scholarly journals Does Fetal Fibronectin Predict the Delivery Route in Nulliparous Women at Postterm Induced by Dinoprostone?

2019 ◽  
pp. 1
Author(s):  
Hale Goksever Celik ◽  
Engin Celik ◽  
Gonca Yetkin Yildirim
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Cervical Length ◽  
Vaginal Route ◽  
Fetal Fibronectin ◽  
Nulliparous Women ◽  
Significant Difference ◽  
Alternative Approaches ◽  
Delivery Route ◽  
High Possibility

<p><strong>Objective:</strong> Digital cervical evaluation has been used to determine the likelihood of vaginal delivery which is considered by many women to be non-tolerable. Recently, alternative approaches such as transperineal ultrasound, fetal fibronectin test in cervicovaginal secretions have been investigating for the prediction of the delivery route. We aimed to study whether the usefulness of qualitative fetal fibronectin test in cervicovaginal secretions for the prediction of vaginal delivery in pregnant women at postterm induced with dinoprostone.</p><p><strong>Study design:</strong> A total of 32 nulliparous pregnant women at postterm were enrolled in this prospective observational study. Fetal fibronectin test was applied to all participated women before the induction with dinoprostone and transvaginal ultrasonography was performed to measure cervical length.</p><p><strong>Results:</strong> The women having positive fetal fibronectin test result gave birth through vaginal route, except one case. Although there is no statistically significant difference, the shorter cervical length was associated with vaginal delivery in our population.</p><p><strong>Conclusion:</strong> Fetal fibronectin test has a predictive value for delivery route in nulliparous women at postterm. Fetal fibronectin test may be used as a “rule out” test because the rate of fetal fibronectin positivity was found to be higher in patients who gave birth via vaginal route. As also shown in our study, although there is no statistically significant difference, the pregnant women with shorter cervical length might have a high possibility to achieve vaginal delivery.</p>

scholarly journals Prediction of vaginal delivery with transperineal ultrasound in women induced with dinoprostone beyond 40 weeks of gestation

2018 ◽  
Vol 7 (8) ◽  
pp. 2998
Author(s):  
Hale Göksever Çelik ◽  
Engin Çelik ◽  
Gökhan Yıldırım
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Prospective Observational Study ◽  
Transperineal Ultrasound ◽  
Direct Visualization ◽  
Fetal Head ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
High Possibility ◽  
Angle Of Progression

Background: Digital cervical evaluation has been used to determine the likelihood of vaginal delivery which is considered by many women to be non-tolerable. Recently, transperineal ultrasound allowing direct visualization of the fetal skull has been using for the prediction of labor route. Authors aimed to study whether measurements on transperineal ultrasound are predictive for vaginal delivery in pregnant women induced with dinoprostone at 40.0-42.0 gestational weeks.Methods: A total of 55 pregnant women at 40.0-42.0 gestational weeks were enrolled in this prospective observational study. All participated women were examined before the induction with dinoprostone to measure the head-perineum distance (HPD), the head-pubis distance and the angle of progression of fetal head (AOP).Results: The greater AOP, the shorter HPD and the head-pubis distance were associated with vaginal delivery in the nulliparous women. The HPD and the head-pubis distance were shorter, whereas the AOP was greater in the multiparous women giving birth by vaginal route.Conclusions: Transperineal ultrasound can be applied at the beginning of labor to predict whether vaginal delivery will occur or not. As shown in our study, the pregnant women with shorter HPD and wider AOP might have a high possibility to achieve vaginal delivery.

scholarly journals Predictive Accuracy of Three Dimensional Ultrasound Measurement of Fetal Adrenal Gland Volume in Preterm Labor Cases

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
W H A Eltantawy ◽  
M M N Mohyieldin ◽  
A H Mohammed
Keyword(s):  
Preterm Birth ◽  
Adrenal Gland ◽  
Pregnant Women ◽  
Preterm Labor ◽  
Cervical Length ◽  
Fetal Fibronectin ◽  
Gland Volume ◽  
Significant Difference ◽  
Threatened Preterm Labor ◽  
Adrenal Gland Volume

