scholarly journals 727: Neonatal morbidity and mortality associated with induction of labor at 39 weeks versus expectant management

2020 ◽  
Vol 222 (1) ◽  
pp. S460-S461
Author(s):  
Sabrina Burn ◽  
Ruofan Yao ◽  
Jordan Rossi ◽  
Maria Diaz ◽  
Stephen Contag
Keyword(s):  
Expectant Management ◽  
Neonatal Morbidity ◽  
Induction Of Labor ◽  
Morbidity And Mortality

scholarly journals The impact of labor induction at 39 weeks gestation compared with expectant management on maternal and neonatal morbidity in low-risk women: A United States of America Cohort Study

2020 ◽  
Author(s):  
Sabrina Burn ◽  
Ruofan Yao ◽  
Maria Diaz ◽  
Jordan Rossi ◽  
Stephen Contag
Keyword(s):  
Cohort Study ◽  
Expectant Management ◽  
Neonatal Morbidity ◽  
Induction Of Labor ◽  
P Value ◽  
Cesarean Hysterectomy ◽  
Management Group ◽  
Induction Group ◽  
Prolonged Ventilation ◽  
Nicu Admission

Objective: To determine maternal and neonatal morbidity associated with induction of labor at 39 weeks compared with expectant management through 42 weeks. Design: Cohort study Setting & Population: Low risk American women who delivered between 39 and 42 weeks in 2015 to 2017. Methods: Data was abstracted from the national vital statistics database. Multivariable log-binomial regression analysis was conducted to estimate the relative risk of morbidity. Main Outcome Measures: Maternal morbidity included Triple I, blood transfusion, ICU admission, uterine rupture, cesarean hysterectomy, and cesarean delivery. Neonatal morbidity included 5 minute Apgar ≤3, prolonged ventilation, seizures, NICU admission, and neonatal death. Results: A total of 1,885,694 women were included for analysis. Women undergoing induction of labor at 39 weeks were less likely to develop Triple I (p-value < 0.001; aRR 0.66; 95% CI [0.64-0.68]) and require a cesarean section (p-value <0.01; aRR 0.69l 95% CI [0.68-0.69]) than the expectant management group. There was a small, but significant increase in cesarean hysterectomy in the induction group (p-value <0.01; aRR 1.32; 95% CI [1.05-1.65]). Neonates of the induction group were less likely to have 5 minute Apgar ≤3 (p-value < 0.01; aRR 0.69; 95% CI [0.64-0.74]), prolonged ventilation (p-value < 0.01; aRR 0.77; 95% CI [0.72-0.82]), NICU admission (p-value < 0.01; aRR 0.80; 95% CI [0.79-0.82]), and/or neonatal seizures (p-value <0.01; aRR 0.80; 95% CI [0.66-0.98]) compared to the expectant management group. Conclusions: Induction of labor at 39 weeks gestation compared with expectant management is not harmful and has maternal and neonatal benefits.

scholarly journals MANAGEMENT PRELABOUR RUPTURE OF THE MEMBRANES AT TERM;

2008 ◽  
Vol 15 (02) ◽  
pp. 216-219
Author(s):  
MISBAH KAUSAR JAVAI JAVAID ◽  
SAMIA HASSAN ◽  
TAYYABA TAHIRA
Keyword(s):  
Expectant Management ◽  
Neonatal Morbidity ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Infected Wound ◽  
Maternal Complications ◽  
Group Rate ◽  
Misoprostol Group ◽  
Study Setting

To find outmaternal and fetal outcome in induction of labourcompared with expectant management for prelabour rupture of membranes at term. Design: Open randomizedcomparative study. Setting and period: Gynae Unit- II Services Hospital, from 1 April 2007 to 30 September 2007. stPatient and methods: 100 patients at > 37 weeks with ruptures membranes with no contraindication to vaginal deliverywere enrolled in the study. 50 patients were in the expectant group while 50 patients were in the induction group.Results: Both groups had the same general characteristics but the Misoprostol group had a significantly shorter latancyperiod (10-16 hour Vs 20-24 hours), shorter period of hospitalization, lesser LSCS rate (24% Vs 34%) lesser need ofaugmentation (40% Vs 62%), choroamnionitis (3%Vs 7.8%), and postpartumfever (1% Vs 1.8%) when compared withexpectant group. Rate of infected wound after LSCS were compared in induction and expectant groups (2.2% Vs2.6%), also there was no difference between them regarding neonatal morbidity and nursery admission. Conclusion:So it was concluded that there was slightly high maternal complications in expectant group but no long-term maternalmorbidity. Both groups have no effect on neonatal morbidity and mortality however the duration between PROM anddelivery effect the neonatal admission in nursery and antibiotic requirements.

scholarly journals Racial and Economic Neighborhood Segregation, Site of Delivery, and Very Preterm Neonatal Morbidity and Mortality

