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Articoli di riviste sul tema "The second stage of labor simulation"

Autore: Grafiati

Pubblicato: 14 dicembre 2024

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1

Chronis, Konstantinos, Alexandros Xanthopoulos e Dimitrios E. Koulouriotis. "Simulation Modeling and Analysis of a Door Industry". International Journal of Operations Research and Information Systems 12, n. 1 (gennaio 2021): 43–57. http://dx.doi.org/10.4018/ijoris.2021010104.

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Ιn this paper, the authors study the production line of a door industry. The first stage of this research consists of the detailed documentation with flow charts and systematization of all production processes, all product types, as well as all stages of production and equipment. The standard production times were calculated for each workstation, together with the relevant workforce requirements. In the second stage of this research, a discrete event simulation model of the factory was developed to assist in the production planning decision-making. The simulation model was verified using actual production data relating to 19 customer orders for a total of 1,281 doors. Four simulation experiments were executed, where the effect of alternative shifts on the manufacturing line's efficiency was investigated. The performance metrics of total production, mean daily production, and mean labor cost per product were considered. This experimental trial resulted in the identification of the shift configuration that achieves increased productivity while maintaining relatively low labor costs.

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Viktorov, V. V., R. F. Magafurov, R. R. Gafurova e L. R. Kudayarova. "Assessment of the Development of Skills in the Provision of Emergency Medical Care by Students of the Pediatric Faculty at the Stages of Preparation for the Primary Accreditation of a Specialist". Virtual Technologies in Medicine 1, n. 3 (17 settembre 2021): 139–40. http://dx.doi.org/10.46594/2687-0037_2021_3_1337.

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An analysis of the data of 100 assessment checklists of the University students at the stages of preparation for primary accreditation in the specialty "Pediatrics" — the station "Emergency Medical Aid", which was carried out in practical classes within the discipline "Cycle of simulation training", is presented. The data on mistakes made by the students when working at the station are given, which must be paid attention to in order to successfully pass the second stage of accreditation and master professional competencies that correspond to the labor functions of a district pediatrician.

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Xuan, Rongrong, Mingshuwen Yang, Yajie Gao, Shuaijun Ren, Jialin Li, Zhenglun Yang, Yang Song et al. "A Simulation Analysis of Maternal Pelvic Floor Muscle". International Journal of Environmental Research and Public Health 18, n. 20 (15 ottobre 2021): 10821. http://dx.doi.org/10.3390/ijerph182010821.

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Pelvic floor disorder (PFD) is a common disease affecting the quality of life of middle-aged and elderly women. Pelvic floor muscle (PFM) damage is related to delivery mode, fetal size, and parity. Spontaneous vaginal delivery causes especially great damage to PFM. The purpose of this study was to summarize the characteristics of PFM action during the second stage of labor by collecting female pelvic MRI (magnetic resonance imaging) data and, further, to try to investigate the potential pathogenetic mechanism of PFD. A three-dimensional model was established to study the influence factors and characteristics of PFM strength. In the second stage of labor, the mechanical responses, possible damage, and the key parts of postpartum lesions of PFM due to the different fetal biparietal diameter (BPD) sizes were analyzed by finite element simulations. The research results showed that the peak stress and strain of PFM appeared at one-half of the delivery period and at the attachment point of the pubococcygeus to the skeleton. In addition, during the simulation process, the pubococcygeus was stretched by about 1.2 times and the levator ani muscle was stretched by more than two-fold. There was also greater stress and strain in the middle area of the levator ani muscle and pubococcygeus. According to the statistics, either being too young or in old maternal age will increase the probability of postpartum PFM injury. During delivery, the entire PFM underwent the huge deformation, in which the levator ani muscle and the pubococcygeus were seriously stretched and the attachment point between the pubococcygeus and the skeleton were the places with the highest probability of postpartum lesions.

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Kaganova, M. A., N. V. Spiridonova, I. A. Bordovskiy e V. Yu Soloviev. "Complications in the Second Stage of Labor With Breech Presentation, Working Out the Algorithm of Actions Within the Framework of Simulation Training". Virtual Technologies in Medicine 1, n. 3 (17 settembre 2021): 118–19. http://dx.doi.org/10.46594/2687-0037_2021_2_1314.

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Chen, Jia, Yujuan Yuan e Yadong Wang. "Manipulative Reduction for Abnormal Uterine Inclination in Vaginal Delivery". Computational and Mathematical Methods in Medicine 2022 (30 gennaio 2022): 1–5. http://dx.doi.org/10.1155/2022/4765447.

