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intrapartum assessment of labor

Michael F Robuck, Christine M O'Brien, Kelsi M Knapp, Sheila Shay, James D West, J M Newton, James C Slaughter, Bibhash Paria, Jeff Reese, Jennifer L Herington
In mouse models used to study parturition or pre-clinical therapeutic testing, measurement of uterine contractions is limited to either ex vivo isometric tension or operative IUP. The goal of this study was to: 1) develop a method for transcervical insertion of a pressure catheter to measure in vivo intrauterine contractile pressure during mouse pregnancy, 2) determine whether this method can be utilized numerous times in a single mouse pregnancy without affecting the timing of delivery or fetal outcome, and 3) compare the in vivo contractile activity between mouse models of term and preterm labor (PTL)...
March 2, 2018: Reproduction: the Official Journal of the Society for the Study of Fertility
Otto Henrique May Feuerschuette, Sheila Koettker Silveira, Ana Carolina Labor Cancelier, Rosemeri Maurici da Silva, Daisson José Trevisol, Jefferson Ricardo Pereira
Group B Streptococcus is the leading etiologic factor of neonatal sepsis. Intrapartum real-time polymerase chain reaction (RT-PCR) may allow faster and more accurate detection of maternal colonization. The aim of this study was to determine the sensitivity and specificity of RT-PCR when compared to the reference standard culture in selective broth media collected from rectovaginal tract from laboring women. We selected 15 studies that included 6368 women. Papers selection, data extraction, and quality assessment were carried out by two independent researchers...
February 2, 2018: Diagnostic Microbiology and Infectious Disease
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
Nerys Benfield, Felicia Hawkins, Laurie Ray, Andrea McGowan, Ketty Floyd, Dawn Africa, Myrta Barreto, Erika Levi
OBJECTIVES: Nurses play an integral role in intrapartum and postpartum patient education. This exploratory study aims to assess the attitudes, knowledge, and practices of labor and delivery and postpartum nurses regarding contraception, and evaluate for changes in these measures one year after an institutional initiative allowing routine availability of immediate postpartum long-acting reversible contraception (LARC). STUDY DESIGN: In 2014 Montefiore Medical Center began to routinely offer comprehensive immediate postpartum contraception...
February 8, 2018: Contraception
Julia C Phillippi, Kathleen Danhausen, Jill Alliman, R David Phillippi
INTRODUCTION: This systematic review investigates the effect of the birth center setting on neonatal mortality in economically developed countries to aid women and clinicians in decision making. METHODS: We searched the Google Scholar, CINAHL, and PubMed databases using key terms birth/birthing center or out of hospital with perinatal/neonatal outcomes. Ancestry searches identified additional studies, and an alert was set for new publications. We included primary source studies in English, published after 1980, conducted in a developed country, and researching planned birth in centers with guidelines similar to American Association of Birth Centers standards...
January 2018: Journal of Midwifery & Women's Health
Wen Sun, Fen Liu, Shiliang Liu, Sara-Michelle Gratton, Darine El-Chaar, Shi Wu Wen, Dunjin Chen
OBJECTIVES: Few studies have assessed the impact of induction of labor on breech presentation. This study aims to summarize the effect of induction of labor of breech presentation on perinatal morbidity. METHODS: Literature review was done in Medline, Embase, Web of science and Cochrane Library up to 20 October 2017. Randomized control studies, cohort studies, and case control publishing studies comparing induction of labor versus spontaneous labor of singleton live breech birth were included...
March 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Alison G Cahill, Methodius G Tuuli, Molly J Stout, Julia D López, George A Macones
BACKGROUND: Intrapartum electronic fetal monitoring (EFM) is the most commonly used tool in obstetrics in the United States, however, which EFM patterns predict acidemia remains unclear. OBJECTIVE: This study was designed to describe the frequency of patterns seen in labor using modern nomenclature, and to test the hypothesis that visually interpreted patterns are associated with acidemia and morbidities in term infants. We further identified patterns prior to delivery, alone or in combination, predictive of acidemia and neonatal morbidity...
January 31, 2018: American Journal of Obstetrics and Gynecology
Aryeh Shander, Tamara Friedman, Greg Palleschi, Linda Shore-Lesserson
A case of a patient with severe factor XI (FXI) deficiency who presented for her seventh labor and delivery is presented. The nature of FXI deficiency, its prevalence, and issues related to genetic screening are discussed. Published literature on the topic is reviewed, including criteria that were developed to assess bleeding, laboratory tools used to estimate bleeding risk, and available treatments. Within the context of this challenging clinical dilemma, specific recommendations are provided for the antepartum, intrapartum, and postpartum stages of pregnancy...
