scholarly journals Redefining Second Stage of Labor: Number of Pushing Contractions

2020 ◽  
Vol 10 (02) ◽  
pp. e183-e186
Author(s):  
Serin M. Bok ◽  
Gabriela E. Pena Carmona ◽  
Jake Crawford ◽  
Ramy Eskander ◽  
Mina Desai ◽  
...  
Keyword(s):  
Uterine Contraction ◽  
Medical Center ◽  
Spontaneous Vaginal Delivery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Newborn Weight ◽  
Time Standards ◽  
Term Newborns ◽  
Second Stage Labor ◽  
Maternal Effort

Abstract Introduction Despite time standards for second stage labor, “delayed pushing,” uterine contraction frequency, and alternate contraction pushing may alter the effective maternal effort. We sought to quantify the number of pushing contractions needed for a spontaneous vaginal delivery (SVD) among primipara and multipara patients. Methods Deliveries at Harbor-UCLA Medical Center in 2017 were selected for SVD of singleton, term newborns. The first 100 primipara and 100 multipara deliveries were analyzed and monitor tracings quantified for pushing contractions. Results Significantly more pushing contractions were required by primiparas versus multiparas (17.3 ± 1.7 vs. 5.5 ± 0.7; p < 0.001) in accord with a longer second stage (86.7 ± 7.8 vs. 27.2 ± 4.9 min; p < 0.001) and epidural was associated with greater number of pushing contractions among both primipara (18.5 ± 1.8 vs. 10.8 ± 0.8) and multipara women (6.1 ± 0.8 vs. 4.1 ± 0.3). Newborn weight (<3000, 3000–3500, >3500 g) demonstrated a trend for increased pushing contractions among primipara (16.9, 16.5, 19.8 pushes, respectively) though not multiparas. Conclusion Although correlated with the absolute duration of the second stage, the number of pushing contractions eliminates ambiguities of “delayed pushing,” pushing every-other, and frequency of contractions. Examination of larger databases and patients with second stage “arrest disorders” may provide pushing contraction criteria predictive of SVD and prevention of morbidity.

scholarly journals Analisis Perbedaan Posisi Meneran Miring Kiri dan Setengah Duduk Pada Ibu Bersalin Dengan Lama Kala II Di RSUD Dr. H. Moch Anshari Saleh Banjarmasin

2019 ◽  
pp. 39-46
Author(s):  
Dewi Pusparani Sinambela ◽  
St. Hateriah
Keyword(s):  
Univariate Analysis ◽  
Data Retrieval ◽  
Bivariate Analysis ◽  
P Value ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Long Time ◽  
Second Stage Labor

Latar Belakang: Lama Kala II dalam persalinan yaitu jangka waktu mulai dari serviks berdilatasi penuh sampai dengan kelahiran bayi tidak boleh melebihi 2 jam pada primigravidan dan 1 jam pada multigravida. Pemilihan posisi melahirkan sangat dianjurkan untuk memberikan rasa nyaman pada ibu, posisi dapat membantu penurunan janin ke dasar panggul dan mempercepat proses persalinan. Dari data yang diperoleh bulan Januari 2018 jumlah persalinan kala II lama sebanyak 0,30% dari 240 persalinan normal.Tujuan: Menganalisis Perbedaan Posisi Meneran Miring Kiri dan Setengah Duduk Pada Ibu Bersalin Dengan Lama Kala II.Metode: Jenis penelitian ini adalah Analisis kuantitatif. Rancangan penelitian menggunakan quasi eksperiment. Populasi penelitian semua ibu bersalin di RSUD Dr. H. Moch Anshari Saleh Banjarmasin. Pengambilan sebanyak 30 responden. Pengambilan data dilakukan dengan menggunakan ceklist. Analisa data yang dilakukan adalah Analisa Univariat dan Analisa Bivariat dengan uji Fisher Exact Test.Hasil: Responden yang menggunakan posisi meneran miring kiri 15 orang (50%) dan setengah duduk sebanyak 15 orang (50%). Jumlah responden primipara yang mengalami persalinan kala II 60 menit sebanyak 12 orang (40,0%), primipara yang mengalami kala II 60 menit sebanyak 2 orang (6,7%) dan responden multipara yang mengalami kala II 30 menit sebanyak 16 orang (53,3%), multipara yang mengalami kala II 30 menit sebanyak 0 orang (0%) dari hasil uji Fisher Exact Test dengan nilai p sebesar 0,483.Simpulan: Tidak ada perbedaan posisi miring kiri dengan posisi setengah duduk terhadap kemajuan persalinan kala II di RSUD Dr. H. Moch. Anshari Saleh Banjarmasin. Kata Kunci: Lama Kala II, Persalinan, Posisi Meneran.   Analysis of Different Left and Half Posisition Straining on Mother with Second Duration of Labour In RSUD Dr. H. Moch Anshari Saleh BanjarmasinABSTRACT Background: The duration of second stage of labor is the period from the full dilated cervix to the birth of the baby should not exceed 2 hours in primigravida and 1 hour in multigravida. Position selection is very beneficial for giving comfort to the mother, the position can help lower the fetus to the pelvic floor and improve labor. From the data obtained in January 2018 the number of prolonged second stage deliveries was 0.30% of 240 normal deliveries.Objective: Analyze the Differences in Position Meniring Left and Half Seated at the Maternity with Long Time II.Method: This type of research is quantitative analysis. The study design used quasi experiment. The study population of all mothers giving birth at Dr. RSUD H. Moch Anshari Saleh Banjarmasin. Taking as many as 30 respondents. Data retrieval is done using a checklist. Data analysis performed was Univariate Analysis and Bivariate Analysis with Fisher Exact Test.Results: Respondents who used the left oblique piercing position were 15 people (50%) and half sat as many as 15 people (50%). The number of primiparous respondents who increased labor at second time 60 minutes was 12 people (40.0%), primipara who added second stage 60 minutes as many as 2 people (6.7%) and multiparous respondents who used second time 30 minutes as many as 16 people (53.3%), multiparas who replaced time II 30 minutes as many as 0 people (0%) from the results of the Fisher Exact Test with a p value of 0.483.Conclusion: There was no difference in left oblique position with sitting position towards the progress of second stage labor in Dr. Hospital. H. Moch. Ansari Saleh Banjarmasin.  Keywords : Second Duration, Labour, Straining Position 

