Labor Curves in Multiparous Women Related to Interbirth Intervals

2018 ◽  
Vol 35 (14) ◽  
pp. 1429-1432
Author(s):  
Brittney Mason ◽  
Melissa Matulich ◽  
Kate Swanson ◽  
Erin Irwin ◽  
Alfred Rademaker ◽  
...  
Keyword(s):  
Active Phase ◽  
Interbirth Interval ◽  
Model Group ◽  
Linear Mixed Effects Model ◽  
Linear Mixed Effects ◽  
Interbirth Intervals ◽  
Second Stage ◽  
Vaginal Deliveries ◽  
Individual Effects ◽  
Multiparous Women

Objective Previous studies have shown that risk of cesarean section increases among multiparous women as interbirth interval increases. One possibility is that progress of labor may vary with interbirth interval, such that with longer intervals, labor curves of multiparas more closely resemble those of nulliparas. We sought to define labor curves among a cohort of multiparas with varying interbirth intervals. Study Design This was a retrospective cohort study of term multiparas with known interval from last delivery and only vaginal deliveries. Subjects were grouped by interval between the studied pregnancy and the most recent birth: 0 to 59, 60 to 119, and ≥120 months. Statistical analysis was performed using linear mixed effects model. Group slopes and intercepts were compared using model t-tests for individual effects. Length of second stage was compared using a Wilcoxon's rank-sum test. Results Groups did not differ significantly in demographic or obstetrical characteristics. Rate of dilation was similar between the 0 to 59 and 60 to 119 month groups (p = 0.38), but faster in the ≥120 month group compared with the 60 to 119 month group (p = 0.037). Median duration of second stage increased slightly with increased interbirth interval (p = 0.003). Conclusion Prolonged interbirth interval is not associated with slower active phase of labor.

scholarly journals Impact factors on fetal descent rates in the active phase of labor: a retrospective cohort study

2018 ◽  
Vol 46 (6) ◽  
pp. 579-585 ◽  
Author(s):  
Nina Kimmich ◽  
Jana Juhasova ◽  
Christian Haslinger ◽  
Nicole Ochsenbein-Kölble ◽  
Roland Zimmermann
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Total Duration ◽  
Active Phase ◽  
University Hospital ◽  
Impact Factors ◽  
Nulliparous Women ◽  
Vaginal Deliveries ◽  
Multiparous Women

Abstract Aim: To assess fetal descent rates of nulliparous and multiparous women in the active phase of labor and to evaluate significant impact factors. Methods: In a retrospective cohort study at the University Hospital of Zurich, Switzerland, we evaluated 6045 spontaneous vaginal deliveries with a singleton in vertex presentation between January 2007 and July 2014 at 34 0/7 to 42 0/7 gestational weeks. Median fetal descent rates and their 10th and 90th percentiles were assessed in the active phase of labor and different impact factors were evaluated. Results: Fetal descent rates are exponentially increasing. Nulliparous women have slower fetal descent than multiparous women (P<0.001), ranging from 0 to 5.81 cm/h and from 0 to 15 cm/h, respectively. The total duration of fetal descent in labor is 5.42 h for nulliparous and 2.71 h for multiparous women. Accelerating impact factors are a lower fetal station, multiparity, increasing maternal weight and fetal occipitoanterior position, whereas epidural anesthesia decelerates fetal descent (P<0.001). Conclusions: Fetal descent is a hyperbolic increasing process with faster descent in multiparous women compared to nulliparous women, is highly inter individual and is associated with different impact factors. The diagnosis of labor arrest or prolonged labor should therefore be based on such rates as well as on individual evaluation of every parturient.

