Duration Of Labor Research Articles

Development and Validation of a Predictive Tool for Postpartum Hemorrhage after Vaginal Delivery: A Prospective Cohort Study.

Postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity worldwide. This study aimed to develop and validate a predictive model for PPH after vaginal deliveries, based on routinely available clinical and biological data. The derivation monocentric cohort included pregnant women with vaginal delivery at Brest University Hospital (France) between April 2013 and May 2015. Immediate PPH was defined as a blood loss of ≥500 mL in the first 24 h after delivery and measured with a graduated collector bag. A logistic model, using a combination of multiple imputation and variable selection with bootstrap, was used to construct a predictive model and a score for PPH. An external validation was performed on a prospective cohort of women who delivered between 2015 and 2019 at Brest University Hospital. Among 2742 deliveries, PPH occurred in 141 (5.1%) women. Eight factors were independently associated with PPH: pre-eclampsia (aOR 6.25, 95% CI 2.35-16.65), antepartum bleeding (aOR 2.36, 95% CI 1.43-3.91), multiple pregnancy (aOR 3.24, 95% CI 1.52-6.92), labor duration ≥ 8 h (aOR 1.81, 95% CI 1.20-2.73), macrosomia (aOR 2.33, 95% CI 1.36-4.00), episiotomy (aOR 2.02, 95% CI 1.40-2.93), platelet count < 150 Giga/L (aOR 2.59, 95% CI 1.47-4.55) and aPTT ratio ≥ 1.1 (aOR 2.01, 95% CI 1.25-3.23). The derived predictive score, ranging from 0 to 10 (woman at risk if score ≥ 1), demonstrated a good discriminant power (AUROC 0.69; 95% CI 0.65-0.74) and calibration. The external validation cohort was composed of 3061 vaginal deliveries. The predictive score on this independent cohort showed an acceptable ability to discriminate (AUROC 0.66; 95% CI 0.62-0.70). We derived and validated a robust predictive model identifying women at risk for PPH using in-depth statistical methodology. This score has the potential to improve the care of pregnant women and to take preventive actions on them.

Outcome of Primigravida with Unengaged Fetal Head at Term or Onset of Labour

Objective: To investigate the duration and course of labour, the need for intervention and feto-maternal outcome in a primigravida with an unengaged fetal head at term in labour.
 Study Design: Prospective longitudinal study.
 Place and Duration of Study: Department of Obstetrics and Gynaecology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jun 2018 to Oct 2019.
 Methodology: This study was carried out on 150 term primigravida women with an unengaged head in labour. Informed consent, detailed history and examination were made along with ultra-sonographic and pelvic assessment.
 Results: Deflexed head was a frequent cause 49(32.67%), cephalopelvic disproportion 24(16%), and loop of cord around theneck 8(5.34%), however, no cause was found 54(36%) women with unengaged fetal head. Ninety three patients (62%)continued with spontaneous labour, while the rest had to be induced. Vaginal deliveries were 100(66.67%), while 50(33.34%) were delivered via Lower Segment Caesarean Section. Out of the 57patients who received induction of labour, 25(43.86%) had vaginal deliveries, while 32(56.14%) underwent Lower Segment Caesarean Section. Five (3.34%) went into a postpartum haemorrhage. Grade 3 perineal tears were seen in 3(2%) patients, and one had a wound infection. APGAR score at ten minutes was between 7 and at ten minutes in 115(76.67%) neonates.
 Conclusion: In primigravida at the onset of labour with an unengaged fetal head at term gestation, vaginal delivery is possible with watchful expectancy and appropriate intervention. However, there is a need to ensure that all inductions are strongly indicated.

