scholarly journals Prediction of vaginal delivery by using intrapartum ultrasound – a prospective cohort study

2019 ◽  
Keyword(s):  
Cohort Study ◽  
Vaginal Delivery ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Demographic Data ◽  
Area Under The Curve ◽  
Operating Characteristics ◽  
Fetal Head ◽  
Nulliparous Women ◽  
First Stage Of Labor

Non-invasive transperineal ultrasound is used to detect the descent of the fetal head by measuring head-perineum distance (HPD) and angle of progression (AP). The aim of the study was to evaluate HPD and AP as predictors of vaginal delivery in the first stage of labor. Methods: A prospective cohort study was made in Riga Maternity Hospital in Latvia in 2016. In the study were included nulliparous women with singleton pregnancies in cephalic presentation. HPD and AP were measured using transperineal ultrasoud. Demographic data, delivery parameters and birth outcomes were collected. Results: Of 36 women enrolled in the study, 26 (72.2%) had a vaginal delivery. The area under the receiver–operating characteristics curve was 0.865 (95% confidence interval (CI) 0.75-0.98) for the prediction of vaginal delivery using HPD as the test variable. The area under the curve was 0.877 (95% CI 0.77-0.99) using AP. All women delivered vaginally, if HPD was ≤40 mm (18 (50%) women). 8 (22.2%) of 18 women with HPD >40 mm delivered vaginally (P<0.001). 21 women of 22 (61.1%) with AP ≥105° delivered vaginally. In the other 14 (38.9%) women with AP <105° 5 delivered vaginally (P<0.001). Conclusions: Both HPD ≤ 40 mm and AP ≥ 105° are predictors for vaginal birth in the first stage of labor.

scholarly journals Intrapartum ultrasound to predict vaginal labor: a prospective cohort study

2017 ◽  
Vol 6 (11) ◽  
pp. 4778
Author(s):  
Helene Ingeberg ◽  
Anna Miskova ◽  
Diana Andzane
Keyword(s):  
Cohort Study ◽  
Vaginal Delivery ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Area Under The Curve ◽  
Maternity Hospital ◽  
The Other ◽  
Operating Characteristics ◽  
Fetal Head ◽  
Nulliparous Women

Background: Non-invasive transperineal ultrasound has been used to detect the descent of the fetal head using head-perineum distance (HPD) and angle of progression (AOP). The aim was to evaluate HPD and AOP as predictors of vaginal delivery in the first stage of labor.Methods: This was a prospective cohort study in Riga Maternity Hospital in Latvia from May till August 2016. The study included only nulliparous women with singleton pregnancies and cephalic presentation. Ultrasound was used to measure HPD and AOP. Data was collected on demographics, labor parameters and outcome.Results: Of 36 women enrolled, 26 (72.2%) had a vaginal delivery. The area under the receiver–operating characteristics curve for the prediction of vaginal delivery was 0.865 (95% confidence interval (CI) 0.75-0.98) using HPD as the test variable and the area under the curve was 0.877 (95% CI 0.77-0.99) for AOP. The median HPD was lower in the women delivering vaginally than in the women delivering by cesarean section (P<0.001). HPD was ≤40 mm in 18 (50%) women, of whom all delivered vaginally. HPD was >40 mm in the other 18 women, of whom 8 (22.2%) delivered vaginally (P<0.001). AOP was ≥105° in 22 (61.1%) women and, of these, 21 delivered vaginally. AOP was <105° in the other 14 (38.9%) women, of whom 5 delivered vaginally (P<0.001).Conclusions: HPD ≤40 mm and AOP ≥105° are both predictive of vaginal delivery in the first stage of labor.

scholarly journals Pelvic Floor Disorders 6 Months after Attempted Operative Vaginal Delivery According to the Fetal Head Station: A Prospective Cohort Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0168591 ◽  
Author(s):  
Guillaume Ducarme ◽  
Jean-François Hamel ◽  
Stéphanie Brun ◽  
Hugo Madar ◽  
Benjamin Merlot ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Pelvic Floor Disorders ◽  
Fetal Head ◽  
Operative Vaginal Delivery

Evaluating Fundal Dominant Contractions on Spatiotemporal Electrohysterography as a Marker for Effective Labor Contractions

2018 ◽  
Vol 36 (09) ◽  
pp. 924-929 ◽  
Author(s):  
Rodney K. Edwards ◽  
Neil R. Euliano ◽  
Savyasachi Singh ◽  
Rachel C. LeDuke ◽  
William W. Andrews ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vaginal Delivery ◽  
Prospective Cohort Study ◽  
Study Design ◽  
Prospective Cohort ◽  
Cervical Dilation ◽  
Labor Dystocia ◽  
Nulliparous Women ◽  
Vaginal Deliveries