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Objective. To investigate the manipulative reduction in abnormal uterine inclination in vaginal delivery. Methods. With the independently developed uterine inclination surveyor, 40 primiparas with abnormal uterine inclination were randomly divided into two groups: treatment group (Group A, 20 cases) and control group (Group B, 20 cases). The general condition of the primipara, the labor stages, the changes in uterine inclination after treatment, postpartum hemorrhage at 2 hours, and the general condition of fetuses were observed to study the therapeutic value of manual reduction in abnormal uterine inclination. Result. In the control group, one uterine inclination was not corrected with the change in labor process, and the pregnancy was terminated due to stagnation of the active phase. In the first stage of labor, the time spent in the treatment group ( 393.4 ± 31.3 mins) was significantly lower than that in the control group ( 440.7 ± 34.9 mins) ( P = 0.001 ). Compared with the control group ( 49.8 ± 6.5 mins), the treatment group ( 42.6 ± 7.2 mins) also exhibited a significantly shortened second stage of labor ( P = 0.02 ). Sixteen cases (16/20) in the treatment group returned to normal after manual reduction, and 9 cases (9/20) in the control group returned to normal with the progression of natural labor. Manual reduction could be used as an option to treat abnormal uterine inclination ( P = 0.01 ). There was no significant difference in the third stage of labor ( P = 0.2 ), 2-hour postpartum hemorrhage ( P = 0.35 ), Apgar score ( P = 0.64 ), or body weight ( P = 0.76 ) between the two groups. Conclusion. Manual reduction in the treatment of abnormal uterine inclination has obvious effects, shortens the birth process, and is safe for the fetus.

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Lien, K. C., J. A. Ashton-Miller e J. O. L. Delancey. "Poster 9: Effect of Voluntary Push Timing on the Duration of the Second Stage of Labor: Results from a Computer Simulation". Journal of Pelvic Medicine and Surgery 11, Supplement 1 (2005): S29—S30. http://dx.doi.org/10.1097/01.spv.0000178865.41836.b9.

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Abdul Fatah, Ireana Yusra, Nor Izzah Hazirah Abdul Hadi e Razwan Rohimi. "Design Modification and Structure Simulation Analysis of Tapioca Peeling Machine". Malaysian Journal of Applied Sciences 7, n. 2 (31 ottobre 2022): 83–92. http://dx.doi.org/10.37231/myjas.2022.7.2.339.

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This project works on the design of a tapioca peeling machine for peeling freshly harvested tapioca tubers with the capacity of peeling tubers of different weight and diameter sizes. The need to mitigate the low output, drudgery, high labor costs and losses associated with manual peeling called for the design of the machine to improve the agricultural yield of the crop. The objectives of the research were to study the existing tapioca peeling technologies, to select and size the machine components, to develop the layout of the machine and to carry out the cost analysis of the tapioca peeling machine. To solve the problem, the innovation was formulated to peel tapioca skin with two stage of peeling (the first layer and the second layer) to increase productivity. From simulation of eco-auto-tap , the design of machine can work succesfully, and be a great improvement in the tapioca machine

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Ballit, Abbass, Morgane Ferrandini e Tien-Tuan Dao. "Novel hybrid rigid-deformable fetal modeling for simulating the vaginal delivery within the second stage of labor". Computer Methods and Programs in Biomedicine 250 (giugno 2024): 108168. http://dx.doi.org/10.1016/j.cmpb.2024.108168.

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Dykas, Paweł, e Tomasz Misiak. "The Neoclassical Growth Model with Sinusoidal Investments". Przegląd Statystyczny 63, n. 1 (31 marzo 2016): 49–66. http://dx.doi.org/10.5604/01.3001.0014.1148.

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The aim of the present study is an attempt to extend the neoclassical model of economic growth of Solow by repealing the assumption of fixed investment and introducing an investment function dependent sinusoidally on the time. The adoption of the sinusoidal function of investment is substantiated by the fact that investments (like manufacturing) are largely depended on the economic situation, which is subject to periodic fluctuations. The authors introduce the theoretical considerations on the notion of cyclical and smooth path of temporal capital-labour ratio and labour productivity. When using these tools the authors identified, by calculating the relative deviations of the mentioned path, the impact of investment function dependent sinusoidally on the time.In the empirical analysis the authors conducted the calibration of parameters used by the research model. Based on panel data for the EU15 between the years 2000–2013 the α parameter (production flexibility in relation to capital) was estimated first at 0,349. That value was adopted to further numerical analysis. In the second stage the simulations of numerical, calibrated deviations of temporal cyclical path of capital-labour ratio (labor productivity) from the smooth path of capital-labour ratio (labor productivity) was performed. When conducting numerical analysis the impact of different investment rates (15%, 20%, 25%) and periods of cyclical fluctuations (4 or 10 years) have been considered in relation to the formation of these deviations. Numerical analysis for the economies of the EU15 group was made for one hundred time series.

