an early amniotomy is performed as opposed to giving more PGE2 vaginal gel, for women undergoing IOL at term. STUDY DESIGN: Following an evening dose of PGE2 vaginal gel, 245 women with live singleton pregnancies, ≥37+0 weeks, were randomized into an amniotomy or repeat-PGE2 group...
April 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
J Boujenah, J Oliveira, C De La Hosseraye, A Benbara, A Tigaizin, A Bricou, L Carbillon
OBJECTIVE: To investigate the effect of using fetal scalp blood sampling on the risk of neonatal respiratory distress syndrome (NRDS) with meconium-stained amniotic fluid (MSAF). METHODS: Prospective data collection with regard to MSAF during labor for low-risk term cephalic singleton live birth from 2012 to 2014. Maternal, obstetric and neonatal data were compared according to the occurrence of respiratory distress syndrome (RDS group) or not (no RDS group). RESULTS: Of 515 newborns born through MSAF, 46 experienced RDS and from them 10 experienced meconium aspiration syndrome...
December 2016: Journal of Maternal-fetal & Neonatal Medicine
Yi-Ping Li, Shin-Yu Lin, Chih-Hsin Yeh, Heng-Cheng Hsu, Ya-Ling Yang, Chien-Nan Lee, Su-Chen Kuo
OBJECTIVE: Pleasant and humane childbirth is every mother's wish. The objective of this study was to propose a practicable mother-friendly childbirth model tailored to Taiwanese women in order to improve the quality of perinatal care and maternal satisfaction. MATERIAL AND METHODS: In this study, the guidelines of several countries were systematically reviewed, and a standard set of clinical guidelines were established by a focus group. In addition, a total of 172 Taiwanese obstetricians were visited, and a cross-sectional study of these obstetricians' attitudes toward the practicality and effectiveness of the model was performed using questionnaires...
December 2015: Taiwanese Journal of Obstetrics & Gynecology
David Stenson, Tove Wallstrom, Maria Sjostrand, Helena Akerud, Kristina Gemzell-Danielsson, Eva Wiberg-Itzel
OBJECTIVE: To evaluate the frequency of uterine rupture following induction of labor in women with a previous cesarean section. Misoprostol was compared to other methods of induction. METHODS: A retrospective cohort study of 208 women attempting induction of labor after one previous cesarean section. Delivery data were collected retrospectively and compared. Group 1(2009-2010) was compared with Group 2 (2012-2013). In Group 1, the main method of induction was vaginal PGE2 (prostaglandin-E2), amniotomy, oxytocin or a balloon catheter...
October 2016: Journal of Maternal-fetal & Neonatal Medicine
Susanne Grylka-Baeschlin, Antje Petersen, André Karch, Mechthild M Gross
OBJECTIVE: understanding the labour characteristics of women attempting vaginal birth after caesarean (VBAC) may suggest how to improve intrapartum management and may enhance success rates. Promoting VBAC is a relevant factor in decreasing overall caesarean section (c-section) rates. However, the labour processes of women attempting VBAC are not well investigated. The aim of this paper is to compare multiparae planning a first VBAC (pVBAC) with primiparae and with multiparae planning a second vaginal birth, all starting to give birth vaginally, with regard to (a) perinatal characteristics, (b) the timing of intrapartal spontaneous rupture of membranes (SROM) and of interventions, and (c) labour duration, with respect to the first and second stages...
March 2016: Midwifery
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