scholarly journals Angle of progression with trans-perineal ultrasound and delivery type in labor’s second stage; a cross-sectional study in Isfahan, Iran

2021 ◽  
Vol 7 (1) ◽  
pp. e05-e05
Author(s):  
Elaheh Zarean ◽  
Ferdos Mehrabian ◽  
Mahsa Sadat Miri

Introduction: Numerous studies have shown that clinical evaluation in labor is not very accurate, therefore ultrasound is one of the instruments that can give us a more objective assessment than the clinical evaluation. Objectives: In this study, we investigate the magnitude of the angle of progression (AoP) at the second stage of labor in fetuses with cephalic presentation and its relation to spontaneous vaginal delivery. Patients and Methods: In this cross-sectional study, we measured the AoP using trans-perineal sonography in the 2nd stage of the labor and compared AoP in normal vaginal delivery (NVD), cesarean and NVD with vacuum groups on 80 pregnant women. We also investigated the correlation between AoP and induction time and duration of the second stage of labor. Results: In 80 study patients, 54 (67.5 %) had normal vaginal deliveries, 21 (26.2 %) had cesarean section and 5 (6.2%) had NVD with a vacuum. There was a statistically significant difference between NVD, cesarean section, and NVD with vacuum in terms of the AoP (P<0.01). There was a statistically significant correlation between AoP and induction time, duration of 2nd stage of labor and Apgar scores (P<0.05). Conclusion: Higher progression angle is associated with shorter induction time and 2nd stage of labor, higher neonatal Apgar scores and a higher chance of spontaneous vaginal delivery which makes it an appropriate index for predicting pregnancy outcomes.

2017 ◽  
Vol 34 (10) ◽  
pp. 0974-0981 ◽  
Author(s):  
Christina Gonzalez ◽  
Amanda Allshouse ◽  
Erick Henry ◽  
Sean Esplin ◽  
Torri Metz

Objective We aimed to evaluate which patient-level factors influence mode of delivery among candidates for operative vaginal delivery. Study Design Cross-sectional study of candidates for operative vaginal delivery from 18 hospitals over 8 years. Probabilities of mode of delivery were estimated using hierarchical logistic modeling adjusting for clustering within physician and hospital. Results Total 3,771 (64%) women delivered with forceps, 1,474 (25%) vacuums, and 665 (11%) cesareans. Odds of forceps versus vacuum were higher with induction (OR = 2.16, 95% CI: 1.76–2.65), nulliparity (OR = 2.06, 95% CI: 1.59–2.66), epidural (OR = 2.05, 95% CI: 1.19–3.56), maternal indication (OR = 1.53, 95% CI 1.16–2.02), older maternal age (OR 1.18, 95% CI 1.06–1.31 per 5 years), and longer second stage (OR = 1.10, 95% CI: 1.01–1.20 per hour).Odds of cesarean versus operative vaginal delivery were higher with maternal indication (OR = 9.0, 95% CI: 7.23–11.20), a perinatologist (OR = 2.51, 95% CI: 1.09–5.78), longer second stage (OR = 1.79, 95% CI: 1.65–1.93 per hour), older gestational age (OR = 1.10, 95% CI: 1.01–1.20 per week), and longer labor (OR = 1.02, 95% CI: 1.01–1.04 per hour). Conclusion Patient-level factors influence the decision to proceed with an operative vaginal delivery and the choice of instrument, thereby emphasizing the importance of maintaining availability of both forceps and vacuums.


2017 ◽  
Vol 35 (04) ◽  
pp. 413-420 ◽  
Author(s):  
Caroline Rouse ◽  
David Cantonwine ◽  
Sarah Little ◽  
Thomas McElrath ◽  
Julian Robinson ◽  
...  

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.


