Duration Of Labor Research Articles

Evaluating the clinical utility of cervical cultures in postpartum endometritis management.

To evaluate the utility of cervical cultures in the diagnosis and management of postpartum endometritis. A retrospective study was conducted on 1069 cervical cultures collected from postpartum women with suspected endometritis between 2011 and 2021. Patient demographics, obstetric history, clinical parameters, and culture results were analyzed. Microorganisms were categorized into five groups based on species and virulence. Statistical analysis was performed to identify associations between risk factors, pathogens, and disease severity. The positivity rate for distinct microorganisms in cervical cultures was 33.1%. Escherichia coli (10.8%) and Group B Streptococcus (7.5%) were the most common isolates. Prolonged labor duration and prolonged rupture of membranes were associated with Enterobacterales infections. Elevated white blood cell count was linked to Enterobacterales and beta-hemolytic Streptococci, while the former were also associated with higher rate of postpartum clinic visit. No significant differences in disease severity were found between other microorganism groups. The study suggests that while cervical cultures can identify potential pathogens in postpartum endometritis, their clinical utility is questionable due to the polymicrobial nature of the disease and the isolation of commensal microorganisms. The lack of significant differences in disease severity across various microorganism groups raises questions regarding the contribution of distinct bacterial identification in endometritis management.

Hydrotherapy During Labor and Birth in Water: A Review of Current Researches

Hydrotherapy is one of the most nonpharmacological methods for pain management in labor, where water at different temperatures is used to treat diseases and reduce pain. The American College of Obstetricians and Gynecologists states that hydrotherapy can be used in the first stage of labor, but there is insufficient evidence on the outcomes of water birth. When the effects of hydrotherapy were examined according to the stages of labor, it was determined that it had an effect on pain, anxiety, comfort level, sympathovagal balance, parenting behavior and active phase duration in the first stage of labor. In the second stage of labor; epidural and opioid use, maternal pain, episiotomy use, intact perineum, shoulder dystocia and duration of labor. In the postpartum period, it has been reported to have an effect on the incidence of postpartum hemorrhage, birth satisfaction and women's sense of autonomy, shorten the duration of hospitalization and increase the rate of breastfeeding. When the effects of water birth on the newborn are examined, it is determined that it has an effect on body temperature, arterial and venous pH, while it has no effect on Apgar. Although there are various studies on water birth in the literature, more studies are needed to obtain evidence-based results. The aim of this review is to examine the current research results of hydrotherapy applied in the first stage of labor and the second stage of labor in water (water birth) in the last 5 years.

Neonatal Jaundice Risk Factors and Multidirectional Intensive Phototherapy Management at Azadi Teaching Hospital in Kirkuk City

Background: A common illness in infants, neonatal jaundice is caused by high bilirubin levels in the first few days of life, which results in yellowing of the skin and eyes. Aim: This study aims to explore neonatal jaundice risk factors and assess the efficacy of multidirectional intensive phototherapy management at Azadi Teaching Hospital in Kirkuk City. Patients and Methods: In this retrospective cross-sectional study spanning from April 1st, 2021, to October 1st, 2021, a total of 497 newborns were examined. Jaundiced neonates underwent intensive phototherapy utilizing the Bilisphere 360 system, which featured a chamber with 16 cylindrical, blue TL 20W/52 fluorescent tubes. The newborns were positioned on a gauze hammock suspended at the chamber's center, illuminated on all sides. Results: A study found that neonatal jaundice affects 50.70% of studied neonates, primarily in the 16-21-day age group, with males accounting for 57.95% of the sample. 94.84% of neonates experience jaundice due to ABO blood group incompatibility and 88.10% due to Rh incompatibility. Additionally, 77.78% of term deliveries are associated with jaundice. Infants with jaundice have higher Thyroid Stimulating Hormone (TSB) and Thyroid Stimulating Hormone (TSH) levels and a younger mean age compared to non-jaundiced infants. Bilisphere 360 proves significantly more effective in the critical 12 to 48 hours after admission, with a mean total bilirubin of 10.71 ± 1.01 mg/dl compared to 14.65 ± 1.71 mg/dl for Neonatal Exchange Transfusions (P-Value: 0.001). Factors like blood group incompatibility, labor duration, and birth weight influence TSB levels in jaundiced neonates. The Bilisphere 360 method is found to be more effective in managing neonatal jaundice than Neonatal Exchange Transfusions in reducing total bilirubin levels.

