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Intrapartum care

Patricia A Janssen, Jozette J C Stienen, Rollin Brant, Gillian E Hanley
BACKGROUND: To determine if maternal characteristics measurable upon admission to hospital predict cesarean among low-risk spontaneously laboring nulliparous women. METHODS: We undertook a secondary analysis of data from a clinical trial of early labor support for nulliparous women carrying a singleton fetus in cephalic presentation at 37-41 weeks of gestation in British Columbia, Canada. Study participants did not have any discernible risk factors for cesarean at the onset of labor...
October 17, 2016: Birth
Susan Bradley, Christine McCourt, Juliet Rayment, Divya Parmar
The psycho-social elements of labour and delivery are central to any woman's birth experience, but international efforts to reduce maternal mortality in low-income contexts have neglected these aspects and focused on technological birth. In many contexts, maternity care is seen as dehumanised and disrespectful, which can have a negative impact on utilisation of services. We undertook a systematic review and meta-synthesis of the growing literature on women's experiences of facility-based delivery in sub-Saharan Africa to examine the drivers of disrespectful intrapartum care...
September 28, 2016: Social Science & Medicine
Vanessa Poliquin, Elissa Cohen, Philippe Guillaume Poliquin, Carol Schneider, Savas Menticoglou
OBJECTIVE: We reviewed cases of group B Streptococcus (GBS) sepsis in term infants at our institution to identify areas for potential prevention. METHODS: We identified cases by searching our institution's microbiology databases for all positive GBS blood and cerebrospinal fluid cultures taken from infants between 2008 and 2013. Patients were included if the timing of the positive culture met the criteria for early-onset GBS disease (age 7 days or under). Charts that met inclusion criteria were abstracted for details related to antepartum screening, intrapartum care, and postpartum outcome...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Cheryl K Roth, Lindsey J Syed
von Willebrand disease is the most prevalent inherited bleeding disorder, affecting up to 1.3% of the population. It is caused by a defect or deficiency of the von Willebrand factor. Women with the condition may not be aware of their condition at the time of childbirth, but they are at high risk of postpartum hemorrhage even days after birth. In this article we briefly review the condition and specific considerations for the antepartum, intrapartum, and postpartum phases. It is important for nurses who care for women during childbirth to have a keen understanding of this condition...
October 2016: Nursing for Women's Health
Louise T Day, Daniel Hruschka, Felicity Mussell, Eva Jeffers, Stacy L Saha, Shafiul Alam
BACKGROUND: Prior studies have shown that using uterotonics to augment or induce labor before arrival at comprehensive Emergency Obstetric and Neonatal Care (CEmONC) settings (henceforth, "outside uterotonics") may contribute to perinatal mortality in low- and middle-income countries. We estimate its effect on perinatal mortality in rural Bangladesh. METHODS: Using hospital records (23986 singleton term births, Jan 1, 2009-Dec 31, 2015) from rural Bangladesh, we use a logistic regression model to estimate the increased risk of perinatal death from uterotonics administered outside a CEmONC facility...
October 6, 2016: Reproductive Health
E R Allanson, T Waqar, Crh White, Ö Tunçalp, J E Dickinson
BACKGROUND: Umbilical cord lactate is one approach to measuring acidosis and intrapartum hypoxia, knowledge of which may be helpful for clinicians involved in the care of women and newborns. OBJECTIVE: To synthesise the evidence on accuracy of umbilical cord lactate in measuring acidosis and predicting poor neonatal outcome. SEARCH STRATEGY: Studies published and unpublished between 1990 and 2014 from PubMed/Medline, EMBASE, Cochrane Central Register of Controlled Trials, and clinicaltrials...
October 5, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Joshua O Akinyemi, Rotimi F Afolabi, Olutosin A Awolude
BACKGROUND: The maternal, newborn and child health care continuum require that mother/child pair should receive the full package of antenatal, intrapartum and postnatal care in order to derive maximum benefits. Continuity of care is a challenge in sub-Saharan Africa. In this study, we investigate the patterns and factors associated with dropout in the continuum of maternity (antenatal, delivery and postnatal) care in Nigeria. METHOD: Using women recode file from the 2013 Nigeria Demographic and Health Survey, we analysed data on 20,467 women with an index birth within 5 years prior to data collection...
