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1
Choudhary, Anjali, and Meenakshi Tanwar. "Partogram and its relevance in modern obstetrics." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 4 (March 26, 2019): 1500. http://dx.doi.org/10.18203/2320-1770.ijrcog20191207.
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Background: Normal labor and childbirth is fraught with complexities. In the modern times the child birth has proven to be more challenging than ever. Partogram has proven to be a simple and useful tool in monitoring normal labor. The objective of this endeavor was to site our experiences in using partogram for ‘plotting’ labors, to assess its utility, limitations and cite controversies.Methods: Authors analyzed progress of labor plotted on partograms in parturient women to see whether their labor patterns conform to the standard partogram, and can logical conclusions be drawn from their use to decide partogram’s utility and applicability.Results: The use of partogram was not universal and its charting inadequate due to lack of motivation on part of labor room residents, busy labor rooms. When plotted meticulously they showed a wide variation, and many women did not conform to the rates of dilatation of the graph. The use of partogram did not alter the rate of cesarean section for non-progressive labors with use and non-use of partogram.Conclusions: Philpott’s partogram is a very visual and useful tool to monitor labours and detect labour abnormalities timely. Although it has served as a labour management tool across the labour rooms its use is not universal. There is a plethora of conflicting opinions regarding its utility in modern obstetrics today, ranging from a complete faith in the tool to finding it obsolete and in need of a revision to calling it a medicalization of a natural process.
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Khurshid, Hafiza Naveeda, Samar Noor, Huma Tasheen, Shabana Khokar, and Sobia Saleem. "Mean Blood Loss in Third Stage of Labour Treated with and without Prophylactic Tranexamic Acid." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 26, 2022): 45–47. http://dx.doi.org/10.53350/pjmhs2216545.
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Background: Massive obstetrical hemorrhage, a leading contributor towards maternal fatality in economically developing countries, is occasionally related with the passive and apathetic management of the third stage of labor. The increasing frequency of anaemia among pregnant women in developing countries, mild to moderate blood loss during labour necessitates massive transfusions with associated complications. Aim: Recent studies claimed that prophylactic tranexamic acid can significantly reduce the mean blood loss during 3rd stage of labour and advocated it in future practice. Methods: The research was conducted as randomized controlled trial carried out from February 2021 to October 2021 in the Department of Diagnostic Radiology and Obstetrics & Gynaecology Department, Ganga Ram Hospital, Lahore. A total of 116 pregnant women aged between 18-35 years presenting in labor at term (37-42 weeks of gestation as per dating scan) which were randomly allocated into two groups. Patients in Group-A were given additional tranexamic acid at the end of 2nd stage of labor while those in Group-B received conventional treatment alone. Results: Patients were 28.33±4.77 years with the mean age while the mean gestational age at delivery was 39.39±1.69 weeks. 30(25.9%) women were primiparas and 86 (74.1%) were multiaparas. The mean BMI of these patients was 27.50±3.90 Kg/m2 while the average duration of 3rd stage of labor was 4.69±1.83 minutes. Patients taking prophylactic tranexamic acid lost significantly less blood in the third stage of labors than controls (244.83±21.47 vs. 354.09±22.36 ml; p-value<0.001). Conclusion: In the present study, prophylactic tranexamic acid was found to significantly reduce the mean blood loss during 3rd stage of labor which along with low cost, widespread availability and oral administration advocates the routine use of tranexamic acid (during 3rd stage of labor) in future obstetric practice to minimize blood loss with subsequent decreased need for blood transfusion and better patient’s recovery. Keywords: Third Stage of Labor, Blood Loss, Tranexamic Acid
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Malhotra, Narendra, Ameet Patki, Uday Thanawala, Amarnath Bhide, Shirish N. Daftary, Shyam V. Desai, and Jesse Levi. "Programmed Labor—Indegenous Protocol to Optimize Labor Outcome." Journal of South Asian Federation of Obstetrics and Gynaecology 1, no. 1 (2009): 61–64. http://dx.doi.org/10.5005/jp-journals-10006-1048.
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ABSTRACT Objective To Asses and develop an indigenous protocol to optimize labour outcome, as Programmed Labor. Design Open, prospective (Between January 2000 to December 2007), randomized, parallel group, monocentric, comparative matching trial. Settings Labor rooms at Nowrosjee Wadia Maternity, Mumbai. Selection criteria 200 patients in each group, aged between 21-30, as low-risk parturient. Intervention Partography, Oxytocin, Primiprost, Pentazocin, Dizepam, Tramadol, Drotin, Ketamine. Outcome parameters Satisfactory obstetric outcome, progressive labor of shorter duration, less blood loss and pain relief. Results Study group had mean shorter duration of active labor as 3.5 hrs compared to controls of 5.2 hrs. Excellant pain relief was of 24 and 62% of substantial relief in comparison to 32% only in other group with no patient falling in excellent group. Second stage of labor was reduced by half (26 to 48 meters) and lesser third stage blood loss. Conclusions Programmed labor with indigenous protocol developed and practiced, results in progressive, shorter, and comfortable labors with lesser blood loss.
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Ms. S.U. Puri, Prof. Dr. M. M. Ghaisas, and Prof. Dr. R. V. Shete. "Maternal Height and Labor Induction: Implications for Method Selection and Success Rates." international journal of engineering technology and management sciences 8, no. 2 (2024): 25–31. http://dx.doi.org/10.46647/ijetms.2024.v08i02.003.
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The impact of maternal height on the selection of methods for labor induction and its success rates is a critical aspect of obstetric care. This review article aims to explore the relationship between maternal height and the process of labor induction, success rate of labour induction and rate of cesarean section, considering various factors and outcomes. The study delves into the influence of maternal height on the efficacy of different induction methods, including pharmacological approaches such as oxytocin and prostaglandins, as well as non- pharmacological methods like membrane sweeping and amniotomy. Overall, this review provides valuable insights into the complex interplay between maternal height and the selection and success of labor induction methods, offering implications for clinical practice and further research in the field of obstetrics and gynecology.
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Feinberg, B. "Artificial preterm labor in private practice." Journal of obstetrics and women's diseases 7, no. 1 (September 2, 2020): 67–69. http://dx.doi.org/10.17816/jowd7167-69.
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Unfortunately, The benefits of Lister's antiseptic science, says Fehling, have been taken advantage of by gynecology to a much greater extent than obstetrics. From obstetric operations to caesarean section, Lister's scholarship brought more benefits than forceps and perforations. It would therefore be desirable that in the future, artificial premature birth under the influence of anti- and asepsis would give both the mother and the fetus better results than at the present time, and then only this operative aid in a state will be replaced, as a cesarean section with conditional shown and perforated.
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Sawant, Prabha P., Shilpa N. Chaudhari, Kishorkumar Hol, and Shraddha Shastri. "Lustrum study of labour induction." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 8 (July 27, 2022): 2218. http://dx.doi.org/10.18203/2320-1770.ijrcog20221940.
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Background: The rate of labor induction is steadily increasing. Approximately one out of four pregnant women has their labor induced. Over the years, various professional societies have recommended the use of induction of labor in circumstances in which the risk of waiting for the onset of spontaneous labor are judged by clinicians to be greater than the risks associated with shortening duration of pregnancy by induction. This study was carried out to categories indications and to know trends of indication over 5 years.Methods: This retrospective analytical study was conducted over a period of five years from 01 June 2016 to 31 May 2021 at the department of obstetrics and gynecology, tertiary care hospital, Pune, Maharashtra, India. The rate, indications and trend in indications of labor induction was calculated over the study period. The data so collected was presented with graphical representation.Results: There was a total of 10407 deliveries during the study period out of which, 865 were induced. So, the rate of labor induction in the study was found to be 8.31%. Post-datism accounts for 54.4% followed by pregnancy induced hypertension remains the major obstetric cause accounting for 16.6% of labour induction. Intrauterine growth restriction (IUGR) accounted for 3.6% causes of labour induction.Conclusions: Vaginal birth has lesser morbidity and mortality involving both the mother and the child compared to caesarean and will always be regarded as the superior mode of delivery. Apart from post-datism, the commoner obstetric indications for induction of labour are PIH and IUGR. Increasing trend in the incidence of pregnancy-induced hypertension (PIH) and IUGR is observed and therefore probably correlating to foetal distress after induction of labour causing increased trend of need for caesarean section over the five years.
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Fisher, A. "Asepsis in obstetrics." Journal of obstetrics and women's diseases 6, no. 12 (September 1, 2020): 1231–32. http://dx.doi.org/10.17816/jowd6121231-1232.
