scholarly journals The prediction and assessment of the intrauterine fetal with umbilical cord around neck well-being by daily fetal movement counting chart (DFMC)

2021 ◽  
Author(s):  
zijun li ◽  
Xin Zhou ◽  
Yaqin Zheng ◽  
Min Liu ◽  
Xiaoying Fu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Umbilical Cord ◽  
Mode Of Delivery ◽  
Well Being ◽  
Fetal Movement ◽  
Fetal Safety ◽  
Independent Risk Factors

Abstract Background Currently, FM is a sole subjective index which depends on self-assessment of pregnant women, and it can objectively reflect the well being of intrauterine fetus. It has been the focus of obstetricians' research and attention how to quantify fetal movement (FM) and change it into a relatively objective evaluation index. We sought to predict and evaluate the well being of intrauterine fetal with umbilical cord around the neck (UCAN) by performance of daily fetal movement counting chart (DFMC). Methods To retrospectively select 100-case pregnant women who met the enrolled requirements, and whether the fetal was intrauterine safety or not was predicted by analysis of the DFMC before delivery. According to the different perinatal outcomes after delivery, 100-cases pregnant women were divided into intrauterine safety (IUS) group (44 cases) and intrauterine unsafe (IUNS) group (56 cases). And the independent risk factors of fetal intrauterine safety, including maternal age, gestational week, umbilical artery systolic blood flow to diastolic blood flow ratio (S/D), amniotic fluid index (AFI), modified Fischer score of non stress test (NST), DFMC and mode of delivery were analyzed by multi-factors Binary Logistic Regression. Results Only FM and mode of delivery were independent risk factors affecting fetal safety intrauterine (all p value < 0.05). There was no remarkable difference between DFMC prediction and clinical retrospective evaluation of fetal safety in natural delivery and forceps delivery (all P value > 0.05), except in cesarean section (p < 0.05). The sensitivity, specificity and Yuden index of DFMC for predicting the intrauterine safety in natural vaginal delivery were 86.5%, 90.0% and 0.77 respectively, and in cesarean section were 66.7%, 94.6% and 0.61, respectively. Abnormal DFMC may account for the highest proportion of emergency cesarean section (87.5%, 35/40). Conclusions DFMC can effectively predict and evaluate the well being of intrauterine fetus with UCAN. At the same time, it can also provide limited clinical proofs for pregnant women with UCAN to choose model of delivery.

Ultrasonographic Multimodality Diagnostic Model of Thyroid Nodules

2018 ◽  
Vol 41 (2) ◽  
pp. 63-77
Author(s):  
Rui-na Zhao ◽  
Bo Zhang ◽  
Yu-xin Jiang ◽  
Xiao Yang ◽  
Xing-jian Lai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Flow Distribution ◽  
Ultrasound Elastography ◽  
Diagnostic Model ◽  
Blood Flow Distribution ◽  
Conventional Ultrasound ◽  
Independent Risk Factors

The aim of this study was to identify independent risk factors for thyroid cancer, establish an ultrasonographic multimodality diagnostic model for thyroid nodules, and explore the diagnostic value of the model. From November 2011 to February 2015, 307 patients with a total of 367 thyroid nodules underwent conventional ultrasound, contrast-enhanced ultrasound (CEUS), and ultrasound elastography examinations before surgery. A binary logistic regression analysis was performed to identify independent risk factors for thyroid cancer and to establish a multimodality diagnostic model for thyroid nodules. The diagnostic performance of conventional ultrasound, CEUS, ultrasound elastography, and the multimodality diagnostic model was assessed and compared. The following seven independent risk factors were included in the logistic regression models: age, irregular shape, hypoechoic pattern, marked hypoechoic pattern, irregular blood flow distribution, heterogeneous enhancement, and an elastic score of 3/4. The multimodality diagnostic model had a diagnostic accuracy of 86.9%, with a sensitivity of 93.5% and a specificity of 77.3%. The multimodality diagnostic model improved the diagnostic accuracy compared with that of conventional ultrasound, CEUS, and ultrasound elastography. Independent risk factors for thyroid cancer included age, irregular shape, hypoechoic pattern, marked hypoechoic pattern, irregular blood flow distribution, heterogeneous enhancement, and an elastic score of 3/4. The multimodality diagnostic model was demonstrated to be effective in the diagnosis of thyroid nodules.

