scholarly journals Sonographic Risk Assessment for An Unplanned Operative Delivery: A Prospective Study

2021 ◽  
Author(s):  
Sharon Perlman ◽  
Hanoch Schreiber ◽  
Zvi Kivilevitch ◽  
Ron Bardin ◽  
Eran Kassif ◽  
...  
Keyword(s):  
Prospective Study ◽  
Vaginal Delivery ◽  
Fetal Weight ◽  
Maximum Likelihood Estimates ◽  
Operative Delivery ◽  
Maternal Height ◽  
Spontaneous Vaginal Delivery ◽  
Pubic Arch ◽  
Estimated Fetal Weight ◽  
Angle Of Progression

Abstract Purpose: To assess the value of pre-labor maternal and fetal sonographic variables to predict an unplanned operative delivery.Methods: In this prospective study, nulliparous women were recruited at 37.0-42.0 weeks of gestation. Sonographic measurements included estimated fetal weight, maternal pubic arch angle, and the angle of progression. We performed a descriptive and comparative analysis between two outcome groups: spontaneous vaginal delivery (SVD) and unplanned operative delivery (UOD) (vacuum-assisted, forceps-assisted and cesarean deliveries). Multivariate logistic regression with ROC analysis was used to create discriminatory models for UOD. Results: Among 234 patients in the study group, 175 had a spontaneous vaginal delivery and 59 an unplanned operative delivery. Maternal height and pubic arch angle (PAA) significantly correlated with UOD. Analysis of Maximum Likelihood Estimates revealed a multivariate model for the prediction of UOD, including the parameters of maternal age, maternal height, sonographic PAA, angle of progression (AOP), and estimated fetal weight, with an area under the curve of 0.7118. Conclusion: Sonographic parameters representing maternal pelvic configuration (PAA) and maternal-fetal interface (AOP) improve the prediction ability of pre-labor models for a UOD. These data may aid the obstetrician in the counseling process before delivery.

Intrapartum fetal head circumference and estimated fetal weight as predictors of operative delivery

2017 ◽  
Vol 137 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Noha H. Rabei ◽  
Amr M. El-Helaly ◽  
Amr H. Farag ◽  
Ahmed K. El-Naggar ◽  
Mohamed K. Etman ◽  
...  
Keyword(s):  
Head Circumference ◽  
Fetal Weight ◽  
Operative Delivery ◽  
Fetal Head ◽  
Estimated Fetal Weight

796: Comparison of three methods for estimated fetal weight during active labor: a prospective study

2015 ◽  
Vol 212 (1) ◽  
pp. S385
Author(s):  
Eran Weiner ◽  
Jacob Bar ◽  
Nataly Fainstein ◽  
Yossi Mizrachi ◽  
Osnat Elyashiv ◽  
...  
Keyword(s):  
Prospective Study ◽  
Fetal Weight ◽  
Active Labor ◽  
A Prospective Study ◽  
Estimated Fetal Weight

Angle of Progression on Ultrasound in the Second Stage of Labor and Spontaneous Vaginal Delivery

2017 ◽  
Vol 35 (04) ◽  
pp. 413-420 ◽  
Author(s):  
Caroline Rouse ◽  
David Cantonwine ◽  
Sarah Little ◽  
Thomas McElrath ◽  
Julian Robinson ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Transperineal Ultrasound ◽  
Survival Models ◽  
Spontaneous Vaginal Delivery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Nulliparous Women ◽  
Angle Of Progression

Objective The objective of this study was to assess the association between the angle of progression (AoP) measured by transperineal ultrasound and mode of delivery and duration of the second stage. Study Design This is a prospective observational study of nulliparous women with a singleton gestation at term in which serial transperineal ultrasound examinations were obtained during the second stage of labor. Multivariable logistic regression and adjusted survival models were used for the analysis. Results A total of 137 patients were included in the analysis and median AoP for the study group was 153 degrees. The adjusted odds ratio (aOR) of requiring an operative delivery was 2.6 times higher for those patients who had an AoP < 153 degrees and the aOR of requiring a cesarean delivery was almost six times higher when compared with those patients who had an AoP ≥ 153 degrees (95% confidence interval [CI]: 1.0, 6.2; p = 0.04; aOR: 5.8, 95% CI: 1.2–28.3; p = 0.03, respectively). Those patients with an AoP < 153 degrees were at a higher hazard of staying pregnant longer (adjusted hazard ratio: 1.8, 95% CI: 1.2–2.8, p = 0.005). Conclusion The AoP has the potential to predict spontaneous vaginal delivery and the duration of the second stage of labor which may be useful in counseling patients and managing their labor.

