scholarly journals Pregnancy and COVID-19

2021 ◽  
Author(s):  
Sushruti Kaushal ◽  
Harpreet Kaur
Keyword(s):  
Pregnant Women ◽  
Regional Anaesthesia ◽  
Physiological State ◽  
Severe Disease ◽  
Mode Of Delivery ◽  
Fetal Monitoring ◽  
Hospital Environment ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Delivery Services

Pregnancy is a physiological state that alters the body’s response to infections. COVID-19 has been found to cause severe disease in pregnancy with morbidity and mortality that is higher than in non-pregnant adults. There is risk of transmission of SARS-CoV2 infection to fetus during ante-natal period, intra-partum and post-delivery from an infected mother. It is necessary to provide an un-interrupted ante-natal care and delivery services to pregnant women during the pandemic. Tele-consultation is important modality to reduce the physical exposure of pregnant women to the hospital environment and should be utilised. Screening, isolation, testing and treatment for SARS-CoV2 infection in pregnant women should follow the local guidelines and remain essentially the same as in non-pregnant adults. Admission, if required, should be in a facility that can provide obstetric maternal and fetal monitoring in addition to care for COVID-19 illness. Use of nitrous oxide and inhalational oxygen for fetal indication should be avoided during labor. Second stage of labor is considered an aerosol generating procedure and should be managed with adequate precautions. Mode of delivery should be as per obstetric indications. Regional anaesthesia should be preferred during caesarean. COVID-19 is not a contra-indication to breast feeding. For antenatal women, COVID-19 vaccination can be considered after shared decision making.

814: Nulliparous women in the second stage of labor: changes in neonatal outcomes over the past 10 years stratified by mode of delivery

2015 ◽  
Vol 212 (1) ◽  
pp. S392
Author(s):  
Joseph Fitzwater ◽  
Nana-Ama Ankumah ◽  
Sukhkamal Campbell ◽  
Joseph Biggio ◽  
John Owen ◽  
...  
Keyword(s):  
Mode Of Delivery ◽  
Neonatal Outcomes ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
The Past ◽  
Nulliparous Women

scholarly journals Upright kneeling position during second stage of labor: a pilot study

2018 ◽  
Vol 7 (2) ◽  
pp. 401 ◽  
Author(s):  
Anjali Dabral ◽  
Pallavi Pawar ◽  
Rekha Bharti ◽  
Archana Kumari ◽  
Achla Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Admission Rate ◽  
North India ◽  
Care Hospital ◽  
Apgar Scores ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Perineal Tears ◽  
Second Stage Of Labour

Background: Women delivering in upright position have shorter labour due to efficient and stronger contractions with faster descent of foetal head. The present study aimed to find out effect of upright kneeling position in the second stage of labour on maternal and foetal outcome and assess patients’ satisfaction.Methods: The study was carried out in a tertiary care hospital of North India from October 2012 to February 2014. Low risk women admitted in early labour were divided into two groups, women delivering in kneeling position and in supine position. The outcome measures studied were, duration of second stage of labour, mode of delivery, 2nd degree perineal tears, Apgar scores at 5 minutes, NICU admission rate and patient satisfaction.Results: The mean duration of second stage of labour in kneeling group was shorter by 14.901 minutes. The rate of vaginal delivery was comparable for both primigravidas and multigravida in kneeling and supine groups, RR: 2.275, 95% CI (0.7872-6.5831) and RR: 1.633, 95% CI (0.393-6.775). Primigravidas had more 2nd degree perineal tears in kneeling group as compared to supine, RR 4.191, 95% CI (1.54 to 11.41). No difference in Apgar scores >7 at 5 minutes was observed in both groups, however, significantly lesser babies in kneeling group were admitted in NICU, RR 0.246, 95% CI (0.079 to 0.761). There was no difference on comparing satisfaction scores of primigravidas and multigravida in both supine and kneeling position.Conclusions: Kneeling position reduces the duration of second stage of labour and NICU admissions.