170 What are the independent risk factors for repeated cesarean section in trial of VBAC?

2001 ◽  
Vol 185 (6) ◽  
pp. S127
Author(s):  
Zahi Ben-Aroya ◽  
Mordechai Hallak ◽  
David Segal ◽  
Michael Friger ◽  
Miriam Katz
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Independent Risk Factors

scholarly journals Effect of "Motivational Interviewing" and "Information, Motivation and Behavioral Skills” on Choosing Mode of Delivery in Pregnant Women: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Mahboubeh Shirzad ◽  
Elham Shakibazadeh ◽  
Abbas Rahimi Foroushani ◽  
Mehrandokht Abedini ◽  
Hamid Poursharifi
Keyword(s):  
Cesarean Section ◽  
Motivational Interviewing ◽  
Pregnant Women ◽  
Self Efficacy ◽  
Mobile Application ◽  
Controlled Trial ◽  
Mode Of Delivery ◽  
Brief Interventions ◽  
Behavioral Skills ◽  
Face To Face

Abstract Background: Cesarean section is an important surgical procedure to save mothers and/or babies’ lives. Current trends show that the rate of Cesarean section is increasing dramatically over the years. The aims of this study were to compare the effects of "motivational interviewing" and "information, motivation and behavioral skills” model on choosing mode of delivery among pregnant women.Methods: In a four-armed, parallel-design randomized controlled trial, 120 women were randomly assigned to three brief interventions and one control groups. We recruited pregnant women referring to Ebnesina hospital, Tehran- Iran from 2019-2020. The intervention groups included: 1) motivational interviewing; 2) face-to-face information, motivation and behavioural skills model; and 3) information, motivation and behavioural skills model provided using a mobile application. The inclusion criteria were being literate, gestational age 24 to 32 weeks, being able to speak Persian, having no complications in the current pregnancy, having no indications for CS, and having enough time to participate in the study. The most important outcomes of the study included women’s intentions to undergo any mode of delivery, women’s self-efficacy in choosing the mode of delivery, and mode of delivery. Data were analyzed using descriptive statistics (mean, frequency and standard deviation), inferential statistics including independent t-test, paired t-test, Chi-squared and One-way ANOVA tests and logistic regression.Results: Following the interventions, significant differences were found in the mode of delivery (P < 0.05) and women’s self-efficacy and intention (P < 0.05). Women who had used the mobile application had more improvements in the self-efficacy and intention than the face-to-face intervention groups.Conclusions: Our study showed positive significant effects of various types of brief interventions to reduce unnecessary Cesarean section rate among the participant women. Providing the intervention using mobile application showed even better results. Our findings may contribute to a rise in normal vaginal delivery; and these simple, non-expensive, tailored to women, and culture-oriented brief interventions can be considered as appropriate strategies to reduce Cesarean section rate in local, national, and/or regional levels.Trial registration: This study has been registered in Iran Randomized Clinical Trial Center (IRCT20151208025431N7). Registered October 07, 2018.