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Barros, J. G., A. G. Costa, M. Carvalho Afonso, N. Clode e L. M. Graça. "OP15.07: The effect of simulation training in clinical determination of fetal head position during the second stage of labour". Ultrasound in Obstetrics & Gynecology 48, S1 (settembre 2016): 99. http://dx.doi.org/10.1002/uog.16300.

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Horbova, O. V., e N. S. Murkovych. "Research OF Complex Processes Based on Step-By-Step Modeling". Science and Transport Progress, n. 5(95) (18 ottobre 2021): 51–59. http://dx.doi.org/10.15802/stp2021/252704.

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Purpose. When solving practical problems that require the creation and further analysis of the model, an important criterion is the labour intensity of modeling. In this regard, the article is aimed at formalizing the modeling process and using the method of step-by-step modeling for the design of technological processes. This approach allows you to design processes and tasks according to the following stages: physical modeling, mathematical modeling, discrete computer modeling and simulation. Methodology. To solve the problem, a methodology of step-by-step modeling is used. The simulation involves 3 stages and uses the decomposition algorithm, i. e. considers the problem from global to detailed. At the first stage of this implementation, the necessary information is collected for the experiment. This information is presented in the form of statistics. In the second stage, further processing takes place, which is performed by checking the compliance of the input data and the process with the question of how this process should be performed. The last stage is the simulation of passages of this fragment, which is represented by a chain of transitions, obtaining statistics of time efficiency of this process, weaknesses of the process and the ability to compare the results obtained during modeling and in the real process, as well as the ability to predict future results and actions. Findings. The technique can be used to study complex technological processes in the enterprise. It allows modeling of complex processes to obtain information about the time efficiency of the technological operation, finding weaknesses in it and patterns in the occurrence of random events that may affect the operation. Using this approach can be very effective in the systems that require constant real-time monitoring, as this tool can be modified by adding sensor kits that will constantly send information to the system or equip an additional system that will provide ready-made information packets. Originality. The method of step-by-step modeling of representation has been improved, which consists in the simultaneous use of physical, mathematical and simulation modeling of complex processes with a set of stages of their implementation. Practical value. The proposed technique is designed for step-by-step modeling of the technological process with the subsequent construction of simulation programming.

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Wang, Yangling, Liangjiao Wu, Xiaomei Wu e Changna Zhou. "The Association between Physical Exercise during Pregnancy and Maternal and Neonatal Health Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials". Computational and Mathematical Methods in Medicine 2022 (21 agosto 2022): 1–11. http://dx.doi.org/10.1155/2022/3462392.

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Objective. To explore the effect of exercise during pregnancy on the maternal and neonatal health outcomes. Methods. Eligible papers were systematically retrieved from PubMed, Embase, OVID, and ScienceDirect. Two researchers independently extracted the primary endpoints from the included literature. Random-effect model or fixed-effect model were utilized to generate and compute relative risk and mean difference, as appropriate. Publication bias was quantified and assessed using the funnel plot with Egger’s test. Results. This study included 13 literatures with a total of 3047 pregnant women with gestational weeks more than 10 weeks. The incidence of vaginal delivery was significantly higher in the intervention group than that in the control group (28.7% vs 23.3%, P < 0.001 ). The differences of duration of the first stage and second stage of labor between the interventional group and control group were both statistically insignificant (mean difference: 27.92, 95% CI: − 70.60, 14.7, P = 0.20 ; mean difference: 0.63, 95% CI: − 4.47, 5.74, P = 0.81 ). In addition, there were no significant differences with regard to gestational age at delivery ( mean difference = − 0.23 , 95% CI: − 1.29, 0.83, P = 0.67 ), Apgar score ( mean difference = 0.06 , 95% CI: − 0.13, 0.26, P = 0.53 ), and birth weight ( mean difference = − 23.78 , 95% CI: − 60.66, 13.11, P = 0.21 ) between the 2 groups. Women in the intervention group were more likely to experience vaginal delivery than the control group ( RR = 1.27 , 95% CI: 1.04, 1.55, P = 0.01 ). Conclusions. Physical exercise during pregnancy could improve the incidence of natural labor.

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Felis S. "Obstetric Perineal Trauma and Episiotomy". American Journal of Medical and Clinical Research & Reviews 02, n. 12 (2023): 01–13. http://dx.doi.org/10.58372/2835-6276.1122.

