The management of labour

2020 ◽  
pp. 331-338
Author(s):  
Devendra Kanagalingam
Keyword(s):  
Active Management ◽  
Cervical Dilatation ◽  
Routine Practice ◽  
Fetal Outcomes ◽  
Uterine Contractions ◽  
Best Management ◽  
Spontaneous Expulsion ◽  
Three Stages

Normal labour is a process of spontaneous expulsion of the fetus, placenta, and membranes at term. This process is initiated by complex endocrine mechanisms that cause uterine contractions which lead to effacement and dilatation of the cervix and descent of the fetus, resulting in delivery. About 10% of women go into labour in the preterm period. The progress is dependent on uterine contractions (power), the size and presentation of the fetus (passenger), and the size of the pelvis (passage). For ease of management, the observed labour is artificially divided into three stages. The partogram is used to manage labour and is where maternal and fetal observations can be plotted in addition to cervical dilatation and descent of the presenting part. The value of active management is still debated but has been adapted in routine practice. More research is needed to decide the best management of labour to optimize the maternal and fetal outcomes.

Using Intraumbilical Vein Injection of Oxytocin in Routine Practice With Active Management of the Third Stage of Labor

2010 ◽  
Vol 116 (3) ◽  
pp. 619-624 ◽  
Author(s):  
Kemal Güngördük ◽  
Osman Asicioglu ◽  
Berhan Besimoglu ◽  
Ozgu Celikkol Güngördük ◽  
Gokhan Yildirm ◽  
...  
Keyword(s):  
Active Management ◽  
Routine Practice ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage

Relations between fetal head descent and cervical dilatation during individual uterine contractions in the active stage of labor

2009 ◽  
Vol 35 (4) ◽  
pp. 654-659 ◽  
Author(s):  
Ofer Barnea ◽  
Oded Luria ◽  
Ariel Jaffa ◽  
Michael Stark ◽  
Harold E. Fox ◽  
...  
Keyword(s):  
Cervical Dilatation ◽  
Active Stage ◽  
Fetal Head ◽  
Uterine Contractions

scholarly journals Factors Influencing Perception of Labor Pain among Parturient Women at Tribhuvan University Teaching Hospital

2013 ◽  
Vol 8 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Isha Shrestha ◽  
N Pradhan ◽  
J Sharma
Keyword(s):  
Teaching Hospital ◽  
Demographic Data ◽  
Labor Pain ◽  
University Teaching ◽  
Cervical Dilatation ◽  
Factors Affecting ◽  
Primary Level ◽  
Uterine Contractions ◽  
Obstetrics And Gynaecology ◽  
Active Labor

Aims: This study was done to understand the severity of labor pain in parturients of Kathmandu and to determine factors affecting it. Methods: A descriptive study was conducted in Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal where 300 term parturientsin active labor (cervical dilatation of 3-5 cm with three uterine contractions in 10 minutes each lasting for ≥ 30 seconds) were analysed for socio-demographic data, clinical profile and pain assessment.Visual analog scale was used for pain assessment. Results: The intensity of labor pain was graded as severe by 32%, moderateby 57% and mild by 11% of parturients.Almost half ofthe parturients in the age group of ≤19years described labor pain as severe as compared to women between 20-34years (30.4%) and ≥35years (20%). Among the nulliparous parturients, 37% described it as severe compared to only 20.7% in≥Para1.In those with≥higher secondary leveleducation, 35.9% described labor pain as severe as compared to those women who had education of ≤primary level(26.9%) and upto secondary level (27.1%). Labor pain was seen to be more severe in advanced labor withmore than half describingit as severe when the cervix was dilated to 5 cm, as compared to only 25.9% and 29.4% of the parturients at 3 and 4cm cervical dilatation respectively. Conclusions: This study concluded that the labor pain was moderate to severe for majority of the parturients.Adolescents, nullipara, patients with higher education and those in advanced laborwere more likely to perceive labor pain of higher intensity. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 26-30 DOI: http://dx.doi.org/10.3126/njog.v8i1.8857

scholarly journals EFEKTIVITAS PIJAT EFFLEURAGE DAN COUNTERPRESSURE TERHADAP KEMAJUAN DILATASI SERVIKS PADA KALA I FASE AKTIF

2019 ◽  
Vol 7 (3) ◽  
pp. 185-190
Author(s):  
Retty Nirmala Santiasari ◽  
Detty Siti Nurdiati ◽  
Wiwin Lismidiati
Keyword(s):  
Sampling Technique ◽  
Active Phase ◽  
Labor Pain ◽  
Cervical Dilatation ◽  
Control Group ◽  
Research Subjects ◽  
Uterine Contractions ◽  
Average Improvement ◽  
Before And After ◽  
Post Test

Backgraound: Labor process begins with the process of cervical dilatation, which is commonly accompanied by pain. Labor pain caused by uterine contractions can cause thinning of the cervix. Effects of labor pain includes inflammation in uterus and labor dystocia. Effleurage and counterpressure are complementary treatment to stimulate uterine contractions. Objective: To analyze the effectiveness of effleurage and counterpressure massages on the progress of cervical dilatation. Method: This was a quasi-experiment study with pre-post test nonequivalent control group. Population was the women in labor in stage I active phase. Research subjects were 68 people that were divided into two groups. Sampling technique was consecutive sampling. Instrument used in this study was the internal examination. Data were analyzed using Wilcoxon and Mann Whitney. Results: The progress of cervical dilatation before and after the intervention of the effleurage was 4.74±0.83 vs 7.47±1.21 with p=0.00 and the result for the counterpressure group was 4.59±0.66 vs 8.03±0.96 with p=0.00. The average improvement of cervical dilatation on the effleurage and counterpressure groups was 2.73 vs 3.44 with p=0.00. Conclusion: The counterpressure has the more significant effect than the effleurage on improving the cervical dilatation.   Keywords: Cervical dilatation, counterpressure, effleurage

scholarly journals Role of methylergometrine versus oxytocin in the active management of third stage of labour: a randomised control trial

