scholarly journals Comparison between Vacuum and Forceps Extraction to Neonatal outcome on Prolonged Second Stage of Labor

Author(s):  
Kurdi Syamsuri

Objective: To assess the effectiveness of vacuum and forceps extraction in prolonged second stage in Dr. Mohammad Hoesin Hospital Palembang. Methods: A retrospective study for 5 years (2005-2009) by doing a prognostic test on prolonged second stage of labor. Results: The subject age most commonly ranges from 20 to 35 years (84.8% in the forceps extraction group and 86% in the vacuum group). The common parity was nulliparity (58.1% in the forceps extraction group and 61.58% in the vacuum extraction). In the forceps extraction group, 76.7% scores >7 in the 1 minute APGAR score with the mean score of 7.14±1.62, whilst in the vacuum extraction group, 79.1% scores >7 in the 1 minute APGAR score, with the mean score of 7.16±1.78. And in the forceps extraction group, 94.2 scores >7 in the 5 minute APGAR score with mean score of 8.62±1.11, whilst in the vacuum extraction group, 93% scores >7 in the 5 minute APGAR score with the mean score of 8.65±1.08. It is concluded that there is no significant differences on both 1 and 5 minute APGAR scores (p value is 0.713 and 0.755, respectively). Maternal complication of extended episiotomy and perineal rupture were found more often in forceps extraction, but with no statistically significant difference (p=0.324). Conclusion: There is no difference of effectiveness between forceps extraction and vacuum extraction in the case of prolonged second stage. Physicians are free whether to use the vacuum or foceps according to their own desirability and skill. [Indones J Obstet Gynecol 2012; 36-1:28-31] Keywords: forceps extraction, prolonged second stage, vacuum extraction

2020 ◽  
Vol 2 (1) ◽  
pp. 11
Author(s):  
Sabah R. H. Ahmed ◽  
Hala A. Ali

Context: Female perineum is a significant part of females because perineal tears and episiotomy habitually happen in childbirth with first-time deliveries. Aim: This study aimed to explore the role of perineal length (PL) estimation in the prediction of maternal and fetal outcomes. Methods: A prospective cohort observational design used to collect data from the Department of Obstetrics and Gynecology, Laboring room, Kafrelsheikh General Hospital, Kafrelsheikh City, Egypt. A purposive sample of 139 parturient women recruited during the period from the first of December 2018 to the end of August 2019. Six tools used to conduct this study. Maternal and newborn characteristics questionnaire, disposable standardized paper tape for measuring PL in centimeters, a standardized scale for measuring maternal height by meters, and body weight in kilograms to calculate Body Mass Index (BMI) (k/m2), REEDA scale, partograph for labor process and Apgar score. Results: There were statistically significant differences regarding the mean age, previous episiotomy and cesarean section of both studied groups (PL less than or equal to 4 cm and more than 4 cm) at p-value <0.001. Out of 139 parturient women, the two groups of PL less than or more than 4 cm had 16.7% versus 56.9%, respectively had normal vaginal delivery, with a statistically significant difference between both groups, while 46.7% versus 6.3% respectively had an episiotomy. However, the mean duration of the second stage of labor had statistically significant differences between both studied groups, with 116.7 ± 44.3 versus 85.1 ± 42.0, respectively. Additionally; Mean birth weight/grams, cephalohematoma, caput succedaneum, and mean APGAR score after 5 minutes had a statistically significant difference between the two groups. Conclusions: Short perineum accompanied by increased duration of the second stage of labor. Cesarean section delivery and perineal trauma are associated with primigravida with short perineum. Regarding the mean APGAR score after 5 minutes, there were statistically significant differences between both studied groups. Maternity and newborn health nursing need to improve the illustration of the risk factors that can lead to undesirable consequences


2017 ◽  
Vol 9 (01) ◽  
pp. 68
Author(s):  
Mulyati Priyantini ◽  
Yuli Trisnawati