Partograph versus no partograph: effect on labour progress and delivery outcome: a comparative study

2017 ◽  
Vol 6 (11) ◽  
pp. 4928 ◽  
Author(s):  
Benazir Ahmed ◽  
Meena Jain ◽  
Hema Bharwani
Keyword(s):  
Comparative Study ◽  
Total Duration ◽  
Birth Asphyxia ◽  
Active Phase ◽  
Delivery Outcome ◽  
Second Stage ◽  
Active Labour ◽  
Vaginal Deliveries ◽  
Significant Difference ◽  
Group 1

Background: Abnormal labour which includes prolonged labour and obstructed labour remain major causes of maternal morbidity. The major reason for neonatal mortality, birth asphyxia and subsequent morbidity is essentially the repercussion which occurs when a complicated labour is not intervened at the right time. A Partograph provides a graphic overview of the progress of labour and records information about maternal and fetal condition during labour. It is considered to be a very effective tool to monitor labour progress and prevent prolonged and obstructed labour.Methods: This prospective randomised comparative study was conducted in the Department of Obstetrics and Gynaecology, JLN Hospital and RC, Bhilai, Chattisgarh, from January 2015 to June 2016. Pregnant women were randomly assigned to two groups, of 200 each, after satisfying the inclusion and exclusion criteria. Women assigned to Group 1 had their active labour modified using modified WHO partograph whereas those assigned to Group 2 were not monitored using the partograph.Results: Use of Partograph (group 1) significantly reduced the duration of active phase of labour (p <0.0001), duration of second stage (p <0.0001) and thus the total duration of labour (active phase plus second stage) (p <0.0001). Requirement of augmentation was also significantly reduced (p <0.05). Group 1 also had significantly more spontaneous vaginal deliveries (p <0.01) with lesser requirement of operative interventions like LSCS or instrumental deliveries like forceps. Use of partograph also significantly improved neonatal outcome with significantly lesser newborns with Apgar <7 (p <0.05). However, there was no significant difference between the two groups with regard to NICU admissions (p>0.05).Conclusions: The use of Partograph, when compared to no Partograph plotting in active labour, is associated with better monitoring of labour progress as well as delivery outcome in the form of a healthy mother and a healthy child.

scholarly journals Cerebral and Somatic Oxygen Saturation in Neonates with Congenital Heart Disease before Surgery

2021 ◽  
Vol 10 (11) ◽  
pp. 2455
Author(s):  
Mi Jin Kim ◽  
Jae Suk Baek ◽  
Jung A Kim ◽  
Seul Gi Cha ◽  
Jeong Jin Yu
Keyword(s):  
Time Trends ◽  
Biochemical Parameters ◽  
Near Infrared ◽  
Mixed Effects ◽  
Contributing Factors ◽  
Linear Mixed Effects Model ◽  
Linear Mixed Effects ◽  
Hypoxic Brain Injury ◽  
Hypoxic Brain ◽  
Cardiac Diagnosis

BACKGROUND: We investigated preoperative cerebral (ScO2) and abdominal (StO2) regional oxygen saturations according to cardiac diagnosis in neonates with critical CHD, their time trends, and the clinical and biochemical parameters associated with them. METHODS: Thirty-seven neonates with a prenatal diagnosis of CHD were included. ScO2 and StO2 values were continuously evaluated using near-infrared spectroscopy. Measurements were obtained hourly before surgery. A linear mixed effects model was used to assess the effects of time and cardiac diagnosis on regional oxygenation and to explore the contributing factors. RESULTS: Regional oxygenation differed according to cardiac diagnosis (p < 0.001). ScO2 was lowest in the patients with severe atrioventricular valvar regurgitation (AVVR) (48.1 ± 8.0%). StO2 tended to be lower than ScO2, and both worsened gradually during the period between birth and surgery. There was also a significant interaction between cardiac diagnosis and time. The factors related to ScO2 were hemoglobin and arterial saturation, whereas no factor was associated with StO2. CONCLUSIONS: Preoperative ScO2 and StO2 in critical CHD differed according to cardiac diagnosis. ScO2 in the patients with severe AVVR was very low, which may imply cerebral hypoxia. ScO2 gradually decreased, suggesting that the longer the time to surgery, the higher the risk of hypoxic brain injury.

