scholarly journals Clinical Effects of Form-Based Management of Forceps Delivery under Intelligent Medical Model

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Siming Xin ◽  
Zhizhong Wang ◽  
Hua Lai ◽  
Lingzhi Liu ◽  
Ting Shen ◽  
...  
Keyword(s):  
Success Rate ◽  
Medical Model ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Clinical Effects ◽  
Forceps Delivery ◽  
Delivery Methods ◽  
Maternal And Neonatal Outcomes ◽  
The One

Background. Forceps delivery is one of the most important measures to facilitate vaginal delivery. It can reduce the rate of first cesarean delivery. Frustratingly, adverse maternal and neonatal outcomes associated with forceps delivery have been frequently reported in recent years. There are two major reasons: one is that the abilities of doctors and midwives in forceps delivery vary from hospital to hospital and the other one is lack of regulations in the management of forceps delivery. In order to improve the success rate of forceps delivery and reduce the incidence of maternal and neonatal complications, we applied form-based management to forceps delivery under an intelligent medical model. The aim of this work is to explore the clinical effects of form-based management of forceps delivery. Methods. Patients with forceps delivery in Maternal and Child Health Hospital Affiliated to Nanchang University were divided into two groups: form-based patients from January 1, 2019, to December 31, 2020, were selected as the study group, while traditional protocol patients from January 1, 2017, to December 31, 2018, were chosen as the control group. Then, we compared the maternal and neonatal outcomes of these two groups. Results. There were significant differences in the maternal and neonatal adverse outcomes such as rate of postpartum hemorrhage, degree of perineal laceration, and incidence of neonatal facial skin abrasions between the two groups, whereas differences in the incidence of asphyxia and intracranial hemorrhage were not significant. Conclusions. Form-based management could help us assess the security of forceps delivery comprehensively, as it could not only improve the success rate of the one-time forceps traction scheme but also reduce the incidence of maternal and neonatal adverse outcomes effectively.

scholarly journals Association between Adherence with Recommended Antenatal Care in Low-Risk, Uncomplicated Pregnancy, and Maternal and Neonatal Adverse Outcomes: Evidence from Italy

2020 ◽  
Vol 18 (1) ◽  
pp. 173
Author(s):  
Giovanni Corrao ◽  
Anna Cantarutti ◽  
Anna Locatelli ◽  
Gloria Porcu ◽  
Luca Merlino ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Prevalence Ratio ◽  
Population Based ◽  
Adverse Outcomes ◽  
Low Risk ◽  
Neonatal Outcomes ◽  
Lombardy Region ◽  
Uncomplicated Pregnancy ◽  
Maternal And Neonatal Outcomes ◽  
Estimate Prevalence

Antenatal care (ANC) aims of monitoring wellbeing of mother and foetus during pregnancy. We validate a set of indicators aimed of measuring the quality of ANC of women on low-risk, uncomplicated pregnancy through their relationship with maternal and neonatal outcomes. We conducted a population-based cohort study including 122,563 deliveries that occurred between 2015 and 2017 in the Lombardy Region, Italy. Promptness and appropriateness of number and timing of gynaecological visits, ultrasounds and laboratory tests were evaluated. We assessed several maternal and neonatal outcomes. Log-binomial regression models were used to estimate prevalence ratio (PR), and corresponding 95% confidence interval (95% CI), for the exposure→outcome association. Compared with women who adhered with recommendations, those who were no adherent had a significant higher prevalence of maternal intensive care units admission (PR: 3.1, 95%CI: 1.2–7.9; and 2.7, 1.1–7.0 respectively for promptness of gynaecological visits, and appropriateness of ultrasound examinations), low Apgar score (1.6, 1.1–1.2; 1.9, 1.3–2.7; and 2.1, 1.5–2.8 respectively for appropriateness and promptness of gynaecological visits, and appropriateness of ultrasound examinations), and low birth weight (1.8, 1.5–2.3 for appropriateness of laboratory test examinations). Benefits for mothers and newborn are expected from improving adherence to guidelines-driven recommendations regarding antenatal care even for low-risk, uncomplicated pregnancies.

scholarly journals Maternal and Neonatal Outcomes after Attempted External Cephalic Version among Women with One Previous Cesarean Delivery

