scholarly journals Study of partogram in relation to labour outcome and significance of alert line in partogram

2018 ◽  
Vol 7 (4) ◽  
pp. 1361
Author(s):  
Vineeta Ghanghoriya ◽  
Kirti Patel
Keyword(s):  
Surgical Intervention ◽  
Total Duration ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Delivery Care ◽  
Evidence Based ◽  
Effective Interventions ◽  
Quality Of Delivery ◽  
Uterine Hyperstimulation

Background: The partogram is a simple, inexpensive tool to provide a continuous pictorial overview of labor. The goal of this study is to use partograph to monitor labor, initiate uterine activity that is sufficient to produce cervical changes, fetal descent while avoiding uterine hyperstimulation, hypostimulation and fetal distress and provide timely surgical intervention where required.Methods: Total 200 term patients, both primigravida and multigravida were selected for study and partograph recording were commenced at 4 cm dilation close maternal and fetal monitoring was done throughout the labour and partogram was plotted to detect any deviation from normal course.Results: Patients were grouped into primigravida and multigravida and based on partogram finding divided into delivered “before alert line” and “between alert and action line” and after action line.175 women delivered vaginally, out of this 106 delivered before alert line ,83 between alert line and action line and 11 after crossing action line.Conclusions: Partographic management of labour is a time honored and evidence based scientific way of managing labour. Partograph improves the quality of delivery care, since it permits to identify dystocia and make logical and effective interventions. It reduces unnecessary strain on mothers by reducing total duration of labour, without any increased foetal morbidity and mortality.

scholarly journals Technical quality of delivery care in private- and public-sector health facilities in Enugu and Lagos States, Nigeria

2018 ◽  
Vol 33 (5) ◽  
pp. 666-674 ◽  
Author(s):  
Atsumi Hirose ◽  
Ibrahim O Yisa ◽  
Amina Aminu ◽  
Nathanael Afolabi ◽  
Makinde Olasunmbo ◽  
...  
Keyword(s):  
Public Sector ◽  
Health Facilities ◽  
Delivery Care ◽  
Technical Quality ◽  
Quality Of Delivery ◽  
Private And Public ◽  
Public Sector Health

The Machine That Goes Ping!

2021 ◽  
pp. 114-149
Author(s):  
Louise Marie Roth
Keyword(s):  
Maternity Care ◽  
Reproductive Rights ◽  
Fetal Monitoring ◽  
Evidence Based ◽  
Reproductive Justice ◽  
Care Providers ◽  
Legal Risk ◽  
Electronic Fetal Monitoring ◽  
Liability Risk

This chapter explores the use of electronic fetal monitoring (EFM) as a prime example of technology fetishism. EFM is not evidence based, but most maternity care providers routinely use it. Obstetricians say that they use EFM to defend themselves against liability, and malpractice attorneys often fetishize the paper strips that the EFM produces as “evidence.” At the same time, an analysis demonstrates that EFM is more common in tort reform states that limit providers’ liability risk, which contradicts the idea that providers use it to reduce legal risk. The chapter then explores institutional motivations for EFM use, including scheduling, workload, and profit benefits. These institutional priorities can undermine patients’ rights, quality of care, and informed consent, which are issues of reproductive justice. This chapter then explores the effects of reproductive rights laws on EFM, finding that more fetus-centered laws encourage more EFM, while EFM is less common in states that protect women’s reproductive rights.

scholarly journals Correlation of intra partum electronic fetal monitoring with neonatal outcome

2017 ◽  
Vol 6 (6) ◽  
pp. 2174
Author(s):  
Sunitha C. ◽  
P. S. Rao ◽  
Prajwal S. ◽  
Reema Kumar Bhat
Keyword(s):  
Positive Association ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Case Group ◽  
Significant Positive Association ◽  
Late Deceleration ◽  
Uterine Hyperstimulation ◽  
Meconium Staining ◽  
Labour Room