2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Laykewold Elyas ◽  
Amha Mekasha ◽  
Amha Admasie ◽  
Etagegnehu Assefa

Background. The prevalence of exclusive breastfeeding (EBF) is globally low (35%) in sub-Saharan Africa, whereas it is 58% in Ethiopia. Exclusive breastfeeding has the potential to prevent 11.6% of under-five deaths in developing countries. Therefore, the main objective of this study was to assess the exclusive breastfeeding practice and associated factors on mothers attending private pediatric and child clinics in Addis Ababa, Ethiopia. Methods. An institutional-based cross-sectional study design was used. A total of 380 samples were obtained. Data were collected using a self-administered questionnaire. Data was entered and analyzed using SPSS version 16. Descriptive statistics and logistic regression analysis were used. Results. From 380 mothers, only 44.2% of the mothers practiced EBF. Two hundred (52.6%) mothers started breastfeeding within 1 hour of delivery; 161 (42.4%) of the mothers gave extra food before six months, and 244 (64.2%) believed that exclusive breastfeeding was sufficient. Moreover, 288 (75.8%) mothers breastfed their children eight or more times per day. Spontaneous vaginal delivery was a significant factor to practice EBF (AOR: 1.86, 95% CI: 1.19–2.89). Conclusion. EBF practice in this study was low. Spontaneous vaginal delivery was a significant factor for EBF; hence, it is very crucial to promote EBF.


PLoS ONE ◽  
2009 ◽  
Vol 4 (8) ◽  
pp. e6572 ◽  
Author(s):  
Michiel L. Houben ◽  
Peter G. J. Nikkels ◽  
Grada M. van Bleek ◽  
Gerard H. A. Visser ◽  
Maroeska M. Rovers ◽  
...  

2020 ◽  
Vol 5 (2) ◽  
pp. 1027-1030
Author(s):  
Shanti Sunuwar Subedi ◽  
Rakina Bhansakarya ◽  
Sajjan Kumar Sharma

Introduction: To evaluate the maternal and perinatal outcome in booked and unbooked cases. Objectives: To assess the maternal and fetal outcomes in unbooked and booked patients. Methodology: This was a cross-sectional comparative study conducted in the Department of Obstetrics and Gynecology from Augustti2019 to January 2020. Using a convenient sampling technique, 204 samples were taken and cross-sectional study was done. Results: There were total 204 cases in this study;102were booked and 102 were unbooked. In this study, 85(83%) of booked cases were educated up to secondary level as compared toti65 (64%) of unbooked cases. There was no significant difference in Apgar score in 1 and 5 minute between booked and unbooked cases. More babies in the unbooked group were transferred to NICU as compared to the booked group and the difference was significant (9.8%vs 1.9%). Greater proportion of booked cases had spontaneous vaginal delivery (81.3% vs 59.8%) and complications like preterm delivery, anemia, preeclampsia/ eclampsia, complicated labor and puerperal sepsis was also less in the booked group. Conclusions: The study showed that unbooked mothers and their newborns had higher chance of having complications.


2020 ◽  
Vol 10 (3) ◽  
pp. 86-90
Author(s):  
Abera Mersha ◽  
Shitaye Shibiru ◽  
Agegnehu Bante

Background: Low Apgar scores in the childbirth period increased risk globally and significantly contributes to both newborn morbidity and mortality. Hence, it is very essential to update information on the status of low fifth-minute Apgar scores and factors affecting. Some studies were conducted, but most are retrospective and record reviews. Besides, there is limited study in country-Ethiopia. Therefore, this study aimed to assess the recent status of low fifth-minute Apgar scores and factors affecting in the study setting. Methods: A facility-based cross-sectional study was conducted among 286 newborns in public health facilities of Arba Minch town, southern Ethiopia from February 6 to March 9, 2019. Study participants were selected using a systematic random sampling method. Pre-tested interviewer-administered questionnaires and checklist were used to collect the data. Data were entered into Epi data version 3.1 and exported to Stata version 15 for analysis. A crude and adjusted odds ratio was computed in the binary logistic regression model. In this study, P-value, < 0.05 was considered to declare factors as a statistically significant association. Results: In this study, 17.8% (95%CI: 13.8%, 22.7%) of neonates had low fifth-minute Apgar scores. Condition of labor (induced/augmented) (AOR=3.33, 95%CI: 1.24, 8.90), meconium-stained liquor (AOR=3.37, 95%CI: 1.17, 9.74), and birth weight (AOR=3.48, 95%CI: 1.23, 9.86) were significantly associated with neonate’s low fifth-minute Apgar scores. Conclusions: This study indicated that a significant number of newborns resulted in low fifth-minute Apgar scores. Strengthen the provision of health information during antenatal care; avoid delay in screening high-risk mothers during pregnancy and delivery, and give immediate interventions should be recommended.


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