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The author's views on the dietetics of normal childbirth (mainly, not in clinics, but in private practice) boil down to the following. If possible, the woman in labor should have a shared bath. Recognizing that there are microorganisms on the external genital organs of each woman in labor, he considers their disinfection at the beginning of labor to be unnecessary, since it would only make sense if possible to apply an aseptic bandage to the disinfected parts, which, for obvious reasons, is not feasible; in view of this, he advises at the beginning of labor to make only a thorough washing of the external genital organs and surrounding parts with well-boiled (depleted) water and soap, repeated after each urination or excrement.
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Hoque, Monjurul. "Incidence of Obstetric and Foetal Complications during Labor and Delivery at a Community Health Centre, Midwives Obstetric Unit of Durban, South Africa." ISRN Obstetrics and Gynecology 2011 (July 31, 2011): 1–6. http://dx.doi.org/10.5402/2011/259308.
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The objectives of this retrospective cohort study were to estimate the incidence of obstetric complications during labor and delivery and their demographic predictors. A total of 2706 pregnant women were consecutively admitted to a midwife obstetric unit with labor pain between January and December 2007 constituted the sample. Among them 16% were diagnosed with obstetrical and foetal complications. The most frequently observed foetal and obstetric complications were foetal distress (35.5/1000) and poor progress of labor (28.3/1000), respectively. Primigravid and grandmultiparity women were 12 (OR = 11.89) and 5 (OR = 4.575) times, respectively, more likely to have complications during labor and delivery. Women without antenatal care had doubled (OR = 1.815, 95% CI, 1.310; 2.515) the chance of having complications. Mothers age <20 years was protective (OR = 0.579, 95% CI, 0.348; 0.963) of complications during delivery compared to women who were ≥35 years. National and local policies and intervention programmes must address the need of the risk groups of pregnant women during labor and delivery.
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Prata, Juliana Amaral, Jane Márcia Progianti, and Helena Scherlowski Leal David. "Productive restructuring in the area of health and obstetric nursing." Texto & Contexto - Enfermagem 23, no. 4 (December 2014): 1123–29. http://dx.doi.org/10.1590/0104-07072014002040013.
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This reflection aimed to show the productive restructuring dimensions achieved in Brazilian healthcare, discussing the nexuses between this phenomenon and the work in obstetrical nursing. Its construction was based on articles about productive restructuring and health available in the Virtual Health Library, reflecting the consequences on this speciality's caregiving process. We observed that the productive restructuring in health care may be seen under the health system management and work organization viewpoints. Despite the negative impacts in the field of work, there has been an appreciation of living labor in obstetrics in a context favorable to changes in labor care, through the introduction of obstetrical nursing and implementation of health care technologies. We conclude that, besides the focus on living labor and soft technologies, such concepts comprise technological innovation, as they have changed and resignified the way of providing care, thus beginning the process of the inversion of the technological core in obstetrics.
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Tatic-Stupar, Zaklina, Aleksandra Novakov-Mikic, Mirjana Bogavac, Stevan Milatovic, and Slobodan Sekulic. "Prediction of labor induction outcome using different clinical parameters." Srpski arhiv za celokupno lekarstvo 141, no. 11-12 (2013): 770–74. http://dx.doi.org/10.2298/sarh1312770t.
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Introduction. Induction of labor is one of the most common obstetric interventions in contemporary obstetrics. Objective. The aim of the study was to evaluate the clinical and sonographic parameters in prediction of success of labor induction. Methods. The prospective study included 422 women in whom induction of labor was carried out at the Department of Obstetrics and Gynecology of Clinical Centre of Vojvodina. The role of body mass index and age of women, parity Bishop score, cervical length measured by transvaginal ultrasound was evaluated in regard of the success of induction, which was considered successful if a vaginal delivery occurred within 24 hours after the onset of induction. Data were statistically analyzed by univariate statistical analysis and Pearson?s ?2 test. Results. Out of 422 women, induction of labor was successful in 356 (84.4%), and it failed in 66 (15.6%) cases. The values of Bishop score and cervical length had positive correlation with the success of induction. Conclusion. Bishop score and transvaginal cervical length were both reliable predictors in determining the success of labor induction, as well as parity and BMI. These parameters are mostly complementary, not competitive in prediction of labor induction success.
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Jain, Mudita, and Rituja Kaushal. "Clinical utility of mifepristone over oxytocin in preventing adversities of parturition outcomes: a comparative study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 12 (November 26, 2018): 4808. http://dx.doi.org/10.18203/2320-1770.ijrcog20184690.
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Background: Of the various medical methods of induction, induction with oxytocin and prostaglandins remain the most popular and acceptable methods in modern obstetric practice. The present cross-sectional study conducted in the Department of Obstetrics and Gynecology, Kamla Raja Hospital, Gwalior, mifepristone has been used through oral route for induction of labor. The objectives of the present study were to evaluate the effect of oral mifepristone for induction of labor, to record the outcome of labor and the incidence of operative interference, and to see any adverse effects on mother and/or neonate with its use, to compare its effect with other medical method of labor induction.Methods: The present study is a prospective comparative study carried out in the Department of Obstetrics and Gynecology, G. R. Medical College and Kamla Raja Hospital, Gwalior (M.P.), from May 2009 to June 2010. Total number of patients involved in the study is 119, study group comprised of 69 patients in which oral mifepristone (200mg) was given on day 1 and day 2 of a four-day observation period. The control group comprised of 50 patients induced with intravenous oxytocin group.Results: On overall assessment of the efficacy of labour induction with oral mifepristone as compared to intravenous (I/V) oxytocin, we found that there was no significant difference in the mode of delivery (vaginal and caesarean section) and Apgar score.Conclusions: The induction of active labour induction, induction to delivery interval is higher in mifepristone group as compared to oxytocin group. However, the drug resulted in higher rates of vaginal birth after cesarean section (VBAC) with no grave maternal and fetal outcomes, so thus aspect of oral mifepristone is of great consideration and requires further research.
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Lakic, Dragana, Branko Petrovic, and Guenka Petrova. "Cost-effectiveness analysis of different types of labor for singleton pregnancy: Real life data." Srpski arhiv za celokupno lekarstvo 142, no. 11-12 (2014): 688–94. http://dx.doi.org/10.2298/sarh1412688l.
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Introduction. Views on the conduct of labor have changed over time, and a significant difference exists in relation to obstetric centers. Objective. To assess cost, clinical outcomes and cost-effectiveness of different types of labor in singleton pregnancies. Methods. A decision model was used to compare vaginal labor, induced labor and planned cesarean section. All data were taken from the Book of Labor from the University Hospital for Gynecology and Obstetrics ?Narodni Front?, Belgrade, Serbia for labors conducted during one month period in 2011. Successful delivery (i.e. labor that began up to 42 gestation weeks, without maternal mortality and the newborn Apgar scores greater than or equal to seven in the fifth minute of life) was considered as the outcome of the cost effectiveness-analysis. To test the robustness of this definition probabilistic sensitivity analysis was performed. Results. From a total of 667 births, vaginal labor was conducted in 98 cases, induced vaginal in 442, while planned cesarean section was performed 127 times. Emergency cesarean section as a complication was much higher in the vaginal labor cohort compared to the induced vaginal cohort (OR=17.374; 95% CI: 8.522 to 35.418; p<0.001). The least costly type of labor was induced vaginal labor: average cost 461 euro, with an effectiveness of 98.17%. Both, vaginal and planned cesarean labor were dominated by the induced labor. The results were robust. Conclusion. Elective induction of labor was associated with the lowest cost compared to other types of labor, with favorable maternal and neonatal outcomes.
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Xess, Somila, and Shipra Shrivastava. "Role of fetal craniotomy in modern day obstetrics: case series." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 4 (March 26, 2019): 1679. http://dx.doi.org/10.18203/2320-1770.ijrcog20191241.
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Although obstructed labor in vanished from the western world where the destructive operations are obsolete and not needed, in developing countries like India obstructed labor with dead fetus and severe infection is a sad reality, and destructive operations are an essential part of obstetric practice and cannot be wished away. In many situations they should be a preferred option to cesarean delivery which needs much better facilities and greater morbidity. Here authors present a case series of three patients who reported with obstructed labour and IUFD. Fetal craniotomy was done and thus maternal morbidity reduced. Craniotomy offers less postpartum morbidity, lesser expertise and resources and therefore better in cases presenting with obstructed labour and dead baby in developing countries.
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Stroganov, V. "Sterility of macerated fruits and aseptic cadaver for phantom operations." Journal of obstetrics and women's diseases 11, no. 11 (December 22, 2020): 1323–29. http://dx.doi.org/10.17816/jowd11111323-1329.
