The Comparison of Intrapartum Sonographic Signs and Digital Examination in Fetus with Cephalic Presentation

2020 ◽  
Vol 103 (11) ◽  
pp. 1178-1184

Objective: The agreement of fetal head position examined by digital vaginal examination (DVE) and intrapartum sonographic signs (ISS) in pregnant women during labor. Materials and Methods: A cross-sectional study was conducted. Two hundred eight-term singleton pregnant women attending labor at Ramathibodi Hospital, Thailand with the fetal cephalic presentation, cervical dilatation of 4 to 8 cm, station –2 or below and no contraindication for DVE were enrolled. The DVE evaluating fetal head position was performed by the third-year obstetrical residents. After DVE, ISS via transabdominal ultrasound for determining fetal head position was obtained immediately by the first researcher. The DVE report and the ultrasonographic images of ISS were recorded separately. The fetal head position based on ISS was designated by the second researcher blinded to the DVE result. The agreement of DVE and ISS for determining fetal head position was analyzed. Results: Two hundred eight pregnant women were analyzed. The fetal head position detected by DVE was consistent with that of ISS at 41.3% (p<0.001). The most percent agreement was observed in the fetus with left occiput anterior position at 72.7% (p<0.001). The lowest percent agreement was found in the direct occiput posterior at 14.3% (p=0.243). Parity, gestational age, current body mass index, epidural analgesia, cervical effacement, caput succedaneum, molding, and station did not significantly affect the discrepancy between DVE and ISS. Conclusion: The agreement between DVE and ISS for evaluating the fetal head position was low. The ISS might be considered for evaluating the fetal head position. Keywords: Fetal head position, Intrapartum sonographic sign, Digital vaginal examination

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Batool Teimoori ◽  
Azar Khaefi Ashkzari ◽  
Farahnaz Farzaneh

Background: Abnormal position and presentation are challenges for obstetricians in about 10% of all pregnancies. Objectives: The purpose of this study was to compare ultrasound with transvaginal finger examination in detecting abnormal position and presentation of fetal head. Methods: This was a cross-sectional study performed in Ali ibn-e Abitaleb Hospital of Zahedan in 2018. The women underwent vaginal finger examination in the first phase of delivery, and then trans-abdominal ultrasound was performed for pregnant women. All examinations and ultrasounds were performed by one person with the same ultrasound device. Data were analyzed with SPSS software. Results: In this study, 100 pregnant women were studied in the first phase of pregnancy. The mean age of the subjects was 24.7 ± 5.5 years old. Fetal head position was determined in 81 and 93% of women with vaginal examination and ultrasound, respectively. There was weak agreement (kappa = 0.416). Fetal presentation was determined by finger examination in 93% of cases and by ultrasound in 100% of cases. There was moderate agreement (kappa = 0.783). Conclusions: In general, the results of this study showed that there was no significant difference between ultrasound and finger examination in the presentation and position of fetal head.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Jyothi Shetty ◽  
Vinod Aahir ◽  
Deeksha Pandey ◽  
Prashanth Adiga ◽  
Asha Kamath

Introduction. Recent evidence indicates that clinical examination, for determination of fetal head position, is subjective and inaccurate. Present study was aimed to compare transabdominal ultrasound for fetal head position with vaginal examination during first stage of labor. Material and Methods. This prospective study was performed at a tertiary center during a two-year period. Before or after clinically indicated vaginal examinations, transverse suprapubic transabdominal real-time ultrasound fetal head position assessment was done. Frequencies of various ultrasound depicted fetal head positions were compared with position determined at vaginal examination. Results. In only 31.5% of patients, fetal head position determinations by vaginal examinations were consistent with those obtained by ultrasound. Cohen’s Kappa test of concordance indicated a poor concordance of 0.15. Accuracy of vaginal examination increased to 66% when fetal head position at vaginal examination was recorded correct if reported within +45° of the ultrasound assessment. Rate of agreement between the two assessment methods for consultants versus residents was 36% and 26%, respectively (P=0.17). Conclusion. We found that vaginal examination was associated with a high error rate in fetal head position determination. Data supports the idea that intrapartum transabdominal ultrasound enhances correct determination of fetal head position during first stage of labor.