The impact of epidural analgesia on the mode of delivery in nulliparous women that attain the second stage of labor

2019 ◽  
Vol 33 (14) ◽  
pp. 2451-2458 ◽  
Author(s):  
Naama Srebnik ◽  
Omri Barkan ◽  
Misgav Rottenstreich ◽  
Alexander Ioscovich ◽  
Rivka Farkash ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Mode Of Delivery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Nulliparous Women ◽  
The Impact

scholarly journals Effect of obesity on the outcome of pregnancy in primigravida patients: an Iraqi experience

2019 ◽  
Vol 8 (3) ◽  
pp. 815
Author(s):  
Ban Dawood Mahmood
Keyword(s):  
Birth Weight ◽  
Cesarean Section ◽  
Mode Of Delivery ◽  
Reproductive Age ◽  
Controlled Study ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Emergency Cesarean ◽  
The Impact ◽  
First Time

Background: A parallel rise in the rate of obesity in women in reproductive age; and cesarean section as outcome of pregnancy is noticed in the last years in our society. It is unknown whether this dual rise is related or not. The impact is more evident on primigravida patients, so authors perform this study to assess the impact of obesity on the outcome of pregnancy in primigravida patients in a major obstetrics hospital.Methods: A prospective controlled study was conducted in Ibn Al-Balady obstetrics hospital. It included 121 primigravida patients who were divided into 3 groups according to WHO BMI categories: normal, overweight, and obese. The mode of delivery of these patients is recorded and was assessed in relation to BMI.Results: About 17% of the patients were obese and they needed more emergency CS as a mode of delivery than normal BMI patients (p<0.01). They also had longer second stage of labor (p<0.01) and delivered babies with higher birth weight that the normal group (p<0.05).Conclusions: Obesity constitutes a growing challenge on the outcome of pregnancy, duration of second stage of labor and baby birth weight in primigravida patients. Women who are getting pregnant for the first time should be advised to lower their BMI as a safety measure to avoid emergency cesarean section.

The Severity of Covid- 19 Among Pregnant Women and The Risk of Adverse Maternal Outcome

2021 ◽  
Vol 15 (9) ◽  
pp. 2938-2942
Author(s):  
Maria Anwar ◽  
Kiran Jabeen ◽  
Safia Khan ◽  
Shazia Anwar ◽  
Aalia Jadaan ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pregnant Women ◽  
Severe Disease ◽  
Mode Of Delivery ◽  
Maternal Outcome ◽  
Adverse Outcomes ◽  
Maternal Outcomes ◽  
Maternal Risk ◽  
Icu Admission ◽  
Severe Stage

Background and Aim: The obstetrical complications of pregnant women might elevate to a severe stage due to ongoing severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). Limited study focused on association between COVID-19 and pregnant women adverse outcomes. The present study was carried out to evaluate the severity of COVID-19 among pregnant women and risk of adverse maternal outcome. Materials and Methods: This cross-sectional study was carried out on 242 pregnant women of confirmed COVID-19 cases hospitalized in Aziz Fatimah Hospital, Faisalabad and Holy Family hospital Rawalpindi for six months duration from 5th December 2020 to 5th May 2021. Pregnant women demographic details, obstetric characterizations, adverse maternal outcomes, and laboratory findings were noted. Positive tested pregnant women through RT-PCR regardless of clinical symptoms and signs were enrolled as confirmed cases while negative tested pregnant women were excluded. Hypertensive disorders, preexisting pulmonary, obesity, renal, nulliparity, and cardiovascular disease were the maternal risk factors. Different variables were assessed through fisher’s test and regression logistics model. Results: Of the total 242 pregnant women, the prevalence of mild to moderate symptoms, and severe disease were 187 (77.3%) and 43 (17.7%) respectively. About 12 (5%) had a critical stage of the disease. During this study period, about 31 (12.8%) were admitted to the intensive care unit (ICU) and 9 (3.7%) died. Mode of delivery, maternal age, underlying conditions, parity, and admission to ICU were the important demographic factors in severe COVID-19 disease. Other severe maternal outcomes were fever, cough, breath shortness and anosmia. Increase ICU admission and cesarean section delivery were significantly associated with disease severity. Conclusion: Our study founds a mortality rate of 3.7% among pregnant women with COVID-19. A higher prevalence of intensive care admission and cesarean delivery were reported in acute and severe COVID-19disease. The obstetrical and neonatal outcomes significantly affected by the severity of maternal disease; neonatal prematurity, ICU admission, and cesarean sections complications. Keywords: COVID- 19, Pregnant women, Adverse maternal outcomes

Angle of Progression on Ultrasound in the Second Stage of Labor and Spontaneous Vaginal Delivery

2017 ◽  
Vol 35 (04) ◽  
pp. 413-420 ◽  
Author(s):  
Caroline Rouse ◽  
David Cantonwine ◽  
Sarah Little ◽  
Thomas McElrath ◽  
Julian Robinson ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Transperineal Ultrasound ◽  
Survival Models ◽  
Spontaneous Vaginal Delivery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Nulliparous Women ◽  
Angle Of Progression

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.

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