The Effect of Pelvic Rocking Exercise with a Birth Ball and SP6 Acupressure on Duration of the First and Second Stage of Labor

Background: Long duration of labor increases the pain that a mother experiences. Several non-pharmacological methods, such as pelvic rocking exercises and SP6 acupressure, have been discovered to reduce pain and accelerate labor duration. It needs to be clarified which of the two methods is more effective.Purpose: This study aimed to assess the effectiveness of pelvic rocking exercise with a birth ball and SP6 acupressure in shortening the duration of the active phase in the first and the second stage of labor.Methods: This study used a quasi-experimental design involving 64 mothers in the first stage of normal delivery who were recruited using propensity score matching sampling. The participants were divided into two intervention groups (the pelvic rocking exercise with a birth ball and SP6 acupressure). Each respondent in the two intervention groups was monitored for progress of labor during the active phase in the first stage using a partograph starting from cervical dilatation of 4 cm to 10 cm. The duration of the second stage was assessed by calculating the length of time from cervical dilatation of 10 cm to the delivery of the entire baby. The Mann-Whitney U test was performed to assess the difference between the two interventions in the two stages of labor assessed.Results: There was a difference in the duration of labor in the first stage (p=0.00) and the second stage (p=0.001) between the groups given the pelvic rocking exercise with a birth ball and the SP6 acupressure. The pelvic rocking exercise with a birth ball was found to be more effective in shortening the duration of the active phase in the first stage (Mean rank=19.83) and the second stage of labor (Mean rank=24.56) compared to SP6 acupressure (Mean rank of the first stage=45.17 and Mean rank of the second stage=40.44).Conclusion: The pelvic rocking exercise was found to be more effective compared to SP6 acupressure in shortening the duration of the active phase in the first and the second stage of labor. Pelvic rocking exercise can be implemented to help accelerate labor duration so that mothers can feel more comfortable during the labor.

Diabetes Consequences on Preterm Premature Rupture of Membrane Complications

Background & Objective: Diabetes mellitus and gestational diabetes are complications that may be associated with preterm premature rupture of the membrane (i.e. PPROM) during pregnancy. We have investigate the impact of gestational and overt diabetes on PPROM through a statistical campaign. Materials & Methods: This study was conducted in two parts: In the first part, the PPROM patients (211 cases) were classified into three groups, without diabetes (W/ODM=126 cases), gestational diabetes (GDM=69 cases consist of 44 cases under insulin therapy and 25 cases of diet controlled), and diabetes mellitus (ODM=16 cases). PPROM complications were studied and compared between these three groups. In the second part, GDM patients under insulin therapy or diet control were compared to W/ODM patients in terms of PPROM complications. Results: There were no significant statistical differences between the groups regarding pregnancy outcomes, except, for mean gestational age at rupture of membrane and delivery. For maternal outcomes, there were significant changes between groups in terms of labor duration, hospital stay after childbirth, and severe preeclampsia. Fetus and neonatal outcomes suggested that the newborn weight, neonatal hyperglycemia, Apgar score, revive need, infant death, and umbilical cord blood gas test results (except BE) were significantly different between the three groups. Results of the second part of the study, in terms of statistically significant differences between insulin therapy, diet control, and W/ODM are consistent with the first part, for all discussed factors. Conclusion: Results revealed that PPROM protocol management on PPROM cases who have gestational or overt diabetes is applicable and does not have any further risk.

“Effectiveness of Ambulation During First Stage of Labor on Maternal Parameters Among Primi Mothers in A Selected Hospital at Mangaluru”

