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intrapartum assessment of labor

Ann K Blanc, Claudia Diaz, Katharine J McCarthy, Karla Berdichevsky
BACKGROUND: The majority of births in Mexico take place in a health facility and are attended by a skilled birth attendant, yet maternal mortality has not declined to anticipated levels. Coverage estimates of skilled attendance and other maternal and newborn interventions often rely on women's self-report through a population-based survey, the accuracy of which is not well established. METHODS: We used a facility-based design to validate women's report of skilled birth attendance, as well as other key elements of maternal, newborn intrapartum, and immediate postnatal care...
2016: BMC Pregnancy and Childbirth
Mariana Rei, Sara Tavares, Pedro Pinto, Ana P Machado, Sofia Monteiro, Antónia Costa, Cristina Costa-Santos, João Bernardes, Diogo Ayres-De-Campos
BACKGROUND: Visual analysis of cardiotocographic (CTG) tracings has been shown to be prone to poor intra- and interobserver agreement when several interpretation guidelines are used, and this may have an important impact on the technology's performance. OBJECTIVES: The aim of this study was to evaluate agreement in CTG interpretation using the new 2015 FIGO guidelines on intrapartum fetal monitoring. STUDY DESIGN: A pre-existing database of intrapartum CTG tracings was used to sequentially select 151 cases acquired with a fetal electrode, with duration exceeding 60minutes, and signal loss less than 15%...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Ashish Kc, Johan Wrammert, Robert B Clark, Uwe Ewald, Mats Målqvist
BACKGROUND: Newborns are at the greatest risk for dying during the intrapartum period, including labor and delivery, and the first day of life. Fetal heart rate monitoring (FHRM) and partogram use to track labor progress are evidence-based techniques that can help to identify maternal and fetal risk factors so that these can be addressed early. The objective of this study was to assess health worker adherence to protocols for FHRM and partogram use during the intrapartum period, and to assess the association between adherence and intrapartum stillbirth in a tertiary hospital of Nepal...
2016: BMC Pregnancy and Childbirth
Magdalena Ciaciura-Jarno, Wojciech Cnota, Dominik Wójtowicz, Anna Niesłuchowska-Hoxha, Aleksandra Ruci, Rafał Kierach, Aleksandra Stępień, Agnieszka Nowak, Patrycja Sodowska
OBJECTIVES: The aim of the study is to determine the usefulness of ultrasound parameters in the second stage of labor in prediction of the method of delivery and to evaluate the benefits to be derived from this study. MATERIAL AND METHODS: Ultrasound scan was performed with Convex transabdominal probe on 68 pregnant women in labor at term with fetuses in cephalic presentation at the beginning of the second stage of labor and parameters such as angle of progression, head progression distance, head-symphysis distance and head-perineum distance were measured...
2016: Ginekologia Polska
Thangavelautham Suhitharan, Thi Phuong Tu Pham, Helen Chen, Pryseley Nkouibert Assam, Rehena Sultana, Nian-Lin Reena Han, Ene-Choo Tan, Ban Leong Sng
AIM: The aim of this study was to investigate the role of peripartum analgesic and psychological factors that may be related to postpartum depression (PPD). METHODS: This case-control study was conducted in pregnant females who delivered at KK Women's and Children's Hospital from November 2010 to October 2013 and had postpartum psychological assessment. Demographic, medical, and postpartum psychological status assessments, intrapartum data including method of induction of labor, mode of labor analgesia, duration of first and second stages of labor, mode of delivery, and pain intensity on hospital admission and after delivery were collected...
2016: Neuropsychiatric Disease and Treatment
Stine Bernitz, Pål Øian, Leiv Sandvik, Ellen Blix
BACKGROUND: Satisfaction with birth care is part of quality assessment of care. The aim of this study was to investigate possible differences in satisfaction with intrapartum care among low-risk women, randomized to a midwifery unit or to an obstetric unit within the same hospital. METHODS: Randomized controlled trial conducted at the Department of Obstetrics and Gynecology, Østfold Hospital Trust, Norway. A total of 485 women with no expressed preference for level of birth care, assessed to be at low-risk at onset of spontaneous labor were included...
