Combined method of preparing the cervix uteri for labor in pregnant women with a lack of birth preparedness and a tendency to post-term pregnancy

2021 ◽  
Vol 70 (4) ◽  
pp. 5-13
Author(s):  
Ainura M. Burkitova ◽  
Vyacheslav M. Bolotskikh
Keyword(s):  
Pregnant Women ◽  
Foley Catheter ◽  
Induction Of Labor ◽  
The Body ◽  
Cervix Uteri ◽  
Birth Preparedness ◽  
Combined Method ◽  
Term Pregnancy ◽  
Birth Canal ◽  
Post Term Pregnancy

Objective. Development of an effective method for preparing the cervix in pregnant women with a tendency to overmaturity against the background of a lack of biological readiness for childbirth, as well as reducing the time for preparing the soft birth canal for childbirth in order to conduct subsequent labor excitation. Material and methods. The patients were divided into 3 groups depending on the method of preparing the cervix for childbirth: in the 1st group (n = 50) only laminaria was used; in group 2 (n = 50), a Foley catheter was used in combination with mifepristone; in group 3 (n = 50), only mifepristone was used. Inclusion criteria: gestational period 41 weeks 41 weeks and 4 days inclusive, immature cervix (baseline score on the Bishop scale 0-2 points), singleton pregnancy, cephalic presentation, whole fetal bladder, vaginal cleanliness I-II, satisfactory fetal condition (normal type of curve according to CTG and the absence of fetal hemodynamic disorders according to Doppler data). Statistical processing of the obtained data was carried out using the STATISTICA 10.0 program. Research results. The patients of the three groups were comparable in age, gestational age, and did not differ in the parity of childbirth and body mass index. With the combined preparation of the cervix for childbirth with mifepristone and a Foley catheter, the dynamics of the assessment of the cervix on the Bishop scale is higher and achieved faster than when preparing for childbirth only with laminaria or only antigestagens. When combining mifepristone with a catheter Foley, it is possible to reduce the time interval from the onset of pre-induction to the development of labor in comparison with pre-induction of labor only with mifepristone or only with the help of laminaria, as well as reduce the frequency of caesarean section due to the lack of effect from induction of labor compared with pre-induction of labor only with mifepristone or only with the help of laminaria. The undoubted advantage of this combined method of preparing the cervix for childbirth is its effectiveness, low risk of uterine hyperstimulation, fetal distress syndrome, as well as the absence of a high risk of developing infectious complications. Conclusion. The combined method of preparing the body for childbirth with a tendency to post-term pregnancy is effective, safe and allows you to reduce the preparation time of the soft birth canal for childbirth against the background of a lack of biological readiness for childbirth with a tendency to post-term pregnancy.

Induction of Labor as Compared with Serial Antenatal Monitoring in Post-Term Pregnancy

1992 ◽  
Vol 326 (24) ◽  
pp. 1587-1592 ◽  
Author(s):  
Mary E. Hannah ◽  
Walter J. Hannah ◽  
Jonathan Hellmann ◽  
Sheila Hewson ◽  
Ruth Milner ◽  
...  
Keyword(s):  
Induction Of Labor ◽  
Term Pregnancy ◽  
Post Term Pregnancy

Induction of Labor as Compared With Serial Antenatal Monitoring in Post-Term Pregnancy

1992 ◽  
Vol 47 (11) ◽  
pp. 764-766
Author(s):  
MARY E. HANNAH ◽  
WALTER J. HANNAH ◽  
JONATHAN HILLMAN ◽  
SHEILA HEWSON ◽  
RUTH MILNER ◽  
...  
Keyword(s):  
Induction Of Labor ◽  
Term Pregnancy ◽  
Post Term Pregnancy

scholarly journals Actual diagnostic and clinical problems in post-term pregnancy in modern obstetrics

2017 ◽  
Vol 66 (2) ◽  
pp. 93-103
Author(s):  
Ainura M Burkitova ◽  
Viktoriya S Prokhorova ◽  
Viacheslav M Bolotskikh
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Term Pregnancy ◽  
History Of ◽  
Prolonged Pregnancy ◽  
Evaluating Methods ◽  
Clinical Problems ◽  
Post Term Pregnancy

This review is devoted to etiology and diagnostics post-term and prolonged pregnancy. We analyzed the results of studies aimed at the study of diagnostic, pregnancy and complications in childbirth in pregnant women at high risk for post-term pregnancy. When evaluating methods of prenatal training in prolonged and post-term pregnancy most studies showed greatest efficacy in the preparation of the cervix, and the lowest frequency of complications in childbirth when using antigestagens in comparison with other methods of preparing the cervix for childbirth. Despite the long history of the study of this problem, many questions concerning post-term pregnancy, are not fully studied and actual to this day.