Introduction: The birthing women experiences, many demanding sensation and discomfort during labour and child birth. The childbearing women commonly tensed about childbirth and delivery. Ambulation during first stage of labour eases the process and it became a popular measure during this phase. Ambulation has also been found to increase foeto-maternal circulation which in turn increases the well-being of the new-born as well. Through the literature review, movement in labour to facilitates the progress of labour and enhance child birth satisfaction. This consciousness made the researcher to supply or issue the method of ambulation during the first stage of labour. With this aim, the study was conducted to assess the effectiveness of ambulation on maternal parameters in first stage of labor among the primi mother.
 Materials and Methods: A quasi experimental posttest only control group design was adopted to evaluate the efficacy of ambulation during first stage of labor on maternal parameters among primi mothers. Non probability purposive sampling technique was used to recruit 40 primi mothers who are in first stage of labor and were assigned into experimental group and control group. A structured questionnaire was used to collect the demographic variable; Numerical pain rating scale was used to assess the intensity of pain, Tool to assess the frequency and duration of uterine contraction, Stethoscope to assess the foetal heart rate and opinionnaire on ambulation was used to assess the maternal parameters. Tool was administered for 20 minutes at different time interval for experimental group only. Mothers in the control group underwent routine treatment. The data obtained was analyzed and interpreted using descriptive and inferential statistics.
 Results: The study findings showed that there is significant difference in the pain level in both groups. The mean and standard deviation in 2nd post intervention in experimental group is 3.35+0.48 and in control group 2.95+ 0.22. There was significant difference and comparison of cervical dilatation among both the groups. The mean and standard deviation in 2nd post intervention in experimental group is 2.20 +0.41 and in control group 2.10 + 0.30. The comparison of frequency of contraction among both the groups is significant. In this mean and standard deviation in 2nd post intervention in experimental group is 2.20 + 0.41 and in control group 2.10 + 0.00. The comparison of duration of contraction among both the groups is significant. In this mean and standard deviation in 2nd post intervention in experimental group is 2.05 + 0.68 and in control group 2.00 + 0.00 was statistically significant. The comparison of FHR among both the groups is significant. In this mean and standard deviation in 2nd post intervention in experimental group is 3.80 + 0.41 and in control group 3.75 + 0.63. There is no significant difference in control group. There was no significant association between the selected demographic variables with maternal parameters such as pain, cervical dilatation, frequency of contraction, duration of contraction in experimental and control group. There is a significant association between age and fetal heart rate in experimental group.
 Conclusion: The study concluded that the ambulation technique is effective to reduce the duration of labor in first stage among primi mothers. The mothers in the experimental group who were administered ambulation technique experienced reduction in the duration of labor.

Sorting Out the Risks and Benefits of the #797 Recommended Intrapartum Vancomycin Dosing Approach.

ACOG Committee Opinion #797 proposed intrapartum vancomycin dosing guidelines in the absence of thorough evaluation of its risk versus benefit profile on the maternal and neonatal systems. The previously published serum and cord-blood concentration-time data of vancomycin given to mothers in the intrapartum period was analyzed in this work with a two-compartment pharmacokinetic (PK) model. Monte Carlo simulation was used to establish exposure for the studied population for doses of 1000 mg to 2000 mg every 8 h for gestational ages (GA) of 33 to 40 weeks and for birth times up to 4-h intervals. Probabilities of target attainment (PTA) were calculated for efficacy and toxicity indices unique to the peripartum maternal and neonatal population. Neonatal evaluations indicate uniformly high PTAs for the evaluated dosing regimens when the efficacy target is considered. On the other hand, the PTAs for potentially nephrotoxic exposure is expected to reach undesirable levels when three or more doses were to be administered. The risk is profoundly high in GA below 36 weeks and birth times beyond 20 h after the initiation of intrapartum prophylaxis and with doses greater than 1250 mg. Maternal vancomycin exposures seem reasonable up to two intrapartum doses given at 8 h intervals when the dose is kept to 1250 mg or less. Most mothers (up to 83%) who receive three or more doses of the commonly administered regimens are subjected to nephrotoxic exposures. Thus, it appears that the current recommendations by #797 for dosing of vancomycin pose considerable risk to mother and newborn alike, especially in cases with lengthy duration of preterm labor. Capping of doses at 1250 mg may be considered to minimize the need for therapeutic drug monitoring (TDM) interventions. Alternatively, and irrespective of the baseline maternal renal function, TDM for all cases requiring more than two doses of 1500 mg or higher must be assured.

Factors associated with successful vaginal birth after cesarean section among mothers who gave birth in Ambo town, Oromia, Central Ethiopia, a case-control study.