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Obstetric lacerations are a common complication of vaginal delivery. Lacerations can lead to chronic pain and urinary and fecal incontinence. Perineal lacerations are defined by the depth of musculature involved, with fourth-degree lacerations disrupting the anal sphincter and the underlying rectal mucosa and first-degree lacerations having no perineal muscle involvement. Late third-trimester perineal massage can reduce lacerations in primiparous women; perineal support and massage and warm compresses during the second stage of labor can reduce anal sphincter injury. Conservative care of minor hemostatic first- and second-degree lacerations without anatomic distortion reduces pain, analgesia use, and dyspareunia. Minor hemostatic lesions with anatomic disruption can be repaired with surgical glue. Second-degree lacerations are best repaired with a single continuous suture. Lacerations involving the anal sphincter complex require additional expertise, exposure, and lighting; transfer to an operating room should be considered. Limited evidence suggests similar results from overlapping and end-to-end external sphincter repairs. Postdelivery care should focus on controlling pain, preventing constipation, and monitoring for urinary retention. Acetaminophen and nonsteroidal anti-inflammatory drugs should be administered as needed. Opiates should be avoided to decrease risk of constipation; need for opiates suggests infection or problem with the repair. Osmotic laxative use leads to earlier bowel movements and less pain during the first bowel movement. Simulation models are recommended for surgical technique instruction and maintenance, especially for third- and fourth-degree repairs.

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Molaei, Faezeh, e Shirin Ghatrehsamani. "Kinematic-Based Multi-Objective Design Optimization of a Grapevine Pruning Robotic Manipulator". AgriEngineering 4, n. 3 (4 luglio 2022): 606–25. http://dx.doi.org/10.3390/agriengineering4030040.

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Annual cane pruning of grape vineyards is a time-consuming and labor-intensive job, but no mechanized or automatic way has been developed to do it yet. Robotic pruning can be a perfect alternative to human labor. This article proposes a systematic seven-stage procedure to design a kinematically optimized manipulator, named ‘Prubot’, to manage vineyards’ cane pruning. The manipulator structure was chosen, resulting in a 7R (Revolute) manipulator with a spherical shoulder and wrist. To obtain the design constraints, the manipulator task space was modeled. The robot’s second and third link lengths were determined by optimizing the global translational version of the measure of manipulability and the measure of isotropy of the manipulator arm section. Finally, simulations confirmed the appropriateness of the manipulator workspace. Furthermore, sampling-based path planning simulations were carried out to evaluate the manipulator’s kinematic performance. Results illustrated the impressive kinematic performance of the robot in terms of path planning success rate (≅100%). The simulations also suggest that among the eight single-query sampling-based path planning algorithms used in the simulations, Lazy RRT and KPIECE are the best (≤5 s & ~100%) and worst ≥5 s &≤25% path planning algorithms for such a robot in terms of computation time and success rate, respectively. The procedure proposed in this paper offers a foundation for the kinematic and task-based design of a cane pruning manipulator. It could be promisingly used for designing similar agricultural manipulators.

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Kokunko, J. G., e S. A. Krasnova. "Generation of Smooth Reference Trajectories for Unmanned Wheeled Platforms Considering Automatic Constraints On Velocity, Acceleration and Jerk". Mekhatronika, Avtomatizatsiya, Upravlenie 25, n. 6 (6 giugno 2024): 320–31. http://dx.doi.org/10.17587/mau.25.320-331.

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The problem of generating smooth and achievable trajectories for the center of mass of unmanned wheeled platforms approximating a reference sequence of waypoints considering time is considered. A typical solution consists in spline interpolation of separate route sections with their subsequent stitching. At the same time, the problem of satisfying constraints on robot motion features such as velocity, acceleration, and jerk requires additional algorithmization. In contrast to labor-intensive analytical methods, this paper proposes a fundamentally new approach, simple in computational implementation, which provides dynamic smoothing of primitive trajectories. The principle of organization and method of designing an autonomous dynamic model (tracking differentiator) whose output variables, while tracking a primitive non-smooth trajectory, generate smooth curves whose derivatives do not exceed the design constraints of a particular robot and are achievable reference trajectories for it. Block control principle and smooth and bounded S-shaped sigmoidal local links are used to design the differentiator. The paper presents a procedure for setting up a three-block tracking differentiator, whose variables generate a smooth reference trajectory, as well as its first and second derivatives, in a signal pocoordinate form. It is shown that the developed procedure extends to tracking differentiators of any required order without limitation of generality. In particular, the structure and setting of a single-block tracking differentiator for obtaining express results at the stage of robot or polygon motion planning is specified. Numerical simulation results confirming the efficiency of the designed algorithms are presented.