Background: The importance of fetal monitoring during labour has been realized since long. The stress of uterine contractions may affect the fetus adversely especially if the fetus is already compromised, when the placental reserves are suboptimal, or when cord undergoes compression as in those associated with diminished liquor amnii or iatrogenic uterine hyperstimulation due to injudicious use of oxytocin. Even a fetus which is apparently normal in the antenatal period may develop distress during labour. Hence fetal monitoring during antepartum and intrapartum periods is of vital importance for timely detection of fetal distress so that appropriate management may be offered.Methods: This study was a prospective observational study included 100 patients of more than 34 weeks period of gestation were divided into two groups. Patients in labour were analyzed on an Electronic Monitor. Delivery conducted was either by vaginal route, instrumental or by caesarean section depending upon the fetal heart rate tracings and their interpretations as per the case. At the time of delivery umbilical cord blood was taken for the pH analysis. All new born babies were seen by the paediatrician immediately after the delivery and 1 and 5 minute APGAR score assessed for the delivered baby. The various EFM Patterns obtained were compared with the neonatal status at birth using the parameters already mentioned. The false positives and false negatives if any were tabulated. Data so obtained was analyzed statistically thereafter. Statistical Package for Social Sciences (SPSS) Version 13.0 was used for the purpose of analysis.Results: Results revealed that among the 50 subjects of the case group, 7 subjects showed the absence of the beat to beat variability, 12 subjects showed early deceleration, 32 subjects showed late deceleration, and 6 subjects showed the presence of variable deceleration. No significant association of beat to beat variability, early and variable deceleration could be established with meconium staining/NICU admissions/low APGAR. A significant positive association between persistent late deceleration with MSL, APGAR <7 at 1 min, and Instrumental/LSCS delivery was seen. A significant positive association between any CTG abnormality and APGAR at 1 min, type of delivery, and meconium staining was seen.Conclusions: EFM should be used judiciously. Cardiotocography machines are certainly required in the labour room. Equally important is the proper interpretation of the CTG tracings so that unjustified caesarean sections can be minimized, at the same time picking up cases of fetal distress in time which is likely to improve fetal outcome.

scholarly journals Maternal Cash Transfers Led To Increases In Facility Deliveries And Improved Quality Of Delivery Care In Nigeria

2020 ◽  
Vol 39 (6) ◽  
pp. 1051-1059
Author(s):  
Edward N. Okeke ◽  
Zachary Wagner ◽  
Isa S. Abubakar
Keyword(s):  
Cash Transfers ◽  
Delivery Care ◽  
Quality Of Delivery

scholarly journals Partographic analysis of labour by modified WHO partograph in tertiary care centre

2021 ◽  
Vol 10 (5) ◽  
pp. 1920
Author(s):  
Prekshi Jain ◽  
Akshay C. Shah ◽  
Babulal S. Patel ◽  
Shashwat K. Jani
Keyword(s):  
Caesarean Section ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Tertiary Care Centre ◽  
Uterine Hyperstimulation ◽  
Study Population

Background: The partograph is a simple, inexpensive tool to provide a continuous pictorial overview of labor. The goal of this study is to use partograph to monitor labor, initiate uterine activity that is sufficient to produce cervical changes, fetal descent while avoiding uterine hyperstimulation, hypostimulation and fetal distress and provide timely surgical intervention where required. Methods: A hospital-based observational study involving prospective review of partographs for births that occurred in 2020 was conducted in 2 hospitals including SVP Hospital and V.S hospital Ahmedabad. A partographic analysis of labour was done in randomly selected 200 patients using modified WHO partogram. The study population was divided into Primigravida (96) and Multigravida (104) term patients. partograph recording were commenced at 4 cm dilatation. close maternal and fetal monitoring was done throughout the labour and partogram was plotted to detect any deviation from normal course.Results: Patients were grouped into primigravida and multigravida and based on partogram finding divided into mode of delivery. 22 of total 96 primigravida underwent caesarean section and 74 delivered vaginally. 8 of total 104 multigravida underwent caesarean section and 96 delivered vaginally. Out of 200 newborn only 11 had Apgar score <7 at 5 minutes.Conclusion: The WHO modified partograph is highly effective in reducing both maternal and neonatal morbidity. It aids in assessing the progress of labour and to identify when intervention is necessary. It is effective in preventing prolonged labour, obstructed labour, reducing operative intervention and improving neonatal outcome.

Misophonia: An Evidence-Based Case Report

2020 ◽  
Vol 29 (4) ◽  
pp. 685-690
Author(s):  
C. S. Vanaja ◽  
Miriam Soni Abigail
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Case History ◽  
Pure Tone ◽  
Physiological Responses ◽  
Evidence Based ◽  
Management Option ◽  
Pure Tone Audiogram

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.

Coaching Teachers to Enhance the Implementation Quality of Evidence-Based Programs

2013 ◽  
Author(s):  
Kimberly D. Becker ◽  
Dana Darney ◽  
Celene Domitrovich ◽  
Catherine Bradshaw ◽  
Nicholas S. Ialongo
Keyword(s):  
Evidence Based ◽  
Implementation Quality ◽  
Quality Of Evidence ◽  
Evidence Based Programs
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