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When studying obstetrics, a good obstetric phantom is of no small importance as a teaching aid. Teaching operational obstetrics is unthinkable even without it, since one reading cannot be so imprinted in the minds of listeners as the direct application of one or another technique by themselves, and one has to reckon with a number of details, like at the bedside of a woman in labor. No matter how great the clinic is, a number of obstetric operations, due to the rarity of their use, remains unseen by the majority of those involved. I will point out, for example, the operation spondylotomia, evisceratio, decapitatio, the imposition of forceps on the head when presenting the face, etc. That is why the obstetric phantom is an inevitable companion of the study of obstetrics. Recently, a number of improvements have been proposed in this direction. So ex. Schwabe arranged a device with a variable pelvis, on which you can get a normal and narrow pelvis.
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Moray, Arun P., Urmila A. Moray, Vaishali M. Patil, and Grishma A. Moray. "Changing trends in the indications of obstetric hysterectomies in teaching rural hospital." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 8 (July 26, 2018): 3184. http://dx.doi.org/10.18203/2320-1770.ijrcog20183314.
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Background: Obstetric hysterectomy (OH) still remains lifesaving procedure. OH still poses a major obstetrical morbidity in the developing world due to lack of human, infrastructural and monetary resources. Irrespective of attempts like good antenatal care and delivery planning in modern obstetrics to prevent major obstetric complications; unfortunately, OH needs to be performed at times even today. The aim of present study was to determine the changes in the indications of obstetric hysterectomy.Methods: A retrospective review based on hospital data of all the patients’ records subjected to OH from January 1994 to September 2001 (Gr. A) and from January 2006 to December 2015 (Gr. B) was done and analyzed for incidence and changing trends in the indications.Results: The incidence of OH during two periods from January 1994 to September 2001 (Group A) and from January 2006 to December 2015 (Group B) in the Department of Obstetrics and Gynecology at Shri. Bhausaheb Hire Govt. Medical College, Dhule was 3.27/1000 and 0.97/1000 deliveries. Incidence is reduced by more than three folds. In both groups maximum patients were below 30 yrs of age and multipara. The commonest indications for OH in both groups were uterine rupture, uncontrolled Atonic PPH and placental causes. The incidence of uterine rupture as a cause for OH was reduced from 78.16% to 43.24%, while that of Atonic PPH has increased from 16.09% to 28.37% and placental causes has increased from 4.59% to 9.45%. Among the risk factors for OH, the incidence of prolonged or obstructed labour has reduced from 66.66% to 21.62% and that of malpresentations has reduced from 27.58 to 5.4%.Conclusions: There is definite reduction in the incidence of OH, frequency of uterine rupture, obstructed labor and malpresentations in Gr. B due to timely referral, improved infrastructure and transportation facilities.
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Narang, Ridhi, Gurpreet K. Nandmer, and Rekha Sapkal. "Factors affecting post-operative wound gaping and their outcome in obstetrical and gynecological abdominal surgeries." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 4 (March 30, 2017): 1530. http://dx.doi.org/10.18203/2320-1770.ijrcog20171422.
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Background: Postoperative wound gaping is a very traumatic event both for patient and treating doctor as it adds economical and psychological burden to the patient and the family. This study was conducted with the aim to find out the various factors affecting postoperative wound gaping and their outcome in obstetrical and gynecological abdominal surgeries.Methods: This Retrospective observational study was carried out in the Department of Obstetrics and Gynecology at Peoples College of medical sciences and research Centre, Bhopal, India from 1st May 2014 to 31st October 2015.Results: A total of 1310 patients underwent major obstetrical and gynecological abdominal surgeries, out of which 29 cases developed postoperative wound gaping with the percentage being 2.2%. The rate was found to be higher among the emergency obstetric case (51.7%). Associated risk factors being anemia (72%), obesity (65%), hypoproteinemia (62%) and diabetes (52%) among gynecological surgeries and prolonged rupture of membranes (53%), emergency LSCS and previous LSCS (47%) among the obstetric cases. The common causative organism was found to be E. coli (28.5%) followed by acinetobacter and pseudomonas.Conclusions: Anemia, obesity, hypoproteinemia, diabetes, history of previous surgeries, emergency operations are the high risk factors for wound gaping in both obstetrics and gynecology surgeries. Correction of anemia, diabetes preoperatively, high protein diet and prevention of other risk factors like avoiding prolonged labor, use potent antibiotics in cases of rupture of membrane, timely intervention, provide well equipped wards with clean environment would be rewarding for better outcome of the surgery.
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Saraiva Sales, Jandir, Marcus Vinicius da Silva Pereira, Marcos Vinícius Soares Silva, Ana Carolina Gonçalves Pires, Jadson Douglas Lopes Leite, Letícia Duarte Silva, Monique Nayara Coelho Muniz Cardoso, et al. "CHALLENGES AND CONTROVERSIES IN OBSTETRICS." Health and Society 3, no. 04 (July 11, 2023): 01–15. http://dx.doi.org/10.51249/hs.v3i04.1446.
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This article provides a comprehensive review of current evidence on the challenges and controversies in obstetrics, with a focus on shoulder dystocia, fetal monitoring, and the use of oxytocin in labor and delivery. A systematic search was conducted in three databases (Scielo, Google Scholar, and LILACS), resulting in the selection of 10 relevant studies for an integrative review. The studies encompassed various research methodologies, including systematic reviews, cohort studies, clinical trials, qualitative studies, and narrative reviews. The findings provided important insights into the investigated topics, including risk factors associated with shoulder dystocia, effectiveness of fetal monitoring, comparison of oxytocin use protocols, women’s experiences with shoulder dystocia, obstetric complications, controversies surrounding oxytocin use, incidence of shoulder dystocia, and utilization of fetal monitoring. These findings contribute to a better understanding of these topics and may guide clinical practice towards safer and more effective obstetric care. However, further research is needed to fill existing knowledge gaps and inform evidence-based decision-making in obstetrics.
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Chaves, Fabíola Augusta Marinho, and Julio Cesar Soares Aragão. "Misoprostol use in obstetrics." Cadernos UniFOA 13, no. 38 (December 11, 2018): 121–27. http://dx.doi.org/10.47385/cadunifoa.v13.n38.1604.
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This study is a bibliographic review in order to overview the use, indications and contraindications of misoprostol in obstetrics. Thirty three academic articles in Portuguese, Spanish, and English in the range 2005 to 2014 wer collected and analysed. Misoprostol is a methyl analogue of PGE1 and has anti-secretory action and protective properties of the mucosa, and cause increased uterine contractility, induce the development of contractions and cause cervical effacement, facilitating the expansion necessary to carry out obstetric procedures. It is an important drug in obstetric practice and is indicated for treatment of missed abortion, labor induction, shortens the operatory time in situations where the cervix has no dilation, reduce the frequency of complications and caesarean indications, and can be used in prophylaxis of post-partum hemorrhage. Attention should be paid to its misuse as an abortifacient and the existence of reports of congenital malformations, especially the Moebius Syndrome. It is a stable product, safe, effective, inexpensive and easy management, ensuring broad employability of its clinical use in current obstetrics.
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Tanwar, Meenakshi, Anjali Choudhary, and Shweta Mishra. "Analysis of labor induction in a tertiary care hospital." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 11 (October 27, 2020): 4627. http://dx.doi.org/10.18203/2320-1770.ijrcog20204823.
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Background: Induction of labour (IOL) is a very common labour room procedure. Although labor is a natural physiological process, deliberate intervention in the form of induction may be required in many instances. It is needed in almost 20% of pregnant women for a variety of indications. The objective is to evaluate indications, different methods, and feto-maternal outcome of induced labour in tertiary care hospital.Methods: This was a retrospective study of IOL conducted in the department of obstetrics and gynecology, Shri Guru Ram Rai institute of medical and health sciences, Dehradun, Uttarakhand. Women who underwent IOL beyond 28 weeks gestation with single cephalic presentation with no contraindication for vaginal birth were included in the study. Statistical analysis was done with Microsoft excel.Results: A total of 1532 women delivered in the hospital during the study period. Among them, 498 women were induced (32.5%). Most common method of induction was misoprostol (40.36%) followed by prostaglandin E2 gel (26.90%). Out of 498 inductions, 377 women delivered vaginally making success of induction around 75.70%. Among them, 335 women had normal delivery (67.26%) and 42 women required instrumental delivery (8.4%) and 121 women underwent lower segment caesarean section (LSCS) (24.29%).Conclusions: Elective inductions of labor in properly selected indications at optimized timings aid in achieving a favorable maternal and fetal outcome. Methods of inductions, timing and intrapartum monitoring plays an important role in influencing obstetric outcome.