Abstract Background Preterm birth is one of the major clinical problems in obstetrics and neonatology as it is associated with perinatal mortality, serious neonatal morbidity and in some cases childhood disability. It is reported that more than 80% of all neonatal mortality and morbidity is due to preterm birth. Objective In this study fetal adrenal gland volume and fetal zone measurement were used as a predictors for occurrence of labor in singleton pregnancies complicated by threatened preterm labor in comparison to cervical length and cervicovaginal fetal fibronectin. Methodology The study was carried out at Ain Shams University Maternity Hospital. The current study include 88 pregnant women who presented with symptoms or signs of threatened preterm labor (PTL). All women were subjected to full history taking, full general, abdominal, pelvic examination, in addition to ultrasound fetal biometry, measurement of cervical length, measurement of fetal fibronectin, fetal adrenal gland volume AGV and fetal zone acquisitions. Results Our results showed high statistically significant difference between the two groups of women regarding CL measurement, FZE and cAGV with P values &lt; 0.001 suggesting that ultrasound examination of fetal adrenal gland and assessment of FZE at time of evaluation for symptoms of PTL may be clinically beneficial in predicting the occurrence of labor in pregnant women at risk of preterm labor. Conclusion Our results demonstrate that in women presenting with threatened preterm labor, cAGV and FZE measured by 3-dimensional ultrasound seem to be significant predictors of delivery within 7 days, when compared to CL and cervicovaginal fetal fibronectin.

Vaginal examination vs. cervical length – which is superior in predicting preterm birth?

2017 ◽  
Vol 45 (8) ◽  
Author(s):  
Merav Sharvit ◽  
Reut Weiss ◽  
Yael Ganor Paz ◽  
Keren Tzadikevitch Geffen ◽  
Netanella Danielli Miller ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Medical Center ◽  
Characteristic Curve ◽  
Multiple Pregnancy ◽  
Predictive Ability ◽  
Cervical Length ◽  
Receiver Operator Characteristic Curve ◽  
Retrospective Case ◽  
Nulliparous Women ◽  
Significant Difference

AbstractObjective:To compare the predictive value of preterm birth (PTB) by transvaginal sonographic cervical length (CL) measurement to digital examination of the cervix (Bishop score – BS), in patients with premature contractions (PC) and intact membranes.Design:A retrospective case-control study.Setting:Meir Medical Center, Kfar Saba, Israel.Population:Women at 24–34 weeks of gestation who were hospitalized with PC and intact membranes.Methods:All patients underwent CL and BS measurements upon admission. Power analysis revealed that 375 patients were needed to show a significant difference between the two methods for predicting PTB. Each one served as her own control.Main outcome measures:PTB<37 and<34 weeks.Results:Receiver-operator characteristic curve (ROC) and logistic regression analyses indicated a correlation between both shortened CL and increased BS to PTB (P<0.001). Neither test offered an advantage in predicting PTB. Areas under the curve for BS and CL ROC were similar for PTB before 37 weeks gestation (0.611 vs. 0.640, P=0.28). For nulliparous women, CL predicted PTB better that BS (0.642 vs. 0.724, P=0.03). For singleton and multiple pregnancy pregnancies, BS and CL did not differ significantly in predicting PTB (P=0.9, P=0.2, respectively). For nulliparous with multiple pregnancy, the BS and CL ROC curves differ nearly significantly (0.554 vs. 0.709, P=0.07), with better predictive ability for CL.Conclusions:CL and BS have similar value in predicting PTB in patients with PC. For nulliparous women, CL is superior over the BS.

The comparison of USG measured cervical length in pregnant women with previous induced abortion versus those who have not had an induced abortion

2019 ◽  
Vol 8 (10) ◽  
pp. 4024
Author(s):  
Harshita Naidu ◽  
Nivedita Hegde ◽  
Anjali M. ◽  
Rohini Kanniga ◽  
Akhila Vasudeva
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Transvaginal Ultrasound ◽  
Induced Abortion ◽  
Cervical Length ◽  
Care Hospital ◽  
Spontaneous Preterm Delivery ◽  
Increased Risk ◽  
Significant Difference ◽  
History Of

