Duration Of Labor Research Articles

The correlation between total deceleration and acceleration surface areas on electronic fetal monitoring and neonatal cord blood pH in postdate pregnancies.

To assess the correlation between the total decelerations area in the final 120 min before delivery and neonatal cord blood pH in postdate pregnancies. This cross-sectional study included women with gestational age greater than 41 weeks, singleton pregnancy, and a category II electronic fetal monitoring (EFM) of at least 30 min during the final 120 min before delivery. We included postdate deliveries of an otherwise low-risk parturient population. Each area was calculated as duration × depth × 1/2. Correlations were tested using the Spearman correlation coefficient. A total of 100 EFMs were included in the analysis. Median pH was significantly lower in neonates above the median total deceleration area under the curve (AUC; 7.26 vs. 7.32, P=0.002). Gestational age at delivery was independently associated with total deceleration AUC above median (adjusted odds ratio 1.21, 95% confidence interval 1.09-1.37) controlling for history of previous cesarean delivery and duration of second stage of labor. A significant correlation was found between cord blood pH and total deceleration area (P < 0.001, Spearman correlation coefficient -0.37). Among women with postdate pregnancies, the total deceleration area and the mean maximum duration of decelerations were negatively correlated with cord blood pH. Further studies are needed to incorporate deceleration area as a method in predicting fetal acidemia.

Prolonged labor and adverse cardiac outcomes in pregnant patients with congenital heart disease

Patients with congenital heart disease are at high risk for peripartum cardiac morbidity, yet data on the impact of duration of labor on cardiac outcomes are limited. Prolonged labor is a known risk factor for maternal morbidity, but the impact of prolonged labor on cardiac outcomes in patients with congenital heart disease has not been evaluated. This study aimed to evaluate the association between prolonged labor (≥24 hours) and adverse peripartum maternal cardiac outcomes in pregnant patients with congenital heart disease. This was a retrospective cohort study of pregnant patients ≥18 years with congenital heart disease who received prenatal care and delivered at an academic institution between 1998 and 2020 with a singleton gestation. Pregnancies that ended <20 weeks' gestation and patients who underwent an outright cesarean delivery without exposure to labor were excluded. The primary outcome was a composite adverse maternal cardiac outcome that occurred intrapartum or up to 6 weeks postpartum, defined as the occurrence of 1 or more of the following events: heart failure or clinical volume overload requiring diuresis, pulmonary edema, arrhythmia requiring treatment, thromboembolic complications including deep vein thrombosis or pulmonary embolism, transient ischemic attack, stroke, endocarditis, myocardial infarction, aortic dissection, cardiac arrest, or cardiac death. Outcomes were compared between patients with prolonged labor (≥24 hours) and those without prolonged labor (<24 hours). An interaction between prolonged labor and cesarean delivery was evaluated. A total of 229 patients were included. The median duration of labor was 14 hours, and 18% of patients labored for ≥24 hours. Overall, 11.8% experienced the composite cardiac outcome with a significantly higher rate in the prolonged labor group (22% vs 9.6%; P=.03). After adjusting for confounders, including nulliparity, labor induction, gestational age, and World Health Organization class, there was a 2.7-fold increase in the odds of the composite cardiac outcome for patients who experienced prolonged labor (adjusted odds ratio, 2.7; 95% confidence interval, 1.1-7.1). There was no significant difference in cardiac outcome between those who had a vaginal delivery and those who had a cesarean delivery during labor (10.0% vs 16.1%; P=.18). There was, however, a significant interaction between prolonged labor and cesarean delivery; after adjustment for confounders, patients who underwent a cesarean delivery after prolonged labor had a 6.8-fold increase in the odds of experiencing the composite cardiac outcome when compared with those who underwent a cesarean delivery without prolonged labor (30.8% vs 7.1%; adjusted odds ratio, 6.8; 95% confidence interval, 1.4-32.5), most commonly, heart failure or volume overload requiring diuresis. In a cohort of pregnant patients with congenital heart disease, prolonged duration of labor ≥24 hours was significantly associated with an increased risk for an adverse peripartum cardiac outcome, especially among those who underwent a cesarean delivery after that time. These findings suggest that close attention should be paid to the duration of labor, and those who require a cesarean delivery after a prolonged labor should be monitored closely for signs of volume overload and other adverse cardiac events.