While Trial of labour after previous cesarean section for women with no contraindication for vaginal delivery is an important strategy to reduce short- and long-term morbidity related with repeated cesarean section, the rate of cesarean section and repeated cesarean section with its complication are increasing. The objective of the study was to assess factors associated with successful vaginal birth among women with previous cesarean delivery in public hospitals of Ambo town in 2019. A case-control study was conducted in Ambo public Hospitals in 2019. A total of 243 clients were included, of which 81 clients were cases and 162 clients were controls with controls to cases ratio of 2. A Lottery method was applied to select the controls and cases were selected consecutively. Bivariate, followed by multivariate analyses, were conducted with 95% CI and p-value <0.05 to identify factors associated with successful vaginal birth after cesarean delivery. Parity three and four(AOR = 3.45, 95%CI(1.16, 10.229), labour monitoring with partograph (AOR= 4.77, 95%CI: 1.65,13.88), prior vaginal birth after caesareans (AOR = 5.68, 95%CI:1.44,22.46), occiput-posterior position (AOR = 0.109, 95%CI: (0.02, 0.49), duration of labour after admission less than 8 hours (AOR = 4.57, 95%CI: 1.92,10.85) and artificial rupture of membrane (AOR = 5.02 95%CI: 1.67,15.06) were factors significantly associated with successful vaginal birth after previous cesarean section. The study shows that parity, duration of labour, previous history of successful vaginal birth after cesarean section, artificial rupture of membrane, and partograph monitoring of labour were associated with successful vaginal birth after previous cesarean section. All Women with a history of cesarean section should be counselled and encouraged to undergo a trial of labour as long as it is not contraindicated.

Late preterm delivery has a distinctive second-stage duration and characteristics

Late preterm neonates born between 34.0 and 36.6 weeks' gestation are at increased risk for short- and long-term morbidity and mortality when compared with their term counterparts. Currently, no separate labor curve is available for late preterm births, and this group's optimal duration of the second stage of labor has never been defined separately. This study aimed to compare the second stage duration between late preterm and term births. This was a retrospective study from May 2014 until May 2021. Eligible were women with a singleton pregnancy, vertex presentation, spontaneous or induced onset of labor, and those who delivered vaginally beyond 34.0 weeks of gestation. The primary outcome of our study was to compare and characterize the second stage of labor duration between late preterm and term births. We analyzed 962 late preterm and 9476 term vaginal deliveries. Women who delivered during the late preterm period were more likely to be multiparous (52.4% vs 45.2%; P<.001) and fewer required oxytocin during labor (41.2% vs 54.4%; P<.001) or used epidural analgesia (75.2% vs 83.6%; P<.001). The overall mean duration of the second stage of labor was significantly shorter in the late preterm period than at term (1.08±1.09 hours vs 1.49±1.22 hours; P<.001). This was even more pronounced for nulliparous women (1.05±1.00 hours vs 2.10±1.17 hours; P<.001). Among multiparous women, epidural use significantly affected the duration of the second stage of labor, and the second stage was relatively longer during the late preterm period than at term in this subgroup (1.16 vs 0.5 hours; P<.001). Using a multivariate Cox regression, variables such as maternal age (hazard ratio, 1.02; 95% confidence interval, 1.01-1.04), parity (hazard ratio, 4.11; 95% confidence interval, 3.65-4.63), preterm birth (hazard ratio, 2.08; 95% confidence interval, 1.4-3.10), and birthweight at delivery (hazard ratio, 1.15; 95% confidence interval, 1.01-1.30) shortened the second stage, whereas induction of labor (hazard ratio, 0.75; 95% confidence interval, 0.66-0.86) and epidural use (hazard ratio, 0.68; 95% confidence interval, 0.64-0.86) extended its total duration. Regardless of parity, lower rates of operative vaginal deliveries were observed in the late preterm period than at term (3.7% vs 15.5%; P<.001). This period was also associated with lower rates of third- and fourth-degree perineal lacerations (0.2% vs 2.2%; P<.001) but higher rates of chorioamnionitis (1.7% vs 0.1%; P<.001), Apgar score at 5 minutes <7 (1.0% vs 0.2%; P<.001), and admission to the neonatal intensive care unit (19.3% vs 1.0%; P<.001). Women who delivered vaginally during the late preterm period had a distinctive second-stage duration. Primarily, it was shown to be significantly shorter for nulliparous and multiparous women. Future studies should further clarify the optimal duration of this stage in relation to neonatal outcomes at such a vulnerable period.