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Dinanty, Mandietha. "Enhancement of CSR Programs to Improve Value Creation for the Stakeholder: A Case Study of PT Adhi Karya (Persero) Tbk". European Journal of Business and Management Research 7, n. 4 (20 luglio 2022): 143–47. http://dx.doi.org/10.24018/ejbmr.2022.7.4.1500.

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PT Adhi Karya (Persero) Tbk. (ADHI) is a company engaged in the construction sector in Indonesia with the main business core including construction and engineering services, property, manufacture, and investment & concession. Throughout 2020, ADHI received appreciation in the form of awards for its achievements. This investment activity is not only a form of developing opportunities from ADHI's CSR missions, but also as a participation in stakeholders’ priorities programs that focus on national strategic infrastructure development. To analyze and research this, both qualitative and quantitative research methodology is used in this research to gain information and identify alternatives for the best way of enhancement strategies. This research uses AHP (Analytic Hierarchy Process) technique for data simulation, with BCOR (Benefits-Costs-Opportunities-Risks) method of data and elements identification. The primary qualitative data gathered is from two stages of FGD (Focus Group Discussion) with secondary data, the first one is to define the parameters of criteria which will be filled in the simulation, the second one is to analyze the output from the result of simulation and decide the final suggestion for the business strategy recommendation. As a result of this research, regardless of the main solution of the consulting activity, the goal of ADHI's business strategy selection is to support the community with an efficient and productive CSR program with a technology-based support system. Therefore, the best alternative is a combination of alternatives 1 and 2 which are Local Micro and Small Enterprises Support and Accommodation and Local Tourism Businesses Exposure and Awareness to Public. This model can be valuable at least due to political, economic, social, environmental and legal factors in each region. This model requires the development of educated and experienced personnel, as this type of CSR program requires a deep understanding of everything from organizational management to labor law to equal employment opportunities.

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Leveno, Kenneth J., David B. Nelson e Donald D. McIntire. "Second-stage Labor". Obstetric Anesthesia Digest 37, n. 1 (marzo 2017): 18. http://dx.doi.org/10.1097/01.aoa.0000512010.88591.cc.

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Y. Orlov, Mikhail, e Sergey S. Matveev. "Numerical Simulation Application for the Design and Fine-Tuning of Small-Sized Gas Turbine Engine Combustor". Open Mechanical Engineering Journal 8, n. 1 (9 dicembre 2014): 450–56. http://dx.doi.org/10.2174/1874155x01408010450.

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The small-sized GTE are used more and more both as the basis of power plants and power machines for various purposes. The technical and operational characteristics of these engines are largely determined by the design quality of their combustion chambers (CC). One of the most advanced methods of CC scientific investigation is the bench testing. However, such CC operation study is complicated by labour-intensiveness of an experiment and its significant costs. Therefore, in recent years GTE designers started to use widely the numerical simulation for these purposes. However, the level of such calculation development does not allow often to solve the issue of CC fine-tuning in order to achieve the required parameters. It is also difficult to determine the reliability degree of such calculations. The preliminary calculation of the combustion chamber was performed first of all. Its purpose is the CC shape development and its determination of its geometric dimensions. At that, the main requirement was to ensure the possibilities of one CC placement between the previously-designed compressor and the turbine and the performance of a whole set of technical specifications by the engine. At the second stage using The CC fine-tuning was performed in order to optimize the performance by using CFD-calculation. At that the calculated method was used for which the verification has been performed by the bench tests. Such a CC fine-tuning allowed to reduce the product development period and improve its characteristics.

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Petrenko, E. V., e O. O. Pampukha. "Impacted fetal head during caesarean section: prevalence, risk factors, methods of prevention and management (literature review)". UKRAINIAN JOURNAL HEALTH OF WOMAN, n. 2(171) (30 marzo 2024): 12–18. http://dx.doi.org/10.15574/hw.2024.171.12.

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Under certain circumstances, the fetal head may stop descending into the vagina during the second stage of labor, having its largest circumference into the pelvic cavity, while conservative methods of treatment may not be effective, and the clinical situation may require an emergency cesarean section with a "the deeply impacted fetal head" in the pelvic cavity. This is a technically complex method of delivery in this clinical situation, associated with serious risks for both the woman and the child. There are a number of approaches to prevent these complications and techniques for removing the fetus in this situation, however, there is currently no consensus on which of these approaches is best for this type of cesarean section. The aim - to investigate the main current data on possible techniques for fetal extraction with impacted fetal head during cesarean section and to compare their safety and effectiveness. A review of the literature on the definition of the concept of «impacted fetal head» during cesarean section, the distribution and risk factors of this complication, the study of possible complications for the mother and the fetus, techniques for preventing the occurrence of this condition, methods of removing the fetus with impacted head during cesarean section, as well as promising management methods. A comprehensive study of this obstetric emergency remains relevant for modern science, because it requires special techniques and skills of an obstetrician-gynecologist to prevent injuries to the mother and child, bleeding and other life-threatening conditions. There is a need to standardize the definition of terminology, improve the skills of doctors through simulation training and conduct large randomised trials to determine the best approaches and provide highly skilled care to mothers and children in situations that can potentially result in severe trauma. No conflict of interests was declared by the authors.