The Effects of Virtual Reality in Maternal Delivery: Systematic Review and Meta-analysis.

Extreme labor pain has negative effects; pharmacologic analgesic modalities are effective but are accompanied by adverse effects. Virtual reality (VR) works as a distracting nonpharmacologic intervention for pain and anxiety relief; however, the effects of VR use in laboring women is unknown. Our study aimed to determine the safety and effectiveness of VR technology during labor and delivery and investigate whether it impacts labor and patient satisfaction. In all, 7 databases (PubMed, Embase, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, and Wan-Fang Database) were systematically searched for randomized controlled trials of VR use in pregnancy and childbirth from the time of database construction until November 24, 2021. Two researchers extracted data and evaluated study quality using the Cochrane Risk of Bias tool 2.0. Outcome measures were labor pain, anxiety, duration, satisfaction, and adverse events. Meta-analyses were performed where possible. A total of 12 studies with 1095 participants were included, of which 1 and 11 studies were rated as "Low risk" and "Some concerns" for risk of bias, respectively. Of the 12 studies, 11 reported labor pain, 7 reported labor anxiety, and 4 reported labor duration. Meta-analysis revealed that VR use could relieve pain during labor (mean difference -1.81, 95% CI -2.04 to -1.57; P<.001) and the active period (standardized mean difference [SMD] -0.41, 95% CI -0.68 to -0.14; P=.003); reduce anxiety (SMD -1.39, 95% CI -1.99 to -0.78; P<.001); and improve satisfaction with delivery (relative risk 1.32, 95% CI 1.10-1.59; P=.003). The effects of VR on the duration of the first (SMD -1.12, 95% CI -2.38 to 0.13; P=.08) and second (SMD -0.22, 95% CI -0.67 to 0.24; P=.35) stages of labor were not statistically significant. VR is safe and effective in relieving maternal labor pain and anxiety; however, due to the heterogeneity among studies conducted to date, more rigorous, large-scale, and standardized randomized controlled trials are required to provide a higher-quality evidence base for the use of VR technology in maternal labor, with the aim of improving experience and outcomes. PROSPERO CRD42021295410; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=295410.

Association of maternal, fetal and labor variables with a low Apgar score in the fifth minute in term pregnancy: a case-control study.

To search for maternal, labor-related and fetal variables associated with low Apgar in the fifth minute in term pregnancy. A retrospective case-control study with term births was conducted in a public teaching hospital from 2013 to 2020. Cases were term births with Apgar score less than 7 in the fifth minute, and controls, the next one or two births following a case, with Apgar of 7 or more. Non-cephalic presentations, multiples and malformations were excluded. We accessed 100 cases and 190 controls. We considered significant values of p < 0.05. Were accessed 27 variables which could be risk factors, from which 12 were associatedwith the outcome. We found a protective effect of prelabor cesarean for the outcome, odds ratio (OR) 0.38, p = 0.013. Consequently, we conducted two sets of analyses: in the whole group and in the group of laboring women. The values of OR were in general greater in the group of laboring women, compared with the whole group. We conducted multivariate analysis within the group of women in labor. The variables which fitted best in the model were nulliparity, male sex of the fetus, less than six prenatal visits and abnormal cardiotocography; all remained significant. An association of rupture of membranes more than 360min with the outcome, even after controlling fpr duration of labor, was found; adjusted OR 2.45, p = 0.023. Twelve variables were associated with the outcome. Prelabor cesarean had a protective effect. The time of ruptured membranes was associated with low Apgar.

Analysis of the labor consumption and duration of the assembly processes of structural coating plates blocks using the crane method