September 27, 2016: BMC Pregnancy and Childbirth
Lily Lee, Jessica Dy, Hussam Azzam
OBJECTIF: La présente directive vise à fournir des conseils concernant la prise en charge du travail spontané intrapartum, normal ou anormal, à terme, chez les femmes en santé, ainsi que des conseils relatifs à la prise en charge de la dystocie lors du premier et du deuxième stade du travail, pour favoriser l'accouchement vaginal et optimiser les issues de la grossesse. DONNéES PROBANTES: Des documents publiés ont été récupérés au moyen de recherches effectuées dans PubMed et la Cochrane Library, en octobre 2011, à partir d'une terminologie appropriée et contrôlée (p...
September 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Lily Lee, Jessica Dy, Hussam Azzam
OBJECTIVE: The purpose of this guideline is to provide guidance for the intrapartum management of spontaneous labour, whether normal or abnormal, in term, healthy women, and to provide guidance in the management of first and second stage dystocia to increase the likelihood of a vaginal birth and optimize birth outcomes. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in October 2011 using appropriate, controlled vocabulary (e...
September 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Kelly B Smith, Leslie A Sadownik, Rosemary Basson, Jordanna Isaacson, Lori A Brotto
OBJECTIVE: To assess clinicians' frequency of and comfort with provision of maternity care for women with vulvodynia, their beliefs and practices regarding delivery mode, and frequency of maternal requests for Caesarean section (CS). METHODS: We invited physicians and midwives to complete a questionnaire assessing their frequency of contact with pregnant women with vulvodynia; their level of comfort providing antenatal, intrapartum, and postpartum care for these women; whether they believed that vulvodynia is an indication for elective CS and the frequency of making this recommendation; and the number of patients with vulvodynia who strongly requested CS...
September 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Viera Husarova, Laura Macdarby, Patrick Dicker, Fergal D Malone, Conan L McCaul
OBJECTIVE: To identify patterns in intrapartum analgesia use in the migrant obstetric population. METHODS: A retrospective analysis included all deliveries with neonates above 500g in weight at a university hospital in Dublin, Ireland between 2009 and 2013. Analgesia was classified as neuraxial or non-neuraxial. Parturients were excluded owing to missing data, elective cesarean deliveries, and the use of analgesia during treatment for obstetric complications. RESULTS: There were 36 689 deliveries included in the present study...
November 2016: International Journal of Gynaecology and Obstetrics
Oona M R Campbell, Clara Calvert, Adrienne Testa, Matthew Strehlow, Lenka Benova, Emily Keyes, France Donnay, David Macleod, Sabine Gabrysch, Luo Rong, Carine Ronsmans, Salim Sadruddin, Marge Koblinsky, Patricia Bailey
All women should have access to high quality maternity services-but what do we know about the health care available to and used by women? With a focus on low-income and middle-income countries, we present data that policy makers and planners can use to evaluate whether maternal health services are functioning to meet needs of women nationally, and potentially subnationally. We describe configurations of intrapartum care systems, and focus in particular on where, and with whom, deliveries take place. The necessity of ascertaining actual facility capability and providers' skills is highlighted, as is the paucity of information on maternity waiting homes and transport as mechanisms to link women to care...
September 14, 2016: Lancet
Suellen Miller, Edgardo Abalos, Monica Chamillard, Agustin Ciapponi, Daniela Colaci, Daniel Comandé, Virginia Diaz, Stacie Geller, Claudia Hanson, Ana Langer, Victoria Manuelli, Kathryn Millar, Imran Morhason-Bello, Cynthia Pileggi Castro, Vicky Nogueira Pileggi, Nuriya Robinson, Michelle Skaer, João Paulo Souza, Joshua P Vogel, Fernando Althabe
On the continuum of maternal health care, two extreme situations exist: too little, too late (TLTL) and too much, too soon (TMTS). TLTL describes care with inadequate resources, below evidence-based standards, or care withheld or unavailable until too late to help. TLTL is an underlying problem associated with high maternal mortality and morbidity. TMTS describes the routine over-medicalisation of normal pregnancy and birth. TMTS includes unnecessary use of non-evidence-based interventions, as well as use of interventions that can be life saving when used appropriately, but harmful when applied routinely or overused...