2021 ◽  
Author(s):  
Sabitha Umapathy Srinivasan ◽  
Swarnamukhi P.
Keyword(s):  
Blood Pressure ◽  
Blood Loss ◽  
Active Management ◽  
Randomised Control Trial ◽  
Routine Practice ◽  
Study Group ◽  
Randomized Design ◽  
Third Stage ◽  
The Mean

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal death globally. The routine practice of active management of third stage of labour has been shown to reduce haemorrhage by up to 60%. The present study evaluated the role of methylergometrine versus oxytocin in active management of third stage of labour in reducing the risk of PPH.Methods: This study was conducted on a total of 400 women admitted in the labour ward of PESIMSR hospital, by using simple randomized design. The first study group included women who received intramuscular oxytocin (n=200) and, the second group included women who received intravenous Methylergometrine (n=200) within, one minute of delivery of the baby.Results: The mean blood loss among study first and the second study group were 172.8 ml and 148.9 ml respectively (p<0.05) and, the mean duration of third stage of labour were 5.9 and 5.1 minutes respectively (p<0.05). The mean pre-and post-delivery haemoglobin values among the first and second group were 11.76 mg/dl, 10.46 mg/dl and, 11.76 mg/dl, 10.6 mg/dl respectively (p<0.05). There was an increase in the blood pressure in the ergometrine group and, slight decrease of blood pressure in oxytocin group.Conclusions: The use of methyl ergometrine as part of active management of third stage of labour was associated with a significant reduction in mean blood loss value, duration of third stage of labour, and the additional need of oxytocic though, methylergometrine has significant side effects like nausea, vomiting and rise in blood pressure.

scholarly journals Intrahepatic Cholestasis of Pregnancy in Women With Twin Pregnancy

2016 ◽  
Vol 19 (6) ◽  
pp. 697-707 ◽  
Author(s):  
Dan Shan ◽  
Yayi Hu ◽  
Peiyuan Qiu ◽  
Bechu Shelley Mathew ◽  
Yun Chen ◽  
...  
Keyword(s):  
Subgroup Analysis ◽  
Intrahepatic Cholestasis ◽  
Early Onset ◽  
Onset Time ◽  
Adverse Outcomes ◽  
Active Management ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Fetal Outcomes ◽  
Twin Pregnancies ◽  
Cholestasis Of Pregnancy

The aim of the present work was to determine maternal and fetal outcomes of intrahepatic cholestasis of pregnancy (ICP) in twin pregnancies. All twin pregnancies delivered above 28 gestational weeks in West China Second University Hospital from January 2013 to May 2015 were included. Data on maternal demographics and obstetric complications together with fetal outcomes were collected. The risk of adverse maternal and fetal outcomes were determined in relation to ICP by crude odds ratios (OR) and adjusted ORs (aOR) with 95% confidence intervals (CI). Subgroup analysis concentrated on the effect of assisted reproductive technology (ART), ICP severity, and onset time. A total of 1,472 twin pregnancies were included, of which 362 were cholestasis patients and 677 were conceived by ART. Higher rates of preeclampsia (aOR 1.96; 95% CI 1.35, 2.85), meconium-stained amniotic fluid (aOR 3.10; 95% CI 2.10, 4.61), and preterm deliveries (aOR 3.20; 95% CI 2.35, 4.37) were observed in ICP patients. Subgroup analysis revealed higher incidences of adverse outcomes in severe and early onset ICP groups. In conclusion, adverse maternal and fetal outcomes were strongly associated with ICP in twin patients. Active management and close antenatal monitoring are needed, especially in the early onset and severe groups.

scholarly journals EFEKTIVITAS PIJAT EFFLEURAGE DAN COUNTERPRESSURE TERHADAP KEMAJUAN DILATASI SERVIKS PADA KALA I FASE AKTIF

2019 ◽  
Vol 7 (3) ◽  
pp. 185-197
Author(s):  
Retty Nirmala Santiasari ◽  
Detty Siti Nurdiati ◽  
Wiwin Lismidiati
Keyword(s):  
Sampling Technique ◽  
Active Phase ◽  
Labor Pain ◽  
Cervical Dilatation ◽  
Control Group ◽  
Research Subjects ◽  
Uterine Contractions ◽  
Average Improvement ◽  
Before And After ◽  
Post Test

Backgraound: Labor process begins with the process of cervical dilatation, which is commonly accompanied by pain. Labor pain caused by uterine contractions can cause thinning of the cervix. Effects of labor pain includes inflammation in uterus and labor dystocia. Effleurage and counterpressure are complementary treatment to stimulate uterine contractions. Objective: To analyze the effectiveness of effleurage and counterpressure massages on the progress of cervical dilatation. Method: This was a quasi-experiment study with pre-post test nonequivalent control group. Population was the women in labor in stage I active phase. Research subjects were 68 people that were divided into two groups. Sampling technique was consecutive sampling. Instrument used in this study was the internal examination. Data were analyzed using Wilcoxon and Mann Whitney. Results: The progress of cervical dilatation before and after the intervention of the effleurage was 4.74±0.83 vs 7.47±1.21 with p=0.00 and the result for the counterpressure group was 4.59±0.66 vs 8.03±0.96 with p=0.00. The average improvement of cervical dilatation on the effleurage and counterpressure groups was 2.73 vs 3.44 with p=0.00. Conclusion: The counterpressure has the more significant effect than the effleurage on improving the cervical dilatation. Keywords: Cervical dilatation, counterpressure, effleurage

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