scholarly journals Prediction of labor outcome by measuring the angle of progression using two dimensional trans-perineal Ultrasound: A prospective cohort study

2021 ◽  
Vol 12 (3) ◽  
pp. 200-204
Author(s):  
Diaa Abdelhalim ◽  
Hussein Abolmakarem ◽  
Mohamed Hassan
Keyword(s):  
Vaginal Delivery ◽  
Primary Outcome ◽  
Mode Of Delivery ◽  
Perineal Ultrasound ◽  
Vaginal Route ◽  
Fetal Head ◽  
Spontaneous Vaginal Delivery ◽  
Non Invasive ◽  
Secondary Outcomes ◽  
Angle Of Progression

Background: Failure of descent due to fetal malposition is one of the most common indications for performing surgical deliveries. It has recently been suggested that trans-perineal intra-partum ultrasonography may be useful in assessing fetal head engagement, position and station as well as it’s reliable, cheap, painless and effective tool. Measuring the ‘angle of progression’ could assist in the obstetrician’s decision regarding mode of delivery. Objectives: The primary outcome is to use the AOP to develop a predictive model for the probability of successful vaginal delivery. Secondary outcomes including assessment of possibly successful VBAC in previous one CS women. Methods: We recruited 500 women in labor. For each woman, a (TPU) was performed to measure the AOP in late first and second stages of labor. We compared AOP between women who delivered fetuses through vaginal route to those who delivered by CS. Results: Through 467 women included in the study, AOP was significantly Higher in spontaneous vaginal delivery group (with cut off 123°±8.5°) as compared with women delivered by vacuum or by CS (113°±10.5°) (P=0.003). The VBAC as another secodary outcome seems to be insignificant. Conclusions: TPU is safe, non-invasive and easily preformed technique which is useful to predict labor outcomes.

scholarly journals ECLAMPSIA

2006 ◽  
Vol 13 (01) ◽  
pp. 27-31
Author(s):  
SHAHIDA SHERAZ ◽  
MOHAMMAD BOOTA ◽  
SOHAIL SHAHZAD
Keyword(s):  
Cesarean Section ◽  
Prospective Study ◽  
Vaginal Delivery ◽  
Magnesium Sulphate ◽  
Mode Of Delivery ◽  
Fetal Loss ◽  
Spontaneous Vaginal Delivery ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
A Prospective Study

Objective: To evaluate incidence, morbidity and mortalityassociated with eclampsia. Design: A prospective study. Place and Duration: The study which was carried out at PAFHospital Rafiqui, Shorkot spanned over a period of 2½ years from Jun 2002-Dec 2004. Patients and Methods: Thestudy comprises of 55 eclamptic cases diagnosed out of 3391 consecutive deliveries, carried out in our hospital.Results: The incidence of eclampsia, in this study, was found to be 1.62%. Out of 55 cases 38(69.1%) patients wereprimigravida. Forty three (78.2%) of the patients were between the ages of 21 to 30 years. In 50(90.9%) patientsgestational age was less than 35 weeks. Thirty seven (67.3%) cases had antepartum eclampsia. Forty four (80%)patients received diazepam while the remaining 11(20%) received magnesium sulphate (MgSO4) as anticonvulsant.Commonest mode of delivery was spontaneous vaginal delivery \(31 cases, 56.4%) followed by lower caesareansection (21 cases, 38.2%). Fetal loss was seen in 12(20.7%) cases. Two patients died of eclampsia, maternal mortalityrate being 3.6%. Conclusion: Eclampsia is a life threatening complication of pregnancy. However an improvement inantenatal care, upgrading the neonatal facilities and early delivery by cesarean section can improve the perinataloutcome.

scholarly journals Association of Recorded Estimated Fetal Weight and Cesarean Delivery in Attempted Vaginal Delivery at Term

