Duration Of Labor Research Articles

Regulated Expiratory Methods During Childbirth Process: A Randomized Controlled Trial

ObjectivesTo evaluate the impact of a regulated expiratory method (REM) on the childbirth process. MethodsThis was a randomized trial. Study population included all first-time mothers with a spontaneous onset of labour, at an early stage, and a fetus in cephalic presentation with a normal weight for gestational age. The evaluated intervention was REM based on the use of a specific device. The primary outcome was the cesarean delivery rate. Secondary outcomes included first and second stages of labour times, rates of spontaneous and instrumental vaginal births, and pain scores. Subjective qualitative outcomes related to childbirth experience were evaluated via 2 interviews conducted with the parturient and the midwife responsible for her delivery. Intention-to-treat analysis was employed to compare the 2 groups. ResultsThe reduction in primary cesarean rates between the 2 groups was not significant (26.7% in control group vs. 18.3% in intervention group; P = 0.274). However, REM allowed for a significant reduction in second stage (P = 0.039) and pushing effort times (P = 0.003). According to midwives, REM had a significant positive impact on parturients’ breathing (P < 0.0001) and pushing effort intensity (P = 0.041). It facilitated communication with the parturient (P = 0.002). Moreover, the evaluated method had a significant positive impact on patient's childbirth experience. ConclusionsAlthough the reduction in immediate cesarean rates was not significant, REM has the potential to shorten labour duration, improve pain management, and ultimately improve maternal childbirth experience.

Association of maternal SARS-CoV-2 infection at the time of admission for delivery with labor process and outcomes of vaginal birth: A cohort study.

This study aimed to investigate the impact of maternal SARS-CoV-2 infection at the time of admission for delivery on labor process and outcomes of vaginal birth. A cohort study was carried out at the Obstetrics Department of Anhui Provincial Hospital, China, where universal reverse transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 infection was introduced for all women admitted for labor and delivery from December 1-31, 2022. Women were divided into positive and negative groups based on the test result. All women having a singleton vaginal birth were included in final analysis. The effect of SARS-CoV-2 positivity on labor process and outcomes of vaginal birth was estimated by regression analyses. Among a total of 360 women included, 87 had a positive SARS-CoV-2 test and 273 a negative test. Women in the positive group had an increased likelihood of having longer labor (median 9.3 vs 8.3 hours; sB [log-transformed] 0.19; 95% confidence interval [CI] 0.09-0.28), episiotomy (39.1% vs 23.8%; adjusted odds ratio [aOR] 2.31; 95% CI 1.27-4.21), grade III meconium-stained amniotic fluid (19.5% vs 7.0%; aOR 2.52; 95% CI 1.15-5.54) and postpartum hospital stay exceeding 37 hours (58.6% vs 46.5%; aOR 1.71; 95% CI 1.00-2.91). They had reduced rates exclusive breastfeeding (26.7% vs 39%; aOR 0.21; 95% CI 0.09-0.46) as well as mixed feeding (46.5% vs 52.2%; aOR 0.28; 95% CI 0.13-0.60) at 1 week postpartum. No significant differences were observed in other aspects of labor process and birth outcomes, including the uptake of labor analgesia, postpartum hemorrhage (>500 mL) or neonatal outcomes. A positive maternal SARS-CoV-2 test in labor among women having vaginal birth was associated with a slightly longer duration of labor, increased likelihood of episiotomy, increased incidence of grade III meconium-stained amniotic fluid, a longer postpartum hospital stay and a lower rate of breastfeeding 1 week postpartum. However, it did not have an adverse impact on other birth outcomes.

Managing Maternal Fatigue During Childbirth: A Systematic Review

Background: Fatigue is a complex phenomenon. It is a common problem that occurs at all periods of childbearing. Pregnancy and labor are recognized as a normal physiological process, and fatigue, a common symptom that occurs frequently throughout the childbearing experience, has the potential to negatively affect the woman’s prenatal and birth experience. Fatigue is often overlooked by health professionals. Objective: The aim of this systematic review is to review the literature regarding the factors influencing maternal fatigue during childbirth and its management. Methods: The Joanna Briggs Institute (JBI) systematic review was used to guide this study. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed to report this systematic review. The database was searched from CINALH, Pubmed, PsyInfo, ThaiJO, and other sources for grey literature from 1990-2021. The methodological quality process used the critical appraisal tool for RCT study and MINORS (Methodological Index for Non-randomized Studies). Nine published articles were selected for this study. Results: The factors influencing maternal fatigue during childbirth were found to be physiological, psychological, and situational. The physiological factors were age, parity, uterine contractility, available energy substrate, nutrition adequacy, and prenatal exercise. The psychological factors were pain and anxiety. The situational factors were childbirth education, pain medication, prenatal employment, sleep, breathing technique, and pushing intervention. The strategies of managing fatigue during childbirth were 1) assessing maternal fatigue in early pregnancy; 2) childbirth preparation; 3) conservation of energy; 4) shortened duration of labor; and 5) reduced labor pain and anxiety. Conclusion: Maternal fatigue during childbirth impacts the mother, the child, and the family. It is important for nurses to understand the deleterious effects of fatigue on childbearing women and to promote interventions that reduce or prevent fatigue during pregnancy and childbirth.

Characterizing uterine responsiveness to oxytocin augmentation across four labor patterns in maternal obesity.