THIS STUDY ASSESSES THE ROLE OF NST IN DETECTING FETAL COMPROMISE IN CASES OF REDUCED MATERNAL PERCEPTION OF FETAL MOVEMENT

2021 ◽  
pp. 62-65
Author(s):  
Archana Kiran ◽  
Umapada Mondal ◽  
Debarshi jana
Keyword(s):  
Pregnant Women ◽  
Stress Test ◽  
Perinatal Outcomes ◽  
Fetal Monitoring ◽  
Well Being ◽  
Fetal Movement ◽  
Obstetrics And Gynaecology ◽  
Fetal Movements ◽  
Modern Era

Introduction:In modern era of medicine, antenatal fetal monitoring is an essential way that assess the fetal well being. Aims and objectives: This study was performed to test the association between non-stress test ( NST) results and fetal and perinatal outcomes in pregnant women with perceived decrease in fetal movements attending our hospital. To determine the role of Non stress test on fetal and prenatal outcome of pregnant women with perceived decrease in fetal movements attending labor room. Materials and methods: Study is carried out at 'Imambara District Hospital', at the Dept. Of obstetrics and gynaecology, Hooghly, WB. All the pregnant mother with decreased fetal movement perception in the 3rdtrimester, attending OBG (OPD) and ANC or getting admitted in Dept. OF OBSTETRICS AND GYNAECOLOGY, at IMAMBARADIST. HOSPITAL, Chinsurah, Hooghly, WB. 1st May 2018 – April 30, 2019. Conclusion: The antenatal surveillance of cases with reduced perception of fetal movement by mother with NST can effectively screen for identication of high risk foetuses and segregate the cases that are at risk for poor perinatal outcome.

scholarly journals Effect of “motivational interviewing” and “information, motivation, and behavioral skills” counseling interventions on choosing the mode of delivery in pregnant women: a study protocol for a randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahboubeh Shirzad ◽  
Elham Shakibazadeh ◽  
Abbas Rahimi Foroushani ◽  
Mehrandokht Abedini ◽  
Hamid Poursharifi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Section ◽  
Motivational Interviewing ◽  
Pregnant Women ◽  
Controlled Trial ◽  
Mode Of Delivery ◽  
Normal Vaginal Delivery ◽  
Behavioral Skills ◽  
Randomized Controlled ◽  
Counseling Interventions

Abstract Background Cesarean section is an important surgical procedure, when normal vaginal delivery imposes a risk to mother and/or baby. The World Health Organization states the ideal rate for Cesarean section to be between 10 and 15% of all births. In recent decades, the rate has been increased dramatically worldwide. This paper explains the protocol of a randomized controlled trial that aims to compare the effect of “motivational interviewing” and “information, motivation, and behavioral skills” counseling interventions on choosing mode of delivery in pregnant women. Methods A four-armed, parallel-design randomized controlled trial will be conducted on pregnant women. One hundred and twenty women will be randomly assigned to four groups including three intervention groups and one control group. The intervention groups included the following: (1) motivational interviewing; (2) face-to-face information, motivation, and behavioral skills model; and (3) information, motivation, and behavioral skills model provided using a mobile application. The inclusion criteria include being literate, being in gestational age from 24 to 32 weeks, being able to speak Persian, having no complications in the current pregnancy, having no indications for Cesarean section, and having enough time to participate in the intervention. The primary outcome of the study is the mode of delivery. The secondary outcomes are women’s intention to undergo Cesarean section and women’s self-efficacy. Discussion The interventions of this protocol have been programmed to reduce unnecessary Cesarean sections. Findings may contribute to a rise in normal vaginal delivery, and the effective intervention may be extended for use in national Cesarean section plans. Trial registration Iran Randomized Clinical Trial Center IRCT20151208025431N7. Registered on December 07, 2018.

scholarly journals 3162 Colonization of Pregnant Women with Group B streptococcus in Latin America and Infant Outcomes

2019 ◽  
Vol 3 (s1) ◽  
pp. 37-38
Author(s):  
Elena HogenEsch ◽  
Lisa Haddad ◽  
Inci Yildirim ◽  
Saad B Omer
Keyword(s):  
Risk Factors ◽  
Latin America ◽  
Preterm Birth ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Clinical Risk Factor ◽  
Prevalence Rates ◽  
Data Set ◽  
Study Population