Comparison of the Effect of Vaginal Misoprostol with and Without Laminaria on Ripening or Cervical Preparation in the Second Trimester Abortion: A Randomized Clinical Trial Study

Background: Therapeutic abortion in the second trimester of pregnancy is the treatment of choice in cases such as severe anomalies or fetal death, and both medical and mechanical methods are used to prepare the cervix. One of the various medical methods is the use of misoprostol (Miso) and one of the various mechanical methods is the use of laminaria (Lam). Objectives: This study aimed to compare the use of Miso alone and its combination with Lam in therapeutic abortion in the second trimester of pregnancy. Methods: In this clinical trial study, pregnant women between 14 and 20 weeks of gestation who were admitted to Ali-Ibn Abitaleb Hospital in Zahedan from July 2019 to September 2020 and were candidates for pregnancy termination due to severe anomalies or fetal death were investigated. After obtaining consent, patients were randomly divided into two groups of 45 receiving Miso alone and Miso + Lam. Then, in addition to demographic variables, the number of hospitalization days, the need for curettage, blood transfusions, analgesics, and the symptoms and complications of drugs were investigated. Results: In this study, none of the demographic factors were significantly different between the two groups (P &gt; 0.05). However, the need for curettage (P = 0.05), labor time (P = 0.04), and hospitalization days (P = 0.003) in the Miso + Lam group were less than the group of Miso alone. Conclusions: Our results showed that curettage cases, labor duration, and length of hospital stay decreased in the Miso + Lam group.

PENGARUH PIJAT OKSITOSIN TERHADAP LAMA PERSALINAN KALA I FASE AKTIF DI KLINIK PIM KOTA DEPOK TAHUN 2021

Background: The other causes of maternal deaths In West Java Province, 19.74%, one of which was due to prolonged labor. One way to speed up the progress of labor is by giving oxytocin massage. The purpose of the study was to knowing the effect of oxytocin massage on the duration of the active phase of the first stage of labor at the Ismail Medika Inpatient Pratama Clinic, Depok Period March-April 2021. Methods: quasi-experimental research design using a posttest only design with control groups. The sample in this study amounted to 30 mothers giving birth with each group consisting of 15 respondents with purposive sampling technique. The data were analyzed using the Mann-Whitney test which was previously tested for normality. Result: univariate analysis of the duration of labor in the first active phase of the intervention group was mostly normal 86.7%, the control group was mostly 66.7%. The results of the bivariate analysis showed that there was an effect of oxytocin massage on the duration of the first stage of labor in the active phase with a significance value of 0.000. The conclusion of this research is oxytocin massage affects the duration of the active phase of the first stage of labor. Suggestions for midwives are expected to be able to assist maternity mothers in meeting the mother's need for comfort in non-pharmacological pain control when providing delivery care by applying the oxytocin massage technique so that labor can run effectively and safely both in terms of the length of labor and the condition of the baby being born.

Association of labour duration in spontaneous deliveries with low neonatal Apgar scores and foetal acidosis: the Japan Environment and Children’s Study

This study evaluated the association between labour duration (LD) and incidence of low neonatal Apgar scores and foetal acidosis. Data of 37,682 women with full-term singleton spontaneous vaginal deliveries from the Japan Environment and Children’s Study were analysed. Women were classified according to the median LD as nulliparous (< 10 or ≥ 10 h) or multiparous (< 5 or ≥ 5 h) and further into five subcategories: nulliparous (< 10.0, 10.0–12.9, 13.0–15.9, 16.0–18.9, and ≥ 19 h) and multiparous (< 5.0, 5.0–7.9, 8.0–10.9, 11.0–13.9, and ≥ 14.0 h). Multiple logistic regression models were used to determine odds ratios (ORs) for outcomes in women with over-median LD. Over-median LD exhibited no statistically significant association with low neonatal Apgar scores. The adjusted ORs for both umbilical artery (UmA-pH) < 7.2 and < 7.1 were increased in nulliparous women with over-median LD, whereas only the adjusted OR for UmA-pH < 7.2 was increased in multiparous women with over-median LD. Moreover, this association manifested as a plateau in nulliparous women with LD ≥ 13 h and without dose-dependent association in multiparous women.