Cognate similarity and intervocalic /d/ production in Riverense Spanish

2021 ◽  
pp. 136700692199680
Author(s):  
Michael Gradoville ◽  
Mark Waltermire ◽  
Avizia Long
Keyword(s):  
Language Contact ◽  
Mixed Effects ◽  
Frequency Effect ◽  
Acoustic Measurements ◽  
Linear Mixed Effects Model ◽  
Phonetic Variation ◽  
Linear Mixed Effects ◽  
Contact Language ◽  
The Relationship ◽  
Phonetic Realization

Aims and objectives: While previous research has shown that phonetic variation in language contact situations is affected by whether a word has a cognate in the contact language, this paper aims to show that such an effect is not monotonic. According to the usage-based model, items in memory are organized according to similarity, thus we anticipated that formally more similar cognates would show a stronger cognate effect. Methodology: This variationist sociophonetic study investigates the relationship between cognate similarity and phonetic realization. We examined this relationship in the bilingual community of Rivera, Uruguay, in which both Portuguese and Spanish are spoken with regularity. Specifically, we focused on intervocalic /d/, which in monolingual Spanish is realized as an approximant [ð̞] or phonetic zero, but in monolingual Brazilian Portuguese is produced as a stop [d] or, in most varieties, an affricate [ʤ] before [i]. Data and analysis: We analyzed a corpus of sociolinguistic interviews of the Spanish spoken in Rivera. Acoustic measurements were taken from approximately 60 tokens each from 40 different speakers. Using a linear mixed-effects model, we examined the relationship between several predictors and the degree of constriction of intervocalic /d/. Findings/conclusions: While there is an overall frequency effect whereby more frequent words exhibit less constriction of intervocalic /d/, as both frequency and cognate similarity increase, less constriction of intervocalic /d/ obtains. Therefore, frequent cognates in Portuguese that have very similar forms affect the production of intervocalic /d/ more so than other cognates. Originality: No previous study has demonstrated that the cognate effect on phonetic variation in a situation of language contact is regulated by form similarity between cognate pairs. Significance/implications: The data support the usage-based model in that similar cognates have more lexical connections and can therefore show greater influence on phonetic realization than can cognates that share less phonetic material.

scholarly journals Increased Response to Altered Auditory Feedback in Dyslexia: A Weaker Sensorimotor Magnet Implied in the Phonological Deficit

2017 ◽  
Vol 60 (3) ◽  
pp. 654-667 ◽  
Author(s):  
Mark R. van den Bunt ◽  
Margriet A. Groen ◽  
Takayuki Ito ◽  
Ana A. Francisco ◽  
Vincent L. Gracco ◽  
...  
Keyword(s):  
Native Speakers ◽  
Reading Group ◽  
Linear Mixed Effects Model ◽  
Phonological Representations ◽  
Linear Mixed Effects ◽  
Phonological Deficit ◽  
Adaptation Response ◽  
After Effect ◽  
Effect Phase ◽  
Phonological Abilities

Purpose The purpose of this study was to examine whether developmental dyslexia (DD) is characterized by deficiencies in speech sensory and motor feedforward and feedback mechanisms, which are involved in the modulation of phonological representations. Method A total of 42 adult native speakers of Dutch (22 adults with DD; 20 participants who were typically reading controls) were asked to produce /bep/ while the first formant (F1) of the /e/ was not altered (baseline), increased (ramp), held at maximal perturbation (hold), and not altered again (after-effect). The F1 of the produced utterance was measured for each trial and used for statistical analyses. The measured F1s produced during each phase were entered in a linear mixed-effects model. Results Participants with DD adapted more strongly during the ramp phase and returned to baseline to a lesser extent when feedback was back to normal (after-effect phase) when compared with the typically reading group. In this study, a faster deviation from baseline during the ramp phase, a stronger adaptation response during the hold phase, and a slower return to baseline during the after-effect phase were associated with poorer reading and phonological abilities. Conclusion The data of the current study are consistent with the notion that the phonological deficit in DD is associated with a weaker sensorimotor magnet for phonological representations.

Prolonged interpregnancy interval: how does it impact the length of second stage of labor?