January 29, 2018: Anesthesia and Analgesia
Fabian Kohls, Lars Brodowski, Elna Kuehnle, Nadine Kniebusch, Karim Djaffar Kalache, Alexander Weichert
Introduction This prospective study aimed to define the angle of progression (AOP) in relation to the height position of the fetal head during the first stage of labour. It was investigated if it is possible to predict the mode of delivery or the duration of labour by AOP. Methods Influencing factors on delivery were head circumference, birth-weight, administration of oxytocin, epidural anaesthesia (EA) and parity, and their impact on AOP was analysed. AOP was calculated using three different formulas. Inclusion criteria were vaginal delivery of singletons in cephalic, occipito-anterior presentation...
December 15, 2017: Zeitschrift Für Geburtshilfe und Neonatologie
Olufemi T Oladapo, Meghan A Bohren, Bukola Fawole, Kidza Mugerwa, Olubunmi A Ojelade, Musibau A Titiloye, Francis E Alu, Musana O Mambya, Lawal Oyeneyin, Salim Bataale, Adesina Akintan, Olubunmi Alabi, Amos Adebayo, Ola Okike, Hadiza A Idris, Sanni Wilfred, Halima Bello, David Kyaddondo, Akinpelu O Olutayo, Josaphat Byamugisha, Joao Paulo Souza, A Metin Gülmezoglu
OBJECTIVE: "Negotiated standards" describe a level of quality of care that is acceptable and achievable within a specific health system, based on consensus between key stakeholders. This paper presents the development of negotiated standards for effective labor and childbirth care in selected hospitals and communities in Nigeria and Uganda. METHODS: A four-step development process involving different methodologies. The process included: (1) review and synthesis of internationally recognized intrapartum clinical principles and practices; (2) primary qualitative research to assess values and preferences of women and healthcare providers, and practices that align with these preferences; (3) draft contextualization of effective and ineffective behaviors to reflect values and preferences; and (4) WHO-mediated negotiations between relevant stakeholders, including community members, providers, and administrators...
December 2017: International Journal of Gynaecology and Obstetrics
Chung Ming Chor, Wai Yin Winnie Chan, Wing Ting Ada Tse, Daljit Singh Sahota
Purpose: First, to describe a new method of assessing cephalopelvic disproportion by measuring the retropubic tissue thickness (RTT), and second, to determine whether RTT was associated with an eventual delivery by cesarean section. Methods: Three-dimensional transperineal ultrasound scans were performed on 129 laboring nulliparous women to obtain 3-dimensional volume datasets for assessing RTT. RTT was measured off-line by three operators (A, B, and C) as the shortest distance between the capsule of the pubic symphysis and the outer border of the fetal skull...
August 11, 2017: Ultrasonography
Samira Sami, Kate Kerber, Solomon Kenyi, Ribka Amsalu, Barbara Tomczyk, Debra Jackson, Alexander Dimiti, Elaine Scudder, Janet Meyers, Jean Paul De Charles Umurungi, Kemish Kenneth, Luke C Mullany
BACKGROUND: Approximately 2.7 million neonatal deaths occur annually, with highest rates of neonatal mortality in countries that have recently experienced conflict. Constant instability in South Sudan further strains a weakened health system and poses public health challenges during the neonatal period. We aimed to describe the state of newborn facility-level care in displaced person camps across Juba, Malakal, and Maban. METHODS: We conducted clinical observations of the labor and delivery period, exit interviews with recently delivered mothers, health facility assessments, and direct observations of midwife time-use...
November 29, 2017: Reproductive Health
Naama R Bogot, Misagv Rottenstreich, Rinad M Nabulsi, Yonatan Turner, Rivka Farkash, Arnon Samueloff, Sorina Grisaru-Granovsky
PURPOSE: To evaluate whether the characteristics of the radiological uterine myometrial discontinuity (RMD) is associated with maternal-neonatal outcomes and post-cesarean section (CS) complications. A secondary aim was to describe the evolution of the CT uterine surgical incision and the related outcome of a subsequent trial of labor after cesarean (TOLAC). METHODS: Single center retrospective cohort study of CT scans was performed within 6 weeks from cesarean delivery...