Objective To evaluate if fundal (F) dominance of the electrohysterogram is associated with vaginal delivery and lack of F dominance is associated with cesarean for labor dystocia. Study Design We conducted a prospective cohort study of nulliparous women in spontaneous labor at ≥36 weeks. Clinicians were blinded to electrohysterography data which were in addition to standard cardiotocography. All contractions in the hour preceding diagnosis of complete cervical dilation (for women delivering vaginally) or the hour preceding the decision for cesarean were analyzed. Results Of 224 patients, 167 had evaluable data. The proportion of F dominant contractions was not different for women undergoing cesarean for labor dystocia (n = 11) compared with all others (n = 156)—88.7 ± 10.2 versus 86.0 ± 11.4%; p = 0.44. Results were similar when comparing the cesarean for labor dystocia group to those undergoing cesarean for other indications (n = 10) and vaginal deliveries (n = 146)—88.7 ± 10.2 versus 86.5 ± 10.0 versus 85.9 ± 11.5%; p = 0.74. Conclusion We were unable to confirm our earlier finding that F dominance of the electrohysterogram is associated with vaginal delivery and lack of F dominance is associated with cesarean for dystocia.

scholarly journals Predictive accuracy of risk scales following self-harm: Multicentre, prospective cohort study

2017 ◽  
Vol 210 (6) ◽  
pp. 429-436 ◽  
Author(s):  
Leah Quinlivan ◽  
Jayne Cooper ◽  
Declan Meehan ◽  
Damien Longson ◽  
John Potokar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Predictive Accuracy ◽  
Area Under The Curve ◽  
Global Scale ◽  
National Guidelines ◽  
Liaison Psychiatry ◽  
Predictive Values ◽  
Self Harm

BackgroundScales are widely used in psychiatric assessments following self-harm. Robust evidence for their diagnostic use is lacking.AimsTo evaluate the performance of risk scales (Manchester Self-Harm Rule, ReACT Self-Harm Rule, SAD PERSONS scale, Modified SAD PERSONS scale, Barratt Impulsiveness Scale); and patient and clinician estimates of risk in identifying patients who repeat self-harm within 6 months.MethodA multisite prospective cohort study was conducted of adults aged 18 years and over referred to liaison psychiatry services following self-harm. Scale a priori cut-offs were evaluated using diagnostic accuracy statistics. The area under the curve (AUC) was used to determine optimal cut-offs and compare global accuracy.ResultsIn total, 483 episodes of self-harm were included in the study. The episode-based 6-month repetition rate was 30% (n = 145). Sensitivity ranged from 1% (95% CI 0–5) for the SAD PERSONS scale, to 97% (95% CI 93–99) for the Manchester Self-Harm Rule. Positive predictive values ranged from 13% (95% CI 2–47) for the Modified SAD PERSONS Scale to 47% (95% CI 41–53) for the clinician assessment of risk. The AUC ranged from 0.55 (95% CI 0.50–0.61) for the SAD PERSONS scale to 0.74 (95% CI 0.69–0.79) for the clinician global scale. The remaining scales performed significantly worse than clinician and patient estimates of risk (P < 0.001).ConclusionsRisk scales following self-harm have limited clinical utility and may waste valuable resources. Most scales performed no better than clinician or patient ratings of risk. Some performed considerably worse. Positive predictive values were modest. In line with national guidelines, risk scales should not be used to determine patient management or predict self-harm.

Influences of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study

2018 ◽  
Vol 34 (3) ◽  
pp. 526-534 ◽  
Author(s):  
Cheng Chen ◽  
Yan Yan ◽  
Xiao Gao ◽  
Shiting Xiang ◽  
Qiong He ◽  
...  
Keyword(s):  
Cohort Study ◽  
Regression Model ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Prospective Cohort Study ◽  
Exclusive Breastfeeding ◽  
Prospective Cohort ◽  
Breastfeeding Duration ◽  
Breastfeeding Initiation ◽  
Breastfeeding Practices

Background: Mothers are encouraged to exclusively breastfeed for the first 6 months. However, cesarean delivery rates have increased worldwide, which may affect breastfeeding. Research aim: This study aimed to determine the potential effects of cesarean delivery on breastfeeding practices and breastfeeding duration. Methods: This was a 6-month cohort study extracted from a 24-month prospective cohort study of mother–infant pairs in three communities in Hunan, China. Data about participants’ characteristics, delivery methods, breastfeeding initiation, use of formula in the hospital, exclusive breastfeeding, and any breastfeeding were collected at 1, 3, and 6 months following each infant’s birth. The chi-square test, logistic regression model, and Cox proportional hazard regression model were used to examine the relationship between breastfeeding practices and cesarean delivery. Results: The number of women who had a cesarean delivery was 387 (40.6%), and 567 (59.4%) women had a vaginal delivery. The exclusive breastfeeding rates at 1, 3, and 6 months were 80.2%, 67.4%, and 21.5%, respectively. Women who had a cesarean delivery showed a lower rate of exclusive breastfeeding and any breastfeeding than those who had a vaginal delivery ( p < .05). In addition, cesarean delivery was related with using formula in the hospital and delayed breastfeeding initiation. Cesarean delivery also shortened the breastfeeding duration (hazard ratio = 1.40, 95% confidence interval [1.06, 1.84]). Conclusion: Healthcare professionals should provide more breastfeeding skills to women who have a cesarean delivery and warn mothers about the dangers of elective cesarean section for breastfeeding practices.

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