Background: The majority of women who undergo induced abortion are young and of low parity. Hence, it is desirable to look for any association effects of induced abortion with future reproductive outcomes. In this study, we aim to compare ultrasound measured cervical length in pregnant women with previous induced abortion versus those who have not had an induced abortion.Methods: This was a prospective observational study performed at tertiary care hospital. Total of 400 patients were recruited, divided into two groups. Patients with an induced abortion in previous pregnancy were included as cases and those with no history were taken as controls. Cervical length was measured by transvaginal ultrasound in all participants at 11-14, 18-22 and 28-32 weeks. Pregnancies were followed up to note incidence of spontaneous preterm delivery, preterm pre labour rupture of membranes (PPROM), threatened preterm, and second trimester miscarriage.Results: Authors have found that there was no significant difference in the cervical length of pregnant patients with or without a history of prior induced abortions.  In our study authors found that mean cervical length at 11-14weeks, 18-22 weeks, and 28-32 weeks was 3.47±0.126cm and 3.48±0.195cm; 3.44±0.296cm and 3.49±0.182cm; 3.36±0.477cm and 3.42±0.310cm respectively among cases and controls. However, there was a demonstrably increased risk of spontaneous preterm delivery, PPROM and threatened preterm in patients with a history of prior induced abortion.Conclusions: Authors conclude that previous induced abortion increases the risk of threatened preterm, PPROM, spontaneous preterm delivery in the subsequent pregnancy. But, this risk is not predictable by measuring cervical length as the mean cervical length remained the same in both the groups.

scholarly journals The effects of body mass index, smoking and anemia on fetal birth weight

2021 ◽  
Vol 29 ◽  
Author(s):  
Ersin Çintesun ◽  
Feyza Nur İncesu Çintesun ◽  
Meltem Aydoğdu ◽  
Emine Taşkın ◽  
Mete Can Ateş ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Birth Weight ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Body Mass ◽  
Fetal Weight ◽  
Important Indicator ◽  
Significant Difference ◽  
Fetal Birth Weight ◽  
Smoking Group

Objective: Fetal growth is an important indicator of fetal health. Low birth weight (LBW) is also associated with increased perinatal morbidity and mortality. Numerous factors that affect fetal weight have been identified. In this study, we aimed to investigate the effect of body mass index, smoking, and anemia on fetal birth weight on term pregnant women who had vaginal delivery in our clinic. Methods: This study is a retrospective cross-sectional study. This study included patients who had a spontaneous vaginal delivery at our hospital between January 1st, 2018, and June 15th, 2020. Measurements of hemoglobin (Hb) and hematocrit (Hct) levels during birth supported the diagnosis of anemia. Hb levels were compared in three categories in this study: (1) Hb<10 g/dL; (2) ≥10<11 g/dL; and (3) Hb ≥11 g/dL. Anemia was defined as having a Hb level <11 mg/dL. Birth weight was categorized as LBW <2500 g; normal birth weight (NBW) as ≥2500–3999 g, and macrosomia as ≥4000 g. Results: Analysis was performed on 1428 pregnant women. There was a statistically significant difference for the Hct and Hb subgroups between the groups (p<0.05). Fetal birth weight was found higher in the non-smoking group than in the smoking group (3302.1± 381.5 g vs. 2839.7±491.5 g; p<0.001). Body mass index (BMI) and Hb levels positively predicted fetal birth weight (β=0.134; p<0.001 and β=0.051; p=0.046), smoking was negatively predicted fetal birth weight (β=-0.245; p<0.001). Conclusion: BMI, Hb levels, and smoking status during mothers’ delivery are effective on fetal weight. Smoking was the strongest predictor of fetal birth weight compared with the other variables.

scholarly journals Sildenafil Citrate Versus Nifedipine and Dydrogesreone in Prevention of Preterm Labor with Short Cervix