2016 ◽  
Vol 128 (3) ◽  
pp. 487-494 ◽  
Author(s):  
Rosemary J. Froehlich ◽  
Grecio Sandoval ◽  
Jennifer L. Bailit ◽  
William A. Grobman ◽  
Uma M. Reddy ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Fetal Weight ◽  
Estimated Fetal Weight

scholarly journals Neuraxial analgesia interfered with the circadian rhythm of labor: a propensity score matched cohort study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Li Wang ◽  
Xuyuan Ma ◽  
Le Chen ◽  
Fangfang Jiang ◽  
Jie Zhou
Keyword(s):  
Cohort Study ◽  
Circadian Rhythm ◽  
Propensity Score ◽  
Vaginal Delivery ◽  
Curve Fitting ◽  
Operative Delivery ◽  
Matched Cohort ◽  
Spontaneous Vaginal Delivery ◽  
Neuraxial Analgesia ◽  
Birth Time

Abstract Objectives To investigate whether neuraxial analgesia and other medical interventions have effects on the circadian rhythm of labor. Methods It was a retrospective propensity score matched cohort study. Parturients were recruited, who delivered term singletons in cephalic position, from seven hospitals in Harvard University Partners Healthcare Systems, 2016–2018. The parturients were divided into two groups, neuraxial analgesia delivery and spontaneous vaginal delivery, the stratification was performed according to labor induction, oxytocin, operative delivery. The parturients in each group were divided into 12 periods in every 2 h based on the birth time of babies. Cosine function fitting was used to verify whether the birth time had the characteristic of circadian rhythm. Results In spontaneous vaginal deliveries, the peak of birth time was at 2:00–4:00, and the nadir was at 14:00–16:00, this showed a circadian rhythm presented by a cosine curve fitting with the formula (y = 0.0847 + 0.01711 × cos(− 0.2138 × x + 0.4471). The labor rhythm of NAD (Neuraxial Analgesia Delivery) group changed completely, inconsistent with the cosine curve fitting of the circadian rhythm. The intervention of induction and oxytocin blurred the circadian rhythm of SVD (Spontaneous Vaginal Delivery) group and increased the amplitude of the fluctuation in NAD (Neuraxial Analgesia Delivery) group. The intervention of operative delivery had changed the distribution curve completely both in the SVD (Spontaneous Vaginal Delivery) group and the NAD (Neuraxial Analgesia Delivery) group. Conclusions Neuraxial analgesia did affect on circadian rhythm of labor, changed the cosine rhythm of labor with spontaneous vaginal delivery, and this trend was aggravated by the use of induction, oxytocin and operative delivery.

Factors Predicting Successful Vaginal Delivery Following Induction of Labor in Term Pregnancy v1

2021 ◽  
Author(s):  
Wirada Hansahiranwadee ◽  
Threebhorn Kamlungkuea ◽  
Jittima Manonai Bartlett
Keyword(s):  
Prediction Model ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Fetal Weight ◽  
Term Pregnancy ◽  
Individual Probability ◽  
History Of ◽  
Estimated Fetal Weight

Objective This study was proposed to evaluatefactors predicting successful vaginal delivery following labor induction and develop induction prediction model in term pregnancy among Thai pregnant women. Method We conducted a retrospective cohort study using electronic medical recordsof 23,833 deliveries from April 2010 - July 2021 at tertiary-level hospital in Bangkok, Thailand. Univariate regression was performed to identify association of individual parameters to successful vaginal delivery. Multiple logistic regression analysis of all possible variables from univariate analysis was performed to develop prediction model with statistically significant of p value < 0.05. Results Of thetotal 809 labor-induced pregnancies, the vaginal delivery rate was 56.6%. Among predicting variables, history of previous vaginal delivery (aOR 5.75, 95%CI3.701-8.961), maternal delivery BMI < 25 kg/m2 (aOR 2.010, 95%CI1.303-3.286), estimated fetal weight < 3500 g (aOR 2.193, 95%CI1.246-3.860), and gestational age ≤ 39 weeks (aOR 1.501, 95%CI1.038-2.173) significantly increased the probability of successful vaginal delivery following labor induction. The final prediction model has been internally validated. Model calibration and discrimination were satisfactory with Hosmer-Lemeshow test P= 0.21 and with AUC of 0.732 (95% CI 0.692-0.772). Conclusions This study determined the pragmatic predictors for successful vaginal delivery following labor induction comprised of history of previous vaginal delivery, maternal delivery BMI < 25 kg/m2, estimated fetal weight < 3500 g, and gestational age ≤ 39 weeks. The final induction prediction model was well-performing internally validated prediction model to estimate individual probability when undergoing induction of labor. Despite of restricted population, the predicting factors and model could be useful for further prospective study and clinical practice to improve induction outcomes.

Sign in / Sign up

Export Citation Format

Share Document