scholarly journals Oxytocin administration for induction and augmentation of labour in polish maternity units – an observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Barbara Baranowska ◽  
Anna Kajdy ◽  
Iwona Kiersnowska ◽  
Dorota Sys ◽  
Urszula Tataj-Puzyna ◽  
...  
Keyword(s):  
Blood Loss ◽  
Cumulative Dose ◽  
Maternity Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Labour Induction ◽  
National Guidelines ◽  
Short Term ◽  
Apgar Scores ◽  
Postpartum Blood Loss

Abstract Background There is not enough data regarding practices and protocols on the dose of oxytocin administrated to women during labour. Empirical evidence indicates that compliance with the guidelines improves the quality of healthcare and reduces adverse effects. The study aimed to evaluate practices of oxytocin provision for labour induction and augmentation in two maternity units in Poland. Methods The article presents a prospective observational study. Data from 545 (n = 545) labours was collected in two maternity units. First, the total dose (the total amount of oxytocin provided from the beginning in the labour ward until delivery including the III and IV stage of labour) and cumulative dose of oxytocin (the amount of oxytocin given until the birth of the neonate) administered to women during labour was calculated. Then, the relationship between the cumulative dose of oxytocin and short term perinatal outcomes (mode of delivery, use of epidural anaesthesia, Apgar scores, birth weight and postpartum blood loss) was analysed. Finally, the compliance of oxytocin supply during labour with national guidelines in the following five criteria: medium, start dose, escalation rate, interval, the continuation of infusion after established labour was examined. Results The average cumulative dose of oxytocin administrated to women before birth was 4402 mU following labour induction and 2366 mU following labour augmentation. The actual administration of oxytocin deviated both from the unit and national guidelines in 93.6% of all observed labours (mainly because of continuation of infusion after established labour). We found no statistically significant correlation between the cumulative dose of oxytocin administered and mode of delivery, immediate postpartum blood loss or Apgar scores. There was no observed effect of cumulative dose oxytocin on short-term perinatal outcomes. The two units participating in the study had similar protocols and did not differ significantly in terms of total oxytocin dose, rates of induction and augmentation - the only observed difference was the mode of delivery. Conclusions The study showed no effect of the mean cumulative oxytocin dose on short-term perinatal outcomes and high rate of non-compliance of the practice of oxytocin administration for labour induction and augmentation with the national recommendations. Cooperation between different professional groups of maternity care providers should be considered in building national guidelines for maternity care.. Further studies investigating possible long-term effects of the meant cumulative dose of oxytocin and the reasons for non-compliance of practice with guidelines should be carried out.

Oxytocin administration for induction and augmentation of labour in Polish maternity units– an observational study

2020 ◽  
Author(s):  
Barbara Baranowska ◽  
Anna Kajdy ◽  
Iwona Kiersnowska ◽  
Dorota Sys ◽  
Urszula Tataj-Puzyna ◽  
...  
Keyword(s):  
Blood Loss ◽  
Observational Study ◽  
Cumulative Dose ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Labour Induction ◽  
National Guidelines ◽  
Short Term ◽  
Apgar Scores ◽  
Postpartum Blood Loss

Abstract Background: There is not enough data regarding practices and protocols that healthcare personnel follow and the amount of oxytocin that women receive during labour. Empirical evidence indicates that compliance with the guidelines improves the quality of healthcare and reduces adverse effects. The study aimed to evaluate practices of oxytocin provision for labour induction and augmentation in Polish maternity units. Methods: The article presents a prospective observational study. Data collection took place in two selected maternity units between January 15 and July 31, 2019 (n=545). The analysis included the total amount and cumulative dose of oxytocin during labour. We analysed the relationship between the cumulative dose of oxytocin and short term perinatal outcomes (mode of delivery, use of epidural anaesthesia, Apgar scores, birth weight and postpartum blood loss). The study examines the compliance of oxytocin supply during labour with national guidelines in the following five criteria: medium, start dose, escalation rate, interval, the continuation of infusion after established labour. Results: The average total amount of oxytocin administrated to women before birth was 7.329µg following labour induction and 3.952µg following labour augmentation. The actual administration of oxytocin deviated both from the unit and national guidelines in 93.6% of all observed labours (mainly because of continuation of infusion after established labour). We found no statistically significant correlation between the cumulative dose of oxytocin administered and mode of delivery, immediate postpartum blood loss or Apgar scores. There was no observed effect of cumulative dose oxytocin on short-term perinatal outcomes. Hospitals with similar protocols did not differ significantly in terms of total oxytocin amount, rates of induction and augmentation - the only observed difference was the mode of delivery. Conclusions: There was no practical effect of cumulative dose oxytocin on short-term perinatal outcomes. In the study, we observed significant discrepancies between protocols and practice.