Angle of Progression on Ultrasound in the Second Stage of Labor and Spontaneous Vaginal Delivery

2017 ◽  
Vol 35 (04) ◽  
pp. 413-420 ◽  
Author(s):  
Caroline Rouse ◽  
David Cantonwine ◽  
Sarah Little ◽  
Thomas McElrath ◽  
Julian Robinson ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Transperineal Ultrasound ◽  
Survival Models ◽  
Spontaneous Vaginal Delivery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Nulliparous Women ◽  
Angle Of Progression

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.

scholarly journals URINARY INCONTINENCE THREE MONTHS AFTER DELIVERY;

2013 ◽  
Vol 20 (04) ◽  
pp. 530-536
Author(s):  
HABIBA SHARAF ALI ◽  
NIDA ANWAR LAKHANI ◽  
NAILA GHULAM SARWAR
Keyword(s):  
Urinary Incontinence ◽  
Mode Of Delivery ◽  
Antenatal Clinic ◽  
Third Trimester ◽  
Spontaneous Vaginal Delivery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
The Third ◽  
Continence Status ◽  
Obstetric Factors

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.

Prediction of spontaneous vaginal delivery in nulliparous women with a prolonged second stage of labor: the value of intrapartum ultrasound

2019 ◽  
Vol 221 (6) ◽  
pp. 642.e1-642.e13 ◽  
Author(s):  
Andrea Dall’Asta ◽  
Laura Angeli ◽  
Bianca Masturzo ◽  
Nicola Volpe ◽  
Giovanni Battista Luca Schera ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Spontaneous Vaginal Delivery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Nulliparous Women

scholarly journals HUBUNGAN TINGKAT KECEMASAN DENGAN LAMA PERSALINAN KALA II PADA IBU BERSALIN DI RSIA ANUGERAH MEDICAL CENTER KOTA METRO

2018 ◽  
Vol 3 (1) ◽  
pp. 16
Author(s):  
Yona Desni Sagita
Keyword(s):  
Maternal Mortality ◽  
Frequency Distribution ◽  
Medical Center ◽  
Maternal Mortality Ratio ◽  
Anxiety Level ◽  
P Value ◽  
Cross Sectional ◽  
Second Stage Of Labor ◽  
Live Births ◽  
Second Stage

