scholarly journals 380: Mode of delivery following prolonged second stage of labor: Does it affect the long-term neurological outcome of the offspring?

2018 ◽  
Vol 218 (1) ◽  
pp. S234
Author(s):  
Asnat Walfisch ◽  
Tamar Wainstock ◽  
Idit Segal ◽  
Daniella Landau ◽  
Eyal Sheiner
2015 ◽  
Vol 212 (1) ◽  
pp. S392
Author(s):  
Joseph Fitzwater ◽  
Nana-Ama Ankumah ◽  
Sukhkamal Campbell ◽  
Joseph Biggio ◽  
John Owen ◽  
...  

Author(s):  
Anjali Dabral ◽  
Pallavi Pawar ◽  
Rekha Bharti ◽  
Archana Kumari ◽  
Achla Batra ◽  
...  

Background: Women delivering in upright position have shorter labour due to efficient and stronger contractions with faster descent of foetal head. The present study aimed to find out effect of upright kneeling position in the second stage of labour on maternal and foetal outcome and assess patients’ satisfaction.Methods: The study was carried out in a tertiary care hospital of North India from October 2012 to February 2014. Low risk women admitted in early labour were divided into two groups, women delivering in kneeling position and in supine position. The outcome measures studied were, duration of second stage of labour, mode of delivery, 2nd degree perineal tears, Apgar scores at 5 minutes, NICU admission rate and patient satisfaction.Results: The mean duration of second stage of labour in kneeling group was shorter by 14.901 minutes. The rate of vaginal delivery was comparable for both primigravidas and multigravida in kneeling and supine groups, RR: 2.275, 95% CI (0.7872-6.5831) and RR: 1.633, 95% CI (0.393-6.775). Primigravidas had more 2nd degree perineal tears in kneeling group as compared to supine, RR 4.191, 95% CI (1.54 to 11.41). No difference in Apgar scores >7 at 5 minutes was observed in both groups, however, significantly lesser babies in kneeling group were admitted in NICU, RR 0.246, 95% CI (0.079 to 0.761). There was no difference on comparing satisfaction scores of primigravidas and multigravida in both supine and kneeling position.Conclusions: Kneeling position reduces the duration of second stage of labour and NICU admissions.


2021 ◽  
Author(s):  
Sushruti Kaushal ◽  
Harpreet Kaur

Pregnancy is a physiological state that alters the body’s response to infections. COVID-19 has been found to cause severe disease in pregnancy with morbidity and mortality that is higher than in non-pregnant adults. There is risk of transmission of SARS-CoV2 infection to fetus during ante-natal period, intra-partum and post-delivery from an infected mother. It is necessary to provide an un-interrupted ante-natal care and delivery services to pregnant women during the pandemic. Tele-consultation is important modality to reduce the physical exposure of pregnant women to the hospital environment and should be utilised. Screening, isolation, testing and treatment for SARS-CoV2 infection in pregnant women should follow the local guidelines and remain essentially the same as in non-pregnant adults. Admission, if required, should be in a facility that can provide obstetric maternal and fetal monitoring in addition to care for COVID-19 illness. Use of nitrous oxide and inhalational oxygen for fetal indication should be avoided during labor. Second stage of labor is considered an aerosol generating procedure and should be managed with adequate precautions. Mode of delivery should be as per obstetric indications. Regional anaesthesia should be preferred during caesarean. COVID-19 is not a contra-indication to breast feeding. For antenatal women, COVID-19 vaccination can be considered after shared decision making.


2019 ◽  
Vol 33 (14) ◽  
pp. 2451-2458 ◽  
Author(s):  
Naama Srebnik ◽  
Omri Barkan ◽  
Misgav Rottenstreich ◽  
Alexander Ioscovich ◽  
Rivka Farkash ◽  
...  