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Simpson, Kathleen Rice. "Second Stage Labor Care". MCN, The American Journal of Maternal/Child Nursing 29, n. 6 (novembre 2004): 416. http://dx.doi.org/10.1097/00005721-200411000-00021.

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&NA;. "Second-Stage Labor Care". Journal of Perinatal & Neonatal Nursing 23, n. 1 (gennaio 2009): 40–41. http://dx.doi.org/10.1097/01.jpn.0000346220.40578.96.

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CHENG, YVONNE W., e AARON B. CAUGHEY. "Second Stage of Labor". Clinical Obstetrics and Gynecology 58, n. 2 (giugno 2015): 227–40. http://dx.doi.org/10.1097/grf.0000000000000113.

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Kerns, Marion J. "Second Stage of Labor". Journal of Obstetric, Gynecologic & Neonatal Nursing 26, n. 1 (gennaio 1997): 15. http://dx.doi.org/10.1111/j.1552-6909.1997.tb01499.x.

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Hanson, Lisa. "Second-Stage Labor Care". Journal of Perinatal & Neonatal Nursing 23, n. 1 (gennaio 2009): 31–39. http://dx.doi.org/10.1097/jpn.0b013e318196526b.

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Simpson, Kathleen Rice. "Length of Second-Stage Labor". MCN, The American Journal of Maternal/Child Nursing 41, n. 6 (2016): 380. http://dx.doi.org/10.1097/nmc.0000000000000284.

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Hofmeyr, G. J., e M. Singata-Madliki. "The second stage of labor". Best Practice & Research Clinical Obstetrics & Gynaecology 67 (agosto 2020): 53–64. http://dx.doi.org/10.1016/j.bpobgyn.2020.03.012.

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Singh, Sanjay. "The second stage of labour". International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, n. 10 (26 settembre 2019): 4120. http://dx.doi.org/10.18203/2320-1770.ijrcog20194395.

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Abstract (sommario):

The second stage of labor begins with full dilatation of cervix and ends with delivery of the fetus. In most of the cases the labor progresses uneventfully, without any need of an active intervention but in few cases complications may occur. With passage of time there has been better understanding about second stage of labor, still there are several grey areas yet to be resolved. This review endeavours to scrutinize a variety of care practices including positions, time and type of pushing, use of epidural analgesia, and perineal support techniques etc and discuss evidence based management of second stage of labor. The review was carried out in the period of 1900-2019 by searching in Pub Med, Embase, Scopus, Google scholar, Web of sciences using relevant key words. Reports, articles, fact sheets and official publications of World health Organization (WHO), Ministry of health and family welfare-Govt of India and various other countries were also reviewed.

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McKeon, Valerie A., e Maureen O'Reilly. "Nursing Management of Second Stage Labor". Worldviews on Evidence-Based Nursing E4, n. 1 (febbraio 1997): 24–31. http://dx.doi.org/10.1111/j.1524-475x.1997.00024.x.

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Mahendru, Rajiv. "Shortening the second stage of labor?" Journal of the Turkish German Gynecological Association 11, n. 2 (1 giugno 2010): 95–98. http://dx.doi.org/10.5152/jtgga.2010.07.

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Bergstrom, Linda, Lori Richards, Adele Proctor, Leticia Bohrer Avila, Janice M. Morse e Joyce E. Roberts. "Birth Talk in Second Stage Labor". Qualitative Health Research 19, n. 7 (25 giugno 2009): 954–64. http://dx.doi.org/10.1177/1049732309338613.

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31

Mckay, Susan, e Joyce Roberts. "Second Stage Labor: What Is Normal?" Journal of Obstetric, Gynecologic & Neonatal Nursing 14, n. 2 (marzo 1985): 101–6. http://dx.doi.org/10.1111/j.1552-6909.1985.tb02212.x.

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32

LaRusso, Laurie. "Extending the Second Stage of Labor". Nursing for Women's Health 20, n. 3 (giugno 2016): 241. http://dx.doi.org/10.1016/j.nwh.2016.04.012.