2018 ◽  
Vol 08 (04) ◽  
pp. e349-e354 ◽  
Author(s):  
Rodney McLaren ◽  
Fouad Atallah ◽  
Nelli Fisher ◽  
Howard Minkoff
Keyword(s):  
Cesarean Delivery ◽  
Retrospective Cohort ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
External Cephalic Version ◽  
Multivariable Logistic Regression Analysis ◽  
Success Rates ◽  
Trial Of Labor ◽  
Maternal And Neonatal Outcomes ◽  
Previous Cesarean

Objective This study was aimed to evaluate success rates of (1) external cephalic version (ECV) among women with one prior cesarean delivery (CD) and (2) maternal and neonatal outcomes after ECV among women with prior CD. Study Design Two linked studies using U.S. Natality Database were performed. First we performed a retrospective cohort comparing ECV success rates of women with prior CD and women without prior CD. Then we compared the outcomes of TOLACs (trial of labor after cesarean delivery) that occurred after ECV with those that occurred without ECV. Multivariable logistic regression analysis was used to estimate adverse outcomes. Results A total of 715 women had ECV after 36 weeks with prior CD and 9,976 had ECV without prior scar. ECV success rate with scar was 80.6% and without scar was 86.4% (p < 0.001). Seven hundred and sixteen women underwent TOLAC after ECV attempt and 234,617 underwent TOLAC without a preceding attempt. Women with preceding version had increased risks of maternal transfusion (1 vs. 0.4%, adjusted OR [odds ratio]: 2.48 [95% CI (confidence interval): 1.17–5.23]), unplanned hysterectomy (0.4 vs. 0.06%, adjusted OR: 6.90 [95% CI: 2.19–21.78]), and low 5-minute Apgar's score (2.5 vs. 1.5%, adjusted OR: 1.76 [95% CI: 1.10–2.82]). Conclusion Women with prior CD may have a decrease in the rate of successful ECV. While the absolute risks are low, ECV appears to increase risks of adverse maternal and neonatal outcomes among women undergoing a trial of labor.

Maternal and Neonatal Outcomes of Successful Kiellandʼs Rotational Forceps Delivery

2013 ◽  
Vol 121 (5) ◽  
pp. 1032-1039 ◽  
Author(s):  
Sarah J. Stock ◽  
Katherine Josephs ◽  
Sarah Farquharson ◽  
Corinne Love ◽  
Sarah E. Cooper ◽  
...  
Keyword(s):  
Neonatal Outcomes ◽  
Forceps Delivery ◽  
Maternal And Neonatal Outcomes

Rate of teenage pregnancy in Jordan and its impact on maternal and neonatal outcomes

2017 ◽  
Vol 31 (6) ◽  
Author(s):  
Yousef S. Khader ◽  
Anwar Batieha ◽  
Rana Kareem Al fursan ◽  
Rami Al-Hader ◽  
Sa’ad S. Hijazi
Keyword(s):  
Teenage Pregnancy ◽  
Small Sample ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
National Study ◽  
Premature Delivery ◽  
Discharge Data ◽  
Increased Risk ◽  
Maternity Hospitals ◽  
Maternal And Neonatal Outcomes

Abstract Objective Research regarding the adverse outcomes of adolescent childbearing has suffered from many limitations such as a small sample size and non-representative samples. This study was conducted to determine the rate of teenage pregnancy among Jordanian adolescents and its associated adverse maternal and neonatal outcomes. Methods The study is a part of a comprehensive national study of perinatal mortality that was conducted between 2011 and 2012 in Jordan. All women who gave birth after 20 weeks of gestation in 18 maternity hospitals in Jordan between 2011 and 2012 were invited to participate in the study. Consenting women were interviewed by the trained midwives in these hospitals using a structured questionnaire prepared for the purpose of this study. Additional information was also collected based on the physical examination by the midwife and the obstetrician at admission and at discharge. Data on the newborn were also collected by the pediatric nurses and the neonatologists in these hospitals. Results The overall rate of teenage pregnancy [95% confidence interval (CI) was 6.2% (5.9%, 6.5%)]. Of the studied maternal and neonatal outcomes, women aged <20 years were more likely to deliver prematurely compared to women aged 20–35 years [odds ratio (OR)=1.5, 95% CI: 1.2, 1.9; p < 0.005)]. However, the two groups of women did not differ significantly in low birth weight delivery (OR = 1.2, 95% CI: 0.9, 1.5; p = 0.167) and neonatal mortality (OR = 1.2, 95% CI: 0.8, 1.3; p = 0.491) in the multivariate analysis. Conclusion Teenage pregnancy was associated with increased risk of premature delivery, apart from the effects of socioeconomic factors.