2020 ◽  
Vol 48 (8) ◽  
pp. 811-818
Author(s):  
Nicole B. Kurata ◽  
Keith K. Ogasawara ◽  
Kathryn L. Pedula ◽  
William A. Goh
Keyword(s):  
Perinatal Outcomes ◽  
Kaiser Permanente ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Labor Duration ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
Comparison Groups ◽  
Maternal And Neonatal Outcomes ◽  
Interpregnancy Intervals

AbstractObjectivesShort interpregnancy intervals (IPI) have been linked to multiple adverse maternal and neonatal outcomes, but less is known about prolonged IPI, including its relationship with labor progression. The objective of the study was to investigate whether prolonged IPIs are associated with longer second stages of labor.MethodsA perinatal database from Kaiser Permanente Hawaii was used to identify 442 women with a prolonged IPI ≥60 months. Four hundred forty two nulliparous and 442 multiparous women with an IPI 18–59 months were selected as comparison groups. The primary outcome was second stage of labor duration. Perinatal outcomes were compared between these groups.ResultsThe median (IQR) second stage of labor duration was 76 (38–141) min in nulliparous women, 15 (9–28) min in multiparous women, and 18 (10–38) min in women with a prolonged IPI (p<0.0001). Pairwise comparisons revealed significantly different second stage duration in the nulliparous group compared to both the multiparous and prolonged IPI groups, but no difference between the multiparous and prolonged IPI groups. There was a significant association with the length of the IPI; median duration 30 (12–61) min for IPI ≥120 months vs. 15 (9–27) min for IPI 18–59 months and 16 (9–31) min for IPI 60–119 months (p=0.0014).ConclusionsThe second stage of labor did not differ in women with a prolonged IPI compared to normal multiparous women. Women with an IPI ≥120 months had a significantly longer second stage vs. those with a shorter IPI. These findings provide a better understanding of labor progression in pregnancies with a prolonged IPI.

Short-form 6D assessment in compression module of the American College of Phlebology Patient Reported Outcome Venous Registry

2017 ◽  
Vol 33 (6) ◽  
pp. 425-429 ◽  
Author(s):  
Yung-Wei Chi ◽  
Blythe Durbin-Johnson ◽  
Marlin Schul
Keyword(s):  
Short Form ◽  
Patient Reported Outcome ◽  
Compression Stockings ◽  
Test Analysis ◽  
Linear Mixed Effects Model ◽  
Linear Mixed Effects ◽  
Time Period ◽  
Patient Reported ◽  
Registry Analysis

Objective The goal of this American College of Phlebology Patient Reported Outcome Venous Registry analysis was to examine the clinical efficacy of compression stockings using short-form 6D questionnaire (SF-6D). Method SF-6D scores were modeled over time using linear mixed effects model. Changes of SF-6D score from baseline to the last encounter were examined using a paired t-test. Analysis of variance was used to compare changes from baseline in SF-6D scores between C classifications. All analyses were conducted using SAS software, version 9.4 (SAS Institute, Cary NC). Results Baseline mean SF-6D score was 0.83 and at follow-up, 0.85. Mean SF-6D change was +0.02 points (P = .001) over an average time period of 5.5 months. Patients’ SF-6D scores were estimated to increase by +0.03 points (P = .005) per year of usage of compression stockings. SF-6D score changes across C classifications did not demonstrate significant differences (P = .265). Conclusion There was an improvement of SF-6D score in the registry participants who used circular knit compression stockings.

The level of unpleasantness of pain influences the choice of home treatment during medical abortion

2011 ◽  
Vol 2 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Satu Suhonen ◽  
Marja Tikka ◽  
Seppo Kivinen ◽  
Timo Kauppila
Keyword(s):  
Medical Abortion ◽  
Nulliparous Women ◽  
Home Based ◽  
Vaginal Deliveries ◽  
Multiparous Women ◽  
Induced Abortions ◽  
Pain Drawings ◽  
Nonopioid Analgesics ◽  
Post Abortion ◽  
At Home