ABSTRAKFokus utama asuhan persalinan adalah pencegahan komplikasi untuk mengurangi angka kesakitan dan kematian ibu. Salah satu upaya adalah mencegah terjadinya ruptur perineum. Posisi tangan yang dipakai penolong persalinan kala II untuk mencegah ruptur perineum antara lain posisi tangan APN dan Varney. Penelitian ini bertujuan untuk mengetahui efektivitas antara posisi tangan penolong menurut APN dan menurut Varney dalam mencegah ruptur perineum spontan pada kala II persalinan di RSIA ‘Bunda arif’ Purwokerto. Penelitian ini merupakan penelitian observasional analitik, menggunakan pendekatan cross sectional dengan populasi seluruh persalinan spontan di RSIA ‘Bunda arif’ Purwokerto. Sampel yang digunakan adalah quota sampling  sebanyak 30 sampel yang memenuhi kriteria inklusi. Metode analisis data menggunakan uji U Mann-Whitney. Hasil penelitian ini adalah Kejadian ruptur perineum pada posisi tangan menurut APN sebanyak 93,3%, sedangkan menurut Varney sebanyak 86,7%. Hasil analisa statistik uji U Mann-Whitney didapatkan p value = 0,550 (p>0,005) sedangkan U value  = 33,000 (Uh < U t ), artinya tidak ada perbedaan bermakna, tetapi posisi tangan Varney lebih baik dengan selisih ruptur 6,6%. Posisi tangan penolong menurut Varney lebih efektif daripada posisi tangan menurut APN dalam pencegahan ruptur perineum spontan pada kala II persalinan, tetapi keduanya tidak memberikan perbedaan yang bermakna terhadap kejadian ruptur perineum. Penolong persalinan dapat menemukan metode yang paling tepat dalam meminimalisir kejadian ruptur perineum spontan untuk menurunkan angka kesakitan dan kematian ibu.Keyword : Posisi tangan penolong, ruptur perineumEFFECTIVENESS OF HANDLING POSITION IN PREVENTION OF PERINEUM RUPTURE IN NORMAL LABORABSTRACTMain focus of delivery care is preventing the complication to reduce the maternal morbidity and mortality. One of the efforts to prevent the occurance of perineal rupture. The position hand which is used birth attendant in the second stage of labor to prevent perineal rupture among others APN and Varney hands position. The goal of this reasearch is to know the effectiveness between APN and Varney hands position to prevent spontanoeus perineal rupture in the second stage of labor in RSIA ‘Bunda arif’ Purwokerto. This reasearch was observational analytic by approachment cross sectional with population of this reasearch was all of spontaneous delivery in RSIA ‘Bunda arif’ Purwokerto and the sample used quota sampling, it’s about 30 sample can be a inclusion criteria. The analyze method data used U Mann-Whitney test. The result of this experiment are precentage of spontaneous perineal rupture by  APN hands position is 93,3%, while by Varney is 86,7%. Result of statistic analysis used U Mann-Whitney test is p value = 0,550 (p>0.005) and U value  = 33,000 (Uh < U t). It means, not significant difference, but Varney hands position better by a margin of 6.6%. the conclusion are varney hands position is more effective than APN hands position in  prevention spontaneous perineal rupture in the second stage of labor, but both not significant for perinel rupture. Suggestion : Birth attendants can find the most appopriate method to minimize perineal ruptured to reduce maternal morbidity and mortalityKeyword : APN & Varney hands position, and perineal rupture.