Risk of postpartum hemorrhage with increasing first stage labor duration

With increasing rates of postpartum hemorrhage (PPH) in high-income countries, an important clinical concern is the impact of labor duration on the risk of PPH. This study examined the relationship between increasing active first stage labor duration and PPH and explored the role of second stage labor duration and cesarean delivery (CD) in this association. Including 77,690 nulliparous women with spontaneous labor onset, first stage labor duration was defined as the time from 5 cm to 10 cm, second stage duration from 10 cm dilation to birth and PPH as estimated blood loss > 1000 ml. Using modified Poisson regression for risk ratios (RR) and confidence intervals (CI), we found a 1.5-fold (RR, 1.53; 95% CI, 1.41‒1.66) increased PPH risk when first stage of labor exceeded 12.1 h compared to the reference (< 7.7 h). Mediation analysis showed that 18.5% (95% CI, 9.7‒29.6) of the increased PPH risk with a prolonged first stage (≥ 7.7 h) was due to a prolonged second stage (> 3 h) or CD. These results suggest that including first stage duration in intrapartum assessments could improve PPH risk identification in first-time mothers with a singleton fetus in vertex presentation at full term with spontaneous labor onset.

Cesarean delivery, labor duration, and mothers’ mortality risk over 50 years of follow-up

BackgroundPregnancy complications have been recognized as a window to future health. Though cesarean delivery is common, it is unknown whether labor duration and mode of delivery are associated with maternal long-term mortality. ObjectiveTo examine whether labor duration and mode of delivery were associated with all-cause and cause-specific mortality. Study DesignParticipants were mothers from the multisite Collaborative Perinatal Project (CPP) cohort (1959–1966; n=43,646, limited to last CPP delivery). We ascertained all-cause and specific causes of death as of 2016 via linkage to the National Death Index and Social Security Death Master File. Hazard ratios (HR) testing mode of delivery and labor duration were estimated using Cox proportional hazards models adjusted for demographic and clinical characteristics. We further stratified analyses by parity. ResultsAmong participants with a recorded delivery mode, 5.9% (2486/42,335) had a cesarean delivery. Participants who had a cesarean were older (26.9 vs 24.3 years), with higher body mass index (24.0 vs 22.7 kg/m2), were less likely to be nulliparous (21% vs 30%), and more likely to have a household income of at least $6000 (22% vs 17%), to smoke ≥1 pack/d (18% vs 15%), to have diabetes mellitus (12% vs 1%) and to have a prior medical condition (47% vs 34%), compared to participants with a vaginal delivery. Delivery mode was similar by race/ethnicity, marital status, and education. Median labor duration was 395 minutes among participants who had an intrapartum cesarean delivery and 350 minutes among participants delivered vaginally. By 2016, 52.2% of participants with a cesarean delivery and 38.5% of participants with a vaginal delivery had died. Cesarean vs vaginal delivery was significantly associated with increased risk for all-cause mortality (HR=1.16 (95% confidence interval [CI]: 1.09, 1.23); in nulliparas, HR=1.27 (95% CI: 1.09, 1.47); in multiparas, HR=1.13 (95% CI: 1.06, 1.21) as well as increased risk of death from cardiovascular disease, diabetes, respiratory disease, infection, and kidney disease. Associations with death from cardiovascular disease, infection, and kidney disease were stronger for multiparas than nulliparas, though the association with death from diabetes was stronger among nulliparas. Labor duration was not significantly related to overall mortality. ConclusionIn a historic United States cohort with a low cesarean delivery rate, cesarean delivery was an indicator for subsequent increased mortality risk, particularly related to cardiovascular disease and diabetes. Future studies with long-term follow-up are warranted given the current high prevalence of cesarean delivery.