2016: BMC Pregnancy and Childbirth
Atsuko Taga, Yukiyasu Sato, Chieko Sakae, Yumiko Satake, Ikuko Emoto, Shunsuke Maruyama, Hiroko Mise, Tomoko Kim
OBJECTIVE: To assess the applicability of trial of labor in cases of low-lying placenta. METHODS: In this observational cohort study, we collected data from the women with low-lying placenta delivered at our hospital between April 2012 and December 2015. Low-lying placenta was diagnosed when the length from the placental lowest edge to the internal cervical os (placenta-os distance) was 0-20 mm at 36 gestational weeks. Planned mode of delivery for each case was determined by patient's preference...
May 16, 2016: Journal of Maternal-fetal & Neonatal Medicine
Cynthia A French, Xiaomei Cong, Keun Sam Chung
Despite widespread use of epidural analgesia during labor, no consensus has been reached among obstetric and anesthesia providers regarding its effects on breastfeeding. The purpose of this review was to examine the relationship between labor epidural analgesia and breastfeeding in the immediate postpartum period. PubMed, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature were searched for articles published in 1990 or thereafter, using the search term breastfeeding combined with epidural, labor epidural analgesia, labor analgesia, or epidural analgesia Of 117 articles, 23 described empirical studies specific to labor epidural analgesia and measured a breastfeeding outcome...
August 2016: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
Sae Kyung Choi, Yong Gyu Park, Da Hye Lee, Hyun Sun Ko, In Yang Park, Jong Chul Shin
OBJECTIVES: To evaluate the effect of the occiput posterior (OP) position on dystocia and perinatal outcomes. METHODS: This was a prospective cohort study of 162 primiparous women. We performed intrapartum sonography, and fetal occiput positions were recorded. The relationships between the position of the occiput and the course of labor and perinatal outcomes were investigated. Statistical analysis was performed using SAS 9.2. RESULTS: Fifty-six of 162 fetuses were found to be in the OP position during the first stage of labor...
December 2016: Journal of Maternal-fetal & Neonatal Medicine
Ellen M Ray, Jeanne L Alhusen
Estimation of fetal weight is an important component of antenatal and intrapartum management of pregnant women. While many clinicians use ultrasound estimates of fetal weight to assess fetal growth, there are inherent challenges in both the diagnosis and management of suspected fetal macrosomia. Given the inaccuracy in estimating fetal weight, and the risks that accompany cesarean birth or induction of labor, the management of suspected fetal macrosomia requires open communication and shared decision making between the woman and her health care providers...
March 2016: Journal of Midwifery & Women's Health
Elizabeth S Langen, Steven J Weiner, Steven L Bloom, Dwight J Rouse, Michael W Varner, Uma M Reddy, Susan M Ramin, Steve N Caritis, Alan M Peaceman, Yoram Sorokin, Anthony Sciscione, Marshall W Carpenter, Brian M Mercer, John M Thorp, Fergal D Malone, Jay D Iams
OBJECTIVE: To assess the association of cervical effacement with the rate of intrapartum cervical change among nulliparous women. METHODS: We conducted a secondary analysis of a prospective trial of intrapartum fetal pulse oximetry. For women who had vaginal deliveries, interval-censored regression was used to estimate the time to dilate at 1-cm intervals. For each given centimeter of progressive cervical dilation, women were divided into those who had achieved 100% cervical effacement and those who had not...
March 2016: Obstetrics and Gynecology
Abirami Natarajan, Roy Ahn, Brett D Nelson, Melody Eckardt, Jennifer Kamara, Sas Kargbo, Pity Kanu, Thomas F Burke
BACKGROUND: Postpartum hemorrhage remains the leading cause of maternal mortality worldwide. Administration of uterotonics during the third stage of labor is a simple and well established intervention that can significantly decrease the development of postpartum hemorrhage. Little is known about the use of prophylactic uterotonics in peripheral health centers, where the majority of normal deliveries occur. The purpose of this study is to assess health provider current practices and determinants to the use of prophylactic uterotonics in Sierra Leone, a country with one of the highest maternal mortality ratios worldwide...
2016: BMC Pregnancy and Childbirth
L Takács, J Mlíková Seidlerová, F Smolík, S Hoskovcová, P Antonín, J Vařáková, A Valová, T Svoboda, J Dočkalová
OBJECTIVE: To assess women's satisfaction with perinatal care provided in maternity hospitals in Vysočina region, to identify the areas with high satisfaction scores as well as those requiring improvement, and to describe the factors influencing women's satisfaction, i. e. dissatisfaction with the care provided during labor and birth and the early postpartal period. DESIGN: Original study. SETTING: Department of Psychology, Faculty of Philo-sophy, Charles University, Prague...