Author(s):  
Ban Dawood Mahmood

Background: A parallel rise in the rate of obesity in women in reproductive age; and cesarean section as outcome of pregnancy is noticed in the last years in our society. It is unknown whether this dual rise is related or not. The impact is more evident on primigravida patients, so authors perform this study to assess the impact of obesity on the outcome of pregnancy in primigravida patients in a major obstetrics hospital.Methods: A prospective controlled study was conducted in Ibn Al-Balady obstetrics hospital. It included 121 primigravida patients who were divided into 3 groups according to WHO BMI categories: normal, overweight, and obese. The mode of delivery of these patients is recorded and was assessed in relation to BMI.Results: About 17% of the patients were obese and they needed more emergency CS as a mode of delivery than normal BMI patients (p<0.01). They also had longer second stage of labor (p<0.01) and delivered babies with higher birth weight that the normal group (p<0.05).Conclusions: Obesity constitutes a growing challenge on the outcome of pregnancy, duration of second stage of labor and baby birth weight in primigravida patients. Women who are getting pregnant for the first time should be advised to lower their BMI as a safety measure to avoid emergency cesarean section.


2017 ◽  
Vol 35 (04) ◽  
pp. 413-420 ◽  
Author(s):  
Caroline Rouse ◽  
David Cantonwine ◽  
Sarah Little ◽  
Thomas McElrath ◽  
Julian Robinson ◽  
...  

Objective The objective of this study was to assess the association between the angle of progression (AoP) measured by transperineal ultrasound and mode of delivery and duration of the second stage. Study Design This is a prospective observational study of nulliparous women with a singleton gestation at term in which serial transperineal ultrasound examinations were obtained during the second stage of labor. Multivariable logistic regression and adjusted survival models were used for the analysis. Results A total of 137 patients were included in the analysis and median AoP for the study group was 153 degrees. The adjusted odds ratio (aOR) of requiring an operative delivery was 2.6 times higher for those patients who had an AoP < 153 degrees and the aOR of requiring a cesarean delivery was almost six times higher when compared with those patients who had an AoP ≥ 153 degrees (95% confidence interval [CI]: 1.0, 6.2; p = 0.04; aOR: 5.8, 95% CI: 1.2–28.3; p = 0.03, respectively). Those patients with an AoP < 153 degrees were at a higher hazard of staying pregnant longer (adjusted hazard ratio: 1.8, 95% CI: 1.2–2.8, p = 0.005). Conclusion The AoP has the potential to predict spontaneous vaginal delivery and the duration of the second stage of labor which may be useful in counseling patients and managing their labor.


2013 ◽  
Vol 20 (04) ◽  
pp. 530-536
Author(s):  
HABIBA SHARAF ALI ◽  
NIDA ANWAR LAKHANI ◽  
NAILA GHULAM SARWAR

Objective: The objective of this study was to investigate prevalence of urinary incontinence at 3 months postpartum andto study how continence status during pregnancy and different factors influence urinary incontinence at 3 months postpartum inprimiparous women. Setting: Pregnant women attending routine antenatal clinic at Ziauddin hospital and Kharader general hospitalKarachi were recruited to this study. Methods: Urinary incontinence before and during pregnancy was assessed at study enrolment earlyin the third trimester. Incontinence was re-assessed three months postpartum. Logistic regression analysis was used to assess the role ofmaternal and obstetric factors in causing postpartum urinary incontinence. Results: Urinary incontinence was reported in 15 women(10.6% ) out of 141 women, mode of delivery, onset of labor weight of the baby, episiotomy, and the length of the second stage of labor,were not predictive of urinary incontinence after delivery. Adjusted RR for incontinence after spontaneous vaginal delivery compared withelective caesarean section was 2.200(95% CI .6-7.28) among women who were continent during pregnancy. Conclusions: Urinaryincontinence was prevalent 3 months postpartum. The association between incontinence postpartum mode of delivery, onset of labor,perineal trauma and weight of baby was not statistically significant.


Sign in / Sign up

Export Citation Format

Share Document