Abstrak: Berdasarkan data WHO tahun 2015 Rasio kematian ibu (MMR) selama kehamilan dan melahirkan berkisar antara 102/100.000 Kelahiran Hidup. Berdasarkan SDKI Tahun 2013 bahwa Angka Kematian Ibu di Indonesia sebesar 359 per 100.000 kelahiran hidup. Provinsi Lampung memiliki 130 kasus kematian ibu pada saat hamil, melahirkan dan nifas. Studi pendahuluan di Ruang Bersalin RSIA Anugerah Medical Center Kota Metro tahun 2016 bulan November sebanyak 22 ibu dengan perpanjangan kala II. Tujuan penelitian ini untuk mengetahui hubungan tingkat kecemasan terhadap lama persalinan kala II pada ibu bersalin di RSIA Anugerah Medical Center Kota Metro Tahun 2017.Jenis penelitian kualitatif dengan desain analitik dan pendekatan cross sectional. Populasi pada penelitian ini adalah semua seluruh ibu bersalin di RSIA Anugerah Medical Center Kota Metro sebanyak 50 ibu, sedangkan sampel diambil dengan tehnik total sampling sebanyak 50 ibu. Analisis yang digunakan adalah univariat dengan distribusi frekuensi dan bivariat menggunakan uji chi square.Hasil penelitian diketahui bahwa tingkat kecemasan ibu bersalin sebagian besar dengan tingkat kecemasan sedang sebanyak 17 ibu (34%). lama persalinan kala II yang tidak normal sebanyak 22 ibu (44%). Ada hubungan antara tingkat kecemasan dengan lama persalinan kala II pada ibu bersalin dengan nilai p value: 0,009. Kesimpulan penelitian ada hubungan tingkat kecemasan terhadap lama persalinan kala II pada ibu bersalin di RSIA Anugerah Medical Center Kota Metro Tahun 2017, sehingga disarankan kepada tenaga kesehatan untuk meningkatkan berperan aktif dalam mengurangi tingkat kecemasan ibu selama proses persalinan karena berkaitan dengan gangguan pada proses persalinan. Abstract:  The maternal mortality ratio (MMR) during pregnancy and childbirth ranges based on WHO data 2015 estimated from 102 / 100,000 live births. IDHS in 2013 estimated that the Maternal Mortality Rate in Indonesia amounted to 359 per 100,000 live births. Lampung province has 130 cases of maternal mortality during pregnancy, childbirth and childbirth. Preliminary study at the Maternity Room of RSIA Anugerah Medical Center Metro City in 2016 November as many as 22 mothers with second stage extension. The purpose of this study to determine the relationship of anxiety level to the second stage of labor delivery to the maternal mother at RSIA Anugerah Medical Center Metro City Year 2017.This was a quantitative research, analytic survey design with cross sectional approach. The population was whole mother of maternity in RSIA Anugerah Medical Center Metro City that consisted of 50 mother, while sample taken with total sampling technique that consisted of 50 mother. The analysis used univariate with frequency distribution and bivariate using chi square test.The result showed frequency distribution of maternal anxiety level was mostly with moderate anxiety level of 17 mothers (34%). An abnormal second stage of labor during childbirth was 22 mothers (44%). There is no relationship between the level of anxiety with the duration of labor of stage II on maternal mothers with value p value: 0.009.  Conclusion of research there is correlation of anxiety level to the duration of labor of second stage at mother of maternity in RSIA Anugerah Medical Center of Metro City Year 2017. The suggestion for to health worker to increase active role in reducing mother's anxiety level during delivery process because related to disruption at delivery process.

A Randomized Control Trial of Bupivacaine and Fentanyl versus Fentanyl-only for Epidural Analgesia during the Second Stage of Labor

2015 ◽  
Vol 122 (1) ◽  
pp. 172-177 ◽  
Author(s):  
Margaret G. Craig ◽  
Erica N. Grant ◽  
Weike Tao ◽  
Donald D. McIntire ◽  
Kenneth J. Leveno
Keyword(s):  
Mode Of Delivery ◽  
Group Versus ◽  
Postnatal Period ◽  
Neonatal Outcomes ◽  
Motor Blockade ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Nulliparous Women ◽  
Epidural Bupivacaine ◽  
Second Stage Labor

Abstract Background: The purpose of this prospective, double-blinded, parallel-arm, randomized trial was to examine the effects of epidural bupivacaine on the length of the second stage of labor in nulliparous women. Methods: The authors assessed length of second-stage labor, degree of motor blockade, mode of delivery, and visual analog scores in 310 nulliparous women with labor epidurals randomized to receive either: (1) 0.125% bupivacaine and fentanyl 2 μg/ml or (2) fentanyl 10 μg/ml alone via epidural using double blinding. Results: The median duration of the second stage was 75 min (41, 128) in the bupivacaine/fentanyl group versus 73 min (42, 120) in the fentanyl-only group (P = 0.17) with a median difference of 6.0 (95% CI, −6.0 to 18.0). Furthermore, there was no difference in degree of motor blockade, incidence of operative delivery, visual analog scores, or neonatal outcomes between the two groups. No adverse events were reported. Conclusions: Use of epidural bupivacaine/fentanyl or a fentanyl-only infusion during the second stage of labor did not affect the duration of the second stage of labor, degree of motor blockade, mode of delivery, pain relief, and maternal or neonatal outcomes. However, in the fentanyl-only infusion group, there was a fivefold increase in opioid exposure to the fetus with unknown effects on neurobehavior, an outcome not assessed beyond the immediate postnatal period in this study.

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