The labor intensity of the construction process is determined by the methods of technical standardization of processes by the methods of time tracking. On the basis of these observations, regulations are developed in the form of GN or other collections of norms of labor costs. Labor intensity is measured in person–hours, and the rate of labor costs is derived from the rate of time, taking into account the number of performers. Variants of consolidation and installation of structural plates of the covering are not typical. The main processes necessary for the duration and labor–intensiveness of the structural slabs of the coating by the free method have been analyzed. A potential development has been identified that will ensure a reduction in the labor–intensiveness of the assembly process and provide cyclical assembly work. The consolidation process is optionally performed on the assembly stand, which belongs to the assembly equipment equipment. To install the stand, a site is specially prepared in the form of a horizontally planned surface of the earth with a layer of compacted crushed stone. Cells made of wooden sleepers are placed on the crushed stone, which are set according to vertical planning marks with the help of geodetic devices. Then a collection stand is installed on the sleeping cells. Structurally, the stand consists of several parts. That is why the manufacturability of the installation of the structural plates of the covering was improved by means of constructive and technological solutions. First, the columns are mounted (columns with a height of 12 m were used for the analysis), so it is not possible to carry out consolidation in the area of the columns. The stands are placed next to each other in the working area of the crane. All calculations were performed in tabular form according to the formula. The installation process of 12 m high columns includes the sub–processes of unloading and disassembly, installation and fastening. The components of these processes are actions (operations). According to the methodology, a schedule of the processes of consolidation and installation of blocks of structural slabs with preliminary installation of columns according to the corresponding calculations was built.

Maternal satisfaction and associated factors towards institutional delivery service at public hospitals in the Somali region, Eastern Ethiopia.

Client satisfaction reflects the gap between the expected service and the experience of the service, from the client's point of view. Maternal satisfaction with delivery services affects the selection of birthplaces and helps to identify gaps between actual health care and desired health care outcomes. There is a dearth of evidence on the factors of client satisfaction towards delivery services in the Somali region. The aim of this study was to assess maternal satisfaction and associated factors towards institutional delivery service at public hospitals in the Somali region, Eastern Ethiopia, in 2018. An institution-based cross-sectional study design was conducted from December 1-30, 2018, on a total of 320 delivering mothers who gave birth. A systematic random sampling technique was used. A pretested structured questionnaire was used for data collection through a face-to-face interview. The data was checked for completeness and entered into EpiData. Statistical analysis was done by SPSS version.20. Binary logistic regression was used to identify factors. Multivariable analysis was done to compute adjusted odds ratios at 95% CI and a P-value &lt;0.05 was used to declare a statistically significant association. The overall maternal satisfaction towards delivery service was 76.60% (95%CI: 71.90, 80.90). The short duration of labor below 12 hours (AOR = 1.80, 95%CI: 1.01, 3.2), waiting time below 15 minutes (AOR = 2.78, 95%CI: 1.10, 6.99) and planned pregnancy (AOR = 3.68, 95%CI: 1.59, 8.47) were significantly associated with mother's satisfaction towards delivery services. This study revealed that more than three-quarters of mothers were satisfied with the institutional delivery service. Longer waiting time, suffering from persistent labor and having unplanned pregnancies hindering factors for maternal satisfaction. Therefore, programs on education and counseling towards pregnancy planning should be strengthened. Efforts should be made on availing adequate skilled birth attendants to manage persistent labor and handle longer waiting times.

Involvement of Oxytocin and Progesterone Receptor Expression in the Etiology of Canine Uterine Inertia

An altered oxytocin and progesterone receptor (OXTR and PGR, respectively) expression was postulated in canine uterine inertia (UI), which is the lack of functional myometrial contractions. OXTR and PGR expressions were compared in uterine tissue obtained during C-section due to primary UI (PUI; n = 12) and obstructive dystocia (OD, n = 8). In PUI, the influence of litter size was studied (small/normal/large litter: PUI-S/N/L: n = 5/4/3). Staining intensity in immunohistochemistry was scored for the longitudinal and circular myometrial layer and summarized per dog (IP-Myoscore). Mean P4 did not differ significantly between PUI (n = 9) and OD (n = 7). OXTR and PGR expressions (ratios) were significantly higher in PUI (OXTR: p = 0.0019; PGR: p = 0.0339), also for OXTR in PUI-N versus OD (p = 0.0034). A trend for a higher PGR IP-Myoscore was identified (PUI-N vs. OD, p = 0.0626) as well as an influence of litter size (lowest PGR-Myoscore in PUI-L, p = 0.0391). In conclusion, PUI was not related to higher P4, but potentially increased PGR availability compared to OD. It remains to be clarified whether OXTR is upregulated in PUI due to a counterregulatory mechanism to overcome myometrial quiescence or downregulated in OD due to physiological slow OXTR desensitization associated with an advanced duration of labor. Identified OXTR differences between myometrial layers indicate the need for further research.