2021 ◽  
Vol 7 (2) ◽  
pp. e33-e33
Author(s):  
Atena Mohammady Rouzbahani ◽  
Mahrokh Dolatian ◽  
Tayebeh Jahedbozorgan ◽  
Faraz Mojab ◽  
Majid Tajik

Introduction: Episiotomy is a surgical incision at the vaginal opening performed in the second stage of labor during childbirth. The purpose of performing an episiotomy is to increase the size of the soft tissue of the pelvis floor and prevent damage to the perineum, facilitate delivery, and reduce the time during childbirth. Objectives: This study aimed to determine the effect of Teucriumpolium ointment on wound healing in primiparous women. Patients and Methods: This triple-blinded clinical trial was conducted on 84 primiparous women referred to Mahdieh hospital in Tehran. Participants randomly received 2% T. polium ointment and placebo. The first time the ointment was started 24 hours after delivery and continued twice a day for 10 days. Wound healing rate was measured by redness, edema, ecchymosis, discharge, and approximation (REEDA) scale on days 1, 5, and 10 postpartum. The data were analyzed using SPSS version 23. Results: The results were performed on 84 women, 43 people using T. polium ointment and 41 people using placebo ointment. There was no significant difference between the two groups regarding obstetrics and demographic characteristics at the beginning of the study. The mean scores of REEDA in the T. polium group in the first 12 hours, days 5 and 10 were significantly different from the placebo group (P<0.001). Conclusion: Wound healing following episiotomy can be accelerated due to antibacterial, anti-inflammatory, and antiseptic properties of T. polium ointment. Trial Registration: The trial protocol was approved by the Iranian registry of clinical trial (#IRCT20100130003226N18; https://en.irct.ir/trial/40004, ethical code# IR.SBMU.RETECH.1398.055).


2017 ◽  
Vol 2 (1) ◽  
pp. 6
Author(s):  
Halimatussakdiah Halimatussakdiah

In the first stage of delivery, some obstacles are usually happened, including irregular contractions, inadequate duration, and unexpected contractions’ frequency. Consequently, the baby will have asphyxia and the duration of the first and the second stage of the childbrith process will be expanded. The objective of this study was to see the correlation between the duration of both deliveries’ stages on mother multigravida toward Newborn Apgar Score. The method of this study was an analytical correlation with a cross-sectional study. The sample was 35 mother obtained with consecutive sampling method. The data instrument was the observation from. The study was done on 5 and 20 August 2016 in Government Hospital Banda Aceh. The data was done analyzed with statistical test analysis using correlation computing devices. The result of the bivariate analysis showed that there is a correlation between the duration of the first stage of delivery with the first minute Apgar Score (p-value 0,010), fifth minute Apgar score (p-value 0,010), while the second stage with the first minute Apgar Score (p-value 0,000), fifth minute Apgar score (p-value 0,000). From this study, it is expected that the chosen of adequate intervention, the duration of delivery of the first and the second stage has not happened so that the asphyxia on the newborns are decreasing.Keywords: Apgar Score, labor, first and second stageKala I persalinan sering ditemukan hambatan atau kendala. Kendala tersebut antara lain kontraksi rahim yang irreguler, durasi kontraksi yang tidak adekuat dan frekuensi kontraksi yang irreguler sehingga bayi mengalami asfiksia dan menimbulkan perpanjangan waktu kala I dan II persalinan. Tujuan penelitian untuk mengetahui hubungan lamanya persalinan kala I dan II pada ibu bersalin multipara terhadap Apgar Score  Bayi baru lahir. Jenis penelitian Analitik Korelatif, dengan desain Cross Sectional study. Jumlah sampel 35 ibu bersalin multipara tehnik pengambilan sampel dengan metode Consecutive Sampling. Pengumpulan data  menggunakan lembar observasi. Penelitian dilakukan  tanggal 05 - 20 Agustus 2016 di Rumah Sakit Pemerintah Banda Aceh. Metode analisis data menggunakan uji Statistik Regresi Korelasi dianalisis menggunakan perangkat komputer. Hasil analisa bivariat menunjukan ada hubungan antara lama kala I dengan Apgar Score menit 1 (p-value 0,010), apgar score menit 5 (p-value 0,010), kala II dengan Apgar Score menit 1 (p-value 0,000), apgar score menit 5 (p-value 0,000). Diharapkan pemilihan tindakan yang tepat dapar mencegah lamanya persalinan pada kala I dan II dan tidak terjadi asfiksia pada bayi baru lahir.Kata kunci: Apgar score, kala I dan II, persalinan


2021 ◽  
Author(s):  
tamar katzir ◽  
Yoav Brezinov ◽  
Ella Kharish ◽  
Shira Hadad ◽  
Edi Vaisbuch ◽  
...  