2018 ◽  
Vol 2 (1) ◽  
pp. 01-05
Author(s):  
Abd El-Naser Abd El-Gaber Ali ◽  
Khaled M Abdallah ◽  
Ahmed Abdelhamid
Keyword(s):  
Pregnant Women ◽  
Preterm Labor ◽  
Cervical Length ◽  
Sildenafil Citrate ◽  
Health Concern ◽  
P Value ◽  
Short Cervix ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background: Prevention of the premature birth occurrence remains is considered one of the most tough challenges for obstetricians worldwide, mainly to avoid neonatal prematurity complications leading to short and long term morbidities additionally prematurity prevention will reduce premature neonatal mortality rates which is considered a major health concern of obstetricians, neonatologists and families. Objective: To compare and contrast the efficacy of Sildenafil citrate, Nifedipine and Dydrogesrone in prevention of premature labor in gestations with short cervix. Setting: Obstetrics & Gynecology Departments, Faculties of medicine, south Valley and Al-Azhar (Asyut) Universities, Egypt. Duration: from September 2014 to March 2018. Patients And Methds: the study was conducted on 300 pregnant women who randomly divided into three groups: Group I included 100 cases received Sildenafil citrate (Respatio tablet 20mg twice daily orally), Group II included 100 cases received Nifedipine (Epilat retard tablets 20mg twice daily orally) and Group III included 100 pregnant women received dydrogesreone 10 mg (Duphaston) twice daily orally. Results: incidence of preterm labor was (9.37, 8.51 and 14.28) in (Group I, Group II and Group II) respectively. Mean ± SD of cervical length at 32 weeks of gestation was mildly statistically significant among groups (p value <0.05) but no significance in neonatal outcome (p value >0.05) except birth weight which had a highly statistically significant difference (p value < 0.001). There was a highly statistically significant difference among studied groups as regard to drug side effects in (p value <0.001). Conclusion: Sildenafil citrate was as effective as Nifedipine and better than oral Dydrogesterone on myometrial relaxation and prevention of preterm birth in pregnant women who had short cervix.

scholarly journals Threatened Preterm Labor: Which are become Preterm Labor?

2020 ◽  
pp. 216-222
Author(s):  
Cut M. Yeni ◽  
Rismawati Tambunan ◽  
Hasanuddin
Keyword(s):  
Pregnant Women ◽  
Preterm Labor ◽  
Case Control ◽  
Cervical Length ◽  
Wilcoxon Test ◽  
Fetal Fibronectin ◽  
Whitney Test ◽  
Vaginal Ph ◽  
Chi Squared ◽  
Threatened Preterm Labor

Objective: The research was aimed to show about characteristics of subject, fetal fibronectin, vaginal pH, cervical length of women with threatened preterm labor, and which are become preterm labor? Preterm labor is occurs most often in 20 weeks gestation to less than 37 weeks gestation. This condition is concerned about Obstetric problem and associated with significant neonatal morbidity and mortality.Methods: This study used the design of case control where preterm pregnant women who become research subjects divided into two groups with threat and without the threat of pre-term labor. Fetal fibronectin , vaginal pHand cervical length than in both groups were evaluated as a risk factor for preterm labor. Mann-Whitney test , Wilcoxon test and Chi-squared test were used as statistical tests with a confidence level of 95%.Results: A total of 86 preterm pregnant women involved in this study with an average age 30 , 5 ± 6.25 (group threat) 32.16 ± 5.25 (non-threatening). Comparison of fetal fibronectin (p = 0.005), vaginal PH(p <0.001) and length of the cervix (p <0.001) between the two groups showed a significant difference. A total of 8 subjects of the 43 in the group of pregnant women with the threat pretem labor experiencing preterm labor .Conclusion: The size of a short cervical length, an increase in the pH of the vaginal secretions and increased levels of fetal fibronectin  is a clinical indicator for screening during pregnancy to assess the risk of a preterm labor .Keywords: cervical length, fetal fibronectin, pretermlabor , vaginal pH of the secretions. Abstrak Tujuan: Persalinan preterm adalah persalinan yang terjadi padausia kehamilan 20 hingga kurang dari37 minggu. Kondisi inimerupakanpermasalahan yang sangat mengkhawatirkan dalam bidang kebidanan dan dikaitkan dengan morbiditas dan kematian neonatal yang signifikan. Evaluasi dan skrining terhadap berbagai faktor resiko terjadinya ancaman persalinan preterm adalah hal terpenting dalam mencegah berbagai komplikasi yang mungkin timbul.Metode: Penelitian ini menggunakan desain case control dimana wanita hamil preterm yang menjadi subjek penelitian terbagi menjadi dua yakni kelompok dengan ancaman dan tanpa ancaman persalinan preterm. Fetal fibronectin, pH sekret vagina dan panjang serviks dibandingkan diatara kedua kelompok sebagai faktor resiko ancaman persalinan preterm. Mann-Whitney test, Wilcoxon test dan Chi – squared digunakan sebagai uji statistik dengan tingkat kepercayaan 95%.Hasil: Sebanyak 86 wanita hamil preterm terlibat dalam penelitian ini dengan rerata usia 30,5 ± 6,25 (kelompok ancaman) 32,16 ± 5,25 (tanpa ancaman). Perbandingan Fetal fibronectin (p=0,005), pH sekret vagina (p<0,001) dan panjang serviks (p<0,001) antar kedua kelompok menunjukkan adanya perbedaan yang bermakna. Sebanyak 8 subjek dari 43 pada kelompok wanita hamil pretem dengan ancaman persalinan preterm yang mengalami persalinan pretermKesimpulan:Ukuran panjang serviks yang pendek, peningkatan pH sekret vagina dan peningkatan kadar fetal fibronectin merupakan indikator klinis untuk skrining selama kehamilan guna menilai resiko terjadinya persalinan pretermKata kunci: fetal fibronectin, persalinan preterm, Ph vagina, panjang cerviks  