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Nguyen, Lam D., Anh D. Nguyen, Michaela K. Farber, Chi T. Phan, Luong T. Khuat, Ha T. Nguyen, Tuan M. Dang, and Ha T. Ngoc Doan. "Sociodemographic Factors Associated with Request for Labor Epidural Analgesia in a Tertiary Obstetric Hospital in Vietnam." BioMed Research International 2021 (January 30, 2021): 1–5. http://dx.doi.org/10.1155/2021/8843390.
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This study is aimed at examining the sociodemographic factors associated with the utilization of labor epidural analgesia at a large obstetric and gynecology hospital in Vietnam. This was a cross-sectional study of women who underwent vaginal delivery in September 2018 at the Hanoi Obstetrics and Gynecology Hospital. The utilization of epidural analgesia during labor was determined. Univariate and multivariate regression models were applied to evaluate the association between patient demographic and socioeconomic factors and request for labor epidural analgesia. A total of 417 women had vaginal deliveries during the study period. 207 women utilized epidural analgesia for pain relief during labor, and 210 did not. Parturients older than 35 years of age (OR 2.84, 95% CI 1.11-8.17), multiparous women (OR 2.8 95% CI 1.85-4.25), women living from an urban area, women with higher income (OR 6.47, 95% CI 2.59-19.23), and women with higher level of education were more likely to utilize labor epidurals. Factors related to a parturient request for epidural analgesia during labor at our tertiary obstetric hospital included age greater than 35 years, multiparity, and high income and education levels. Educational outreach to women about the benefits of epidural analgesia can target women who do not share these demographic characteristics.
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Khashaba, Eman, Abdel-Hady El-Gilany, Hend Shalaby, and Rania El-Kurdy. "Personal protective equipment used by obstetricians and obstetric nurses during the COVID-19 pandemic in Mansoura, Egypt." F1000Research 11 (July 4, 2022): 413. http://dx.doi.org/10.12688/f1000research.110835.2.
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Background: This study was done to describe the pattern of personal protective equipment (PPE) use, associated factors, and adverse events among obstetricians and obstetric nurses in obstetrics & gynecology departments. Methods: A cross sectional study was conducted in Obstetrics & Gynecology departments in three hospitals (physician & nurses n=252) using an online Google form including demographic and occupational health data, type of available personal protective equipment during usual care, CS and emergency labor, infection control measures and hazards of full PPE use. Results Full PPE use was 37.7% during CS and 34.9% during emergency labor. The significant predictors of wearing full PPE during CS were daily work hours > 8 hours and receiving formal training about PPE use. During CS & emergency labor most of HCws used sterile gloves and sterile fluid resistant gowns and surgical mask.to less extent used face shields or tight fitting googles and one tenth (11.8%) only used N95. The most common health effects of full PPE use was sense of heat (79.5%). Conclusion: During the COVID-19 pandemic more vigorous respiratory (N95 mask) and eye protection is required during aerosol-generating procedures. Formal training is an evident predictor for full PPE use.
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Khashaba, Eman, Abdel-Hady El-Gilany, Hend Shalaby, and Rania El-Kurdy. "Personal protective equipment used by obstetricians and obstetric nurses during the COVID-19 pandemic in Mansoura, Egypt." F1000Research 11 (April 12, 2022): 413. http://dx.doi.org/10.12688/f1000research.110835.1.
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Background: This study was done to describe the pattern of personal protective equipment (PPE) use, associated factors, and adverse events among obstetricians and obstetric nurses in obstetrics & gynecology departments. Methods: A cross sectional study was conducted in Obstetrics & Gynecology departments in three hospitals (physician & nurses n=252) using an online Google form including demographic and occupational health data, type of available personal protective equipment during usual care, CS and emergency labor, infection control measures and hazards of full PPE use. Results Full PPE use was 37.7% during CS and 34.9% during emergency labor. The significant predictors of wearing full PPE during CS were daily work hours > 8 hours and receiving formal training about PPE use. During CS & emergency labor most of HCws used sterile gloves and sterile fluid resistant gowns and surgical mask.to less extent used face shields or tight fitting googles and one tenth (11.8%) only used N95. The most common health effects of full PPE use was sense of heat (79.5%). Conclusion: During the COVID-19 pandemic more vigorous respiratory (N95 mask) and eye protection is required during aerosol-generating procedures. Formal training is an evident predictor for full PPE use.
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Kodla, Chandrika S. "A study of prevalence, causes, risk factors and outcome of severe obstetrics haemorrhage." Journal of Scientific and Innovative Research 4, no. 2 (April 25, 2015): 83–87. http://dx.doi.org/10.31254/jsir.2015.4207.
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Severe obstetric hemorrhage is the most feared obstetric emergency that can occur to any woman at childbirth. If unattended, the hemorrhage can kill even a healthy woman. The Hemorrhage accounts for nearly one-quarter of all maternal deaths and for almost half of all postpartum deaths in low-income countries. The most common type of obstetric hemorrhage is postpartum hemorrhage (PPH), mainly primary. PPH occurring within 24 h postpartum. Primary PPH is the focus of this article. This was a cross sectional observational study conducted in a Tertiary care hospital conducted from November 2010 to June 2012 having high no of referrals from city as well as periphery. The cross tabulations were used to study the demographic, obstetrical and medical factors in women with severe obstetrical haemorrhage. Total number of patients admitted in labour room was 12,800 and 12,356 patients delivered during this period. Results showed that severe obstetrical haemorrhage (more than 1500 ml) was in 115 patients (prevalence of 0.9%). The prevalence of severe obstetric haemorrhage was 0.9 %. As 85.2% 0f the patients in study were unbooked, it contributed the high prevalence rate & antenatal care. A large proportion of the patients (62%) were multipara. Mortality in this study was 21.73% and morbidity was 78.26%. Most common cause of obstetric haemorrhage in this study was uterine atonic pph. The frequency and impact of severe hemorrhage can be effectively reduced by reducing avoidable risk factors, especially those related to obstetric interventions as increased Caesarean section rate and induction of labor. Other risk factors not amenable to change such as age, ethnic origin, and preexisting medical diseases or bleeding disorders can be minimized by extra vigilance and planned conjoined management.
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Dragoljub Plesinac, Snezana. "Prostaglandin E1, E2 and oxytocin in labor induction." Open Medicine 1, no. 4 (December 1, 2006): 416–18. http://dx.doi.org/10.2478/s11536-006-0038-3.
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AbstractThe risks of induction must be carefully weighed against the risks of allowing the pregnancy to continue and not inducing labor. The aim of the study was to show labor and neonatal outcome of 335 deliveries inducted in 2004 at Institute of gynecology and obstetrics Clinical Center of Serbia. Inductions were performed with PGE2, PGE1 and Oxytocin. The best ripening effect was noted in PGE2 group. The average duration of labor was 8.6h in PGE1group, 5.9h in PGE2 group and 10.4h in OT group. Sixty eight labors finished with cesarean section (20%). Comparing duration of labor, percentage of emergency cesarean sections, incidence of fetal distress during the labor we suggest Dinoprostone, placed intracervically, as an agent of choice for induction of labor.
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Musin, Ilnur I., Edvard A. Berg, Ruslan I. Safiullin, Marat F. Urmantsev, Dina F. Absalyamova, Yulia N. Fatkullina, and Ksenia N. Yashchuk. "Urological complications in obstetrics." Journal of obstetrics and women's diseases 70, no. 5 (November 2, 2021): 147–55. http://dx.doi.org/10.17816/jowd62212.
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Urinary tract injury is a rare but severe complication during abdominal delivery. Over the past quarter of the last century, the frequency of abdominal delivery in Russia has more than tripled due to the increase in the number of pregnant women at high risk for the development of maternal and perinatal complications. Intraoperative diagnosis of urinary tract injuries allows timely treatment with better postoperative outcomes. Given the high percentage of caesarean sections in many countries, the risk of the above complications remains high. Risk factors for urinary tract injury during cesarean section are an increase in womens average age and body mass index, high parity, the presence of adhesions, prior cesarean section, emergency cesarean section, and cesarean section in the second stage of labor. This article discusses several clinical cases on the development of urological complications in obstetrics and gynecology. Due to modern progress in the field of operative obstetrics, vesicouterine fistulas caused by obstetric causes may not occur as often as in the last century. Nevertheless, even despite this, one should not forget about elementary preventive measures in operative delivery, especially in such obstetric situations as placental ingrowth, bleeding, hematoma, and parametria.
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Algodi, Mohammed, Diana S. Wolfe, and Cynthia C. Taub. "The Utility of Maternal Point of Care Ultrasound on Labor and Delivery Wards." Journal of Cardiovascular Development and Disease 9, no. 1 (January 14, 2022): 29. http://dx.doi.org/10.3390/jcdd9010029.