Auricular Acupuncture on Uterine Point on PGF2α Levels and First-Stage of Labor Duration among Primigravida Women

Lama persalinan dipengaruhi oleh empat faktor, diantaranya faktor power atau kontraksi. Kontraksi persalinan diawali dengan penurunan hormone progesterone dan meningkatnya hormone oksitosin yang diinisiasi oleh prostaglandin (PGF2α). Akupunkur auricular titik uterus terletak pada trianggula fossa yang dipersarafi nervus trigeminus dan nervus vagus. Menstimulasi titik Uterus dapat mengirim gelombang rangsangan ke susunan saraf pusat pada hipotalamus posterior memproduksi Oksitosin. Tujuan untuk menganalisis efektifitas akupunktur auricular titih Uterus terhadap PGF2α dan lama persalinan kala I primigravida. Metode penelitian true experimental design dengan metode two-group pretest-posttest design. Jumlah sampel penelitian 48 ibu inpartu kala I yang dipilih secara rundomice control trial dan memenuhi kriteria inklusi primigravida resiko rendah. Data dianalisis menggunakan uji Wilcoxon dan Mann Whitney. Hasil penelitian akupunktur aurikular titik Uterus meningkatkan kadar PGF2α (ρ=0,002), meningkat bermakna (201,29±132,916) dibandingkan dengan kelompok relaksasi nafas dalam 132;08±93,530). Akupunktur aurikular titik Uterus memperpendek lama persalinan kala I (440,3±72,94; 440,00) jika dibandingkan dengan kelompok relaksasi nafas dalam (517,6±101,00; 507,50) sehingga ada perbedaan yang sangat bermakna (ρ=0,004). Kesimpulannya akupunktur aurikular titik Uterus efektif memperpendek lama persalinan dengan meningkatkan kadar PGF2α.

Effectiveness of antepartum breathing exercises on the outcome of labour: A randomized controlled trial

Abstract Background Childbirth is a life-transforming intense event to a woman and her family. Even though a variety of non-pharmacological techniques are readily available to alleviate the distress of women in labour, the majority of women are unaware of its benefits. The objective of the study was to explore the impact of a simple non-pharmacological technique i.e., antepartum breathing exercises on maternal outcomes of labour among primigravid women. Methods A single centre prospective, single-blinded, randomized controlled trial was conducted at the antenatal outpatient clinic of a secondary healthcare institution. Eligible primigravid women were randomized into intervention and standard care groups. Both groups received standard obstetrical care. In addition, the intervention group were taught antepartum breathing exercises and were advised to practise daily and also during the active stage of labour. The primary outcome of the trial was the maternal outcome of labour measured in terms of onset of labour, nature of delivery, duration of labour, and need for augmentation of labour. Data was collected using World Health Organization (WHO) partograph, structured observational record on the outcome of labour. Results A total of 98 (70%) primigravid women who practised antepartum breathing exercises had spontaneous onset of labour. The odds of spontaneous onset of labour after randomization in the intervention group was 2.192 times more when compared to standard care at a (95% confidence interval 1.31–3.36, p&lt;.001). Also, the requirement for augmentation of labour was minimal and there was a reduction in the rate of caesarean deliveries (p &lt;.05) based on the χ2 test. The overall mean duration of labour was less compared to standard care group F(1)= 133.800, p &lt;.001. Conclusion Antepartum breathing exercises during labour can facilitate spontaneous vaginal birth, shorten the duration of labour, and reduce the need for operative interference.