Evaluation of the Effectiveness of Obstetric Lubricant Gel in Labor in Nulliparous and Primiparous Women: A Randomized Controlled Study

Aim: Our hypothesis was that lubricating gels used at the beginning of the active phase of labor could reduce the incidence of episiotomies and shorten the duration of labor. This study aims to investigate and confirm this theory with a randomized controlled trial. Material and Methods: A prospective randomized controlled trial was conducted at obstetrics and gynecology department of a university hospital between January 2017 and April 2017. The study included 102 nulliparous and 93 primiparous singleton pregnancies. 50 primiparous women and 47 nulliparous patients were randomly assigned to the obstetric gel group. Obstetric gel was applied to participants in the study groups at the beginning of the active phase of labor. Outcomes were episiotomy rates and duration of labor. Results: Episiotomy rates were significantly lower in nulliparous obstetric gel group (36.1% and 63.6%, p=0.005). The duration of the active phase of the first and second stage of labor was significantly lower in the obstetrical gel groups compared to the control groups in both parities (150 ± 86 and 203. 5 ± 134, p=0.021, 28.8 ± 18.2 and 62.6 ± 53.8, p

Effect of omicron infection on maternal and neonatal delivery outcomes: A retrospective cohort study

BackgroundPeople are very concerned about the adverse effects of Omicron infection on delivery modes, duration of labor, and the postpartum status of pregnant women and neonates. Methods382 pregnant women (Omicron group: 136 cases; non-Omicron group: 246 cases) giving birth in our hospital were collected, demographic characteristics, vaccination, clinical manifestation and medication, delivery outcomes of pregnant women and neonates were recorded. Delivery outcomes were compared between the Omicron and non-Omicron groups, acute infection and non-acute infection groups to explore the relationship between adverse delivery outcomes and Omicron infection. ResultsPregnant women in the Omicron group had a longer hospitalization time (6.3 ± 3.6 days vs.5.5 ± 2.3 days), more 2-hour postpartum hemorrhage (291.7 ± 104.9 mL vs.262.7 ± 91.2 mL) and higher neonatal-pediatric transfer rate (20.6 % vs. 2.8 %), which might be associated with fetal distress, prenatal fever and pneumonia/respiratory distress. Neonates transferred to pediatrics due to jaundice were unique in the Omicron group. Fever-pregnant women have a more prolonged second stage of labor and hospital stay while coughing or expectoration ones have a shorter third stage of labor. Delivery outcomes did not differ whether the infected pregnant women were in the acute phase and whether to use antipyretics. ConclusionOmicron infection can increase the 2-hour postpartum hemorrhage volume and the neonatal-pediatric transfer rate. The symptoms can affect the duration of labor and hospital stay. However, whether the infected pregnant women are in the acute phase or use antipyretics do not affect the delivery outcome.

Fetomaternal Outcome in Relation to Second Stage of Labour Duration

Fetomaternal Outcome in Relation to Second Stage of Labour Duration

Revolutionizing Postpartum Hemorrhage Prediction with Insights from Iraq

Background: Postpartum hemorrhage (PPH) is a severe complication affecting women with gestational hypertension or preeclampsia, yet predictive models for PPH in this population remain underdeveloped. Specific Background: Existing studies have not adequately addressed the combined influence of antepartum and intrapartum factors on the predictability of PPH. Knowledge Gap: There is a lack of comprehensive models integrating both antepartum and intrapartum variables to predict PPH risk in women with gestational hypertension or mild preeclampsia. Aims: The study investigates the predictability of preeclampsia (PPH) in women with gestational hypertension or preeclampsia at term using logistic regression models incorporating both antepartum and intrapartum factors. Methods: The study, conducted in Karbala, Iraq, involved 1252 women with hypertension or preeclampsia, developed two logistic regression models, and assessed their predictive efficacy using receiver operating characteristic analysis and calibration techniques. Results: A study found that 168 participants (10.4%) experienced preterm pregnancies, with antepartum predictors including maternal age, pre-pregnancy BMI, and preeclampsia, and intrapartum factors like gestational age and labor duration. Novelty: The study introduces a novel predictive model for Pregnancy-Positive Hypertension (PPH) that integrates antepartum and intrapartum variables for risk assessment in high-risk populations. Implications: The study suggests that combining antepartum and intrapartum variables can improve risk stratification and preventive measures, requiring further refinement for improved maternal care outcomes. Highlights: Antepartum and intrapartum variables enhance PPH prediction accuracy. Model B outperforms antepartum-only model in predicting PPH. Results stress need for improved risk stratification and prevention strategies. Keywords: postpartum hemorrhage, gestational hypertension, preeclampsia, predictive modeling, logistic regression

Duration of Induction of Labor for Second-Trimester Medication Abortion and Adverse Outcomes.