Abstract Purpose To determine the validity of Intrapartum ultrasound (IPUS), and particularly the angle of progression (AOP), in predicting delivery mode when measured in real-life clinical practice among women with protracted second stages of labor. Methods Using electronic medical records, nulliparous women with a second stage of labor of ≥ 3hours ("prolonged") and a documented AOP measurement during the second stage were identified. The ability of a single AOP measurement in "prolonged" second stage to predict a vaginal delivery (VD) was assessed. Fetal head descend, measured by AOP change/hour (calculated from serial measurements) was compared between women who delivered vaginally and those who had a cesarean delivery (CD) for arrest of descent. Results Of the 191 women who met the inclusion criteria, 62 (32.5%) delivered spontaneously, 96 (50.2%) had a vacuum extraction (VE) and 33 (17.3%) had a CD. The mean AOP was wider among women who had VD (spontaneous or VE) compared to those who had CD (153º±19 vs. 133º±17, p < 0.001). Wider AOPs were associated with higher rates of VD and an AOP ≥ 127º was associated with a VD rate of 88.6% (148/167). Among the 87 women who had more than one AOP measurement, the mean AOP change per hour was higher in the VD group than in the CD group (15.1º±11.4º vs. 6.2º±6.3º, p < 0.001). Conclusion Ultrasound assessed fetal head station in nulliparous women with a protracted second stage of labor can be an accurate and objective additive tool in predicting mode and interval time to delivery in real-life clinical practice.


Author(s):  
Peace Chinyere Igwe ◽  
John Okafor Egede ◽  
Emeka Onwe Ogah ◽  
Chidebe Christian Anikwe ◽  
Matthew Igwe Nwali ◽  
...  

Introduction: A Decision to Delivery Interval (DDI) of 30 minutes for emergency caesarean section has been widely recommended but there is little evidence to support it. This target may not be practicable in a busy maternity unity and therefore, the anticipated beneficial effect on neonatal outcome requires re-evaluation. Aim: To determine the association between decision-delivery interval and perinatal outcome of emergency caesarean section at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA) over a period of four years. Materials and Methods: This was a retrospective observational study of the cases in emergency caesarean sections performed at the Department of Obstetrics and Gynaecology, AEFUTHA from 1st January 2012 to 1st January 2016. Hospital records of the women with singleton pregnancy at term who delivered through emergency caesarean sections were retrieved. Data extracted include socio-demographic and obstetric characteristics, duration between decision for caesarean section and intervention, indications for the caesarean section, reasons for delay in DDI, association between booking status and DDI and association of DDI and foetal outcome, APGAR score at 1st and 5th minutes and admission to NICU. Data were analysed with IBM statistics version 20. The p-value <0.05 were regarded as statistically significant. Results: A total of 638 emergency caesarean sections involving singleton pregnancies at term, 522 (81.8%) of which had complete records and were analysed. The mean age of participants was 27.8±5.1 years, 89.3% were para 1-4 and 55.0% were unbooked. Only 6 (1.1%) of the emergency caesarean sections were performed within the recommended 30 minutes of DDI. The mean DDI was 189±124 minutes with range of 25 minutes to 1220 minutes. Two cases performed within 25 minutes were cases of foetal distress and cord prolapse while only a case of reduced foetal movement was delayed to 1220 minutes. The most common indications for emergency caesarean section were cephalopelvic disproportion 129 (24.7%) and foetal distress 65 (12.5%). The major cause of delay was delay in cross-matching of blood for surgery 136 (26.1%) while delay in giving informed consent contributed 67 (12.8%). There was no correlation between DDI of 75 minutes or above and the 1st minute APGAR score (AOR=2.48, CI=0.86-7.16, p-value=0.09), 5th minute APGAR score (AOR=3.08, CI=1.55-6.11, p-value=0.09), foetal outcome (AOR=0.82, CI=017-3.79, p-value=0.08) and admission to Newborn Intensive Care Unit (NICU) (AOR=2.08, CI=0.77-5.56, p-value=0.14). Conclusion: This study showed that there was no correlation between DDI>75 minutes and poor perinatal outcome. Efforts should be made to strengthen the health system and improve the quality of care in order to keep DDI within this time limit for improved perinatal health outcome and indices.


