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intrapartum assessment of labor

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https://www.readbyqxmd.com/read/29096560/a-novel-modality-for-intrapartum-fetal-heart-rate-monitoring
#1
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
https://www.readbyqxmd.com/read/29078943/update-on-fetal-monitoring-overview-of-approaches-and-management-of-category-ii-tracings
#2
REVIEW
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
https://www.readbyqxmd.com/read/28961642/comparison-of-the-effects-of-using-physiological-methods-and-accompanying-a-doula-in-deliveries-on-nulliparous-women-s-anxiety-and-pain-a-case-study-in-iran
#3
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
https://www.readbyqxmd.com/read/28934088/accuracy-of-a-rapid-intrapartum-group%C3%A2-b-streptococcus-test-a-new-immunochromatographic-assay
#4
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
https://www.readbyqxmd.com/read/28931404/a-cluster-randomized-trial-to-reduce-major-perinatal-morbidity-among-women-with-one-prior-cesarean-delivery-in-qu%C3%A3-bec-prisma-trial-study-protocol-for-a-randomized-controlled-trial
#5
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
https://www.readbyqxmd.com/read/28913129/evaluating-the-content-and-quality-of-intrapartum-care-in-vaginal-births-an-example-of-a-state-hospital
#6
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: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28835213/evaluation-of-the-mobile-nurse-training-mnt-intervention-a-step-towards-improvement-in-intrapartum-practices-in-bihar-india
#7
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
https://www.readbyqxmd.com/read/28814285/quality-of-midwife-provided-intrapartum-care-in-amhara-regional-state-ethiopia
#8
Tegbar Yigzaw, Fantu Abebe, Lalem Belay, Yewulsew Assaye, Equlinet Misganaw, Ashebir Kidane, Desalegn Ademie, Jos van Roosmalen, Jelle Stekelenburg, Young-Mi Kim
BACKGROUND: Despite much progress recently, Ethiopia remains one of the largest contributors to the global burden of maternal and newborn deaths and stillbirths. Ethiopia's plan to meet the sustainable development goals for maternal and child health includes unprecedented emphasis on improving quality of care. The purpose of this study was to assess the quality of midwifery care during labor, delivery and immediate postpartum period. METHODS: A cross-sectional study using multiple data collection methods and a 2-stage cluster sampling technique was conducted from January 25 to February 14, 2015 in government health facilities of the Amhara National Regional State of Ethiopia...
August 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28800671/-outcomes-of-planned-out-of-hospital-and-low-risk-hospital-births-in-lower-saxony
#9
Antje Petersen, Lea-Marie Köhler, Christiane Schwarz, Bernhard Vaske, Mechthild M Gross
Introduction Internationally, there is debate on the safety of different birth settings inside and outside of hospitals. Low-risk women in Germany can choose where they give birth, and out-of-hospital births are especially necessary in regions lacking infrastructure. To date, national studies are required. Materials and Methods We investigated planned out-of-hospital (OH) and hospital births in Lower Saxony, Germany, in 2005. Women with a singleton fetus in the vertex position were included once they reached 34+0 gestational weeks...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28799705/the-process-of-intrapartum-care-among-skilled-birth-attendants-in-the-dominican-republic-and-maternal-perceptions-of-care-during-labor-and-birth-a-case-report
#10
Peter Schindler, Rosa Burgos, Kimberly Vuong, Hilary Aviela Lerner, Elsa Evangelista, Flor Josefina Rodriguez, Lourdes Peralta Polanco, Jennifer Foster
INTRODUCTION: The World Health Organization calls for situation analyses of maternity settings globally to improve maternal-newborn health. This study evaluated the care processes of skilled birth attendants and women's satisfaction with the care in a public hospital in the Dominican Republic. The purpose of the assessment was to establish a baseline to build quality improvements. METHODS: A cross-sectional, mixed-methods, observational study was conducted by an international team...