OBJECTIVES/SPECIFIC AIMS: The primary objective of this study is to determine the prevalence of maternal GBS colonization and demographic risk factors associated with maternal GBS colonization in Latin America. Secondary objectives include: To determine if there is an association between maternal colonization with GBS and stillbirth or preterm birth in Latin America. To determine the effect of cesarean section (CS) on the incidence of neonatal sepsis with GBS in mothers colonized with GBS. METHODS/STUDY POPULATION: Study Population: Pregnant women who received prenatal care at sites that utilize the Perinatal Information System (SIP) from 1989 through 2015, and were screened for GBS between 35 and 37 weeks of gestation. Maternal exclusion criteria included spontaneous abortion, stillbirth before 35 weeks, and lack of screening for GBS. Methods: Estimated prevalence (and 95% confidence interval) of maternal GBS colonization for the entire data set, by region, and by country. The prevalence data for each country further stratified by maternal age, ethnicity, education, civil status and habitation. Descriptive statistics calculated for each clinical prenatal and clinical perinatal health indicator as well as for each clinical history variable for GBS colonized and non-GBS colonized women. Odds ratios will be calculated for each demographic and clinical risk factor. Fisher’s exact tests will be used to test hypotheses about the relationship between maternal GBS colonization and specific perinatal outcomes such as stillbirth or preterm birth. We will use multiple logistic regression models to test the hypotheses about the relationships between demographic variables, maternal GBS colonization and perinatal outcomes. RESULTS/ANTICIPATED RESULTS: Preliminary results: 712,061 records included in database. 98,852 records with data for GBS screening. o90.6% White, 7.4% Mixed, 0.6% Black, 0.3% Native Indian, 0.1% Other. GBS prevalence among screened women, 17.5% There was a significant association between maternal GBS colonization and ethnicity (X2 (4, N=97006)=569.901, p<0.01) o Prevalence rates by ethnicity: 20.5% Black, 18.4% White, 15.2% Native Indian, 8.8% Mixed, 3.3% Other. There was a significant association between maternal GBS colonization and age (X2 (4, N=98655)=119.901, p<0.01) o Prevalence rates by age group:. Age ≤ 20 - 15.2%. Age 21-34 – 17.8%. Age ≥ 35 – 19.6% Anticipated results:. GBS positive mothers will have an increased burden of stillbirth and preterm birth compared to GBS negative mothers. Neonates born to GBS colonized mothers who deliver via cesarean section will have a decreased incidence of sepsis compared to neonates born to GBS colonized mothers who deliver vaginally DISCUSSION/SIGNIFICANCE OF IMPACT: There have been no comprehensive studies to date that use the CLAP data to characterize the epidemiology of maternal GBS colonization and GBS disease and the burden of neonatal GBS disease in Latin America. Taking advantage of this unique database, this is the first region-wide study using systematically collected data. Our preliminary analysis indicates that GBS colonization status among pregnant women in Latin America is 17.5%, which is greater than previously reported. While there is evidence that maternal carriage of GBS is associated with stillbirth, this will be the first study to quantify the burden of GBS-associated stillbirth in Latin America. Additionally, previous work has been inconclusive in regards to maternal colonization with GBS and its association with preterm birth. This will be the largest study to evaluate the association of maternal GBS carriage with preterm birth. Findings from this study have the potential to inform public health policy and interventions by identifying the prevalence and risk factors.

scholarly journals Comparison between the Effects of Thiopental Sodium and Propofol on Maternal Hemodynamics during Cesarean Section Under General Anesthesia and Apgar score of the newborns

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E Elshaer ◽  
H Omar ◽  
A Elshaer ◽  
T Youssif ◽  
W Abdelmoneim
Keyword(s):  
Blood Pressure ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Umbilical Cord ◽  
Apgar Score ◽  
Well Being ◽  
Elective Cesarean Section ◽  
Anesthetic Drugs ◽  
Significant Difference ◽  
Thiopental Sodium