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33

Nelson, David B., Donald D. McIntire e Kenneth J. Leveno. "Second-stage labor: consensus versus science". American Journal of Obstetrics and Gynecology 222, n. 2 (febbraio 2020): 144–49. http://dx.doi.org/10.1016/j.ajog.2019.08.044.

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34

Yan, Xiani, Jennifer A. Kruger, Xinshan Li, Poul M. F. Nielsen e Martyn P. Nash. "Modeling the second stage of labor". Wiley Interdisciplinary Reviews: Systems Biology and Medicine 8, n. 6 (25 agosto 2016): 506–16. http://dx.doi.org/10.1002/wsbm.1351.

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35

Gimovsky, Alexis C., e Vincenzo Berghella. "Evidence-based labor management: second stage of labor (part 4)". American Journal of Obstetrics & Gynecology MFM 4, n. 2 (marzo 2022): 100548. http://dx.doi.org/10.1016/j.ajogmf.2021.100548.

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36

Bianchi, Ann L., e Ellise D. Adams. "Labor Support During Second Stage Labor for Women With Epidurals". Nursing for Women's Health 13, n. 1 (febbraio 2009): 38–47. http://dx.doi.org/10.1111/j.1751-486x.2009.01372.x.

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37

Roberts, Joyce, e Deborah Woolley. "A Second Look at the Second Stage of Labor". Journal of Obstetric, Gynecologic & Neonatal Nursing 25, n. 5 (giugno 1996): 415–23. http://dx.doi.org/10.1111/j.1552-6909.1996.tb02446.x.

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38

Hanis, Ismawati, Chairuna Chairuna e Sri Handayani. "Relationship of Parity, Maternal Age and Birth Weight with the Duration of the Second Stage of Labor". Jurnal Kebidanan Malahayati 9, n. 2 (29 aprile 2023): 368–274. http://dx.doi.org/10.33024/jkm.v9i2.9786.

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Abstract (sommario):

Background: second stage of labor begins when the cervix is fully dilated and ends with the birth of a baby. The duration of second stage of labor commonly lasts 2 hours for primigravida mothers and one hour for multigravida mothers. Prolonged labor is one of complications experienced by mothers in second stage of labor. Prolonged labor can cause several complications for both mothers and infants. Prolonged labor can harm both the mother and the infant. The harmful effects of complications during second stage of labor for mothers include the incidence of uterine atony, laceration, bleeding, infection, fatigue and shock and improving the birth rate with the C-section incision. Whereas the harmful effects of complications during second stage of labor for infants include asphyxiated, cerebral trauma caused by pressure on the head of the fetus, the injury due to action, and premature rupture of membranes. The severity of the injury increases continuously along with the longer of the duration of the labor process, and the risk of which rises quickly after 24 hours. The longer the labor, the higher the morbidity as well as the mortality. The stage of labor affected by all such factors mentioned is called the second stage of laborObjective: to find out the relationship of parity, maternal age, and birth weight with the duration of the second stage of labor.Methods: this study applied a quantitative research design using an analytical survey method through a cross sectional approach. The sample in this study was chosen using total sampling method with the purposive sampling technique, namely, that the sample was all maternity mothers who were coincidentally present at the time of the study at UPTD Karya Mukti Public Health Center in August 2021. Then, Chi-square statistical test was used to determine the relationship between independent variables and dependent variable.Results: of the 30 respondents, 20 respondents whose parity was not at risk (95.2%) experienced normal duration of second stage of labor, while 5 respondents (55.6%) whose parity was at risk experienced normal duration of second stage of labor. 21 respondents whose maternal age was not at risk (95.5%) experienced normal duration of second stage of labor, while 4 respondents whose maternal age was at risk (50%) experienced normal duration second stage of labor. 23 respondents (92%) with normal birth weight babies experienced normal duration of second stage of labor, while 2 respondents (40%)with large birth weight babies experienced normal duration of second stage of labor. The results of the Chi-square statistical test showed that there was a significant relationship between parity and the duration of the second stage of labor with the p-value of 0.019 £ 0.05 and the OR value of 9.157. There was a significant relationship between maternal age and the duration of the second stage of labor with the p-value of 0.011 £ 0.05 and the OR value of 5.387, and there was a significant relationship between birth weight and the duration of the second stage of labor with the p-value of 0.022 £ 0.05 and OR value of 3.405.Conclusions: there was a relationship between parity and the duration of second stage of labor. There was a relationship between maternal age and the duration of second stage of labor, and there was a relationship between birth weight and the duration of second stage of labor. Suggestions: It is hoped that health workers will further improve IEC (Information, Education, and Communication) regarding safe gestational age, safe parity and balanced nutrition as a form of antenatal care for pregnant women which is very influential, especially during the second stage of labor. In addition, for pregnant women, it is better to perform quality ANC to predict whether mothers will be likely to experience prolonged labor or not and also to prevent prolonged labor and other complications of pregnancy and labor. Then, based on the results of ANC tests, the mothers immediately referred to a more adequate hospitals/maternity hospitals to monitor the condition of their pregnancy so as to prevent the risk that will be faced by the mothers and fetus during labor. Keywords: Parity, Maternal Age, Birth Weight, Duration of Second Stage Labor