scholarly journals Effects of the Timing of Labour Induction on Maternal and Neonatal Outcomes in Low-risk Nulliparous Chinese Women

2020 ◽  
Author(s):  
Qiang WEI ◽  
Qin-yan CAO ◽  
Li ZHANG ◽  
Yi XU ◽  
Mei-fan DUAN
Keyword(s):  
Neonatal Intensive Care ◽  
Chinese Women ◽  
Low Risk ◽  
Neonatal Outcomes ◽  
Labour Induction ◽  
Control Group ◽  
Study Group ◽  
Retrospective Case ◽  
Maternal And Neonatal Outcomes ◽  
Control Study

Abstract Backgroud: When labour induction should be offered to women at or beyond term is unclear. This work aimed to investigate the effects of the timing of labour induction on maternal and neonatal outcomes in low-risk pregnancies. Methods: This retrospective case-control study involved low-risk primigravid pregnant mothers in whom labour was induced at 40-41+6 weeks at our two hospitals between January and December 2017. According to the gestational age at labour induction, participants were categorized into the study group (40-40+6 weeks, n=284) or to the control group (41-41+6 weeks, n=172), and maternal and neonatal outcomes were compared.Results: The study group showed significantly shorter labour in the first stage (391.8±225.7 vs. 472.0±268.9 min, P=0.006), second stage (65.41±38.66 vs. 53.73±31.58 min, P= 0.008) and total stage (453.0±235.8 vs. 535.7±259.8 min, P=0.005). The two groups showed no significant differences in the methods of labour induction or in the rates of failure of labour induction, of caesarean delivery, of postpartum haemorrhage, or of admission to the neonatal intensive care unit.Conclusions: Our retrospective study suggests that inducing labour at 40-40+6 weeks does not increase the risk of adverse maternal or foetal outcomes, and that it shortens labour. These results suggest that labor induction at 40-40+6 weeks was feasible for low-risk primiparas.Trial registration: The research has been approved by the Ethics Committee of West China Second Hospital of Sichuan University and Chengdu Women and Children's Central Hospital, China. Patients gave written informed consent for their anonymized medical data to be analyzed and published for research purposes.

scholarly journals Prevalence of Gestational Diabetes Mellitus, Maternal and Neonatal outcomes in a Peripheral Hospital in North India

2017 ◽  
Vol 5 (6) ◽  
pp. 2343 ◽  
Author(s):  
Naiyma Choudhary ◽  
Mohd Rasheed ◽  
Vivek Aggarwal
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Hypertension ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
North India ◽  
Peripheral Hospital ◽  
Medical Entity ◽  
Maternal And Neonatal Outcomes

Background: Gestational diabetes mellitus (GDM) is a well-known medical entity which should be diagnosed at the earliest to prevent adverse maternal and neonatal outcomes due to hyperglycemia.Methods: This study was done in patients attending antenatal OPD in a peripheral hospital in North India. A total of 569 patients diagnosed as GDM were included in the study out of 6321 who attended the antenatal clinic.Results: The prevalence of gestational diabetes mellitus was found to be 9%. Gestational hypertension was seen in 29.35% of patients. The percent of babies who were admitted to NICU was 29.35%.Conclusions: These results stress the need for early detection and treatment of GDM to prevent adverse outcomes.

scholarly journals Obstetric and Neonatal Outcomes Related To Intrapartum Hydration Strategies in Low-Risk Deliveries: An Observational Study

2021 ◽  
Author(s):  
Ana B. Hernández-López ◽  
Cristina Muriel-Miguel ◽  
Tirso Pérez-Medina ◽  
Aurora Fernández-Cañadas Morillo ◽  
Carolina López-Lapeyrere ◽  
...  
Keyword(s):  
Weight Loss ◽  
Total Duration ◽  
Adverse Outcomes ◽  
Low Risk ◽  
Neonatal Outcomes ◽  
Nulliparous Women ◽  
Study Population ◽  
Maternal And Neonatal Outcomes ◽  
Prolonged Labor ◽  
Myometrial Contractility