August 11, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28764569/screening-for-group-b-streptococcus-gbs-at-labour-onset-using-pcr-accuracy-and-potential-impact-a-pilot-study
#11
Sandhya Ramesh Babu, Rachel McDermott, Irum Farooq, David Le Blanc, Wendy Ferguson, Naomi McCallion, Richard Drew, Maeve Eogan
This pilot study assessed the diagnostic accuracy and potential impact of a rapid PCR-based screening test for the detection of group B Streptococcus (GBS) at the onset of labour for the purpose of optimising intrapartum antibiotic prophylaxis (IAP). Vaginal and rectal swabs from a convenience sample of 158 women were analysed by conventional broth-enriched culture and a rapid PCR test. Overall, GBS carriage was 18.98% by culture and 19.62% by PCR. PCR for the detection of GBS had a sensitivity of 93.1%, specificity of 96...
August 1, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28707059/a-prospective-cohort-study-on-the-prediction-of-fetal-distress-and-neonatal-status-with-arterial-and-venous-doppler-measurements-in-appropriately-grown-term-fetuses
#12
Ihsan Atabay, Semir Kose, Erkan Cagliyan, Bora Baysal, Ebru Yucesoy, Sabahattin Altunyurt
PURPOSE: To assess the predictive power of the cerebro-placental ratio (CPR) and the venous-arterial index (VAI) for the development of intrapartum fetal distress (FD) and neonatal intensive care unit (NICU) admission. METHODS: Fetal umbilical artery, middle cerebral artery and umbilical vein Doppler measurements were obtained before the active phase of labor in 311 singleton pregnancies at ≥37 weeks. A continuous electronic fetal monitorization was applied, and an umbilical cord blood sample was obtained for each participant...
October 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28678829/intrapartum-pcr-assay-versus-antepartum-culture-for-assessment-of-vaginal-carriage-of-group-b-streptococci-in-a-danish-cohort-at-birth
#13
Mohammed Rohi Khalil, Niels Uldbjerg, Poul Bak Thorsen, Jens Kjølseth Møller
The aim of this study was to compare the performances of two strategies for predicting intrapartum vaginal carriage of group B streptococci (GBS). One strategy was based on an antepartum culture and the other on an intrapartum polymerase chain reaction (PCR). We conducted a prospective observational study enrolling 902 pregnant women offered GBS screening before delivery by two strategies. The Culture-strategy was based on vaginal and rectal cultures at 35-37 weeks' gestation, whereas the PCR-strategy was based on PCR assay on intrapartum vaginal swab samples...
2017: PloS One
https://www.readbyqxmd.com/read/28627262/a-longitudinal-study-investigating-cervical-changes-during-labor-using-a-wireless-ultrasound-device
#14
Juyoung Kim, Sukyoung Kim, Seungjoo Jeon, Sunyoung Jung
PURPOSE: Cervical assessment during digital vaginal examination (DVE) includes assessing cervical dilatation, effacement, position and consistency. Only cervical dilatation during labor has been previously researched. We investigated cervical changes, including cervical dilatation and effacement, using a wireless ultrasound (US) device. MATERIALS AND METHODS: This was a longitudinal study investigating cervical changes during labor using a wireless US device. Twenty-five women in labor participated in a serial comparison of cervical dilatation, length and thickness measured during intrapartum transperineal sonography using a wireless mobile US device (SONON) with measurements of cervical dilatation and effacement obtained during serial DVEs...
June 21, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28618098/pre-labor-fetal-cardiac-function-and-its-relationship-with-intrapartum-fetal-compromise-and-neonatal-status-at-term
#15
Amal A Alsolai, Larissa N Bligh, Ristan M Greer, Sailesh Kumar
OBJECTIVES: To prospectively investigate the relationship between fetal cardiac function and Doppler parameters with intrapartum fetal compromise (IFC) in term appropriately grown fetuses prior to labour. Secondary outcomes were to correlate prenatal cardiac function with neonatal acid base status, intrapartum fetal heart rate abnormalities adverse neonatal outcomes. METHODS: This was a blinded, prospective, observational, cohort study, at the Mater Mother's Hospital, Brisbane, Australia...