To evaluate the relationship between duration of labor during second-trimester medication abortion and adverse outcomes. We conducted a retrospective cohort study including all individuals with a singleton gestation undergoing second-trimester medication abortion without evidence of advanced cervical dilation, rupture of membranes, or preterm labor at four centers. The primary exposure was duration of labor (ie, hours spent from receiving misoprostol to fetal expulsion). The primary outcome was composite morbidity , defined as uterine rupture, need for blood transfusion, clinical chorioamnionitis, intensive care unit admission, or need for readmission. We performed bivariate and multivariate negative binomial analyses. A post hoc subgroup analysis was performed to assess for the risk of the primary outcome by gestational age. We performed tests of homogeneity based on history of uterine scarring and parity. Six hundred eighty-one individuals were included. The median duration of labor was 11 hours (interquartile range 8-17 hours). One hundred thirty-one (19.2%) experienced the primary outcome. When duration of labor was evaluated continuously, a longer duration of labor was associated with an increased frequency of morbidity (adjusted β=0.68, 95% CI, 0.32-1.04). When duration of labor was evaluated categorically, those experiencing the highest quartile of duration (ie, 17 hours or more) had a statistically higher risk for experiencing morbidity compared with individuals in all other quartiles (adjusted relative risk 1.99, 95% CI, 1.34-2.96). When we focused on components of the composite outcome, clinical chorioamnionitis was significantly different between those experiencing a longer duration and those experiencing a shorter duration of labor (26.2% vs 10.6%, P <.001). On subgroup analysis, gestational age was not associated with the risk of composite morbidity. Tests of homogeneity demonstrated no significant difference in the risk for morbidity among individuals with a history of uterine scarring or based on parity. Duration of labor was independently associated with risks for adverse maternal outcomes during second-trimester medication abortion, specifically clinical chorioamnionitis.

Incidence, risk factors and diagnostic accuracy of clinical palpation in picking up post-void residual urine in postnatal women.

To determine the incidence of covert and overt postpartum urinary retention after vaginal delivery and the associated risk factors for postpartum urinary retention. To determine how well clinical examination by abdominal palpation correlates with ultrasound findings of urinary retention. Patients after delivery were screened with ultrasound and examined clinically to check for retention of urine after voiding. A total of 822 of women were recruited in the study of which 86 (10.5%) women had significant post-void residue of urine. 33 (38.4%) had overt retention, while 53 (61.6%) had covert retention. Duration of labour and an increased VAS score were found to be significantly higher among those with urinary retention. Using clinical examination to diagnose postpartum urinary retention had a sensitivity of 66.1%, specificity of 88.6%, positive predictive value of 76.5% and negative predictive value of 82.3%. Clinical examination by abdominal palpation is not a very sensitive test in diagnosing PPUR.

The Risk Factors of Postpartum Urinary Retention for Women by Vaginal Birth: A Systematic Review and Meta-Analysis.