Abstract Background Effective myometrial contractility is important for successful labor, although little attention has been paid to the effect of managing intrapartum fluid intake. Ineffective myometrial contractility leads to prolonged labor, thus increasing obstetric and neonatal adverse outcomes. The risk of prolonged labor can be reduced by increasing the total volume of fluids administered during labor. Objective To determine the hydration strategies applied in nulliparous women undergoing low risk labor and their association with obstetric and neonatal outcomes. Methods A prospective cohort study was conducted in a Universitary Hospital. The study population included nulliparous women who presented in active labor or induced labor. Sample size was 147. In order to stratify women based on the hydration received, we set as a cut-off point the mean total volume administered per hour (300 ml/h). This enabled to compare obstetric, clinical, and neonatal outcomes in women who had received ≥ 300 mL/h o < 300 mL/h. The primary outcome was total length of labor. Secondary outcomes included maternal and neonatal outcomes. Results The study population comprised 148 nulliparous women, mean (DS) age 32.2 (4.4) years, mean (DS) gestational age of 39.4 (1.41) weeks. At admission, median (IQR) dilation was 2 (1–3) cm. Labor was induced in 65.5% (n = 97). Obstetric and neonatal outcomes were more favorable in women who received a ≥ 300 mL/h volume, with statistically significant median differences in the duration total duration of labor (526 vs 735 min; p < 0.001). Clinically relevant differences were also observed with respect to cesarean delivery (14.3% vs 18.7%), fever (5.5% vs 7.7%), weight loss at 24 hours (–2.3% vs − 3%) and at 48 hours (–5.7% vs − 6.3 %), incidence of weight loss > 7% at 48 hours (28.6% vs 39.8%), breastfeeding (94.6% vs 82.4%). Conclusions Higher fluid volume administered to nulliparous women during low-risk labor is associated with improved obstetric and neonatal outcomes.

scholarly journals Maternal and neonatal outcomes in pregnancies complicated by maternal obesity

2019 ◽  
Vol 8 (2) ◽  
pp. 474
Author(s):  
Sudha Menon ◽  
Sivaprasad K.
Keyword(s):  
High Risk ◽  
Maternal Obesity ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Induction Of Labour ◽  
Large For Gestational Age ◽  
Obese Women ◽  
Maternal And Neonatal Outcomes

Background: Maternal obesity imparts elevated maternal and neo natal adverse outcomes. Aim of the study was to evaluate and analyse the maternal and neonatal outcomes in obese mothers.Methods: This was a prospective case control study in a tertiary care high risk referral center. Antenatal women with first trimester Body mass index (BMI) of more than 30 Kg/m2 constituted the cases and those antenatal women with BMI <25 Kg/m2 formed the controls.Results: Mean age was slightly more (28.6±4.3 years vs 26.3±3.6 years: P<0.0001) in the obese group. Obese women were significantly more likely to have  of gestational diabetes (OR 5.2, 95% CI 3.2-8.7 P<0.00001), gestational hypertension (Or 3.5, 95% CI 2.1-5.9 P<0.0001) , induction of labour (OR 2.5, 95% CI 1.8-3.6 P<0.0001), failed induction of labour (OR 2.4, 95% CI 1.3-4.2 P=0.003), Preeclampsia (OR 2.8, 95% CI 1.6-4.9 P=0.0002), Caesarian section (Or 4.0, 95% CI 2.9-5.9 P<0.0001) and Postpartum hemorrhage (OR 4.0,95% CI 1.1-14.3 P=0.034), prolonged hospital stay (OR 12.8, 95% CI 7.7-21.1 P<0.0001)  and adverse neonatal outcomes such as low(<7) Apgar (OR 3.2, 95% CI 1.1-10.0 P=0.03), Large for gestational age babies (OR 3.1, 95% Cl 2.1-4.5 P<0.0001) and transfer to new born nursery (OR 3.4, 95% CI 2.3 -5.2 P<0.0001).Conclusions: Maternal obesity in pregnancy is high risk and has many adverse maternal and neonatal outcomes warranting specialized antenatal, intranatal and post-natal care.

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