September 14, 2016: Lancet
Corrina Moucheraud, Helen Owen, Neha S Singh, Courtney Kuonin Ng, Jennifer Requejo, Joy E Lawn, Peter Berman
BACKGROUND: Countdown to 2015 was a multi-institution consortium tracking progress towards Millennium Development Goals (MDGs) 4 and 5. Case studies to explore factors contributing to progress (or lack of progress) in reproductive, maternal, newborn and child health (RMNCH) were undertaken in: Afghanistan, Bangladesh, China, Ethiopia, Kenya, Malawi, Niger, Pakistan, Peru, and Tanzania. This paper aims to identify cross-cutting themes on how and why these countries achieved or did not achieve MDG progress...
2016: BMC Public Health
William L Walker, Nicole P Lindsey, Jennifer A Lehman, Elisabeth R Krow-Lucal, Ingrid B Rabe, Susan L Hills, Stacey W Martin, Marc Fischer, J Erin Staples
Zika virus is a mosquito-borne flavivirus primarily transmitted to humans by Aedes aegypti mosquitoes (1). Zika virus infections have also been documented through intrauterine transmission resulting in congenital infection; intrapartum transmission from a viremic mother to her newborn; sexual transmission; blood transfusion; and laboratory exposure (1-5). Most Zika virus infections are asymptomatic (1,6). Clinical illness, when it occurs, is generally mild and characterized by acute onset of fever, maculopapular rash, arthralgia, or nonpurulent conjunctivitis...
September 16, 2016: MMWR. Morbidity and Mortality Weekly Report
Luchin F Wong, Jacob Wilkes, Kent Korgenski, Michael W Varner, Tracy A Manuck
OBJECTIVE: The objective of this study was to describe pregnancy outcomes, including cervical insufficiency and preterm birth, in the subsequent pregnancy following an intrapartum cervical laceration. STUDY DESIGN: Retrospective cohort of women with their first two consecutive singleton pregnancies carried to ≥ 20(0/7) weeks' gestation within a tertiary health care system from 2002 to 2012. Cervical laceration cases were identified by ICD9 codes and included if suture repair was required...
July 2016: American Journal of Perinatology Reports
Patricia M Corcoran, Christine Catling, Caroline S E Homer
ISSUE: Indigenous women in many countries experience a lack of access to culturally appropriate midwifery services. A number of models of care have been established to provide services to women. Research has examined some services, but there has not been a synthesis of qualitative studies of the models of care to help guide practice development and innovations. AIM: To undertake a review of qualitative studies of midwifery models of care for Indigenous women and babies evaluating the different types of services available and the experiences of women and midwives...
September 6, 2016: Women and Birth: Journal of the Australian College of Midwives
Charlotte Wool, Beth Perry Black, Anne B Nancy Woods
Measurement of quality indicators (QIs) in perinatal palliative care has not been addressed. Parents who chose to continue pregnancy after a diagnosis of a life-limiting fetal condition described perceptions of quality care and their satisfaction with care. This research identified which QIs explained parental satisfaction. High QI scores are associated with parental satisfaction. Parents who were satisfied reported 2.9 times the odds that their baby was treated with dignity and respect and 3.4 times the odds their medical care was addressed...
September 7, 2016: ANS. Advances in Nursing Science
Katharine J McCarthy, Ann K Blanc, Charlotte E Warren, James Kimani, Brian Mdawida, Charity Ndwidga
BACKGROUND: Tracking progress on maternal and newborn survival requires accurate information on the coverage of essential interventions. Despite widespread use, most indicators measuring maternal and newborn intervention coverage have not been validated. This study assessed the ability of women delivering in two Kenyan hospitals to recall critical elements of care received during the intrapartum and immediate postnatal period at two time points: hospital discharge and 13-15 months following delivery...
December 2016: Journal of Global Health
Angie C Jelin, Kirsten Salmeen, Dawn Gano, Irina Burd, Mari-Paule Thiet
Antepartum, intrapartum, and neonatal events can result in a spectrum of long-term neurological sequelae, including cerebral palsy, cognitive delay, schizophrenia, and autism spectrum disorders [1]. Advances in obstetrical and neonatal care have led to survival at earlier gestational ages and consequently increasing numbers of periviable infants who are at significant risk for long-term neurological deficits. Therefore, efforts to decrease and prevent cerebral insults attempt not only to decrease preterm delivery but also to improve neurological outcomes in infants delivered preterm...
2016: F1000Research
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