Oxytocin administration for induction and augmentation of labour in Polish maternity units– an observational study

2020 ◽  
Author(s):  
Barbara Baranowska ◽  
Anna Kajdy ◽  
Iwona Kiersnowska ◽  
Dorota Sys ◽  
Urszula Tataj-Puzyna ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Quality Of Healthcare ◽  
Study Data ◽  
Labour Induction ◽  
Healthcare Personnel ◽  
National Guidelines

Abstract BackgroundThere is not enough data regarding practices and protocols that healthcare personnel follow and the amount of oxytocin that women receive during labour. Empirical evidence indicates that compliance with the guidelines improves the quality of healthcare and reduces adverse effects. The aim of the study was to evaluate oxytocin supply practices of oxytocin for labour induction and augmentation in Polish maternity units.MethodsThe article presents a prospective observational study. Data collection took place in two selected maternity units between January 15 and July 31, 2019 (n=545). Inclusion criteria were women in term pregnancies, undergoing oxytocin induction or augmentation of labour. Exclusion criteria were women who were in preterm labour, aged less than 18 years, and women whose baby was known to have a malformation. ResultsThe average total amount of oxytocin administrated to women before birth was 7,329µg following labour induction and 3.952µg following labour augmentation. The actual administration of oxytocin deviated both from the unit and national guidelines in 93,6% of all observed labours. We found no statistically significant correlation between the amount of oxytocin administered and mode of delivery, immediate postpartum blood loss or Apgar scores. There was no observed effect of total oxytocin on short-term perinatal outcomes. Hospitals with similar protocols did not differ significantly in terms of total oxytocin amount, induction to stimulation ratio—the only observed difference was the mode of delivery. ConclusionsThere is a need for a thorough analysis to find out the reasons for the observed discrepancies between protocols and practice.

scholarly journals The association between isolated oligohydramnios at term and pregnancy outcome and perinatal outcome in case of isolated oligohydramnosis: a retrospective analysis

2021 ◽  
Vol 11 (1) ◽  
pp. 136
Author(s):  
Vijay M. Kansara ◽  
Kunal D. Kadakar ◽  
Akash S. Chikani ◽  
Pinal A. Pateliya
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Labour Induction ◽  
Control Group ◽  
Amniotic Fluid Index ◽  
Observational Cohort ◽  
Adverse Perinatal Outcomes ◽  
The Impact

Background: Current study was carried out to assess the impact of isolated oligohydramnios on perinatal outcomes and mode of delivery.Methods: A retrospective observational cohort study was conducted at term pregnancy with sonographic finding of isolated oligohydramnios (AFI <5 cm) were recruited for the study. Uterine anomaly and high risk pregnancies were excluded from the study. The mode of delivery and perinatal outcome were compared with control group of pregnancy with normal amniotic fluid (AFI >5-25 cm).Results: When compared to the normal AFI, women with oligohydramnios had significantly lower birth weight babies and were delivered at a significantly earlier gestational age. However there was no difference in the APGAR scores at birth and NICU admissions between the two groups. Reactive NST had more chances of good APGAR score at 1 and 5 minute and that lower the AFI more the probability of nonreactive NST and abnormal Doppler. The number of inductions and caesareans done for foetal reasons were significantly higher in the exposed group.Conclusions: Obstetric and perinatal outcome remains similar in both isolated oligohydramnios with reactive NST as well as in patients with normal amniotic fluid index. Isolated oligohydramnios is not associated with adverse perinatal outcomes. However, it increases the risk for labour induction and caesarean section.