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Point-of-care ultrasonography (POCUS) refers to limited bedside ultrasound used to evaluate patients for conditions specific to the scope of their practice. Given the benefits of its application, interest in its use is increasing. We aimed to review the literature and assess the potential feasibility of using POCUS of the heart and lungs in the field of obstetrics. We aim to describe its relevance and value as an adjunctive tool for critically ill obstetric patients on labor and delivery wards.
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Apresyan, S. V., and Z. V. Zyukina. "Late Premature Spontaneous Delivery: Versions and Contraversions." Doctor.Ru 23, no. 2 (2024): 44–48. http://dx.doi.org/10.31550/1727-2378-2024-23-2-44-48.
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Aim. To study modern ideas about late premature spontaneous labor, identify unresolved issues and identify tasks for further research on this theme. Key points. The problem of late premature labor occupies a leading position in modern obstetrics and perinatology. Currently, there is no single opinion and no identical approaches in predicting late premature spontaneous labor. This prevents the creation of a single algorithm of actions to prevent them. The article presents up-to-date information on the marker serum proteins and transcriptomic analysis of the placenta, as well as highlights some aspects of the pathogenesis of premature labor on the model of fetoplacental homeostasis disorders. Conclusion. To reduce the risk of adverse outcomes of late premature spontaneous labor, it is necessary to create clear criteria for their prediction and early diagnosis, as well as timely implementation of organizational and therapeutic measures for this obstetric complication. Keywords: late premature spontaneous labor, marker serum proteins, pregnancy-associated plasma protein-A, placental growth factor, soluble fms-like tyrosine kinase-1, gene expression.
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Ahirwar, Neetu, and Rekha Wadhwani. "Analysis of obstetrics hysterectomy in tertiary care centre." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 6 (May 26, 2018): 2192. http://dx.doi.org/10.18203/2320-1770.ijrcog20182318.
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Background: Emergency peripartum hysterectomy (EPH) is an uncommon obstetric procedure, usually performed as a life-saving measure in cases of intractable obstetric hemorrhage. Obstetrics hysterectomy is performed on gravid uterus during pregnancy labor puerperium. It is a catastrophic inevitable lifesaving emergency procedure in cases of rupture uterus, uncontrollable post-partum haemorrhage, morbidly adherent placenta, and some cases of trauma, sever infection of pregnant uterus. Newer drug like prostaglandins, antibiotics and blood transfusion has brought down the incidence of obstetric hysterectomy.Methods: This retrospective study is performed in department of obstetrics and gynaecology SZH Gandhi medical college Bhopal. Retrospective analysis of record done.Results: In this study there were 51867 deliveries and 99 0bstetric hysterectomy giving the incidence as 1 in 524 deliveries. There were 17113 cesarean section performed hence the incidence as 1 in 173 cesaren section. Majority of patient belong to group para 4 and above i.e. 32.32%. Least incidence is among nullipara patient i.e. 2.02%. The most common indication of obstetric hysterectomy in this study was morbidly adherent placenta, 52 cases i.e. 52.52%% Rupture uterus was second common indication accounting for 36.36% of cases. Most common additional surgical procedure done during obstetric hysterectomy was repair of bladder tear and salpingoophrectomy done in 7 cases i.e. 7.07% of each. Repair of bowel injury done in 1 case i.e. 1.01%.Conclusions: Incidence of maternal mortality in cases of obstetric hysterectomy was 9.09%. most common cause of maternal mortality was haemorrhagic shock accounting for 55.55.
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Curtis, Peter, Remy R. Coeytaux, and Patrice Hapke. "Acupuncture for Birth Preparation and Delivery: How Investigating Mechanisms of Action Can Generate Research." Complementary health practice review 11, no. 3 (January 2006): 176–92. http://dx.doi.org/10.1177/1533210106298060.
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Acupuncture has become an accepted and validated part of Western mainstream medicine and is increasingly used by clinicians, midwives, and acupuncturists for reproductive care, induction of labor, and analgesia. Most studies of the effects of obstetrical acupuncture are descriptive, many in foreign languages. Only a few have evaluated efficacy. Results suggest that acupuncture ripens the cervix, initiates labor, reduces labor pain, and shortens the first stage of labor. There is some evidence suggesting that certain acupuncture points have very specific effects on the fetus and uterus, which may be mediated through the hypopituitary-thalamic axis or by local neurovascular stimulation. The substantial maternal hormonal changes occurring just before and during labor offer a unique opportunity to clarify the mechanisms of action of acupuncture. Using a conceptual model based on possible mechanisms of action of the use of acupuncture in obstetrics, the authors propose specific research questions into the physiology of acupuncture administered before and at parturition.
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Dr. Jannatul Ferdous and Dr. Mohammad Mostafizur Rahman. "An Observation of Outcome in Association with Spontaneous Onset of Labor and Induced Labour of Primigravida at Term." SSB Global Journal of Medical Science 1, no. 1 (December 5, 2020): 18–23. http://dx.doi.org/10.61561/ssbj.v1i1.7.
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Introduction: Labour is a usual physiological process considered by progressive rise in frequency, intensity and duration of uterine contractions resulting in effacement and dilatation of the cervix with descent of the fetus over the birth canal. Initiation of labour is definedas iatrogenic stimulation of uterine reductions to cause the delivery of fetus before the onset of spontaneous labour. Aim of the study: To observe the outcome in association with spontaneous onset of labor and induced labour of primigravida at term.
Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology in Ashiyan Medical College Hospital, Barua Khilkhet, andDhaka, Bangladesh during the period from January 2018 to December 2018. Initially, all pregnant mothers at term (410/7 – 416/7Weeks) were enrolled by purposive sampling. Thereafter, they were scrutinized according to the eligibility criteria. Finally, 80 participants were grouped in each category; namely spontaneous labor group. Thereafter, they were explained regarding the study procedure and informed written consent was charted on the partograph. A structure data sheet was used to obtain socio[1]demographic profile, obstetric profile, maternal and neonatal outcome profile were recorded using apre structured, peer reviewed, interview and observation-based data collection sheet. All data were recorded, managed and analyzed using software Statistical Package for Social Science (SPSS) version 20.
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Kuhn, F. "Hydrastis Canadensis in obstetrics." Journal of obstetrics and women's diseases 6, no. 1 (August 19, 2020): 48–49. http://dx.doi.org/10.17816/jowd6148-49.
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Gido, Rediet, Tesfaye Assebe Yadeta, and Abera Kenay Tura. "Utilization of Obstetric Analgesia for Labor Pain Management and Associated Factors among Obstetric Care Providers in Public Hospitals of Addis Ababa, Ethiopia: A Cross-Sectional Study." Obstetrics and Gynecology International 2021 (November 22, 2021): 1–6. http://dx.doi.org/10.1155/2021/9973001.
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Background. In low-income countries, pain-free labor initiative is an emerging concept and still parturient undergoes through painful labor; this is not different in Ethiopia; despite the national direction to use analgesia for labor pain and strong demand from the women, evidence on utilization of obstetric analgesia for labor pain management in Ethiopia is scarce. The objective of this study was to assess level of obstetric analgesia utilization and associated factors among obstetric care providers in public hospitals in Addis Ababa, Ethiopia. Methods. An institution-based cross-sectional study was used. All obstetric care providers working in labor and delivery units in public hospitals in Addis Ababa were included. The data were collected using a self-administered structured questionnaire. After checking for completeness, data were entered into Epi-data 3.1 and analyzed using SPSS 20. Bivariate and multivariable logistic regressions were used to identify factors associated with utilization of obstetric analgesia. Result. Of 391 obstetric care providers included in the study, 143 (36.6%; 95% CI: 31.5–40.9%) reported providing labor analgesia. Having adequate knowledge (AOR 2.7; 95% CI: 1.37–5.23), ten and more years of work experience (AOR 4.3; 95% CI: 1.81–10.13), and availability of analgesics (AOR 3.3; 95% CI: 1.99–5.53) were significantly associated with providing labor analgesia. Conclusion. Slightly more than 3 in 10 obstetric care providers reported providing labor analgesics to women. Training of providers and ensuring adequate supply of analgesics is required to make sure that women in labor would not suffer from labor pain.
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Corey Brown, Donald, and D. Corydon Hammond. "Evidence-Based Clinical Hypnosis for Obstetrics, Labor and Delivery, and Preterm Labor." International Journal of Clinical and Experimental Hypnosis 55, no. 3 (May 31, 2007): 355–71. http://dx.doi.org/10.1080/00207140701338654.
