scholarly journals Methods of induction of labor and women’s experience: a population-based cohort study with mediation analyses

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pauline Blanc-Petitjean ◽  
Corinne Dupont ◽  
Bruno Carbonne ◽  
Marina Salomé ◽  
François Goffinet ◽  
...  
Keyword(s):  
Balloon Catheter ◽  
Population Based ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Global Satisfaction ◽  
Mediation Analyses ◽  
Adjusted Risk ◽  
Maternal Experience ◽  
Mediating Role ◽  
Women's Experience

Abstract Background Negative childbirth experience may affect mother wellbeing and health. However, it is rarely evaluated in studies comparing methods of induction of labor (IoL). Aim To compare women’s experience of IoL according to the method, considering the mediating role of interventions and complications of delivery. Methods We used data from the MEDIP prospective population-based cohort, including all women with IoL during one month in seven French perinatal networks. The experience of IoL, assessed at 2 months postpartum, was first compared between cervical ripening and oxytocin, and secondarily between different cervical ripening methods. Mediation analyses were used to measure the direct and indirect effects of cervical ripening on maternal experience, through delivery with interventions or complications. Findings The response rate was 47.8% (n = 1453/3042). Compared with oxytocin (n = 541), cervical ripening (n = 910) was associated less often with feelings that labor went ‘as expected’ (adjusted risk ratio for the direct effect 0.78, 95%CI [0.70–0.88]), length of labor was ‘acceptable’ (0.76[0.71–0.82]), ‘vaginal discomfort’ was absent (0.77[0.69–0.85]) and with lower global satisfaction (0.90[0.84–0.96]). Interventions and complications mediated between 6 and 35% of the total effect of cervical ripening on maternal experience. Compared to the dinoprostone insert, maternal experience was not significantly different with the other prostaglandins. The balloon catheter was associated with less pain. Discussion Cervical ripening was associated with a less positive experience of childbirth, whatever the method, only partly explained by interventions and complications of delivery. Conclusion Counselling and support of women requiring cervical ripening might be enhanced to improve the experience of IoL.

scholarly journals Outpatient Induction of Labor – Are Balloon Catheters an Appropriate Method?

2021 ◽  
Vol 81 (01) ◽  
pp. 70-80
Author(s):  
Werner Rath ◽  
Patrick Stelzl ◽  
Sven Kehl
Keyword(s):  
Hospital Stay ◽  
Balloon Catheter ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Controlled Study ◽  
Complication Rates ◽  
Balloon Catheters ◽  
Cervical Priming ◽  
Oral Misoprostol ◽  
Uterine Hyperstimulation

AbstractAs the number of labor inductions in high-income countries has steadily risen, hospital costs and the additional burden on obstetric staff have also increased. Outpatient induction of labor is therefore becoming increasingly important. It has been estimated that 20 – 50% of all pregnant women requiring induction would be eligible for outpatient induction. The use of balloon catheters in patients with an unripe cervix has been shown to be an effective and safe method of cervical priming. Balloon catheters are as effective as the vaginal administration of prostaglandin E2 or oral misoprostol. The advantage of using a balloon catheter is that it avoids uterine hyperstimulation and monitoring is less expensive. This makes balloon catheters a suitable option for outpatient cervical ripening. Admittedly, intravenous administration of oxytocin to induce or augment labor is required in approximately 75% of cases. Balloon catheters are not associated with a higher risk of maternal and neonatal infection compared to vaginal PGE2. Low-risk pregnancies (e.g., post-term pregnancies, gestational diabetes) are suitable for outpatient cervical ripening with a balloon catheter. The data for high-risk pregnancies are still insufficient. The following conditions are recommended when considering an outpatient approach: strict selection of appropriate patients (singleton pregnancy, cephalic presentation, intact membranes), CTG monitoring for 20 – 40 minutes after balloon placement, the patient must be given detailed instructions about the indications for immediate readmission to hospital, and 24-hour phone access to the hospital must be ensured. According to reviewed studies, the balloon catheter remained in place between 12 hours (“overnight”) and 24 hours. The most common reason for readmission to hospital was expulsion of the balloon catheter. The advantages of outpatient versus inpatient induction of cervical ripening with a balloon catheter were the significantly shorter hospital stay, the lower costs, and higher patient satisfaction, with both procedures having been shown to be equally effective. Complication rates (e.g., vaginal bleeding, severe pain, uterine hyperstimulation syndrome) during the cervical ripening phase are low (0.3 – 1.5%); severe adverse outcomes (e.g., placental abruption) have not been reported. Compared to inpatient induction of labor using vaginal PGE2, outpatient cervical ripening using a balloon catheter had a lower rate of deliveries/24 hours and a significantly higher need for oxytocin; however, hospital stay was significantly shorter, frequency of pain during the cervical ripening phase was significantly lower, and patientsʼ duration of sleep was longer. A randomized controlled study comparing outpatient cervical priming with a balloon catheter with outpatient or inpatient induction of labor with oral misoprostol would be of clinical interest.

