Intermittent versus Continuous Catheterization and Differences in the Evolution of Labor: Systematic Review and Meta-analysis

Objective To evaluate the differences between bladder emptying options (permanent catheterization and intermittent bladder emptying/spontaneous urination) regarding the effects on labor length, need of operative vaginal deliveries, and cesarean section rate. Data Sources The search was conducted in MEDLINE, Scopus, Web of Science, and The Cochrane Central Register of Controlled Trials databases. Selection of Studies The survey returned 964 studies. A total of 719 studies were evaluated by title and abstract, of which 4 were selected for inclusion. Data Collection All references were inserted in the Rayyan QCRI tool (Rayyan Systems Inc., Cambridge, MA, USA). The full text of the selected articles was obtained so we could later decide whether or not to include them in this systematic review. Data Synthesis No differences were found in the number of instrumented deliveries or in cesarean section rate between groups. Conclusions After evaluating the studies performed on the topic, we concluded that there is no clear advantage to either method, although continuous catheterization was associated with a greater occurrence of eutocic births. In the remaining outcomes, there were no differences between catheterization types.

Factors Affecting Business Income of Empal Gentong in Cirebon City

The goal of this research is to analyze the effect of capital, labor, length of business, education, and working hours on the empal gentong business income in Cirebon and to analyze which variable has the most effect on that income. We surveyed 30 business owners of empal gentong in Cirebon. The method using in this research is multiple linear regression. This result concludes capital, labor, length of business, education, and working hours have a positive and significant effect jointly on empal gentong business income. The analysis result in partially is capital and length of business have significant effect. Meanwhile, variables of labor, education and working hours have no significant effect on empal gentong business income. From these five variables, the most influential variable on empal gentong business income is the capital variable.Keywords: Income, Capital, Labor, Length of Business, Education, Working Hours

The Effect of Positive Affirmations to Anxiety level and 2nd stage of labor length

The maternal mortality rate by sectio caesarea was 40-80 per 100,000 live births. Secto Cesarean can occur because the mother herself is not sure of her ability to normal birthing. Positive affirmations made by mothers are believed to be one of the supports so that mothers are sure that they can give birth normally and reduce anxiety about childbirth. This type of research is observational analytic with a quasi-experimental design, the type of post test only group design. Based on the results of data analysis with the T test, it was found that there was an effect of giving Positive affirmation on anxiety and 2nd stage of labor with p = 0.000 (p <0.05). Positive affirmation with flashcard affirmation greatly affects the level of anxiety of mothers in labor and it is easier to self-affirm so that negative thoughts about childbirth will be reduced

Is Early Amniotomy Associated with Higher Likelihood of Vaginal Birth after Cesarean?

Objective The study aims to reduce cesarean rates, eligible women are being offered an option of vaginal birth after cesarean (VBAC). However, little data exist regarding efficacy of amniotomy as a tool in this population. We sought to evaluate the impact of early amniotomy on VBAC success. Study Design This is a secondary analysis case-control study using the MFMU (Maternal-Fetal Medicine Units Network) Cesarean Registry. Women were included if they had a singleton pregnancy, were attempting VBAC, and underwent induction with artificial rupture of membranes. Cases were defined as subjects with successful VBAC; controls were defined as subjects with failed trial of labor after cesarean (TOLAC). Early amniotomy was defined as amniotomy at <4 cm. Demographic and obstetric characteristics were compared and multivariate logistic regression was performed. Results A total of 1,490 women were included. Early amniotomy occurred in 59.5% with VBAC versus 63.2% with failed TOLAC (p = 0.24). After controlling for body mass index, prior vaginal delivery, African–American race, labor length, gestational age, birthweight, epidural use, Foley catheter balloon ripening, induction method and oxytocin use, early amniotomy was associated with a 34% decrease in VBAC success (p < 0.01). Women who had early amniotomy did not have higher rates of chorioamnionitis (2.8 vs. 2.9%, p > 0.99). Conclusion Unlike data from nulliparous women, our data suggest that induction with early amniotomy does not increase the likelihood of VBAC.

Risk factors and racial disparities related to low maternal birth satisfaction with labor induction: a prospective, cohort study

Background Decreased birth satisfaction has been associated with labor induction. Yet, there is a paucity of data evaluating risk factors for decreased satisfaction associated with labor induction. We aimed to determine what factors impact low birth satisfaction in labor induction and evaluate racial disparities in birth satisfaction. Methods We performed a prospective cohort study of women with term, singleton gestations undergoing labor induction at our institution from Jan 2018 to Jun 2018. Women completed the validated Birth Satisfaction Scale-Revised postpartum, which is subdivided into 3 domains: (1) quality of care provision, (2) women’s personal attributes, and (3) stress experienced during labor. A total satisfaction score above the mean was classified as “satisfied”, and below as “unsatisfied.” Domain and item scores were compared by race. Results Three hundred thirty of 414 (79.7%) eligible women were included. There was no significant difference in birth satisfaction by age, body mass index, Bishop score, or labor induction agent. Black women were 75% more likely to be unsatisfied than non-Black women (54.0% vs. 37.2%, OR 1.75 [95% CI 1.11–2.76], p = 0.037), nulliparas were 71% more likely to be unsatisfied than multiparas (54.2% vs. 40.9%, OR 1.71 [95% CI 1.09–2.67], p = 0.019), and women whose labor resulted in cesarean birth were almost 3 times more likely to be unsatisfied than women with a vaginal birth (67.4% vs. 42.3%, OR 2.82 [95% CI 1.69–4.70], p < 0.001). Additionally, increased labor length quartile was associated with decreased satisfaction >(p = 0.003). By race, domain 3 scores, which reflect preparedness for labor, were lower for Black women. No differences were seen for domain 1 or 2. Conclusions Black race, cesarean birth, and increasing labor length were identified as risk factors for low birth satisfaction among women who underwent labor induction. Further studies should explore interventions to target women at risk for low birth satisfaction.