2021 ◽  
Author(s):  
Teresa Janevic ◽  
Jennifer Zeitlin ◽  
Natalia N. Egorova ◽  
Paul Hebert ◽  
Amy Balbierz ◽  
...  
Keyword(s):  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
Very Preterm ◽  
Neighborhood Segregation

scholarly journals 757 Outcomes of elective induction of labor at 39 weeks compared to expectant management by age

2021 ◽  
Vol 224 (2) ◽  
pp. S474
Author(s):  
Alyssa R. Hersh ◽  
Eleanor M. Schmidt ◽  
Claire H. Packer ◽  
Bharti Garg ◽  
Aaron B. Caughey
Keyword(s):  
Expectant Management ◽  
Induction Of Labor ◽  
Elective Induction

12: Induction of labor versus expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks–the PPROMEXIL-2 trial (ISRCTN05689407)

2012 ◽  
Vol 206 (1) ◽  
pp. S8-S9
Author(s):  
David van der Ham ◽  
Jantien van der Heijden ◽  
Brent Opmeer ◽  
Hans van Beek ◽  
Christine Willekes ◽  
...  
Keyword(s):  
Expectant Management ◽  
Induction Of Labor ◽  
Prelabor Rupture Of Membranes

Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability

2017 ◽  
Vol 45 (1) ◽  
Author(s):  
Winnie Huiyan Sim ◽  
Edward Araujo Júnior ◽  
Fabricio Da Silva Costa ◽  
Penelope Marie Sheehan
Keyword(s):  
Management Practices ◽  
Discharge Rate ◽  
Expectant Management ◽  
Intraventricular Haemorrhage ◽  
Neonatal Morbidity ◽  
Live Birth Rate ◽  
Neonatal Outcomes ◽  
Prognostic Indicators ◽  
Maternal And Neonatal Outcomes ◽  
The Common

AbstractAim:To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks’ gestation and to identify prognostic indicators of this morbid presentation.Methods:We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM.Results:Mean latency between PPROM and delivery ranged between 20 and 43 days. Women with PPROM <24 weeks had an overall live birth rate of 63.6% and a survival-to-discharge rate of 44.9%. The common neonatal morbidities were respiratory distress syndrome, bronchopulmonary dysplasia and sepsis. The majority of neonatal deaths within 24 h post birth were associated with pulmonary hypoplasia, severe intraventricular haemorrhage and neonatal sepsis. The common maternal outcomes were chorioamnionitis and caesarean sections. The major predictors of neonatal survival were later gestational age at PPROM, adequate residual amniotic fluid levels, C-reactive protein <1 mg/dL within 24 h of admission and PPROM after invasive procedures.Conclusion:Pregnancy latency and neonatal survival following previable PPROM has improved in recent years, although neonatal morbidity remains unchanged despite recent advances in obstetric and neonatal care. There is heterogeneity in management practices across centres worldwide.

Quality of Antenatal, Labour and Delivery Services in Selected Districts in Malawi, Zambia and Zimbabwe: A Descriptive Cross-Sectional Study

2021 ◽  
pp. 1-9
Author(s):  
Clara Opha Haruzivishe
Keyword(s):  
Perinatal Care ◽  
Neonatal Morbidity ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Morbidity And Mortality ◽  
World Health ◽  
Performance Standard ◽  
Cross Sectional ◽  
Care Services

Background: High Maternal and Neonatal Mortality Ratios persist in Sub-Saharan Africa despite increasing perinatal care coverage. This suggests that coverage alone is not adequate to reduce maternal and neonatal morbidity and mortality. Quality of care should be the emphasis of maternal and child care services. Materials and Methods: A descriptive cross-sectional multicentre study was conducted in selected health facilities in Zambia, Malawi and Zimbabwe using purposive sampling. A World Health Organization-WHO 2016 Quality of Maternal and New-born assessment Framework and the WHO (2015) Service Availability and Readiness Assessment tool were used for data collection. Data was analyzed using Statistical Package for Social Scientist (SPSS) version 24.0. Results: Less than 43% of the health facilities satisfied at least three of the five Performance Standards of availability and adequacy of Antenatal infrastructure and supplies. Regarding Antenatal processes/care, an observation was the most common performance standard satisfied by 70.6% of all health facilities assessed while less than 30% fulfilled all other standards. Only 57.1% of the health facilities satisfied 5 of the 11 standards for labour and delivery infrastructure, while only 55.6% of the Health facilities satisfied only two of the 13 standards of Labour and delivery care. Conclusion: To achieve a significant and sustainable reduction in maternal and neonatal morbidity and mortality, there is a need for investment and improvement in maternity care services infrastructure and processes as opposed to focusing on mere attendance of Antenatal, and deliveries by trained birth attendants.

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