scholarly journals INDUCTION OF LABOR

2011 ◽  
Vol 18 (02) ◽  
pp. 201-207
Author(s):  
TAHIRA JABBAR ◽  
SHAMAILA FAISAL ◽  
FAIQA IMRAN ◽  
Robina Kauser
Keyword(s):  
Prostaglandin E2 ◽  
Foley Catheter ◽  
Balloon Catheter ◽  
Fetal Distress ◽  
Induction Of Labor ◽  
The Other ◽  
Cervical Ripening ◽  
Prostaglandin E ◽  
Additional Advantage ◽  
Significant Difference

background: Labor can be induced through a myriad of ways. The aim of this study was to compare the effectiveness of the intracervical Foley balloon catheter and intra vaginal 3 mg prostaglandin E2 tablet(s) in preinduction cervical ripening at term. Methods: Prospective analytic study of a cohort of 280 women selected through non probability sampling admitted in Obstetrics units, in two private hospitals one at Rawalpindi and the other at Mirpur (Azad Kashmir), from January 2009 to March 2010. All women were randomized to receive an intracervical Foley catheter or prostaglandin E2 tablets. The primary measured outcome was ripening of the cervix as measured with the Bishop score. Results: There were no differences in mean Bishop Scores between the prostaglandin and the Foley catheter groups. Bishop scores (mean ± S.D.) after ripening were 6.6±0.81 and 6.7±0.86 for the Foley catheter and prostaglandin groups, respectively (P=0.54). The prostaglandin group showed a statistically shorter induction to delivery time compared with the Foley catheter (16.5±2.2 and 20.51±3.89 h, respectively (P<0.01). Both the groups showed no statistically significant difference between the occurrences of spontaneous vaginal delivery. Labor was established in 72% cases of cervical Foley group. On the other hand induction occurred in 76% cases in prostaglandin group. There was no statistical difference between the need of oxytocin infusion for labor augmentation between the two groups and fetal distress was equally frequent in both the groups. Conclusions: Foley catheter was as effective as Prostaglandin E-2 at term for induction of labor with additional advantage of being cheaper, readily available and had no systemic side effects. 

Induction and Augmentation of Labor

2019 ◽  
Author(s):  
Christopher M Morosky
Keyword(s):  
Balloon Catheter ◽  
Well Being ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Quiescent State ◽  
Patient Request ◽  
Fetal Maturity ◽  
Elective Induction ◽  
Detailed Assessment

Certain maternal and fetal conditions require induction of labor for the safety and well-being of either the mother or baby. Similarly, once fetal maturity has been reached, elective induction of labor remains an option for delivery timing and patient request. A thorough understanding of the physiologic mechanisms of labor onset and maintenance has allowed obstetrical providers to induce labor from the quiescent state and augment spontaneous labor in the latent or prolonged state. The goal of labor induction and augmentation is the successful and expedited delivery of the neonate in a manner that is safe to both the mother and the infant. Positive maternal outcomes include a shortened admission to onset of labor time, shortened first stage of labor, successful vaginal delivery, and avoidance of intraamniotic infection or postpartum hemorrhage. Positive fetal outcomes include absence of meconium amniotic fluid staining, regular newborn nursery admission, and hospital discharge with the mother. In this review, we outline the various mechanical, chemical, and natural methods of labor induction and augmentation, including a detailed assessment of the risks and benefits of each method for both the mother and baby. This review contains 7 figures, 4 tables, and 33 references. Key Words: amniotomy, augmentation of labor, cervical ripening, induction of labor, oxytocin, membrane sweeping, nipple stimulation, prostaglandins, transcervical balloon catheter

Women’s experience of induction of labor using PGE2 as an inpatient versus balloon catheter as an outpatient

2020 ◽  
Vol 249 ◽  
pp. 1-6
Author(s):  
Michael Beckmann ◽  
Melissa Acreman ◽  
Emily Schmidt ◽  
Katharina M.D. Merollini ◽  
Yvette Miller
Keyword(s):  
Balloon Catheter ◽  
Induction Of Labor ◽  
Women's Experience

Experience of using a double balloon catheter for cervical ripening in the induction of labor

2019 ◽  
Vol 3_2019 ◽  
pp. 64-71
Author(s):  
Baev O.R. Baev ◽  
Babich D.A. Babich ◽  
Shmakov R.G. Shmakov ◽  
Polushkina E.S. Polushkina ◽  
Nikolaeva A.V. Nikolaeva ◽  
...  
Keyword(s):  
Balloon Catheter ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Double Balloon

Acrylamide Exposure and Oxidative DNA Damage, Lipid Peroxidation and Fasting Plasma Glucose Alteration: Association and Mediation Analyses in Chinese Urban Adults