The features of hormonal homeostasis in women with cervix maturation

2018 ◽  
pp. 38-42
Author(s):  
I. Zhabchenko ◽  
◽  
I. Lishchenko ◽  
O. Sudmak ◽  
O. Bondarenko ◽  
...  
Keyword(s):  
At Risk ◽  
Blood Serum ◽  
Pregnant Women ◽  
Adrenergic Receptors ◽  
Cervical Insufficiency ◽  
Hormonal Changes ◽  
Term Pregnancy ◽  
Fetoplacental Complex ◽  
Post Term Pregnancy ◽  
Group 1

The problem of untimely maturation of the cervix (belated in pregnancy or premature in the case of obstructive function of the cervix) in modern obstetrics is considered as a biological process closely related to such factors as chronological duration of pregnancy, mechanisms of start and duration of labor, the state of the fetoplacental complex and neck uterus. The objective: the determination of the features of hormonal homeostasis in women with cervix maturation. Materials and methods. In the dynamics of pregnancy, 28 pregnant women who were on treatment and birth in the department of the Pathology of Pregnancy and Childbirth were examined by the MI «IPOG them. Acad. O.M. Lukyanova NAMS of Ukraine». The distribution of women with cervix ripening is as follows: group 1 – pre-pregnant women at risk of post-term pregnancy – 13, 2-group – 15 pre-term women with ischemic-cervical insufficiency. Results. On the eve of labor in 39–40 weeks, the concentration of estradiol in the blood serum of women in group 1 reached the maximum values and amounted to 68.2±1.3 nmol/l. In women with isthmic-cervical insufficiency, the concentration of estradiol in the blood serum was within the limits of gestational norm. As the study shows, the concentration of progesterone in serum in group 1 – 759.9±23.2 nmol/l, the coefficient P/E2 – 10.9±0.78. It should be noted that in the 2nd study group, there is a shift in the estrogen / progesterone balance towards the estrogen, indicating an increase in the activity of α2-adrenergic receptors and a decrease in the representation and activity of β-adrenergic receptors. In the overwhelming number of women under study, 2 groups according to colpocytology had an estrogen type of smear (68.4%), corresponding to their hormonal changes in the concentration of estradiol and progesterone in serum. An increase in the concentration of cortisol in the blood of pregnant women in group 1 indicates a high level of psychoemotional stress and strain of neuroendocrine mechanisms of adaptation, which may be one of the causes of pregnancy. At the same time, the secretion of prolactin was significantly reduced in pregnant women in groups 2 with respect to women in group 1. Conclusions. The given data testify to the specific progesterone deficiency characteristic for pregnant women with functional impairment of obstructive function of cervix, which manifests itself by displacement of estrogen-progesterone ratio and is a sign of instability of hormonal production function of the placenta and one of the main pathogenetic parts of its dysfunction and failure of the cervix during pregnancy. The course of pregnancy in women at risk of post-term pregnancy is accompanied by a violation of the function of the fetoplacental complex represented by absolute and relative hypoestrogeny in the presence of unchanged relative to the norm of concentration of progesterone in serum. Key words: pregnancy, post-term pregnancy, fetoplacental complex, cortisol, thyroid hormones, colpocytology, isthmic-cervical insufficiency.

Management of Post-Term Pregnancy

2021 ◽  
pp. 64-68
Author(s):  
Ashley E. Benson ◽  
Brett D. Einerson
Keyword(s):  
Study Design ◽  
Clinical Case ◽  
Induction Of Labor ◽  
Term Pregnancy ◽  
Post Term Pregnancy ◽  
Landmark Study

This article provides a summary of a landmark study in the field of obstetrics. Should patients with post-term pregnancies undergo induction of labor or be managed with serial antenatal monitoring? The article describes the basics of the study, including funding, study location, who was studied, how many patients, study design, endpoints, results, and criticism and limitations. The article also reviews other relevant studies and implications and concludes with a clinical case for application.

scholarly journals INDUCTION OF LABOR BY PROSTAGLANDIN: A REVIEW FOR INDICATIONS AND RISK FOR CESAREAN SECTION

2017 ◽  
Vol 10 (10) ◽  
pp. 75
Author(s):  
Pravati Tripathy ◽  
Prasanna Baby
Keyword(s):  
Cesarean Section ◽  
Fetal Distress ◽  
Induction Of Labor ◽  
Term Pregnancy ◽  
Drug Of Choice ◽  
The Common ◽  
Failed Induction ◽  
Poor Outcomes ◽  
The Impact ◽  
Post Term Pregnancy

  Objective: Labor induction by medication is now preferred by many obstetricians. The impact of induction remains ambiguous, although many studies and systematic reviews have been conducted. Few studies have reported for its better outcomes while other studies with poor outcomes. The objective of the study is to identify the common indications of induction and the risk of cesarean section after induction.Methods: Various standardized databases, such as Pub Med, Scopus, and Google Scholar, were used to collect the scientific studies, where prostaglandin was used as drug of choice for induction of labor. The key words used were induction of labor, indications of induction, induction by misoprostol, induction and risk of cesarean section, etc. The survey spans over 22 years of study articles published from the year 1995-2017.Result: A total of 112 studies have been included to analyze the indications and risk of cesarean section. The most common indication found in most of the studies was post-term pregnancy. The risk of cesarean section varied from 3% to 48.7%. The common reasons for which the cesarean section was planned were, failed induction, nonprogress of labor, fetal distress, and undiagnosed CPD.Conclusion: Most of the studies recommend induction of labor as a safer option with lower risk of c-section.

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