Postpartum urinary retention is one of the most common complications in women during the immediate postpartum period. The objective was to systematically assess risk factors for postpartum urinary retention after vaginal delivery. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we retrieved relevant studies from PubMed, Embase, Cochrane Library, Web of Science Core Collection, China National Knowledge Internet, Wangfang Database, and Chinese Biomedical Database for observational studies investigating the risk factors for postpartum urinary retention from inception to 11 November 2022. The Newcastle-Ottawa Scale and Joanna Briggs Institute's tool were used to assess the risk of bias. We conducted a meta-analysis using RevMan 5.3. In total, 3,074 articles were screened and data from 27 studies were used in the meta-analysis. Sixteen risk factors were identified, namely, labor augmentation (OR = 1.72, 95% CI = 1.17-2.51), primiparity (OR = 2.36, 95% CI = 1.64-3.38), manual fundal pressure (OR = 2.84, 95% CI = 1.00-8.11), perineal hematoma (OR = 7.28, 95% CI = 1.62-32.72), vulvar edema (OR = 7.99, 95% CI = 5.50-11.63), the total duration of labor (MD = 90.10, 95% CI = 49.11-131.08), the duration of the first stage of labor (MD = 33.97, 95% CI = 10.28-57.65), the duration of the second stage of labor (MD = 14.92, 95% CI = 11.79-18.05), the duration of the second stage of labor > 60min (OR = 3.18, 95% CI = 1.32-7.67), mediolateral episiotomy (OR = 3.65, 95% CI = 1.70-7.83), severe perineal tear (OR = 3.21, 95% CI = 1.84-5.61), epidural analgesia (OR = 3.23, 95% CI = 1.50-6.96), forceps delivery (OR = 4.95, 95% CI = 2.88-8.51), vacuum delivery (OR = 2.44, 95% CI = 1.30-4.58), neonatal birth weight > 4,000g (OR = 3.61, 95% CI = 1.96-6.65), and neonatal birth weight > 3,500g (OR = 1.89, 95% CI = 1.12-3.19). Our results demonstrated that labor augmentation, primiparity, manual fundal pressure, perineal hematoma, vulvar edema, the total duration of labor, the duration of the first stage of labor, the duration of the second stage of labor, the duration of the second stage of labor > 60min, mediolateral episiotomy, severe perineal tear, epidural analgesia, forceps delivery, vacuum delivery, and neonatal birth weight > 4,000g and > 3,500g were risk factors for postpartum urinary retention in women with vaginal delivery. The specific ranges of the first and the second stages of labor causing postpartum urinary retention need to be clarified.

Does an amniotomy reduce duration of labor?

Does an amniotomy reduce duration of labor?

Oxytocin regimen used for induction of labor and pregnancy outcomes

BackgroundFollowing the results of the ARRIVE trial, which demonstrated a reduction in cesarean delivery with no increase in adverse perinatal outcomes after elective induction of labor (IOL) in low-risk nulliparous patients at 39 weeks’ gestation compared with expectant management, the use of induction has increased. Current evidence is insufficient to recommend mid-high-dose over low-dose regimens for routine IOL. Objective(s)We sought to evaluate the association of oxytocin regimen with cesarean delivery and an adverse perinatal composite outcome in low-risk nulliparous patients undergoing IOL at 39 weeks of gestation or greater. Study DesignThis is a secondary analysis of the NICHD Maternal-Fetal Medicine Units Network ARRIVE randomized trial. Patients induced with a mid-to high-dose oxytocin regimen (MHD; starting or incremental increase >2 mU/min) were compared with those receiving a low-dose oxytocin regimen (LD; starting and incremental increase ≤2 mU/min). The co-primary outcomes for this secondary analysis were 1) cesarean delivery and 2) composite of perinatal death or severe neonatal complications. Multivariable Poisson regression was used to estimate adjusted relative risks (aRR) and 97.5% confidence intervals (CI) for the co-primary endpoints, 95% CI for binomial outcomes and multinomial logistic regression was used to estimate adjusted odds ratios (aOR) and 95% CIs for multinomial outcomes. ResultsOf 6,106 participants enrolled in the primary trial, 2,933 underwent induction with oxytocin: 861 in the MHD group and 2,072 in the LD group. The lower frequency of cesarean delivery in the MHD group compared with the LD group (20.3% vs. 25.2%, RR 0.81, 95%CI (0.69-0.94)) was not significant after adjustment (aRR 0.90, 97.5%CI (0.76-1.07)). The composite of perinatal death or severe neonatal complications was more frequent in the MHD group compared with the LD group (6.7% vs. 4.3%, RR 1.55, 95%CI (1.13-2.14)) and remained significant after adjustment (aRR 1.61, 97.5%CI (1.11-2.35)). The majority of the cases in the composite were from the respiratory support (5.2% vs. 3.1%) component with an increase in transient tachypnea of the newborn (3.8% vs. 2.5%, aRR 1.63, 95% CI (1.04-2.54)). The duration of neonatal respiratory support for one day was significantly higher in the MHD group compared with the LD group (3.5% vs. 1.4%, aRR 2.59, 95%CI (1.52-4.39)); however, support beyond one day was not different between the two groups. The MHD group, when compared with the LD group had a higher operative vaginal delivery rate (10.0% vs. 7.0%, aRR 1.54, 95%CI (1.18-2.00)) and shorter duration of time from start of oxytocin to delivery [crude median (interquartile range) 12 (8-17) vs. 13 (9-19) hours, adjusted median difference -2 (-2 to -1), p<0.001], respectively. Conclusion(s)Mid-high-dose oxytocin regimen use for IOL in nulliparas at ≥ 39 weeks’ gestation was not associated with improved maternal or neonatal outcomes compared with low-dose regimens. Although mid-high-dose oxytocin regimen use was associated with a shorter duration of labor, there was an increase in self-limited neonatal respiratory support and no difference in cesarean rates. More evidence is needed to define the magnitude of potential maternal and neonatal benefits and risks associated with oxytocin regimens.