AbstractBackground and aimsMedical abortion is often performed at outpatient clinics or gynaecological wards. Yet, some women may stay at home during medical abortion. Pain has been reported to be one of the main side effects of the procedure.MethodsWe studied whether perceived abortion pain was related to the subjectively evaluated ability to stay at home during medical abortion. The size of the study group was 29 women. We also studied how well these women remembered the intensity and unpleasantness of the abortion pain in a control visit performed 3–6 weeks after abortion.ResultsEspecially, the unpleasantness associated with the pain during abortion was an important predictor when women evaluated their ability to stay at home during medical abortion. In those women who might have been able to stay at home in their own view, midwives looking after these women at the outpatient clinic estimated the pain intensity and unpleasantness also about 50% lower than in those who were not able to stay home in their own view. There were no significant differences in intensity, unpleasantness in hindsight of menstruation pain, or the area of this pain in the pain drawings in those women who considered that they might have stayed at home during medical abortion when compared with those who did not. No difference was found in age, gestational age, magnitude of previous pregnancies, miscarriages, vaginal deliveries, induced abortions, Beck’s Depression Index (BDI), Beck’s Anxiety Index (BAI) or AUDIT scores between those who could have stayed at home or those who would not have been able to stay at home during abortion. Components of abortion pain decreased significantly during the second post-abortion day. The more deliveries the subject had experienced the less pain she had during abortion. Multiparous women reported less than a fourth of the pain magnitude of the nulliparous women during abortion. Parity explained both intensity and unpleasantness of abortion pain better than the expected ability to stay at home. The remembrance of the intensity or unpleasantness of abortion pain correlated with actual pain reported at the time of abortion. However, this remembrance did not correlate with the ability to stay at home during the medical abortion.ConclusionsThe unpleasantness of pain during and immediately after abortion was recalled, not as a measure of the pain itself, but as a deciding factor in their judgement of whether or not they would be able to undergo medical abortion at home. Abortion pain is an important factor in enhancing home-based management of medical abortions. Medical staff may be able to detect those women who do not cope at home during the process by observing the intensity of pain. Therefore, proper treatment of pain might reduce the need for hospital-based medical abortions.ImplicationsThese patients need better care and guidelines for the care of women undergoing medical abortions should include clear recommendations for analgesic treatments, at the least adequate doses of nonopioid analgesics such as paracetamol in combination with NSAIDs like ibuprofen or diclofenac.

scholarly journals Restoration thinning reduces bush encroachment on freehold farmlands in north-central Namibia

2021 ◽  
Author(s):  
Matti T Nghikembua ◽  
Laurie L Marker ◽  
Bruce Brewer ◽  
Arvo Leinonen ◽  
Lauri Mehtätalo ◽  
...  
Keyword(s):  
Wildlife Habitat ◽  
Bush Encroachment ◽  
Mature Trees ◽  
Linear Mixed Effects Model ◽  
North Central ◽  
Linear Mixed Effects ◽  
Height Class ◽  
The Mean ◽  
Generalized Linear Mixed Effects ◽  
Restoration Measures

Abstract Bush encroachment affects ~45 million ha of Namibia and, without appropriate restoration measures, it negatively affects rangeland productivity and biodiversity. Thinning is a common method to counteract bush encroachment. The thinning strategy applied in north-central Namibia was assessed to examine how effective it has been in reducing bush encroachment. Trees/shrubs were selectively thinned manually, targeting all height classes, except individuals with stem diameters ≥18 cm. We investigated the effects on the vegetation and soil properties using surveys on three freehold farms (in 2016 and 2017) in bush-encroached and previously thinned habitats. Our results revealed significant differences in the mean total nitrogen (TN) content between the treatments; thinned areas had higher TN content which would be beneficial for fast-growing grasses. In the thinned plots, the occurrence probability of red umbrella thorn (Vachellia reficiens Warwa) was significantly reduced, indicating that it was the most harvested species; and umbrella thorn (Vachellia tortilis (Burch.) Brenan spp. heteracantha) was increased, indicating that it favoured reduced densities of dominant species. Natural regeneration was rapid; the tree/shrub abundance in the 0–1-m height class in the thinned area surpassed those in the non-thinned by 34 per cent, ~7.2 years since thinning. Thinning significantly reduced tree/shrub abundances of the 1–3- and &gt;3-m height classes, which was still evident 7.2 years since thinning. Based upon the generalized linear mixed-effects model, tree/shrub counts between treatments may equalize in ~14 and 15 years for the 1–3- and &gt;3-m height classes, respectively. Thinning was effective in reducing tree/shrub abundances and can be used to restore wildlife habitat on the Namibian farmland: however, post-thinning management is required to maintain an open savannah vegetation structure as the 0–1-m height class cohort will eventually grow into mature trees/shrubs.

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