scholarly journals Fetomaternal outcome following labour induction in oligohydramnios and borderline liquor: a retrospective study in a tertiary care hospital

2018 ◽  
Vol 7 (11) ◽  
pp. 4615
Author(s):  
Jyothi Susan Thomas ◽  
Mary Daniel ◽  
Sangeetha Selvaraj
Keyword(s):  
Retrospective Study ◽  
Amniotic Fluid ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Morbidity And Mortality ◽  
Labour Induction ◽  
P Value ◽  
Care Hospital ◽  
Parametric Data

Background: Amniotic fluid provides a protective milieu for the growing fetus in pregnancy and labour. A decrease in the amniotic fluid volume has been associated with increased maternal morbidity and fetal morbidity and mortality. The purpose was to compare the effect of labour induction on the fetomaternal outcome in women with oligohydramnios, borderline liquor and normal liquor at term.Methods: A retrospective study of all the labour induction in women with oligohydramnios, borderline liquor and normal liquor volume at 37-42 weeks gestation in a tertiary care teaching hospital. The demographic characteristics, maternal outcomes like mode of delivery, indication for operative delivery, meconium stained liquor and perinatal outcomes were compared in between the three groups. Parametric data was compared by chi-square test and non-parametric data by students’-test. A p-value less than 0.05 was taken as significant.Results: Among the 2338 deliveries during the study period, labour was induced in 266 women (11.3%). Out of which, 109 cases (40.9%) in oligohydramnios group, 111cases (41.7%) in borderline liquor group and 46 cases in normal liquor group. The incidence of meconium stained liquor, the number of operative deliveries and fetal distress was significantly higher and significantly lower birth weight (<2.5 kg) in the group with oligohydramnios and borderline liquor (p <0.05). Low Apgar score and admission to neonatal intensive care unit was higher in the oligohydramnios group (p<0.05).Conclusions: Induction of labour on detecting borderline liquor at term may help in reduction of maternal and fetal morbidity and mortality.

Neonatal Outcome of Second Twins Depending on Presentation and Mode of Delivery

2007 ◽  
Vol 10 (3) ◽  
pp. 521-527 ◽  
Author(s):  
Vesna Bjelic-Radisic ◽  
Gunda Pristauz ◽  
Josef Haas ◽  
Albrecht Giuliani ◽  
Karl Tamussino ◽  
...  
Keyword(s):  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Delivery Mode ◽  
Short Term ◽  
Term Outcome ◽  
Apgar Scores ◽  
Trial Of Labor ◽  
Twin Pregnancies ◽  
Second Twin

AbstractOur objective was to examine the neonatal outcome of second twins depending on presentation and mode of delivery. Using a database we analyzed the short-term neonatal outcome in twin pregnancies offered a trial of labor with special emphasis on the second twin depending on presentation and mode of delivery. Neonatal outcome was evaluated by Apgar scores, umbilical cord blood pH values, and perinatal or neonatal morbidity and mortality. Overall, in 219 (78%) of 281 pregnancies successful vaginal birth (VB) of both twins (VB–VB) was possible, 48 (17%) women had to be delivered by cesarean section (CS) of both twins (CS–CS), and in 14 (5%) women the second twin had to be delivered by CS after VB of the first twin (VB–CS). Successful VB was most common for vertex-vertex (V/V; n = 171, 82%) and vertex-nonvertex (n = 48, 75%) presentation (V/NV). Twins delivered by VB–CS had the lowest values for pHart (p = .006) and pHven (p = .010). pHart less than or equal to 7.00 values occurred only in second twins delivered VB–VB or VB–CS. Lower Apgar scores of the second twin occurred more frequently in the VB–CS and in the VB–VB than in the CS–CS groups (ps < .05). Lower levels of pHart (p = .002) and frequency of pHart less than or equal to 7.00 occurred more often in nonvertex second twins than in vertex second twins (p < .022). The high CS rate in V/NV presentation and the significantly worse perinatal short-term outcome of NV second twins after VB of the first twin underline that randomized studies are necessary to evaluate the best delivery mode for V/NV twins.

scholarly journals PRE-LABOUR RUPTURE OF MEMBRANES AT TERM;