Optimizing labor duration with pilates: evidence from a systematic review and meta-analysis of randomized controlled trials

BackgroundPilates has captured interest due to its possible advantages during pregnancy and childbirth. Although research indicates that Pilates may reduce labor duration, alleviate pain, and improve satisfaction with the childbirth experience, consensus on these outcomes remains elusive, underscoring the necessity for additional studies.AimThis systematic review and meta-analysis aimed to assess the impact of Pilates exercises on labor duration among pregnant women.MethodsThe online database was searched to yield the literature using the terms of ‘Pilates’, ‘childbirth’, and ‘labor duration’, and similar terms including PubMed, Clinical Key, Scopus, Web of Science, Embase, and Cochrane Database of Systematic Reviews up to June 25, 2023. Studies were considered eligible if they were randomized or clinical controlled trials (RCTs/CCTs) published in English, focusing on healthy pregnant women without exercise contraindications. The studies needed to include interventions involving Pilates or exercise movement techniques, a comparison group with no exercise, and outcomes related to labor duration, the period of the active phase, and the second stage of delivery.ResultsEleven studies, totalling 1239 participants, were included in the analysis. These studies provided high-quality evidence from exercise only RCTs/CCTs. The findings indicated a significant reduction in the active phase of labor (8 RCTs, n = 1195; Mean Difference [MD] = -56.35, 95% Confidence Interval [CI] [-89.46 to -23.25]) and overall labor duration (8 RCTs, n = 898; MD = -93.93, 95% CI [-138.34 to -49.51]) in pregnant women who engaged in Pilates exercises compared to those who did not but doesn’t affect on the duration of the second stage of labor (7 RCTs, n = 1135; MD = -0.11, 95% CI [-7.21 to 6.99]).ConclusionsWhile this review primarily addresses the effects of Pilates on healthy and low-risk pregnant women, the findings suggest a potential role for Pilates in shortening labor duration. Therefore, engaging in Pilates or similar physical activities is recommended for pregnant women to potentially facilitate a more efficient labor process.

Rebozo technique to decrease pain intensity and length of labor

Background: Pain and length of labor impact the mother physically and psychologically. Both of these factors must be minimized to avoid complications during labor. In Indonesia, the rebozo technique is still rarely performed by health workers such as midwives, especially in West Sumatra.Objective: This study aims to determine the effect of the rebozo technique on reducing pain intensity and duration of labor in primiparas.Method: This is a quasi-experimental study with a two-group design. Sixty primiparous mothers were randomly divided into two groups (intervention and control groups). The intervention group received the rebozo technique, and the control group received standard treatment. The pain intensity and duration of labor were observed throughout the study. Data analysis used the independent t-test.Results: The study showed that the average pain intensity in the intervention group was lower than the control group (6.423 vs 7.562, p &lt;0.05). The average duration of labor was faster in the intervention group than in the control group (3.643 vs 4.815, p &lt;0.0001).Conclusion: The rebozo technique is effective in reducing pain and accelerating labor.

Effectiveness of Labor Dance on Duration of the First Active Phase of Labor in Nulliparous Women

Prolonged labor, also known as failure to progress, occurs when the total duration of labor is more than 24 hours and if not handled properly will cause various complications for the mother and baby and even lead to death. This study aimed to determine the effectiveness of labor dance on the duration of the first active phase of labor in nulliparous women. This study was a true experimental randomized controlled trial (single blind) with a posttest only with control group design. This research was conducted from 1 February to 31 March 2023 at the Central General Hospital Prof. dr.I.G.N.G Ngoerah Denpasar and Regional General Hospital Wangaya Denpasar. 42 primigravida mothers were randomly selected according to arrival, with 21 people in the intervention and control groups. Data were analyzed using the Mann Whitney test. The average length of the first stage of labor in the experimental group was 252,62 minutes and in the control group was 355,95 minutes (p-value=0,000); effect size of 1,61 (strong effect) with a percentage of 94,5%. There was a statistically significant difference in the duration of the active phase I stage of labor between the experimental and control groups. It is hoped that health workers, especially midwives, will