scholarly journals The effect of delivery ball and warm shower on the childbirth experience of nulliparous women: A randomized controlled clinical trial

2021 ◽  
Author(s):  
parvaneh sharifipour ◽  
Masoomeh Kheirkhah ◽  
Mojgan Rajati ◽  
hamid haghani
Keyword(s):  
Clinical Trial ◽  
Pregnant Women ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Control Groups ◽  
Childbirth Experience ◽  
Nulliparous Women ◽  
Significant Difference ◽  
The Mean ◽  
And Control

Abstract Background Childbirth is a unique experience that affects women’s life. Therefore, this study was performed to determine the effect of delivery ball and warm shower on the childbirth experience of primiparous women. Methods This study is a clinical trial that was carried out on primiparous pregnant women referred to Motazedi Hospital in Kermanshah, Iran. Sampling was done by continuous method and pregnant women were divided into three groups of delivery ball-warm shower (n = 33), delivery ball (n = 33) and control (n = 33). Exercise with ball at the dilation of 4 cm was similar in the two groups of delivery ball-warm shower and delivery ball, but the first group also used warm shower at the dilatation of 7 cm. The control group only received the routine delivery care. Demographic information form consisting of pregnancy history and information about the mother and infant were completed and the childbirth experience questionnaire (CEQ) were completed by the women two hours after the childbirth. Results There was a statistically significant difference in the mean score of childbirth experience after the intervention between the two groups of delivery ball-warm shower and control (P = 0.001), and also between the delivery ball and control groups (P = 0.001). There was a statistically significant difference in the mean scores of professional support between the two groups of delivery ball-warm shower and control (P = 0.02) and also between the delivery ball and control groups (p = 0.02). There was a statistically significant difference in the mean scores of participation between the two groups of delivery ball-warm shower and control (P = 0.003) and also between the delivery ball and control groups (P = 0.01). There was also a statistically significant difference in the mean scores of sense of security between the two groups of delivery ball-warm shower and control (P = 0.01). Conclusion Delivery ball and warm shower were effective interventions to create a positive childbirth experience. This method was more effective than using delivery ball alone in childbirth experience. To achieve a positive experience of childbirth in mothers, the use of both intervention (delivery ball and warm shower) is recommended.

scholarly journals Clinical predictive factors for vaginal delivery following induction of labour among pregnant women in Jordan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rawan A. Obeidat ◽  
Mahmoud Almaaitah ◽  
Abeer Ben-Sadon ◽  
Dina Istaiti ◽  
Hasan Rawashdeh ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Bishop Score ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
The Mean