Influence of Laboring People's Mobility and Positional Changes on Birth Outcomes in Low-Dose Epidural Analgesia Labor: A Systematic Review with Meta-Analysis.

Freedom of movement has been identified as a key issue for pregnant individuals during the birthing process, even if they opt for epidural analgesia, which has relegated people to more static positions during birth for many years. The aims of this systematic review were to evaluate the influence of mobility and positional changes on perinatal and neonatal outcomes in people in labor with epidural analgesia, describe the range of movement interventions used during the first and second stage of labor, and describe the level of motor blockade among people with low-dose epidural analgesia. Bibliographic databases (Web of Science, Cochrane, CINAHL) were consulted from December 2020 to January 2021. The articles selected were clinical trials and observational or analytical studies, the subject of which was mobilization during labor in people with epidural analgesia. The outcome measures were mode of birth, duration of labor, and extrauterine adaptation after birth. A narrative synthesis was used to describe the types of movements interventions employed during the stages of labor and the level of motor blockade among people with low-dose epidural analgesia. Ten articles were selected (8 clinical trials, one cross-sectional study, and one quasiexperimental study), with a total sample of 6086 individuals. A meta-analysis showed nonsignificant results between groups for mode of birth (relative risk [RR], 1.00; 95% CI, 0.87-1.14), duration of labor (RR, 1.64; 95% CI, -34.57 to 37.86), and extrauterine adaptation after birth (RR, 0.86; 95% CI, 0.39-1.93). There was heterogeneity among studies in the type of movement interventions used during the first and second stage of labor. Although no clear benefit was observed for mobilization in epidural labor, no detrimental effects were found either, so perinatal care providers should encourage mobilization if the laboring person so desires, throughout the entire childbirth process.

Systematic Review of Evening Primrose (Oenothera biennis) Preparations for the Facilitation of Parturition.

The objective of this systematic review was to characterize the efficacy and safety of evening primrose (EP) for facilitation of parturition in peripartum persons. This search sought records related to the efficacy and safety of EP preparations to facilitate parturition. Eligibility criteria were primary literature with efficacy or safety outcomes reported; studied in peripartum persons; and available in English. Records were excluded if they were available as abstracts only. Data was synthesized by study characteristics, patient demographics, and outcomes. The RoB2 and ROBINS-I were used to assess risk of bias. A total of 11 studies met inclusion criteria: seven randomized placebo-controlled trials, one randomized non placebo-controlled trial, one case study, one observational retrospective study, and one quasi-experimental cross-sectional study. Efficacy outcomes included Bishop scores and duration of labor during the different phases. Reported adverse events were generally mild and included increased blood pressure, decreased heart rate, pain, bleeding, nausea, and vomiting. Important risks of bias exist across the literature reviewed. The use of EP for parturition in peripartum individuals is not recommended. Further research is warranted before use during parturition or the peripartum period. Other: The authors deny conflicts of interest. The study was neither registered nor funded.

Expression of Concern: The effect of hyoscine butylbromide on the duration and progress of labor in primigravidae: a randomized controlled trial

Expression of Concern: The effect of hyoscine butylbromide on the duration and progress of labor in primigravidae: a randomized controlled trial

Outpatient Foley Catheter for Induction of Labor in Obese Nulliparous Patients: A Secondary Analysis of OFFSITE II Randomized Controlled Trial.