December 2015: Ceská Gynekologie
J Spilka, J Frecon, R Leonarduzzi, N Pustelnik, P Abry, M Doret
Intrapartum fetal heart rate (FHR) constitutes a prominent source of information for the assessment of fetal reactions to stress events during delivery. Yet, early detection of fetal acidosis remains a challenging signal processing task. The originality of the present contribution are three-fold: multiscale representations and wavelet leader based multifractal analysis are used to quantify FHR variability ; Supervised classification is achieved by means of Sparse-SVM that aim jointly to achieve optimal detection performance and to select relevant features in a multivariate setting ; Trajectories in the feature space accounting for the evolution along time of features while labor progresses are involved in the construction of indices quantifying fetal health...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Gözde Gökçe İsbir, Pinar Serçekuş
BACKGROUND: Supportive care during labor, the primary role of intrapartum nurses and midwives, provides comfort to prepartum women and helps facilitate a positive labor experience. It has been argued that supportive care during labor reduces fear and anxiety as well as the resultant side effects. However, evidence supporting this argument is insufficient. PURPOSE: The aim of this study was to assess the effects of intrapartum supportive care on fear of delivery and on the key parameters of the labor process...
December 31, 2015: Journal of Nursing Research: JNR
Kamil Biringer, Pavol Zubor, Erik Kudela, Branislav Kolarovszki, Mirko Zibolen, Jan Danko
The aim of this case report is to describe a rare non-hypoxic cause of pathological changes in fetal heart rate pattern during labor, and to determine management, including a description of important prenatal aspects when pathologic cardiotocographic recording is performed during labor. A fetus with rare arteriovenous malformation of the vein of Galen, which represents less than 1% of all intracranial arteriovenous malformations, was monitored by intrapartum external cardiotocography in the 37 + 5 gestational week...
March 2016: Journal of Obstetrics and Gynaecology Research
Marzena Dębska, Piotr Kretowicz, Romuald Dębski
Ultrasonography has been extensively used in obstetrics and gynecology since 1980's. It found application in pediatric gynecology, procreation period, post-menopause, pregnancy monitoring and after delivery. Although the first reports on the use of ultrasonography in assessing delivery mechanism were published in 1990's, yet to date labor progress is evaluated by means of physical examination in most delivery units. Intrapartum sonography is not routinely performed despite the fact that numerous studies documented high error rates of conventional obstetrical examination...
June 2015: Journal of Ultrasonography
Shiri Shinar, Anat Schwartz, Sharon Maslovitz, Ariel Many
OBJECTIVE: The aim of our study was to determine the optimal time for manual placental removal in an uncomplicated third stage while taking into consideration the risk for blood transfusion. Risk factors for postpartum blood transfusions were studied. METHODS: Computerized data of all vaginal deliveries at our labor and delivery unit from 2010 to 2014 were obtained. Cases of complete and spontaneous placental separation up to 60 minutes into the third stage of labor were extracted for analysis...
March 2016: Birth
Vivian Gu, Nancy Feeley, Ian Gold, Barbara Hayton, Stephanie Robins, Anna Mackinnon, Simcha Samuel, C Sue Carter, Phyllis Zelkowitz
BACKGROUND: Synthetic oxytocin (synOT) is commonly used in labor management to induce and augment labor, and to prevent postpartum hemorrhage. However, its long-term consequences for maternal health and behavior are largely understudied. We examined the relationship between synOT and maternal oxytocin levels, breastfeeding, and maternal mental health at 2 months postpartum. METHODS: Women were recruited during pregnancy or within 48 hours of giving birth through obstetric practices and hospitals...
March 2016: Birth
D Iliescu, S Tudorache, R Dragusin, O Carbunaru, C Patru, M Florea, I A Gheonea
The transperineal ultrasound (TPU) value of the angle of progression (AOP) during fetal head engagement, at station 0, is a critical cut-off for current obstetrical practice, especially when intrapartum instrumental interventions are required. Still, controversial measurements were reported in previous high resolution imagistic studies. Our TPU and direct "gold-standard" magnetic resonance (MRI) measurements confirm that station 0 corresponds to a 120° AOP, concordantly. Based on these findings, the fact that an AOP of 120° or greater was previously strongly associated with vaginal delivery may be due to the achievement of head engagement in labor...
2015: Case Reports in Obstetrics and Gynecology
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