June 15, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28601683/prenatal-intrapartum-and-postnatal-factors-are-associated-with-pediatric-eosinophilic-esophagitis
#16
Elizabeth T Jensen, Jonathan T Kuhl, Lisa J Martin, Marc E Rothenberg, Evan S Dellon
BACKGROUND: Multiple lines of evidence point to the potential importance of early-life environmental factors in the rapid rise in incidence of eosinophilic esophagitis (EoE), but potential exposures have not been extensively studied. OBJECTIVE: To assess the association between prenatal, intrapartum, and postnatal factors and the development of pediatric EoE using a case-control study. METHODS: Cases of EoE were recruited from an existing registry at Cincinnati Children's Hospital Medical Center (CCHMC)...
June 7, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28595604/functionality-and-acceptability-of-a-wireless-fetal-heart-rate-monitoring-device-in-term-pregnant-women-in-rural-southwestern-uganda
#17
Godfrey R Mugyenyi, Esther C Atukunda, Joseph Ngonzi, Adeline Boatin, Blair J Wylie, Jessica E Haberer
BACKGROUND: Over 3 million stillbirths occur annually in sub Saharan Africa; most occur intrapartum and are largely preventable. The standard of care for fetal heart rate (FHR) assessment in most sub-Saharan African settings is a Pinard Stethoscope, limiting observation to one person, at one point in time. We aimed to test the functionality and acceptability of a wireless FHR monitor that could allow for expanded monitoring capacity in rural Southwestern Uganda. METHODS: In a mixed method prospective study, we enrolled 1) non-laboring healthy term pregnant women to wear the device for 30 min and 2) non-study clinicians to observe its use...
June 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28591756/the-fetal-reserve-index-re-engineering-the-interpretation-and-responses-to-fetal-heart-rate-patterns
#18
Robert D Eden, Mark I Evans, Shara M Evans, Barry S Schifrin
OBJECTIVE: Electronic fetal monitoring (EFM) correlates poorly with neonatal outcome. We present a new metric: the "Fetal Reserve Index" (FRI), formally incorporating EFM with maternal, obstetrical, fetal risk factors, and excessive uterine activity for assessment of risk for cerebral palsy (CP). METHODS: We performed a retrospective, case-control series of 50 term CP cases with apparent intrapartum neurological injury and 200 controls. All were deemed neurologically normal on admission...
June 8, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28546816/effects-of-intrathecal-opioids-use-in-cesarean-section-on-breastfeeding-and-newborns-weight-gaining
#19
Fardin Yousefshahi, Fatemeh Davari-Tanha, Atabak Najafi, Mahbod Kaveh, Mohsen Rezaei Hemami, Patricia Khashayar, Mohammad Anbarafshan
Objective: To assess the association between intrapartum intrathecal opioid use and breastfeeding and weight gain following cesarean section. Materials and methods: The prospective double-blinded study was conducted on term pregnant women, undergoing elective cesarean section under spinal anesthesia. They divided into two groups. In the first group, intrathecal Morphine was used to achieve analgesia during or after the operation. The remainder divided into two subgroups, those who did not receive any opioid or those received systemic opioids...
December 2016: Journal of Family & Reproductive Health
https://www.readbyqxmd.com/read/28526449/predictors-of-vaginal-delivery-in-medically-indicated-early-preterm-induction-of-labor
#20
Rachel A Sievert, Spencer G Kuper, Victoria C Jauk, Melissa Parrish, Joseph R Biggio, Lorie M Harper
BACKGROUND: When delivery is indicated prior to 34 weeks, many providers perform a cesarean delivery rather than induce labor based on perceptions of a high failure rate. Given the morbidity of cesarean delivery, an accurate estimate of the success rate and factors associated with success in preterm induction of labor is important in management decisions. OBJECTIVE: We sought to develop a prediction model for successful induction of labor in preterm patients using factors known at the time the decision is made to deliver...
September 2017: American Journal of Obstetrics and Gynecology
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