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Singh, Sanjay, Uttara Aiyer Kohli e Shakti Vardhan. "Management of prolonged second stage of labor". International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, n. 7 (27 giugno 2018): 2527. http://dx.doi.org/10.18203/2320-1770.ijrcog20182855.

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Abstract (sommario):

Second stage of labour has been often neglected leading to increased maternal and perinatal morbidity. Recognising and managing prolonged second stage is a challenge even to an experienced obstetrician. This article reviews the changes in the definition of prolonged second stage over the years. It discusses the causes, recognition and management options along with the difficulties in delivering a patient with prolonged second stage of labour. Though adding an extra hour to the definition of second stage in patients may reduce the rate of caesarean section but some studies also show a rise in maternal and perinatal morbidity. Obstetricians are familiarized to the different techniques of delivery of the impacted head. Once diagnosis of prolonged second stage is confirmed, causes should be identified and addressed, and treatment should be individualised, and timing and mode of intervention planned.

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Rouse, D. J., S. J. Weiner, S. L. Bloom, M. W. Varner, C. Y. Spong, S. M. Ramin, S. N. Caritis et al. "Second-Stage Labor Duration in Nulliparous Women". Obstetric Anesthesia Digest 31, n. 1 (marzo 2011): 26. http://dx.doi.org/10.1097/01.aoa.0000393153.61123.68.

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41

Worstell, Teresa, Arzou D. Ahsan, Alison G. Cahill e Aaron B. Caughey. "Length of the Second Stage of Labor". Obstetrics & Gynecology 123 (maggio 2014): 84S. http://dx.doi.org/10.1097/01.aog.0000447412.62293.82.

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42

Simpson, Kathleen Rice. "Evaluating Quality of Second-Stage Labor Care". MCN, The American Journal of Maternal/Child Nursing 41, n. 5 (2016): 316. http://dx.doi.org/10.1097/nmc.0000000000000270.

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43

Cheng, Yvonne W., Brian L. Shaffer, James M. Nicholson e Aaron B. Caughey. "Second Stage of Labor and Epidural Use". Obstetrics & Gynecology 123, n. 3 (marzo 2014): 527–35. http://dx.doi.org/10.1097/aog.0000000000000134.

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44

San Román, Gustavo. "Second Stage of Labor and Epidural Use". Obstetrics & Gynecology 123, n. 6 (giugno 2014): 1358–59. http://dx.doi.org/10.1097/aog.0000000000000314.

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45

Hochner-Celnikier, Drorith, Amy Solnica e Yuval Lavy. "Second Stage of Labor and Epidural Use". Obstetrics & Gynecology 123, n. 6 (giugno 2014): 1359–60. http://dx.doi.org/10.1097/aog.0000000000000316.

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46

Rouse, Dwight J., Aaron B. Caughey, Alison G. Cahill e William A. Grobman. "Regarding “Second-stage labor: consensus versus science”". American Journal of Obstetrics and Gynecology 223, n. 3 (settembre 2020): 464. http://dx.doi.org/10.1016/j.ajog.2020.03.036.

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47

SULLIVAN, MICHELE G. "Pelvic Exercises May Ease Second-Stage Labor". Family Practice News 35, n. 3 (febbraio 2005): 51. http://dx.doi.org/10.1016/s0300-7073(05)71336-0.

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48

Cheng, Y. W., B. L. Shaffer, J. M. Nicholson e A. B. Caughey. "Second Stage of Labor and Epidural Use". Obstetric Anesthesia Digest 35, n. 1 (marzo 2015): 49–50. http://dx.doi.org/10.1097/01.aoa.0000460423.58316.20.

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49

GOTTLIEB, S. "Midwifery management of second stage of labor". Journal of Nurse-Midwifery 30, n. 2 (marzo 1985): 112–16. http://dx.doi.org/10.1016/0091-2182(85)90118-1.

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50

Charles, Allan G. "Episiotomy and the Second Stage of Labor". JAMA: The Journal of the American Medical Association 253, n. 12 (22 marzo 1985): 1800. http://dx.doi.org/10.1001/jama.1985.03350360126039.

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