1969 ◽  
Vol 3 (2) ◽  
pp. 379-382
Author(s):  
NAZIA LIAQAT ◽  
SAADIAYASMEEN ◽  
FARHAT NASIR ◽  
REHANA RAHIM.

BACKGROUND: Amniotomy is a common and routine obstetrical procedure in many labour wards. It ismostly performed with the intention of accelerating the process of labour. The procedure is not risk free andthe results of various studies performed on the subject are diverse. The rationale of this study was to obtainconclusive evidence on the effect of amniotomy on the duration of labour and to establish protocols forlabour wards in the light of thatevidence.OBJECTIVES: To compare the duration of labour between primigravidas with and without amniotomy.METHODOLOGY: The total number of patients was 50 in each group; A and B who were subjected toamniotomy and no amniotomy respectively. Duration of First and Second stage of labour were noted andStudent T- test was applied to find the significance of difference in the duration of First and Second stages oflabour of the two groups. Data was analyzed using SPSS version 17.0.Results:: The mean ages of patients in Group A and B were 22.6+ 2.66 and 23± 2.03 years respectively (pvalue 0.647). The mean duration of gestation of Group A was 38.8+0.50 weeks and of Group B was 39.16 ±0.52 weeks (p value 0.0634). The duration of First Stage was 169+77 min in Group Aand 205+105 minutesin Group B (p value 0.2877). The Second stage duration was 78.6+45 in Group A and 72 ±32 minutes inGroup B (p value 0.6434).CONCLUSION: Amniotomy has no significant effect in shortening the duration of labour inprimigravidas.KEYWORDS: Amniotomy, Primigravidas, Labour


Author(s):  
Eliyas Sulaiman Mohandas ◽  
Nik Mastura Nik Ismail Azlan ◽  
Salwa Othman ◽  
Muhammad Aizat Azhari

This study aims to investigate whether the use of six selected short stories throughout the duration of a 14-week course could enhance students’ reading comprehension achievement at the end of the semester. Out of the six short stories read, three were chosen as in-class assignments known as ‘Personal Reading Logs’ (hereafter, PRLs). One group of semester two Diploma students taking a reading skills course was selected through a convenience sampling method. A pre-test was conducted by having the students answer a past semester reading quiz of which the results would then be compared to their post-test (final reading exam) results. A paired samples t-test revealed no significant difference in the reading scores of the pre-test and the post-test, t (17) = -.265, p > .05. Since the p-value was bigger than 0.05, this indicated that the mean reading score of the post-test (M = 50.556) was not significantly higher than the mean reading score of the pre-test (M = 49.722). Therefore, the null hypothesis which stated that there was no difference in the mean score of the pre-test and post-test was retained. Overall, the result refuted the findings of other studies promoting the effectiveness of using short stories to enhance L2 reading comprehension achievement.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Salma S. Al Sharhan ◽  
Mohammed H. Al Bar ◽  
Shahad Y. Assiri ◽  
Assayl R. AlOtiabi ◽  
Deemah M. Bin-Nooh ◽  
...  