2013 ◽  
Vol 20 (05) ◽  
pp. 731-735
Author(s):  
BUSHA KHAN ◽  
NUZHAT RASHEED ◽  
BUSHRA MUKHTAR
Keyword(s):  
Mode Of Delivery ◽  
Total Duration ◽  
Perinatal Outcomes ◽  
Well Being ◽  
Labour Induction ◽  
Time Interval ◽  
Misoprostol Group ◽  
Quasi Experimental ◽  
Group B ◽  
Labour Room

Objective: To compare maternal and perinatal outcome in cases of PROM at term, following induction with vaginalmisoprostol (PGE1) to shorten the duration of labour with those managed expectantly. Design: Quasi Experimental study. Setting: Thestudy was carried out in department of obstetrics and gynecology labour room unit-1, Bahawal Victoria Hospital, Bahawalpur.Population: Term pregnancies (37-42 wks) with PROM and cephalic alive fetuses. Methods: Sixty patients with confirmed diagnosis ofPROM were randomized into two groups i.e, A&B. Group A comprising 30 patients were induced with tab. Misoprostol 25 ug at 6 hrlyinterval max of four doses and group B was managed expectantly for 24 hrs followed by induction with intravenous oxytocin. OutcomeMeasures: Total duration of labour, mode of delivery, maternal infection rates and, APGAR score at 1 and 5 min. Results: It was found thatboth groups had similar characteristics, but the misoprostol group had a significantly shorter time interval from PROM to delivery (18.9 vs27.5 hours) i.e total duration of labour. Caesarean section rates were 20% in the misoprostol group and 30.7% in the other. There were nodifferences between them regarding fetal well being, complications during labour and delivery and neonatal or postpartum maternalmorbidity. Within 24 hours, 44% of women had delivered in the expectant group against 73.3% in the misoprostol group. Conclusion:Immediate labour induction with misoprostol in cases of term PROM shortens the total duration of labour, and the time of maternalhospitalization without any maternal and perinatal outcomes disadvantages.

The impact of prepartum factor XIII activity on postpartum blood loss

2019 ◽  
Author(s):  
C Haslinger ◽  
W Korte ◽  
T Hothorn ◽  
R Brun ◽  
C Greenberg ◽  
...  
Keyword(s):  
Blood Loss ◽  
Factor Xiii ◽  
Postpartum Blood Loss ◽  
The Impact

scholarly journals A non-bioartificial liver support system combined with transplantation in HBV-related acute-on-chronic liver failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Peng Li ◽  
Xi Liang ◽  
Shan Xu ◽  
Ye Xiong ◽  
Jianrong Huang
Keyword(s):  
Survival Rate ◽  
Blood Loss ◽  
Liver Failure ◽  
Control Group ◽  
Observation Group ◽  
Intraoperative Blood Loss ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Liver Support ◽  
Liver Support System

AbstractWe aim to determine the impact of an artificial liver support system (ALSS) treatment before liver transplantation (LT), and identify the prognostic factors and evaluate the predictive values of the current commonly used ACLF prognostic models for short-term prognosis after LT. Data from 166 patients who underwent LT with acute-on-chronic liver failure (ACLF) were retrospectively collected from January 2011 to December 2018 from the First Affiliated Hospital of Zhejiang University School of Medicine. Patients were divided into two groups depending on whether they received ALSS treatment pre-LT. In the observation group, liver function tests and prognostic scores were significantly lower after ALSS treatment, and the waiting time for a donor liver was significantly longer than that of the control group. Both intraoperative blood loss and period of postoperative ICU care were significantly lower; however, there were no significant differences between groups in terms of total postoperative hospital stays. Postoperative 4-week and 12-week survival rates in the observation group were significantly higher than those of the control group. Similar trends were also observed at 48 and 96 weeks, however, without significant difference. Multivariate Cox regression analysis of the risk factors related to prognosis showed that preoperative ALSS treatment, neutrophil–lymphocyte ratio, and intraoperative blood loss were independent predicting factors for 4-week survival rate after transplantation. ALSS treatment combined with LT in patients with HBV-related ACLF improved short-term survival. ALSS treatment pre-LT is an independent protective factor affecting the 4-week survival rate after LT.

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