Characteristics Of Stress Urinary Incontinence (SUI) Patients In Dr. Mohammad Hoesin General Hospital On 2019 To 2021

Introduction. Stress urinary incontinence (SUI) is a condition where urine comes out accidentally due to intraabdominal pressure increase when sneezing, coughing, laughing, or weightlifting. SUI often occurs in women and has a negative impact on quality of life. However, not many patients visit the hospital for treatment. This research aims to describe the characteristics of SUI patients in Dr. Mohammad Hoesin General Hospital 2019-2021. Methods. This research is a descriptive observational study with a cross-sectional approach using patient’s medical records in Dr. Mohammad Hoesin General Hospital 2019-2021. The sample in this study are 15 samples taken by total sampling. Results. This study found that SUI was common in patients aged 41-60 years (66,7%). The majority of patients were multiparous (93,3%) and had experienced menopause (86,7%). Most of the patients gave birth spontaneously (80,0%), were obese (53,3%), had a duration of the second stage labor &gt;1 hour (60,0%), had given birth to a baby with birth weight ≥3.000 g (80,0%), and has had an episiotomy (73,3%). The majority of SUI patients had no history of neurological disorders (93,3%). Every SUI patients were treated with anterior colporrhaphy (100,0%). Conclusion. SUI often occurs in patients aged 41-60 years, multiparous, menopausal, obese in BMI, has a history of &gt;1 hour second stage labor, has given birth to a baby with a birth weight ≥3.000 g, and has had an episiotomy. SUI patients at Dr. Mohammad Hoesin General Hospital were treated with anterior colporrhaphy.

The Relationship Of Participation In Pregnancy Exercise With The Duration Of The Second Stage Of Labor In Primigravida

The duration of labor has a risk of causing perinatal death twice as high as normal delivery. The duration of this second stage in primiparas and multiparas is different, namely in primiparas it lasts 1.5-2 hours while in multiparas it lasts 0.5-1 hours. Efforts that can be made by pregnant women so that delivery runs smoothly can be controlled by doing pregnancy exercises. This study aims to determine the relationship between participation in pregnancy exercise and the duration of the second stage of labor in primigravida at the Pratama Bunda Tessa Lubuk Pakam Clinic in 2022. This type of research is a quantitative study with a descriptive correlation design through a cross sectional approach. The population of this study were all primigravida mothers who had delivered at the Mother Tessa Primary Clinic as many as 30 people. The sampling technique used a total sampling of 30 people. The research instrument used a questionnaire sheet which was analyzed using the chi-square test. The results showed that 50% of primigravida mothers who followed pregnancy exercise routinely and 50% who did not participate in pregnancy exercise. The duration of the second stage of labor in primigravida was normal (46.7%), fast (33.3%) and slow (20%). Through the chi-square test obtained p-value = 0.006. The conclusion of this study is the relationship between pregnancy exercise participation and the duration of the second stage of labor in primigravida. So it is hoped that the Mother Tessa Primary Clinic will provide Health Education to pregnant women about the causes of the length of labor, especially in the second stage. And it is also hoped that the clinic can maintain and implement policies for implementing pregnancy exercise for pregnant women, especially primigravida mothers, in an effort to maintain fitness and prepare physically and mentally in the delivery process.

Peripartum prolactin and cortisol level changes. A prospective pilot study.

Although the role of prolactin and cortisol in the human lactation process seems to be undisputed, the changes in postpartum serum concentrations in mothers make data interpretation difficult. To determine the factors that possibly influence these hormones, we examined a group of patients who were admitted to the Gynecology-Obstetrics Clinical Hospital in Poznań for labor induction and/or in the active phase of the first labor period. The serum levels of cortisol and prolactin were assessed in these full-term pregnant women during admission to labor, in the third stage of labor, and on the second day postpartum. The prolactin and cortisol levels were also measured in the umbilical cord for the assessment of newborn babies. The results showed a significant relationship between maternal age and the level of prolactin measured before childbirth and fluctuations in cortisol level with respect to labor duration. In addition, we observed a strong correlation between the level of prolactin assessed before childbirth and the pH and base excess of the umbilical cord artery. Most importantly, a correlation was noted between breastfeeding within 2 hours after the labor and the level of cortisol measured after childbirth. We observed a significant correlation between a summarized labor duration and maternal and umbilical cord cortisol levels measured right after the labor. The fact of breastfeeding within 2 hours after the labor strongly correlated with lower levels of maternal cortisol as well as a cortisol level in umbilical cord blood and it suggests that immediate initiation of breastfeeding reduces stress level for both, mother and newborn.

Direct Comparison of Peak Bulk Flow Rate of Programmable Intermittent Epidural Bolus and Manual Epidural Bolus Using a Closed-End Multiorifice Catheter: An Experimental Study.