Abstract Background Chronic rhinosinusitis (CRS) is a common inflammation of the nose and the paranasal sinuses. Intractable CRS cases are generally treated with endoscopic sinus surgery (ESS). Although the effect of ESS on CRS symptoms has been studied, the pattern of symptom improvement after ESS for CRS is yet to be investigated. The aim of this study was to determine the magnitude and sequence of symptom improvement after ESS for CRS, and to assess the possible preoperative factors that predict surgical outcomes in CRS patients. Methods This was a longitudinal prospective study of 68 patients who had CRS (with or without nasal polyps). The patients underwent ESS at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The Sino-nasal Outcome Test-22 (SNOT-22) questionnaire was used for assessment at four time points during the study: pre-ESS, 1-week post-ESS, 4 weeks post-ESS, and 6 months post-ESS. Results The difference between the mean scores recorded for the five SNOT-22 domains pre-ESS and 6 months post-ESS were as follows: rhinologic symptoms (t-test = 7.22, p-value =  < 0.001); extra-nasal rhinologic symptoms (t-test = 4.87, p-value =  < 0.001); ear/facial symptoms (t-test = 6.34, p-value =  < 0.001); psychological dysfunction (t-test = 1.99, p-value = 0.049); and sleep dysfunction (t-test = 5.58, p-value =  < 0.001). There was a significant difference between the mean scores recorded for the five domains pre-ESS and 6 months post-ESS. Rhinologic symptoms had the largest effect size (d = 1.12), whereas psychological dysfunction had the least effect size (d = 0.24). The only statistically significant difference in the SNOT-22 mean scores recorded 4 weeks post-ESS was observed between allergic and non-allergic patients (t = − 2.16, df = 66, p = 0.035). Conclusion Understanding the pattern of symptom improvement following ESS for CRS will facilitate patient counselling and aid the optimization of the current treatment protocols to maximize surgical outcomes and quality of life. Level of evidence Prospective observational.


Biology ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 358
Author(s):  
Javier Aragoneses ◽  
Ana Suárez ◽  
Nansi López-Valverde ◽  
Francisco Martínez-Martínez ◽  
Juan Manuel Aragoneses

The aim of this study was to evaluate the effect of implant surface treatment with carboxyethylphosphonic acid and fibroblast growth factor 2 on the bone–implant interface during the osseointegration period in vivo using an animal model. The present research was carried out in six minipigs, in whose left tibia implants were inserted as follows: eight implants with a standard surface treatment, for the control group, and eight implants with a surface treatment of carboxyethylphosphonic acid and immobilization of FGF-2, for the test group. At 4 weeks after the insertion of the implants, the animals were sacrificed for the histomorphometric analysis of the samples. The means of the results for the implant–bone contact variable (BIC) were 46.39 ± 17.49% for the test group and 34.00 ± 9.92% for the control group; the difference was not statistically significant. For the corrected implant–bone contact variable (BICc), the mean value of the test group was 60.48 ± 18.11%, and that for the control group, 43.08 ± 10.77%; the difference was statistically significant (p-value = 0.035). The new bone formation (BV/TV) showed average results of 27.28 ± 3.88% for the test group and 26.63 ± 7.90% for the control group, meaning that the differences were not statistically significant (p-value = 0.839). Regarding the bone density at the interthread level (BAI/TA), the mean value of the test group was 32.27 ± 6.70%, and that of the control group was 32.91 ± 7.76%, with a p-value of 0.863, while for the peri-implant density (BAP/TA), the mean value of the test group was 44.96 ± 7.55%, and that for the control group was 44.80 ± 8.68%, without a significant difference between the groups. The current research only found a significant difference for the bone–implant contact at the cortical level; therefore, it could be considered that FGF-2 acts on the mineralization of bone tissue. The application of carboxyethylphosphonic acid on the surface of implants can be considered a promising alternative as a biomimetic coating for the immobilization of FGF-2. Despite no differences in the new bone formation around the implants or in the interthread or peri-implant bone density being detected, the biofunctionalization of the implant surface with FGF-2 accelerates the mineralization of the bone–implant interface at the cortical level, thereby reducing the osseointegration period.


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