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Rai, Rubina, P. Basnet, A. Thakur, and T. Pradhan. "Vaginal administration of isosorbide mononitrate for cervical ripening prior to induction of labor for postdated pregnancy: a randomized controlled trial." Journal of BP Koirala Institute of Health Sciences 1, no. 1 (May 3, 2018): 51–58. http://dx.doi.org/10.3126/jbpkihs.v1i1.19754.
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Introduction: Induction of labor is commonly practiced intervention in modern Obstetrics. The aim of induction of labor is to initiate labor when maternal and fetal conditions necessitate delivery before the onset of spontaneous contraction with purpose to achieve safe vaginal delivery. Induction of labor is one of the most commonly practiced interventions in the Department of Obstetrics and Gynecology every day. The success of this obstetric practice is highly dependent upon the condition of the cervix which is assessed with Bishop‟s Score and it is well known that unfavorable cervix is associated with failure of induction and cesarean section. In the recent years, there has been a considerable interest in the use of nitrous oxide donors for cervical ripening and labor induction.Objective: To evaluate whether isosorbide mononitrate administered vaginally prior to induction in postdated pregnancy is effective for pre-induction cervical ripening and thus, improves the process of induction of labor.Methods: One hundred and twenty women scheduled for labor induction were recruited and assigned randomly to isosorbide mononitrate or placebo followed by misoprostol 25μg. The efficacy of the medication was evaluated by predetermined outcome variables for cervical ripening and induction of labor and delivery.Results: The groups were comparable with respect to age, gestational age and Bishop‟s score. Women receiving isosorbide with misoprostol didn‟t show any improvement in the Bishop‟s score compared to misoprostol and placebo. There was no significant difference between the two groups regarding time of delivery and onset of active stage of labor from induction. Cesarean delivery rates were similar between the two groups; however, the indications of the cesarean section were different between the two groups which were significant statistically. Neonatal outcome were similar between the two groups.Conclusion: The addition of vaginal isosorbide mononitrate to oral misoprostol for cervical ripening and labor induction did not reduce time to vaginal delivery and didn‟t help in improving pre-induction cervical score.Journal of BP Koirala Institute of Health Sciences, Vol. 1, No. 1, 2018, page: 51-58
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Dutta, Indrani, and Usha Madhulika Horo. "Study to determine feto maternal outcomes of programmed labor in a tertiary care hospital of Jharkhand." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 12, no. 10 (September 28, 2023): 3017–20. http://dx.doi.org/10.18203/2320-1770.ijrcog20232940.
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Background: Programmed labor aims to minimize duration and inconvenience of labor both for patient and obstetrician. The present study attempts to provide labor analgesia by using infusion paracetamol in place of conventional ketamine and tramadol. Methods: This study was conducted in the labor room of department of obstetrics and gynecology, RIMS, Ranchi from March 2019 to February 2020. 50 primigravida and 50 multigravidas were studied, with singleton pregnancy, cephalic presentation presenting with spontaneous onset of labor with Gestational age of 37-41 week. Results: 30% of patients were greater than 40 weeks gestation.65% of primigravida experienced severe pain, but only 20% of multigravidas had severe pain.60%primigravidas and 60% multigravidas (of 20% who had severe pain) experienced adequate pain relief with labor analgesia. 60 % primigravida presented with <4 cm cervical dilatation, whereas 40% multigravidas had <4 cm dilatation. 60% primigravida had shortened active phase (3.5 hrs), 60% multigravidas (2.5 hrs) which is suggestive of benefit of obstetrical analgesia in programmed labor. 90% patients had third stage labor less than 3 minutes. Only one multigravida landed in postpartum hemorrhage. All neonates had Apgar score greater than 8. There was no perinatal mortality. Only one primigravida landed in caesarean section due to arrest in second stage. 2 multigravidas had instrumental delivery. Maternal side effects like tachycardia, nausea, cervical and vaginal tears were more in primigravida. Conclusions: Participants with good response to obstetrical analgesia fared better than rest. Response was more satisfactory in primigravida in terms of labor progress.
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Arutyunyants, A. G., and M. B. Ovchinnikova. "Telemedicine in obstetrics in areas with low population density: legal framework and practical results of integration." Medical Science And Education Of Ural 22, no. 3 (September 30, 2021): 27–32. http://dx.doi.org/10.36361/1814-8999-2021-22-3-27-32.
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The purpose of the study is to characterize the legal framework for integrating telemedicine into the obstetric service in the light of the new Order of the Ministry of Health of the Russian Federation of 2010.2020 No. 1130n, to establish aspects of the use of telemedicine in obstetrics, and to show the practical results of its implementation. Material and methods. A scientific and analytical, retrospective study of all cases of the use of telemedicine technologies in the obstetric service of the Perinatal Center of Noyabrsk (Yamalo-Nenets Autonomous Okrug) in 2020 was carried out. Results. The main aspects of the use of telemedicine in obstetrics in areas with a low population density have been established, namely: selection of pregnant women requiring a high level of attention, routing of high-risk pregnant women in health care facilities of levels II and III, extreme conditions of pregnant women and newborns, pregnancy complications and negative medical and genetic prognosis of offspring, high-tech remote medical care for pregnant women, women in labor and newborns in federal healthcare facilities of III B level. The capabilities of patient-centered telemedicine technologies in the context of the COVID-19 pandemic have been determined. The clinical experience of the Noyabrsk Perinatal Center has proved that telemedicine counseling for pregnant women located in areas remote from the PC, prescribed by Order No. 1130n, significantly improves the quality of the regional obstetric care system. Conclusion. The Order of the Ministry of Health of the Russian Federation No. 1130 n ensures the effective integration of telemedicine technologies into the obstetric service, laying the foundation for the formation of a regional regulatory framework for obstetric telemedicine. Thanks to the new Order, the planned development of telemedicine obstetric networks and the organization of remote consulting centers in level III A health facilities have become mandatory. The Order gave impetus to the formation of electronic databases of high-risk pregnant women in each region. It provides for remote provision of both routine and emergency obstetric care. All this allows the obstetric service of the regions with the use of telemedicine to provide high-quality medical care to pregnant women, women in labor and parturient women, even in extreme conditions of epidemics and emergencies.
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Hawkins, Joy L., Charles P. Gibbs, Miriam Orleans, Gallice Martin-Salvaj, and Brenda Beaty. "Obstetric Anesthesia Work Force Survey, 1981 versus 1992." Anesthesiology 87, no. 1 (July 1, 1997): 135–43. http://dx.doi.org/10.1097/00000542-199707000-00018.
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Background In 1981, with support from the American Society of Anesthesiologists and the American College of Obstetricians and Gynecologists, anesthesia and obstetric providers were surveyed to identify the personnel and methods used to provide obstetric anesthesia in the United States. The survey was expanded and repeated in 1992 with support from the same organizations. Methods Comments and questions from the American Society of Anesthesiologists Committee on Obstetrical Anesthesia and the American College of Obstetricians and Gynecologists Committee on Obstetric Practice were added to the original survey instrument to include newer issues while allowing comparison with data from 1981. Using the American Hospital Association registry of hospitals, hospitals were differentiated by number of births per year (stratum I, > or = 1,500 births; stratum II, 500-1,499 births; stratum III, < 500 births) and by U.S. census region. A stratified random sample of hospitals was selected. Two copies of the survey were sent to the administrator of each hospital, one for the chief of obstetrics and one for the chief of anesthesiology. Results Compared with 1981 data, there was an overall reduction in the number of hospitals providing obstetric care (from 4,163 to 3,545), with the decrease occurring in the smallest units (56% of stratum III hospitals in 1981 compared with 45% in 1992). More women received some type of labor analgesia and there was a 100% increase in the use of epidural analgesia. However, regional analgesia was unavailable in 20% of the smallest hospitals. Spinal analgesia for labor was used in 4% of parturients. In 1981, obstetricians provided 30% of epidural analgesia for labor; they provided only 2% in 1992. Regional anesthesia was used for 78-85% (depending on strata) of patients undergoing cesarean section, resulting in a marked decrease in the use of general anesthesia. Anesthesia for cesarean section was provided by nurse anesthetists without the medical direction of an anesthesiologist in only 4% of stratum I hospitals but in 59% of stratum III hospitals. Anesthesia personnel provided neonatal resuscitation in 10% of cesarean deliveries compared with 23% in 1981. Conclusions Compared with 1981, analgesia is more often used by parturients during labor, and general anesthesia is used less often in patients having cesarean section deliveries. In the smallest hospitals, regional analgesia for labor is still unavailable to many parturients, and more than one half of anesthetics for cesarean section are provided by nurse anesthetists without medical direction by an anesthesiologist. Obstetricians are less likely to personally provide epidural analgesia for their patients. Anesthesia personnel are less involved in newborn resuscitation.