The programmable intermittent epidural bolus (PIEB) has been popularized as the optimal delivery technique for labor analgesia. Suggested advantages of this method are less local anesthetic consumption, improved maternal satisfaction, potentially shorter duration of labor, and decreased workload requirements for the anesthesia providers. However, a manual bolus is still routinely used for breakthrough pain when the PIEB is underperforming. We conducted a laboratory-based study to quantify the flow through a multiorifice epidural catheter using the PIEB setting on an epidural pump compared to the manual epidural bolus. Four syringe volumes, 3, 5, 10, and 20 mL, were selected for this experiment. The flow in a manual bolus was also studied with and without the presence of an epidural catheter filter. A generalized estimating equation analysis was done to compare data between the groups. Regardless of the syringe size, there was a several-fold increase in flow when a manual bolus was used compared to a pump-administered dose, with the highest difference in the peak flow rate observed in 3-mL boluses with up to a 12-fold difference, while the difference was, at most, 7-fold in 5-mL and 10-mL boluses. Manual boluses without a filter achieve a mean peak flow rate higher than manual boluses with a filter. Our study found that manual boluses produced a higher flow rate compared to the CADD-Solis epidural pump (Smiths Medical). This study also found that the placement of a particulate filter reduces the flow rates generated while bolusing. Bulk flow rate is directly correlated with induced pressure and solution spread. Because higher bolus pressure has been shown to provide a more efficient distribution of local anesthetic and more efficient pain relief, these results may have impactful clinical significance and will pave the way for future studies.

Satisfaction status and its associated factors on delivery service provided among women who gave birth at hawassa university comprehensive specialized hospital in southern Ethiopia 2022

Background: Despite the Ethiopian federal ministry of health implementing compassionate, respectful, and caring as one of the health sector transformation agendas to increase health service utilization, the level of maternal satisfaction with institutional delivery is still low and varies from region to region. In addition, no previous study was conducted in this study area. Therefore, the main objective of the study was to assess the level of women's satisfaction with institutional delivery services and associated factors among mothers who gave birth at Hawassa University's comprehensive specialized Hospital. Methods and Materials: Institutional based quantitative cross-sectional study was employed from April to May 2022 at Hawassa University's comprehensive specialized hospital. A total of 265 women who came to delivery service were included in the study and systematic sampling techniques was used to select study participant. A semi-structured questionnaire was used to collect data. The data was entered into EPI Data 3.1 version and transported to SPSS version 25 for data analysis. Binary and multi-regression were done for predictor variables associated at p-value &lt;0.05 with the dependent variable. Result: A total of 265 mothers fully responded, making a response rate of 95.3%. This study found that 63% of study participants were satisfied and 37% of them were unsatisfied with the delivery and labor service. Participants' occupation, last pregnancy wanted, health conditions of the mother during and after delivery, media exposure to institutional delivery, total duration of labor, a surgical procedure done for women, the provider gives periodic updates on the progress of labor and explained what is being done and that to be expected were statistically associated with satisfaction status. Conclusion: The study showed that the overall satisfaction of the women with the delivery service provided by health care providers in the study area was relatively low. Therefore, all stakeholders should take immediate and appropriate action on those identified factors.

The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson's Classes: A Propensity Score-Matched Analysis.

Background: Lumbar epidural analgesia (EA) is the most commonly used method for reducing labour pain, but its impact on the duration of the second stage of labour and on neonatal and maternal outcomes remains a matter of debate. Our aim was to examine whether EA affected the course and the outcomes of labour among patients divided according to the Robson-10 group classification system. Methods: Patients of Robson’s classes 1, 2a, 3, and 4a were divided into either the EA group or the non-epidural analgesia (NEA) group. A propensity score-matching analysis was performed to balance the intergroup differences. The primary goal was to analyse the duration of the second stage of labour. The secondary goals were to evaluate neonatal and maternal outcomes. Results: In total, 21,808 cases were analysed. The second stage of labour for all groups was prolonged using EA (p < 0.05) without statistically significant differences in neonatal outcomes. EA resulted in a lower rate of episiotomies in nulliparous patients, with a higher rate of operative vaginal deliveries (OVD) (p < 0.05) and Caesarean sections (CS) (p < 0.05) in some classes. Conclusions: EA prolonged the duration of labour without affecting neonatal outcomes and reduced the rate of episiotomies, but also increased the rate of OVDs.