Abstract Background Cesarean delivery is one of the most current surgeries in women and one of the most significant challenges of anesthesiologists in this kind of surgery is the fetuses' exposure to anesthetic drugs. Regional anesthesia is generally preferred during cesarean section, but general anesthesia may be the only option under certain circumstances such as patient preference, back deformities. The most common drugs which are used in cesarean section to induce general anesthesia are thiopental sodium and propofol. Aim compare the effect of sodium thiopental induction versus propofol induction on hemodynamics of mothers undergoing elective cesarean section under general anesthesia and their effect on Apgar score of their newborns. Materials and Methods A total 260 healthy patients were included in an open randomized study, among whom 130 patients received Thiopentone and 130 received Propofol. These patients were premedicated with granisetron and ranitidine, after induction dose the maintenance was similar for both groups. APGAR scoring and umbilical cord venous gas analysis were among the parameters used for determining the general well-being of newborns. There were no significant difference between the two groups regarding Apgar scoring in 1st, 2nd and 5th minutes. Umbilical cord blood gas values were similar . There was no metabolic acidosis in newborns of mothers receiving thiopental or propofol as anesthetic agents during cesarean section. Results Group (T) received general anesthesia with thiopental at a dose of ( 4-6 mg/kg) while patients in group (P) received general anesthesia with propofol at a dose of (2mg/kg). As regards hemodynamic changes, there were no significant difference in maternal heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure during their measurement throughout the procedure-preoperatively, after delivery of the baby,15 minutes after delivery, after extubation and in recovery room- but after intubation, there were significantly lower in propofol group which suppressed hemodynamic response to intubation . Conclusion Thiopental and propofol can be safely used in cesarean sections, but the use of propofol is more advantageous than thiopental because it provides adequate anesthetic suppression of pressor response of intubation without any depressive effect on newborns.

scholarly journals Effect of "motivational interviewing" and "information, motivation and behavioral skills” counselling interventions on choosing the mode of delivery in pregnant women: A study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Mahboubeh Shirzad ◽  
Elham Shakibazadeh ◽  
Abbas Rahimi Foroushani ◽  
Mehrandokht Abedini ◽  
Hamid Poursharifi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Section ◽  
Motivational Interviewing ◽  
Pregnant Women ◽  
Controlled Trial ◽  
Mode Of Delivery ◽  
Normal Vaginal Delivery ◽  
Behavioral Skills ◽  
Randomized Controlled ◽  
Counselling Interventions

Abstract Background: Caesarean Section is an important surgical procedure, when normal vaginal delivery imposes a risk to mother and/or baby. The World Health Organization states the ideal rate for Cesarean section to be between 10% and 15% of all births. In recent decades, the rate has been increased dramatically worldwide. This paper explains the protocol of a randomized controlled trial that aims to compare the effect of "motivational interviewing" and "information, motivation, and behavioral skills” counselling interventions on choosing mode of delivery in pregnant women.Methods: A four-armed, parallel-design randomized controlled trial will be conducted on pregnant women. One hundred and twenty women will be randomly assigned to four groups including three intervention groups and one control group. The intervention groups included: 1) motivational interviewing; 2) face-to-face information, motivation, and behavioral skills model; and 3) information, motivation, and behavioral skills model provided using a mobile application. The inclusion criteria include being literate, gestational age from 24 to 32 weeks, being able to speak Persian, having no complications in the current pregnancy, having no indications for Cesarean section, and having enough time to participate in the intervention. The primary outcome of the study is the mode of delivery. The secondary outcomes are women’s intention to undergo Cesarean section, and women’s self-efficacy.Discussion: The interventions of this protocol have been programmed to reduce unnecessary Cesarean sections. Findings may contribute to a rise in normal vaginal delivery; and the effective intervention may be extended for use in national Cesarean section plans.Trial registration: This study has been registered in Iran Randomized Clinical Trial Center (IRCT20151208025431N7). Registered December 07, 2018.