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Tsvelev, Yuri V., А. A. Pakhomov, and D. I. Gaivoronskikh. "Cesarean in Saint Petersburg." Journal of obstetrics and women's diseases 52, no. 1 (January 20, 2003): 89–94. http://dx.doi.org/10.17816/jowd88806.
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Caesarean section in modern operative obstetrics belongs to the leading place. Delivery by cesarean section replaced long-term traumatic childbirth with repeated stimulation of labor and such operations as extraction of the fetus at the pelvic end, obstetric forceps, vacuum extraction of the fetus. In the Russian Federation, the frequency of caesarean section has increased 3 times in recent decades and in 1995 it was 11%. In St. Petersburg, according to the Health Committee in 1995-96. it was 12. 8%, and in 2001 it reached 15. 1%.
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Guasch, Emilia, Nicolas Brogly, and Fernando Gilsanz. "COVID in obstetrics: labor analgesia and cesarean section." Current Opinion in Anaesthesiology 34, no. 1 (December 10, 2020): 62–68. http://dx.doi.org/10.1097/aco.0000000000000949.
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Beigh, Salma Kousar, Samar Mukhtar, Nighat Firdous, and Fariha Amaan. "Comparison of caesarean section rate and maternal complications in elective induction versus spontaneous labor." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 11 (October 27, 2021): 4249. http://dx.doi.org/10.18203/2320-1770.ijrcog20214340.
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Background: Elective induction of labor is defined as an initiation of labor, either by mechanical or pharmacological means at a time earlier than nature regardless of a medical or obstetric indication. Objectives were to estimate the proportion of caesarean sections and vaginal deliveries and magnitude of maternal complications following elective induction and spontaneous labor.Methods: The study entitled “comparison of caesarean section rate and maternal complications in elective induction versus spontaneous labor in LD Hospital, Kashmir” was a hospital based observational study, conducted in the Postgraduate Department of Obstetrics and Gynaecology, LallaDed Hospital of Government Medical College, Srinagar over a period of one and a half years.Results: Women in induced labor group had slightly increased risk of caesarean section than those in spontaneous group. Fetal distress was the most common indication for caesarean section in both the groups. There was no difference in both groups regarding maternal complications such as perineal lacerations; postpartum hemorrhage (PPH); need for blood transfusions and post partum hospital stay.Conclusions: Though induction of labor is associated with a slight increased risk of caesarean delivery, it is not related to other maternal complications. Therefore inductions are safe in hands of safe obstetricians.
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Bajkin, Ivana, Sladjana Pejakovic, Mia Manojlovic, Ivana Vorgucin, and Dragana Tomic-Naglic. "Forgotten cause of severe hyponatremia." Srpski arhiv za celokupno lekarstvo, no. 00 (2021): 67. http://dx.doi.org/10.2298/sarh210507067b.
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Introduction. Sheehan syndrome (ShS) is (pan)hypopituitarism because of postpartum pituitary infarction due to massive obstetrical hemorrhage. Enlargement of the pituitary gland, smaller sellar region, disseminated intravascular coagulation (DIC) or autoimmunity are predisposing factors. The absence of lactation after labor and inability to resume the menstrual cycle later are presenting symptoms. Some of patients with Sheehan's syndrome have a sudden onset of severe hypopituitarism immediately after labor, most often in the form of severe hyponatremia. Central adrenal insufficiency is the most usual cause of hyponatremia, although in some cases the syndrome of inappropriate antidiuretic hormone secretion has been also described. Case outline. The female patient, 39-year-old, was admitted to the Intensive Care Unit due to severe hyponatremia with neurological symptoms (Na 103 mmol/L, Cl 72 mmol/L, K 3.7 mmol/L), and absence of lactation. Previously, on the sixth postpartum day, she was admitted to the Obstetrics and Gynecology Clinic due to severe headache, nausea, vomiting, and blurred vision. The symptoms persist from the labor, which was complicated with severe hemorrhage (1000 ml) due to obstetric complications. Treatment began with the 3% hypertonic saline solution with restriction of fluid intake. In regard to panhypopituitarism, replacement therapy with hydrocortisone and levothyroxine was initiated. Diabetes insipidus was excluded. Growth hormone replacement therapy and combination of progesterone and progestogens was started during follow-up. Conclusion. Early diagnosis of Sheehan's syndrome is essential. Pituitary insufficiency in these patients has a great diversity in presentation, that can sometimes result in coma and death.
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Iliescu, Dominic, Aris Antsaklis, Panagiotis Antsaklis, Daniela Paulescu, Alexandru Comanescu, Stefania Tudorache, Iuliana Ceausu, Liliana Novac, and Nicolae Cernea. "Applications of Ultrasound in Prelabor and Labor." Donald School Journal of Ultrasound in Obstetrics and Gynecology 6, no. 3 (2012): 257–69. http://dx.doi.org/10.5005/jp-journals-10009-1249.
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ABSTRACT Ultrasound is a crucial part of everyday obstetrical practice and becomes more and more important in the management of traditionally clinical aspects of obstetrics, such as management of labor and delivery, offering a possibly more objective method of examination. The rate of labor induction has doubled in the last two decades and more objective methods are needed to assess the possible outcome of an induction and help clinicians in order to counsel women appropriately. Regarding the management of labor there is extensive evidence that clinical assessment during labor is not accurate, with potential consecutive major implications in the decision-making and the prognosis of the delivery mode. Several studies have shown that ultrasound is an objective method of assessing labor and its progress and is very helpful in decision-making for instrumental deliveries. The purpose of this article is to review the evidence available in literature regarding the benefits and the role in general of ultrasonography in prelabor and labor. How to cite this article Iliescu D, Antsaklis P, Paulescu D, Comanescu A, Tudorache S, Antsaklis A, Ceausu I, Novac L, Cernea N, Kurjak A. Applications of Ultrasound in Prelabor and Labor. Donald School J Ultrasound Obstet Gynecol 2012;6(3):257-269.
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Weinstein, Daniel, Yossef Ezra, and Uriel Elchalal. "Management of labor and labor complications." Current Opinion in Obstetrics and Gynecology 7, no. 6 (December 1995): 437–41. http://dx.doi.org/10.1097/00001703-199512000-00006.
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De Angelis, Carlo, Chiara De Angelis, Fabrizia Santangelo, Gabriele Saccone, Daniela Ioffredo, Jessica Anna Cinzia Paino, and Attilio Di Spiezio Sardo. "Immersion in water during labor and delivery." Perinatal Journal 28, no. 3 (December 1, 2020): 202–5. http://dx.doi.org/10.2399/prn.20.0283012.
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Objective: Immersion in water during labor and delivery has been studied as an alternative form of obstetric care. The aim of this study was to evaluate obstetrics and neonatal outcomes of women intending to use immersion in water for labor and delivery. Methods: This was a retrospective observational study conducted at a single center in Italy from January 2004 to January 2016. The clinical records of pregnant women intending to use immersion in water for labor and delivery were collected in a dedicated database and included in the study. Only the women who underwent immersion in water starting from the first stage of labor were included in the study. Inclusion criteria were women with uncomplicated singleton gestations and cephalic presentation at or later than 37 weeks of gestation, and with spontaneous onset of labor. The primary outcome of the study was the percentage of women who had both labor and delivery in water. Results: 389 women met the inclusion criteria and were included in the study. 256 (66%) were nulliparous, and 133 (34%) were multiparous. Out of the 389 women intending to use immersion in water for labor and delivery, 278 (71.5%) had labor and delivery in the water, 31 (8.0%) labor in water and delivery on land, and 80 (20.5%) had the first stage of labor in water, and the second stage and delivery on land. The incidence of perineal lacerations was 61.4%. Conclusion: The vast majority of the women who set out to labor and delivery in water achieve their aim.
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Kira, E. F., I. V. Berlev, and O. L. Molchanov. "Pregnancies, labors and postpartum labor period peculiarities in women with disbiotic vaginal infringements." Journal of obstetrics and women's diseases 48, no. 2 (May 15, 1999): 8–11. http://dx.doi.org/10.17816/jowd88059.
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The problem of infectious-inflammatory complications during pregnancy, in labor and in postpartum period is a priority direction in obstetrical practice. For the decision of the given task the complex examination of 111 women was carried out during pregnancy, in labor and in postpartum period. The study of vaginal microecology included a complex estimation of cultural diagnostics results and vaginal smears microscopy, Gram-painted. The carried out research shows, that duly diagnostics and disbiotic vaginal processes correction in pregnant group of risk will allow to lower a number of complications during pregnancy, in labor and postpartum period.