November 28, 2017: Abdominal Radiology
Eran Ashwal, Shiri Shinar, Amir Aviram, Sharon Orbach, Yariv Yogev, Liran Hiersch
BACKGROUND: Intrapartum fetal heart rate (FHR) monitoring is well recommended during labor to assess fetal wellbeing. Though commonly used, the external Doppler and fetal scalp electrode monitor have significant shortcomings. Lately, non-invasive technologies were developed as possible alternatives. OBJECTIVE: The objective of this study is to compare the accuracy of FHR trace using novel Electronic Uterine Monitoring (EUM) to that of external Doppler and fetal scalp electrode monitor...
November 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
Nandini Raghuraman, Alison G Cahill
Electronic fetal monitoring (EFM) is widely used to assess fetal status in labor. Use of intrapartum continuous EFM is associated with a lower risk of neonatal seizures but a higher risk of cesarean or operative delivery. Category II fetal heart tracings (FHTs) are indeterminate in their ability to predict fetal acidemia. Certain patterns of decelerations and variability within this category may be predictive of neonatal morbidity. Adjunct tests of fetal well-being can be used during labor to further triage patients...
December 2017: Obstetrics and Gynecology Clinics of North America
Ramin Ravangard, Aliye Basiri, Zahra Sajjadnia, Nasrin Shokrpour
Childbirth is a great moment in a woman's life and is inevitably influenced by emotional, social, and psychological stress. This study aimed to assess the anxiety and pain level of nulliparous women giving birth using physiological methods (without doula support) during labor and those women supported by a doula at Towhid Hospital of Jam, Bushehr, Iran in 2015. In this interventional study, 150 women were randomly assigned to either an intervention (with doula support) or a control group (with no doula support)...
October 2017: Health Care Manager
A Delabaere, S Curinier, S Ughetto, L Gibold, R Bonnet, A Rossi, D Gallot
OBJECTIVES: To decrease the incidence of early-onset group B streptococcal (GBS) disease, a culture-based screening of all pregnant women at 35-37 weeks is recommended. This gold standard test requires 24-72hours culture. This delay precludes its use for intrapartum screening. This study assesses a new immunoassay, the DIMA test, for identifying GBS-positive patients in the labor ward. MATERIALS AND METHODS: This was a prospective observational study of 195 pregnant women presenting with full-term labor at a single site in France between June and August 2012...
May 2017: Journal of Gynecology Obstetrics and Human Reproduction
N Chaillet, E Bujold, B Masse, W A Grobman, P Rozenberg, J C Pasquier, A Shorten, M Johri, F Beaudoin, H Abenhaim, S Demers, W Fraser, M Dugas, S Blouin, E Dubé, R Gauthier
BACKGROUND: Rates of cesarean delivery are continuously increasing in industrialized countries, with repeated cesarean accounting for about a third of all cesareans. Women who have undergone a first cesarean are facing a difficult choice for their next pregnancy, i.e.: (1) to plan for a second cesarean delivery, associated with higher risk of maternal complications than vaginal delivery; or (b) to have a trial of labor (TOL) with the aim to achieve a vaginal birth after cesarean (VBAC) and to accept a significant, but rare, risk of uterine rupture and its related maternal and neonatal complications...
September 20, 2017: Trials
Zekiye Karaçam, Döndü Arslan Kurnaz, Gizem Güneş
OBJECTIVE: The purpose of the research was to assess the content and quality of the intrapartum care offered in vaginal births in Turkey, based on the example of a state hospital. MATERIALS AND METHODS: This cross-sectional study was conducted between January 1(st), 2013 and December 31(st), 2014 at Aydın Maternity and Children's Hospital. The study sample consisted of 303 women giving vaginal birth, who were recruited into the study using the method of convenience sampling...
March 2017: Turkish Journal of Obstetrics and Gynecology
Aritra Das, Dipty Nawal, Manoj Kumar Singh, Morchan Karthick, Parika Pahwa, Malay Bharat Shah, Tanmay Mahapatra, Kunal Ranjan, Indrajit Chaudhuri
BACKGROUND: Evidence shows that improving the quality of intrapartum care is critical for maternal survival. However, a significant rise in the proportion of facility-based births over the last decade in India - attributable to a cash transfer program - has not resulted in a corresponding reduction in maternal mortality, thanks, in part, to low-skilled care at facilities. The current study evaluated a mobile knowledge-based intervention aimed at improving quality of care by mentoring in-service staff nurses at public obstetric facilities...
August 23, 2017: BMC Pregnancy and Childbirth
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