scholarly journals Relationship between Sonographic Umbilical cord Diameter and Gestational Age in Third Trimester of Pregnancy

2021 ◽  
pp. 20-27
Author(s):  
Sara Essam ALdabouly ◽  
Mohamed Mohsen El Namori ◽  
Mona Khaled Omar ◽  
Essmat Hamdy AboZeid
Keyword(s):  
Pregnant Women ◽  
Umbilical Cord ◽  
Fetal Growth ◽  
Gestational Age ◽  
Umbilical Vein ◽  
Well Being ◽  
Fetal Weight ◽  
University Hospital ◽  
Third Trimester ◽  
Estimated Fetal Weight

Background: Throughout the fourth week of embryonic development the umbilical cord (UC) is formed, which corresponds to the fifth to the twelfth weeks of gestation. Fetuses with intrauterine growth restriction (IUGR) have leaner UCs than fetuses of appropriate gestational age do, and the caliber of the umbilical vein decreases significantly, resulting in a worsening of the Doppler parameters of the umbilical artery in the mother. The goal of this study was to evaluate the significance of sonographic UC diameter in determining gestational age in third trimester in pregnant women. Methods: We conducted a comparative cross-sectional research on 300 pregnant women aged range between (20-35) years, singleton gestation, gestational age (3rd) trimester estimated from antenatal mothers last menstrual period (LMP), viable fetus, presenting to obstetrics and gynecology department at Tanta university hospital. Results: Highly statistically significant positive correlation between UC diameter and gestational age, BPD, FL, AC, AFI, and estimated fetal weight was found. The increase in UC diameter was positively and significantly correlated with the increase in gestational age and estimated fetal weight, indicating that those who have prolonged gestational age and estimated fetal weight are more likely to have wider UC diameter. Conclusions: The UC diameter (UCD) has the potential to be a valuable indicator of fetal growth, well-being, and perinatal outcome. Sonographic measurement of UC diameter could be an efficient method of measuring fetal growth and predicting gestational age (GA), particularly between 28-40 weeks GA. It is possible that abnormal UC diameter can be a strong indicator to identify antenatal mothers at risk for IUFD and poor fetal outcomes.

scholarly journals Incision and Prediction of Risk Factors Related to Surgical Site Infection Following Cesarean Section in Chinese Women

2021 ◽  
Author(s):  
Qiuxiang Huang
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Pregnant Women ◽  
Chinese Women ◽  
Severe Infection ◽  
Control Group ◽  
Site Infection ◽  
Gynecology And Obstetrics ◽  
Group Data

Cesarean Section (CS) is one of the most frequently executed surgical procedures in gynecology and obstetrics. After a cesarean section, surgical site infection (SSI) increases hospital stay, lengthens maternal morbidity, and upsurges treatment costs. The current study determines the prevalence and risk factors for surgical site infection following cesarean section in China. A retrospective study was conducted on 23 cases of pregnant women who underwent cesarean section and incision severe infection and detection from March 2017 to January 2020 at Wuhan Maternal and Child Healthcare Hospital in China as the study group, and 20 cases of uninfected cesarean section during the same period were selected as the control group. Data were compared with the controls based on study variables and the presence of SSI. The mean age was 31&plusmn;2.6. High fever and blood loss were observed in serous SSI-infected patients. The incidence rate of severe surgical site infection was 0.15 %. SSI was observed to be expected in pregnant women who had premature rupture of membrane before surgery (p &lt; 0.001), who underwent postoperative antibiotic therapy (p &lt; 0.001), and the patients who had gestational diabetes mellitus (p &lt;0.001) and hematoma (p &lt; 0.001) during surgery. Hence, following a cesarean section, surgical site infection is common. This research discovered several modifiable risk factors. SSI is associated with multifactorial rather than a single one. The development and strict implementation of a procedure by all health care practitioners can successfully reduce and prevent infection rates following cesarean section.

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