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Sherbina, L. A., T. U. Kusminikh, and V. V. Abramchenko. "Prostaglandines application for labor induction and regulation." Journal of obstetrics and women's diseases 48, no. 2 (May 15, 1999): 35–38. http://dx.doi.org/10.17816/jowd88081.
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The clinical effectiveness of the implimintation of the Prostaglandin's E2 and F2a for labor preparation, for induction and regulation of the childbirth process was studied. Prepidil gel was applied for cervix preparation for labor by various testimony in 142 patients. The maturing of the cervix was note in 50,3% patients, and the effect of stimulation of labor was reach in 46,5% patients. Prostin E2 and F2a were used in case of PPROM and for treatment of the dystocia in 53 patients. The clinical analysis of the labors was performed. It was discovered, that Prostaglandin's have high effectiveness for cervix preparation in labor, for stimulation of childbirth process and labor induction, for the prevention of long pregnancy.
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Syed, Mahnaz, Mohammed Ziaur Rahman, and Syed Tasnuv Sami. "Uterine Artery Doppler Ultrasound Measurement of Preterm Labor in Pregnant Women with Threatened Preterm Labor." Scholars International Journal of Obstetrics and Gynecology 6, no. 03 (March 11, 2023): 104–9. http://dx.doi.org/10.36348/sijog.2023.v06i03.004.
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Introduction: One of the most common causes of hospitalisation during pregnancy is preterm labour. Nearly one-fifth of women hospitalised for preterm labour. The frequency of preterm births is about 12%–13% in the USA and 5%–9% in many other developed countries. One of the main causes of preterm delivery is preterm premature rupture of membranes, while pre-eclampsia and foetal growth restriction (FGR) can be identified as other common causes that could lead to such complications. Objective: to assess the value of uterine artery doppler ultrasound measured of preterm labor in pregnant women with threatened preterm labor. Methods: We performed a single-center cohort study was carried out at Obstetrics and Gynecology, Sylhet MAG Osmani Medical College Hospital & Jalalabad Clinic, Modhushohid, Sylhet, Bangladesh from January to December 2020. Total 141 women were selected for the present study after applying inclusion and exclusion criteria. All participating women signed informed written consent. The study included singleton pregnant women who present to the casualty at gestations between 28 and 34 weeks of gestation with symptoms and signs of threatened preterm labor (defined as presence of at least one uterine contraction per 10 minutes, lasting at least 30 seconds, with a cervical dilatation ≤ 3 cm, and a cervical effacement < 80%). On admission, during obstetric ultrasound scanning, bilateral uterine artery Doppler ultrasound velocimetry was performed using the transabdominal technique. Uterine artery Doppler scans were both conducted at the peak of uterine contraction and in between contractions when the uterus is fully relaxed. Results: Total 141 women presenting with threatened preterm labor were included in the study. The mean gestational age at presentation was 30.86 ± 1.71 weeks (range: 28 – 33.86 weeks). Among 45 (31.9%) delivered within 7 days, while 96 (68.1%) delivered after 7 days of presentation. The mean uterine artery pulsatility index (UA-PI) measured both basally and at the peak contraction were significantly higher among women who delivered within 7 days. ROC curves showed that both basal and contraction UA-PI were significant predictors of delivery within 7 days. There was a significant negative correlation between contraction UA-PI and birth weight. Conclusion: Uterine artery Doppler ultrasound velocimetry measured in women with threatened preterm labor, seems to be a significant predictor of actual preterm labor within 7 days of admission.
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Soomro, Shabana Bano, Fahmida Mahar, Tanweer Akhtar, Sania ., Fozia Unar, and Fouzia Begum. "Elective Induction of Labor and Postpartum Hemorrhage in Females Presenting for Normal Vaginal Delivery at Term." Pakistan Journal of Medical and Health Sciences 16, no. 8 (August 30, 2022): 303–5. http://dx.doi.org/10.53350/pjmhs22168303.
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Background: Labor induction is the process or treatment that stimulates childbirth and delivery. Induction of labor without a medical indication is termed elective induction of labor and appears to be increasing even more rapidly than induction of labor as a whole. Postpartum hemorrhage (PPH) leads to prominent causes of maternal death. Uterine massage is a simple first line treatment as it helps the uterus to contract to reduce bleeding. Objectives: To determine the frequency of elective induction of labor in females undergoing normal vaginal delivery at term and to compare the frequency of postpartum hemorrhage with spontaneous versus elective induced labor in females presenting for normal vaginal delivery at term. Study Design: Descriptive case series study Place and Duration of Study: Department of Obstetrics & Gynecology, Shaikh Zayed Women Hospital, Larkana from 1st October 2021 to 31st March 2022. Methodology: Two hundred females were enrolled. They were divided in two groups; elective induction or spontaneous delivery. Females who had active labour without oxytocin with no membrane rupture before labour, labeled as having spontaneous labour otherwise. Results: The induced delivery was noted in 35(17.50%) females and spontaneous type of delivery was noted in 165(82.50%) females, the postpartum hemorrhage was noted among 23(11.50%) females. The postpartum hemorrhage is not associated with type of delivery (p=0.249). Conclusion: The elective induction of labor in females undergoing normal vaginal delivery at term was 17.50% patients and postpartum hemorrhage was 11.50% patients. Keywords: Postpartum hemorrhage, Postpartum hemorrhage (PPH), Spontaneous, Induced, Labour, Delivery
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Tondon, Neha Pruthi, Renuka Malik, Kanika Kumari, and Anjali Singh. "Occupational COVID-19 exposure among health care workers in obstetric unit in a Central Government Hospital in India: initial experience." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 8 (July 26, 2021): 3029. http://dx.doi.org/10.18203/2320-1770.ijrcog20212949.
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Background: Health care workers (HCW) are the frontline warriors who are at a high risk of acquiring the COVID-19. HCW in obstetrical department are at high-risk due to their close proximity with the patient for examination, giving treatment and in delivery. The objectives of this study were to evaluate the positivity rate of COVID-19 in the initial 3 months of pandemic in health care personnel working in obstetric unit in a tertiary care hospital.Methods: Prospective cohort study was conducted in department of obstetrics and gynecology at tertiary care hospital in Delhi from 10 April to 10 June 2020. Predesigned questionnaire was used to record data of HCWs exposed to COVID-19 patients.Results: In a period of 3 months (April-June 2020), 152 health care workers were exposed to 30 COVID-19 patients. Out of this, 10 HCW were found to be positive on testing, showing a positivity rate of 6.58%. Positivity ratio was 6:3:1 among nurses, auxiliary workers and doctors respectively. Labor room was area of high infection as 80% of HCW were infected in the labor room .80% HCW acquired infection during patient care in hospital and 20% were infected in contact with asymptomatic COVID-19 positive HCW.Conclusions: Positivity rate in obstetric department is comparable to that of general population. Appropriate infection prevention measures like use of PPE, handwashing and maintain safe distance from the patient is the key to prevention of infection. Gloves and N95 masks have been shown to provide superior protection as compared to triple layer masks. Nursing staff and auxiliary workers should be reinforced the importance of use of PPE, hand hygiene and physical distancing.
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Mukadam, Afrah Khalid, and Spenta Jawahar Sumondy. "Study of antecedents and risk factors of preterm labour at a tertiary care hospital." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 12, no. 2 (January 25, 2023): 408–12. http://dx.doi.org/10.18203/2320-1770.ijrcog20230125.
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Background: Preterm labor is an obstetrics emergency and a threat to population health. The 75% of infant mortality is related to preterm labor. Preterm labor not only inflicts financial and emotional distress on the family, it may also lead to permanent disability (physical or neurological damages) in infants. Aim and objectives were to assess the antecedents and risk factors for preterm labour and their preventive aspects and timely diagnosis of preterm labour, close monitoring and management of labour and providing neonatal care. Methods: Study design was of prospective study. Study setting was of department of obstetrics and gynecology at tertiary care centre. Study duration from 18 months, study population included were patients getting admitted in preterm labour in hospital during study period. Sample size was of 50. Results: Mean age of the mothers was 29.7±5.1 years, ranging from 20 to 43 years. It was observed that 84% of the patients were in the age group of 21 to 35 years. 16% of the mothers had GA less than 28 weeks, 28% had GA of 28 to 32 weeks and rest 56% of the mothers had GA of 32 to 37 weeks. Half of all mothers were primigravida, 28% were gravida 2 and rest 22% were gravida 3 or higher. 6% cases with fibroid, 4% had bicornuate uterus and one case had septate uterus. Surgical history of Dilation and curettage in 18%, previous LSCS in 14% and hysterolaparoscopy in 6%. Conclusions: It is recommended that specialized antenatal care for the patients, who are thought to be at risk of preterm birth, should be performed that can bring down the incidence to some extent.