In the OFFSITE II randomized controlled trial, outpatient cervical ripening with a Foley catheter (CF) in nulliparous patients undergoing elective induction of labor (eIOL) shortened the time from admission to delivery. Given that patients with obesity have protracted labor and higher rates of failed IOL, we sought to determine if outpatient ripening with a CF may be even more beneficial for this high-risk group. We performed a secondary analysis of the OFFSITE II randomized controlled trial. For this analysis, all patients from the primary trial were classified by their intervention assignment (inpatient vs. outpatient) and also by their admission body mass index (BMI) class (BMI ≥ 30 and BMI < 30 kg/m2). The primary outcome was time from labor and delivery (L&D) admission to delivery. Secondary outcomes included cesarean delivery, time from admission to hospital discharge, and rates of clinically diagnosed chorioamnionitis and endometritis. In patients with BMI ≥ 30, the primary outcome, time from admission to delivery, (18.0 [13.5-20.9] vs. 20.4 [16.6-31.3] hours, p = 0.01), as well as total hospitalization length (3.2 [2.5-3.3] vs. 3.4 [3.1-4.3] days, p = 0.02) were shorter in the outpatient group. There were no differences in rates of chorioamnionitis or endometritis in outpatient compared with inpatient CF. Furthermore, in those with a BMI ≥ 30, the cesarean rate was significantly lower with outpatient CF (19.4% vs. 44.7%, p = 0.03); it was not statistically different in patients with BMI < 30. In this exploratory retrospective secondary analysis of the OFFSITE II randomized control trial, we found that in patients with BMI ≥ 30 undergoing eIOL, outpatient CF was associated with a lower time from L&D admission until delivery. This was also associated with a shorter time of total hospital duration and decreased the rate of cesarean, a benefit not detected in the overall analysis presented in the primary study. In nulliparas undergoing induction of labor, ripening with outpatient cervical Foley may even more significantly reduce labor duration, total hospital duration, and the rate of cesarean in patients with obesity. · Outpatient CF was associated with a lower time from L&D admission until delivery in obese nulliparas.. · Outpatient CF was associated with a shorter time of total hospital duration in obese nulliparas.. · Outpatient CF was associated with a decreased rate of cesarean birth in obese nulliparas..

The Effect of Fetal Weight and Uterine Contractions on the Duration of Labor

Background: Prolonged labor is defined as labor that has lasted 12 hours or more but is not followed by birth. The incidence of prolonged labor is quite high; it is known that 1 in 5 maternity mothers experience prolonged labor. The case of prolonged labor is included in the list of the 10 highest cases at Srikandi General Hospital Jember, Indonesia. Prolonged labor lasting &gt; 12 hours is associated with severe postpartum hemorrhage, which is the second leading cause of death in East Java and the leading cause of maternal death in Jember Regency. Several factors are thought to affect the duration of labor including uterine contractions and fetal weight. Purpose: This study aims to determine the effect of fetal weight and uterine contractions on the duration of labor at Srikandi IBI General Hospital, Jember, East Java, Indonesia. Methodology: This is an observational analytic study using a cross-sectional design. The population consists of mothers who give birth at Srikandi General Hospital, Jember: 119 mothers who give birth with a sample size according to the Slovin formula of 92 mothers who give birth determined through Systematic Random Sampling. Research variables were assessed through partographs. Data were analyzed by path analysis. Findings: fetal weight has no significant effect on the duration of labor in both the first and second stages (t value = -0.07; 0.91). Uterine contractions had a significant effect on the duration of the second stage (t value = -2.22; -3.65) but did not significantly affect the duration of the first stage of labor (t value = -0.73; -1.13). Conclusion: This study shows that the more adequate uterine contractions, the shorter the duration of the second stage of labor. There may be other factors that influence the duration of labor including age, parity, nutritional status, maternal nutrition, psychology, family assistance, and non-pharmacological care. Further research is needed to examine the effect of these variables on labor.

A comparative study between Patwardhan technique and push &amp; pull method in women undergoing second stage of labor

Introduction: Obstructed labor with the fetal head impacted in the pelvis is an obstetric complication that requires caesarean delivery with skilful handling in an organized manner to avoid serious maternal and neonatal morbidity. The present study was undertaken to compare the Patwardhan technique with push and pull methods and also to evaluate the safety of Patwardhan technique. Material &amp; methods: Study based on a total 90 pregnant women, of age 18 – 35 years with singleton pregnancy in second stage of labor with deeply impacted head, cases examined in labor room who gave consent and fulfilled inclusion criteria including inpatient admissions and referral randomly allocated in three groups 30 each.1. Patwardhan technique. 2. Push Technique 3. Pull technique. Results: Age, gestational age and duration of labor of the subjects in three were similar. There was significantly less incidence of uterine incision extension to either side, board ligament hematoma, intra-operative blood loss and traumatic Postpartum hemorrhage in subjects undergoing Patwardhan’s technique. With regards to neonatal outcome, wound infection, foetal injury and mean duration of hospital stay were significantly less in Patwardhan’s technique. Birth weight and APGAR scores were similar in all groups. Conclusion: There was less incidence of maternal and foetal morbidity in Patwardhan’s technique which makes it a preferred choice for management during second stage of labor