Comparison of First Childbirth Characteristics between Elite Judo Athletes and Non-Athletes: The Preliminary Retrospective Case-Control Study.

It has been speculated that elite athletes are more likely to have obstetric interventions during labor and delivery. So far, the impact of many years of competitive sports participation on childbirth characteristics has not been well-established. This preliminary retrospective case–control study aimed to determine whether the first labors of elite judo competitors required obstetric interventions more frequently and were longer than those of non-athletes. The study comprised 32 parous women: 16 elite judo athletes and 16 non-athletes. Women were included if they had access to the following obstetric data (from their first childbirth hospital discharge reports and/or first child’s health record books): induction and augmentation of labor, mode of delivery, the duration of labor and its second stage, episiotomy, perineal tear, and the neonate’s Apgar score. Electronic surveys were completed concerning childbirth characteristics, level of “eliteness” (judo athletes), and recreational physical activity (non-athletes). The statistical analysis showed no significant between-group differences in any of the first childbirth outcomes under analysis. The preliminary results indicate elite judo practice before first pregnancy had no negative impact on the rates of labor induction and augmentation, delivery mode, duration of labor, the rates of episiotomy and perineal tear, and the neonate’s Apgar score. Due to the small sample size, the conclusions should be considered with caution.

Mistreatment of Women during Childbirth and Associated Factors in Northern West Bank, Palestine.

Mistreatment of women during childbirth is a clear breach of women’s rights during childbirth. This study aimed to determine the prevalence and associated factors of mistreatment of women during childbirth in the north of West Bank, Palestine. A cross-sectional study was conducted among 269 women within the first 16 weeks of their last vaginal childbirth to understand the childbirth events by using proportionate stratified random sampling. An Arabic valid questionnaire was used as a study instrument. Simple and multiple logistic regression analyses were conducted to determine the factors associated with each type of mistreatment. The mean age of the women was 26.5 (SD 4.77) years. The overall prevalence of mistreatment was 97.8%. There were six types of mistreatment. Nine factors were significantly associated with the occurrence of one or more types of mistreatment. Delivery at a public childbirth facility was associated with all of the six types (aAdjOR: 2.17–16.77; p-values < 0.001–0.013). Women who lived in villages (aAdjOR 2.33; p-value = 0.047), had low education (aAdjOR 5.09; p-value = 0.004), underwent induction of labour (aAdjOR 3.03; p-value = 0.001), had a long duration of labour (aAdjOR 1.10; p-value = 0.011), did not receive pain killers (aAdjOR: 2.18–3.63; p-values = 0.010–0.020), or had an episiotomy or tear (aAdjOR 5.98; p-value < 0.001) were more likely to experience one or more types of mistreatment. With every one-hour increase in the duration of labor, women were 1.099 times more likely to experience a failure to meet the professional standard of care. Women were less likely to experience mistreatment with increasing age. Women with increasing age (aAdjOR: 0.91–0.92; p-values = 0.003–0.014) and parity (aAdjOR 0.72; p-value = 0.010) were less likely to experience mistreatment. Awareness of women’s fundamental rights during childbirth, making the childbirth process as normal as possible, and improving the childbirth facilities’ conditions, policies, practices and working environment may decrease mistreatment occurrence.

Factors associated with a maternal lower-limb neurological deficit after vaginal delivery.

The etiology of lower-limb neurological deficit after vaginal delivery remains poorly understood. The objective herein was to identify factors associated with this maternal nerve injury after vaginal delivery. A single-center, case-control (matching 1:4) study. Cases were women with a lower-limb neurological deficit that appeared immediately after vaginal delivery. Controls were randomly selected women who gave birth vaginally during the same period, without any deficit. Finally, to assess the rates of factors associated with these deficits, we studied them using a randomly selected 5% sample of the population with vaginal deliveries. During the 30-month study period, 31 cases were identified among 10333 women who gave birth vaginally (0.3%, 95% CI 0.20-0.43); 124 controls were also included. After logistic regression, the presence of a neurological deficit after delivery was associated with second-stage labor duration (per hour odds ratio [OR] 3.67, 95% CI 2.09-6.44; OR per standard deviation increase 2.73, 95% CI 1.75-4.25, p < 0.001) and instrumental delivery (OR=3.24, 95% CI 1.29-8.14, p=0.012), with no interaction effect (p=0.56). Extrapolation of these factors to a 5% sample of the overall population of women with vaginal births showed that the rate of these deficits would be very low for women with second-stage labor lasting up to 90 min without instrumental delivery (0.05%) but increased to 1.52% when these factors were combined (OR 33.1, 95% CI 9.4-116.9). Following vaginal delivery, the onset of a neurological deficit is principally associated with the duration of second-stage labor and instrumental delivery.