Author(s):  
Shiren Ali Al Hamzawi

Estimates of Trichomonas vaginalis prevalence in pregnant women are variable with few studies in Iraq.T. vaginalis is a worldwide prevalent sexually transmitted infection,but fortunately,it is very treatable. Researchers believed that pregnancy is one of the effective factors for T. vaginalis infection in women.A cross-sectional study performed in Obstetrics and Gynecology Department at Maternity and Children Teaching Hospital in Al-Diwaniya city on two hundred female pregnant patients between the ages of 16-45 years. These females had no intercourse for 2–3 days,not using drugs (antibiotics,antiprotozoal or steroids) for the last 15 days. Vaginal discharges of any type with or without itching,burning sensation or both were their main complaints. Vaginal swabs were taken from all participating patients for direct wet mount microscopy and culture for the detection of Trichomonas vaginalis infection. The study showed that twelve out of two hundred examined pregnant women (6%) presented with T. vaginalis infection. The infection was more in those with mothers’ age (26-35) years,housewives,low education,higher parity,and of rural residents. Other maternal variables were not significantly associated with T. vaginalis infection. The study showed a prevalence of (6%) of T. vaginalis infection in pregnant female attendees. Infection was more in those with mothers ’age (26-35) years,housewives,low educational level,higher parity,and living in rural areas.


Author(s):  
Katarzyna Kwiatkowska ◽  
Katarzyna Kosińska-Kaczyńska ◽  
Izabela Walasik ◽  
Agnieszka Osińska ◽  
Iwona Szymusik

Background: No specific physical activity guidelines are available for women in multiple pregnancy. Aim of the study was to assess the knowledge and experience of women regarding physical activity during their latest twin pregnancy. Methods: A cross-sectional study including women after a twin delivery was conducted in Poland. A questionnaire was distributed in 2018 via web pages and Facebook groups designed for pregnant women. Results: 652 women filled out the questionnaire completely. Only 25% of women performed any physical exercises during twin gestation. The frequency of preterm delivery was similar in physically active and non-active participants. 35% of the respondents claimed to have gained information on proper activity from obstetricians during antenatal counselling while 11% claimed to be unable to identify the reliable sources of information. 7% of women admitted to feel discriminated by social opinion on exercising during a twin pregnancy. Conclusions: The population of women with a twin gestation is not sufficiently physically active and is often discouraged from performing exercises during gestation. Therefore, it is crucial to inform obstetricians to recommend active lifestyle during a twin gestation and to provide reliable information on physical activity to pregnant women. Further research on this topic is necessary in order for obstetric providers to counsel women on appropriate exercise with a twin pregnancy.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saran Tenzin Tamang ◽  
Thinley Dorji ◽  
Sonam Yoezer ◽  
Thinley Phuntsho ◽  
Phurb Dorji

Abstract Background The third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women’s understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies. Methods This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan’s largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as ‘good’ (≥80%), ‘satisfactory’ (60–79%) and ‘poor’ (< 60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson’s correlation coefficient. Association between knowledge score and participant characteristics was tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge ('good’ versus ‘satisfactory’ and ‘poor’ combined) were assessed with odds ratios using a log-binomial regression model. All results with p < 0.05 were considered significant. Results Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had ‘good’ knowledge, 245 (58.1%) had ‘satisfactory’ knowledge and 157 (37.2%) had ‘poor’ knowledge. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 women (20.3%) could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having ‘good’ level of knowledge. Conclusions Most pregnant women had ‘satisfactory’ knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.


Author(s):  
Mohamed A. Baraka ◽  
Lina Hussain AlLehaibi ◽  
Hind Nasser AlSuwaidan ◽  
Duaa Alsulaiman ◽  
Md. Ashraful Islam ◽  
...  

Abstract Background Antimicrobial agents are among the most commonly prescribed drugs in pregnancy due to the increased susceptibility to infections during pregnancy. Antimicrobials can contribute to different maternal complications. Therefore, it is important to study their patterns in prescription and utilization. The data regarding this issue is scarce in Saudi Arabia. Therefore, the aim of this study is to generate data on the antimicrobial agents that are most commonly prescribed during pregnancy as well as their indications and safety. Methods This is a retrospective study focusing on pregnant women with a known antimicrobial use at Johns Hopkins Aramco Healthcare (JHAH). The sample included 344 pregnant women with a total of 688 antimicrobial agents prescribed. Data was collected on the proportion of pregnant women who received antimicrobial agents and on the drug safety during pregnancy using the risk categorization system of the U.S. Food and Drug Administration (FDA). Results The results showed that urinary tract infections (UTIs) were the most reported (59%) infectious diseases. Around 48% of pregnant women received antimicrobial medications at some point during pregnancy. The top two antimicrobial agents based on prescription frequency were B-lactams (44.6%) and azole anti-fungals (30%). The prescribed drugs in the study were found to be from classes B, C and D under the FDA risk classification system. Conclusion The study revealed a high proportion of antimicrobials prescribed during pregnancy that might pose risks to mothers and their fetuses. Future multicenter studies are warranted to evaluate the rational prescription of antimicrobial medications during pregnancy.


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