PENGARUH PEMBERIAN TEH TELUR TERHADAP LAMA PERSALINAN KALA 1 DI BPM “A”

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Prolonged labor is one of the causes of maternal death. The percentage of this case is 20% of all cases of causes of maternal death and 60% of cases of prolonged labor are inadequate. The inadequacy occurs because many women undergo an active phase for more than 6 hours and the cervical opening acceleration is less than 1 hour / cm. The purpose of this study was to determine The Effect of Egg Tea on the First Stage of Labor at BPM "A" Agam Regency in 2021. It was quasi experimental study with posttest design with only none equivalent control. This study was conducted at BPM "A" Agam Regency on February-March 2021. The samples were 20 people (1 control groups and 1 treatment groups). The data were collected through interviews and direct observation. The measuring instrument used pathograph. Then, it was analyzed by univariate and bivariate analysis by using the T test. The results of the study found the average childbirth in the control group was 3.3 hours and the average delivery in the treatment group was 2.6 hours. There is an effect of egg tea administration on the duration of delivery when I, with the result of a symp.sig value of 0.026 &amp;lt; α 0.05. In short, there was an effect of egg tea on the duration of the first stage of labor at BPM "A" Agam Regency in 2021. It is hoped that midwives improve the quality of delivery to women who give birth by carrying out proper handling of women who are at risk of dehydration and lack of energy during the labor process. how to rehydrate by consuming egg tea.&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt; &lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords: &lt;/em&gt;&lt;/strong&gt;&lt;strong&gt;&lt;em&gt;First Stage Labor, Duration of First Stage Labor, Egg Tea&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;

Changes in maternal sleep during pregnancy and pregnancy outcomes

Sleep disorders in pregnancy are incompletely studied, as they are significant health problems with maternal-fetal implications. These are quite common due to the hormonal, anatomical, and functional changes that occur in the mother’s body. Sleep deprivation influences the mother’s health, with important repercussions on the fetus. Polysomnography shows that the changes regarding sleep architecture begin in the first trimester, and disturbances are also observed after birth. Obstetrical implications (way of birth, duration of labor, analgesia, anesthesia at birth, early onset of labor) and maternal conditions (hypertension induced by pregnancy, gestational diabetes, mental disorders) can change sleep quality. Early identification of sleep disorders, as well as prompt prenatal management, especially through non-pharmacological means, is essential to avoid negative consequences.

The effect of heat therapy on pain intensity, duration of labor during first stage among primiparous women and Apgar scores: A systematic review and meta-analysis.

Heat therapy may help in reducing pain during labor as it blocks the receptors of pain, according to gate control theory. This systematic review and meta-analysis study aims to evaluate the effect of heat therapy (HT) systematically and critically on pain intensity, duration of labor during the first stage of labor and Apgar scores. We searched for randomized controlled trials published until October 2020 in PubMed/Medline, EMBASE, ClinicalKey, Ovid Discovery, and other sources. Randomized controlled trials (RCTs) comparing heat therapy with standard treatment were selected. Out of 7625 screened, 10 studies met the inclusion criteria. The results of pooled data have shown that heat therapy was significantly effective in reducing pain intensity in the first stage of labor (standard mean difference, SMD= -1.31; 95% CI: -1.88 - -0.73; p<0.001). Heat therapy had significantly reduced the duration of the first stage of labor (pooled MD= -50.09; 95% CI: -89.70-10.48; p=0.01) and was also superior to the standard therapy group in terms of better Apgar scores at the 5th minute of birth of the newborn (pooled MD= -0.10; 95% CI: -0.19-0.02; p=0.02). Current evidence shows that heat therapy effectively decreases labor pain intensity and shortens the duration of labor in the first stage, and it can be used as nonpharmacological management for labor pain.