Analysis of the Influence of Midwife Led Antenatal Clinic on the Delivery Outcomes of Primipara under the Evaluation of Medical Data.

Objective In order to improve the comprehensive effect of primipara delivery outcomes, the midwife led prenatal clinic of data mining is analyzed to alleviate the negative emotions of patients and improve the delivery results of patients. Methods A total of 86 patients who were filed in the obstetrics department of our hospital from October 2021 to May 2022 and planned to deliver in our hospital were selected as the research objects. They were divided into the reference group (n = 43) and the observation group (n = 43) according to the random number table method. Among them, the reference group received routine antenatal clinics, and the observation group received midwives' participation in antenatal clinics for intervention. The total duration of labor, the scores of various psychological states including antenatal anxiety (SAS) and antenatal depression (SDS), as well as the pregnancy outcome and delivery compliance rate of the two groups were compared. Results The psychological state evaluation of delivery in the observation group, whether SAS score or SDS score, was significantly lower than that in the reference group, and the difference was statistically significant. The whole labor process time of patients in the observation group was significantly shorter than that in the reference group, and the difference was statistically significant. The delivery compliance of patients in the observation group during the whole perinatal period was also higher than that of the reference group, and the difference was statistically significant. All P values were<0.05. Conclusion The antenatal clinic led by midwives can promote primiparas to increase the success rate of natural delivery, improve the treatment compliance of the whole perinatal period, reduce the psychological pressure of primiparas, effectively shorten the total time of production, and have a significant impact on the outcome of delivery. It should be widely used.

Conventional versus modified application of COOK Cervical Ripening Balloon for induction of labor at term: a randomized controlled trial

BackgroundThis study aims to evaluate the efficacy and safety of the modified application of COOK Cervical Ripening Balloon (CCRB) for induction of labor (IOL) at term in primipara.MethodsA total of 227 singleton full-term pregnancies with indications of IOL were enrolled and randomly divided into the control and study groups in our hospital from January 2021 to December 2021. In the control group, a conventional method was used. Both the uterine and vaginal balloons were filled to 80 mL and removed after 12 h. In the study group, a modified method was used. The uterine and vaginal balloons were filled to 120 mL and 40 mL respectively. Light traction was given to help CCRB to be discharged after 12 h placement. Oxytocin was administered in both groups after CCRB was discharged before labor starting. The improved Bishop scores, duration of labor, and spontaneous delivery rate were evaluated in the two groups.ResultsThe improved Bishop scores in the study group were 3.06 ± 0.97 at 12 h placement of CCRB and 4.37 ± 0.87 when CCRB was discharged, which were significantly higher compared to the control group (2.52 ± 0.79, p < 0.05). Duration of the first stage of labor and the full labor in the study group were significantly shorter than those in the control group ((6.17 ± 2.85) h vs. (7.27 ± 2.90) h, p = 0.010; (7.07 ± 3.18) h vs. (8.09 ± 3.11) h, p = 0.028). No difference in spontaneous delivery rate between the two groups was observed. But the delivery rate within 24 h between the two groups was significantly different (79.79% vs. 55.91%, p < 0.05). For the cases with initial Bishop scores ≤ 3, the improved score was significantly increased, the first stage of labor and the full labor were significantly shorter in the study group than those in the control group (p < 0.05). Those results were not observed in cases with initial Bishop scores of 4–6.ConclusionsThe modified application of CCRB could benefit cervical ripening, shorten the duration of labor, especially for cases with poor cervical maturity, and improve the delivery rate within 24 h.Trial registrationRetrospectively registered: ChiCTR2200058270. Registered 04/04/2022.