Abstract Background Induction of labour (IOL) is an important and common clinical procedure in obstetrics. In the current study, we evaluate predictors of vaginal delivery in both nulliparous and multiparous women in north Jordan who were induced with vaginal prostaglandins. Method A prospective study was conducted on 530 pregnant women at King Abdullah University Hospital (KAUH) in north Jordan. All pregnant mothers with singleton live fetuses, who had induction of labour (IOL) between July 2017 and June 2019, were included in the study. Mode of delivery, whether vaginal or caesarean, was the primary outcome. Several maternal and fetal variables were investigated. The safety and benefit of repeated dosage of vaginal prostaglandin E2 (PGE2) tablets, neonatal outcomes and factors that affect duration of labour were also evaluated. Pearson χ2 test was used to investigate the significance of association between categorical variables, while student’s t-test and ANOVA were applied to examine the mean differences between categorical and numerical variables. Linear regression analysis was utilized to study the relation between two continuous variables. A multivariate regression analysis was then performed. Significance level was considered at alpha less than 0.05. Results Nulliparous women (N = 254) had significantly higher cesarean delivery rate (58.7% vs. 17.8%, p < 0.001) and longer duration of labour (16.1 ± 0.74 h vs. 11.0 ± 0.43 h, p < 0.001) than multiparous women (N = 276). In nulliparous women, the rate of vaginal delivery was significantly higher in women with higher Bishop score; the mean Bishop score was 3.47 ± 0.12 in nulliparous women who had vaginal delivery vs. 3.06 ± 0.10 in women who had cesarean delivery (Adjusted odds ratio (AOR) = 1.2, 95% CI: 1.03–1.28, p = 0.03). In multiparous women, the rate of vaginal delivery was significantly higher in women with higher Bishop scores and lower in women with higher body mass index (BMI). The mean Bishop score was 3.97 ± 0.07 in multiparous women who had vaginal delivery vs. 3.56 ± 0.16 in women who had cesarean delivery (AOR = 1.5, 95% CI: 1.1–2.1, p = 0.01). The mean BMI was 30.24 ± 0.28 kg/m2 in multiparous women who had vaginal delivery vs. 32.36 ± 0.73 kg/m2 in women who had cesarean delivery (AOR = 0.89, 95% CI: 0.84–0.96, p = 0.005). 27% of nulliparous women who received more than two PGE2 tablets and 50% of multiparous women who received more than two PGE2 tablets had vaginal delivery with no significant increase in neonatal morbidity. Conclusion Parity and cervical status are the main predictors of successful labour induction. Further studies are required to investigate the benefit of the use of additional doses of vaginal PGE2 above the recommended dose for IOL.

scholarly journals Pengaruh Hypnosis Terhadap Tingkat Kecemasan Ibu Hamil Nullipara Triwulan III Dalam Persiapan Menghadapi Persalinan

2016 ◽  
Vol 2 (1) ◽  
pp. 24-32
Author(s):  
Sugeng Triyani ◽  
Fatimah Fatimah ◽  
Aisyah Aisyah
Keyword(s):  
Pregnant Women ◽  
Rating Scale ◽  
Comparison Group ◽  
P Value ◽  
Group Design ◽  
Nulliparous Women ◽  
Significant Difference ◽  
Experiment Method ◽  
Hamilton Anxiety Rating Scale ◽  
The Mean

Adaptability of pregnant women toward labor preparation is very important. If the mother cannot adapt during the process of labor, usually she will experience anxiety and will give a response of fight or flight triggered by the abundance of Catecholamines hormones and by the presence of fear and other forms of distress. This research used a quasi experiment method with  non  randomized pretest potest  equivalent group  design,  without intervention on  the comparison group. The quetionnaire of Hamilton Anxiety Rating Scale was used to measure the level of anxiety among pregnant women given hypnosis therapy with pregnant women not given the hypnosis therapy. The results showed that there was a significant difference in the mean level of anxiety between cases and controls (SD of 6,004). There was a significant influence on the group that used hypnosis therapy with a mean decrease in anxiety by 21.550 poin with a p value of < 0.001. Therefore, hypnosis is effective in reducing anxiety among nulliparous women in the third quarter of pregnancy.

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