Медико-психологічні предиктори емоційно-поведінкового періоду материнства

Being in a war area or during regular rockets or artillery attacks, the inability to leave the location of a pregnant woman or a woman in postpartum period can affected the psycho-emotional condition of a woman. Therefore, in today's context, attention should be focused on creating predictors and identifying factors that can negatively affect a pregnant woman, the duration of pregnancy and labor, and the postpartum period. During pregnancy, one of the physiological changes in a woman's body is a change in the functioning of the nervous system. This is because during the implantation of the blastocyst, several types of receptors send impulses to the central nervous system, where information is received, scanned and analyzed in the cerebral cortex and produces the phenomenon of increased excitability. As a result of physiological transformations of this increased excitability, due to physiological mechanisms, it is transformed and reduces the excitability of the nervous system for the formation of the embryo and its complementary structures. As a result, pregnant women may experience psycho-emotional changes, sometimes with an unstable duration, mood changes, fatigue or drowsiness, sometimes obsession with pregnancy and worries about the correct growth of the fetus in the womb or various effects or nutritional factors (consumption or exclusion of certain foods or drinks) that may negatively affect it. The factors affecting the psycho-emotional condition during pregnancy (prenatal period) are identified and analyzed: external, social, economic, physiological, psychological, emotional and willed. The factors affecting the psycho-emotional well-being of women in the postnatal period are analyzed: medical, emotional and psychological, and communicative.

Rate of cervical dilatation and duration of active phase of labor among low-risk pregnant women delivering at Dodoma regional referral hospital

Background: Cervical dilation at the onset of the active phase of labor determines the rate of cervical dilatation and the duration of the active phase of labor. Identifying the abnormality toward the natural progress of the active phase of labor is important because timely intervention has been observed to be controversial among developing countries during the current practice among health care providers due to different opinion on the onset of the active phase. Thus, indication like poor progress of labor has been poorly explained in which it has become a common indication for a steady increased rate of primary cesarean section and increased new born morbidity due to birth asphyxia. Objective: This study aimed at determining the rate of cervical dilatation and duration of active phase of labor among low-risk pregnant women delivered at Dodoma Regional Referral Hospital. Methods: This is a hospital-based prospective cross-sectional study where systematic sampling method was employed in obtaining sample of 300 pregnant women. Local partograph and a semi structured questionnaire were used to record the information and findings. Data were analyzed using SPSS version 25. One sample t-test was used to determine and compare the rate and duration of active labor with the WHO standard rate. P value &lt; 0.05 was considered statistically significant. Results: The mean rate of cervical dilatation during active phase for nulliparous was 0.81cm/hour and multiparous was 0.89cm/hour respectively, which is observed to be slower than standard WHO rates. The duration of the active phase of labor was 7.6 hours for nulliparous and 6.8 hours for multiparous. Conclusion: The rate of cervical dilatation was much slower hence the longer duration of active phase in both groups than the WHO standards.

Pregnancy Exercise Shorten the Duration of the Second Stage of Labor

Background : There are several factors that contribute to duration of labor, which are power, passage, and passenger. Pregnancy exercise is one of many interventions that can be done in favor of increasing power during labor.Aim : The purpose of this study was to investigate the correlation between pregnancy exercise and second stage of labor duration.Material and Methods: This was an analytic observational study using cross sectional design conducted in Al-Irsyad Hospital in Surabaya. The total sample was 48 pregnant women who followed pregnancy exercise program and did not follow pregnancy exercise program that met sample criteria. Medical records data on duration of second stage of labor and pregnancy exercise program data were collected then analyzed by mann-whitney test.Results: The mean second stage of labor in pregnancy exercise group was 25.88±13.21 minutes, while in non-pregnancy group was 11.46±4.77 minutes. The analysis using mann-whitney test showed a significant correlation between pregnancy exercise and second stage of labor (p=0.000).Conclusion: There was a significant correlation between pregnancy exercise and second stage of labor. Pregnancy exercise shorten the duration of second stage of labor.