2020 ◽  
Author(s):  
Bin Wang ◽  
Weihong Qiu ◽  
Shijie Yang ◽  
Limin Cao ◽  
Chunmei Zhu ◽  
...  
Keyword(s):  
Lipid Peroxidation ◽  
Dna Damage ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Oxidative Dna Damage ◽  
Adult Population ◽  
Prostaglandin F2α ◽  
Mediation Analyses ◽  
Mediating Role ◽  
Fasting Plasma

<a><b>OBJECTIVE: </b></a>Acrylamide exposure from daily-consumed food has raised global concern.<b> </b>We aimed to assess the exposure-response relationships of internal acrylamide exposure with oxidative DNA damage, lipid peroxidation and fasting plasma glucose (FPG) alteration, and investigate the mediating role of oxidative DNA damage and lipid peroxidation in the association of internal acrylamide exposure with FPG. <p><b>RESEARCH DESIGN AND METHODS:</b> FPG and urinary biomarkers of oxidative DNA damage (8-hydroxy-deoxy-guanosine, 8-OHdG), lipid peroxidation (8-iso-prostaglandin-F2α, 8-iso-PGF2α) and acrylamide exposure (N-acetyl-S-(2-carbamoylethyl)-L-cysteine, AAMA; N-acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cysteine, GAMA) were measured for 3,270 general adults from the Wuhan-Zhuhai cohort. The associations of urinary acrylamide metabolites with 8-OHdG, 8-iso-PGF2α and FPG were assessed by linear mixed models. The mediating roles of 8-OHdG and 8-iso-PGF2α were evaluated by mediation analysis.</p> <p><b>RESULTS:</b> We found significant linear positive dose-response relationships of urinary acrylamide metabolites with 8-OHdG, 8-iso-PGF2α and FPG (except GAMA with FPG), and 8-iso-PGF2α with FPG. Each 1-unit increase in log-transformed level of AAMA, ΣUAAM (AAMA+GAMA) or 8-iso-PGF2α was associated with a 0.17-, 0.15- or 0.23-mmol/L increase in FPG, respectively (<i>P </i>or/and<i> P trend</i><0.05). Each 1% increase in AAMA, GAMA or ΣUAAM was associated with a 0.19%, 0.27% or 0.22% increase in 8-OHdG, respectively, and a 0.40%, 0.48% or 0.44% increase in 8-iso-PGF2α, respectively (<i>P </i>and<i> P trend</i><0.05). Increased 8-iso-PGF2α rather than 8-OHdG significantly mediated 64.29% and 76.92% of the AAMA and ΣUAAM associated-FPG increases, respectively.</p> <p><b>CONCLUSIONS:</b> Exposure of general adult population to acrylamide was associated with FPG elevation, oxidative DNA damage and lipid peroxidation, which in turn partly mediated acrylamide-associated FPG elevation.<b></b></p>

Role of dexamethazone on cervical ripening and induction of labor in term pregnancy

2019 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Tarek Saleh Zaher ◽  
Mahmoud Gharib ◽  
Amal El Saied ◽  
Abdelaziz Amin
Keyword(s):  
Induction Of Labor ◽  
Cervical Ripening ◽  
Term Pregnancy

Mother Phubbing and Adolescent Cyberbullying: The Mediating Role of Perceived Mother Acceptance and the Moderating Role of Emotional Stability

2020 ◽  
pp. 088626052098390
Author(s):  
Jiahui Qu ◽  
Li Lei ◽  
Xingchao Wang ◽  
Xiaochun Xie ◽  
Pengcheng Wang
Keyword(s):  
High School Students ◽  
Positive Association ◽  
Emotional Stability ◽  
School Students ◽  
Mediation Analyses ◽  
Mediating Role ◽  
Indirect Path ◽  
Underlying Mechanisms ◽  
The Relationship

Previous studies have found some risk factors of cyberbullying. However, little is known about how mother phubbing may influence adolescent cyberbullying, and the mediating and moderating mechanisms underlying this relationship. “Phubbing,” which is a portmanteau of “phone” and “subbing,” refers to snubbing other people and focus on smartphones in social interactions. This study examined whether mother phubbing, which refers to being phubbed by one’s mother, would be positively related to adolescent cyberbullying, whether perceived mother acceptance would mediate the relationship between mother phubbing and adolescent cyberbullying, and whether emotional stability would moderate the pathways between mother phubbing and adolescent cyberbullying. The sample consisted of 4,213 Chinese senior high school students (mean age 16.41 years, SD = 0.77, 53% were female). Participants completed measurements regarding mother phubbing, cyberbullying, perceived mother acceptance, and emotional stability. The results indicated that mother phubbing was positively related to cyberbullying, which was mediated by perceived mother acceptance. Further, moderated mediation analyses showed that emotional stability moderated the direct path between mother phubbing and cyberbullying and the indirect path between mother phubbing and perceived mother acceptance. This study highlighted the harmful impact of mother phubbing on adolescents by showing a positive association between mother phubbing and adolescent cyberbullying, as well as the underlying mechanisms between mother phubbing and adolescent cyberbullying.

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