Optimizing care during labor protraction is a key strategy for reducing cesareans, especially among people with obesity. The pathophysiology of labor dystocia remains poorly understood, limiting precise interventions targeting the cause of protraction. In this secondary analysis of nulliparas (n = 92) with obesity (BMI ≥ 30 kg/m2) and spontaneous labor onset, we classified labor into four phenotypes based on duration of protraction and birth route: (1) no protraction, (2) short protraction and vaginal birth, (3) extended protraction meeting criteria for labor arrest, but with eventual progression and vaginal birth, and (4) extended protraction meeting criteria for labor arrest and cesarean birth. Across these phenotypes, we compared MVU, oxytocin dose, and novel measures of uterine responsiveness to oxytocin augmentation (MVU to oxytocin dose ratios). In our sample, phenotype group 1 comprised 14.1% (n = 13); group 2 comprised 30.4% (n = 28); group 3 comprised 34.8% (n = 32); and group 4 comprised 20.7% (n = 19). Uterine responsiveness to oxytocin, but not MVU, decreased with each labor phenotype. Participants with cesarean birth had the lowest uterine responsiveness to oxytocin. Labor and birth outcomes were associated with measures of uterine responsiveness to oxytocin rather than MVU alone, and thus these may be more clinically appropriate measures for guiding clinical decision-making. Current criteria for labor arrest are likely too stringent for nulliparas with obesity, many of whom appear to progress to safe vaginal birth after longer labor durations. Differences in uterine responsiveness to oxytocin augmentation across the groups suggests underlying physiologic differences in the labor phenotypes, which should drive future research targeting pathophysiology.

Literature Review: Pengaruh Terapi Musik Terhadap Lama Persalinan Kala I Fase Aktif

Psychological factors can influence the progress of the labor process. Music therapy is preferred as a non-pharmacological intervention because it has no side effects and benefits as self-hypnosis. This study aims to decide the effect of music therapy on the duration of labor during the active phase. Through the research design using literature research (literature review). Sources of data obtained through analysis of 11 journals through national and international database searches, in the last 10 years (2010-2020), using quality assessment methods and PICOT. The results obtained showed that music had an influence on the duration of labor during the active phase. This is possible due to adequate contractions caused by the workings of music which affect the hypothalamic system in the mother's brain, as a form of acceptance of the intervention given. It was concluded that music therapy has a significant effect on the duration of labor during the first active phase.

Anterior uterocervical angle: is it an ultrasonographic screening tool that estimates the latent phase duration in post term pregnancies?

In recent years, in addition to cervical length measurement, a new ultrasonographic parameter has been defined as uterocervical angle (UCA), which can be used in the prediction of preterm labor. In this study,we evaluated the place of uterocervical angle in predicting the latent phase duration in postterm pregnancies. This prospective study consists of 90 pregnant women aged between 18 to 40 years who were hospitalized with a diagnose of late term pregnancy. Pregnant women with a latent phase duration of 1200 minutes or less were defined as Group 1. Patients with latent phase duration over 1200 minutes were defined as Group 2. All patients' age, BMI, smoke, cervical length measurements, uterocervical angle, latent and active phase of labor durations, length of the third stage and delivery types were compared. The UCA median value of group 1 was 120 (94-147), and group 2 was 99 (94-105) (p < 0.001). CL medians of Groups 1 and 2 were 29 (17-43) and 28 (27-41) respectively (p: 0.871). UCA (AUC: 0.917, p < 0.0001) significantly predicted prolonged latent phase duration. Optimal cut off value was obtained at the value of 105 degree (100% sensitivity, 75% specificity) for UCA. Kaplan-Meier survival analysis showed that duration of labor was significantly higher in a group with low UCA (p: 0.013). UCA can be a successful tool that can be used to predict duration of labor in cases of postterm pregnancies with medical induction.

Perinatal Outcome in Overweight Women: An Audit.

Obesity in pregnancy is associated with a myriad of well-documented complications. However, the outcomes of pregnancy in overweight females, who are not classified as obese, have not been studied. The aim of the study was to assess foeto-maternal outcomes in primigravida who are overweight and compare them to normal-weight patients. This was a prospective observational cohort study and included primigravida with full-term gestation (between 38 and 42 weeks), with a single live foetus in vertex presentation, who were admitted for labour induction. Based on pre-pregnancy weight, patients were divided into normal weight (body mass index, BMI<23kg/m2) and overweight (BMI≥23kg/m2 and<25kg/m2) categories labelled as groups A and B, respectively. Data was collected for gestational age, demographics (age, education, occupation), and obstetric and labour-related parameters per pre-designed proforma. Parameters included were the reason for induction, number of doses of prostaglandin E2 (PGE2) gelused, duration of labour, induction to delivery interval, and mode of birth- operative/ non-operative. Data was also collected for peri-partum maternal complications, neonatal Apgar score, and need for Neonatal Intensive Care Unit (NICU) admissions. One hundred and fifty patients were recruited in the study and divided based on weight into two groups- 115 in Group A (normal weight) and 35 in Group B (overweight). Compared to Group A, a higher proportion ofpatients in Group B needed a third dose of PGE2 gel (n=24, 20.8%vs n=18, 51.4%). Also, more patients in Group B had an induction to delivery time of longer than 30 hours (n=7, 20% vs n=5, 4.3%)and had a higher incidence of failed induction needing caesarean section (n=9, 25.7% vs n=13, 11.3%).Neonates born to overweight mothers had a poor Apgar score at 1 min. However, on reassessment, Apgar improved at 5 minutes, and no statistically significant difference was seen for admission to NICU- 5.7% (n=2) in Group B vs 1.7% (n=2) in Group A Conclusion: Pregnancy in overweight females is associated with prolonged labour, higher instances of failed induction, and poor neonatal outcomes at initial assessment. Thus, perinatal counselling and management should focus on weight control while also planning appropriate strategies for monitoring and treating pregnancy-related complications if weight control measures fail. Although obesity is the main focus of research, we suggest including overweight but non-obese females in such studies as they have similar adverse outcomes and complications.

Comparison of maternal outcomes in caring by Doula, trained lay companion and routine midwifery care

IntroductionThe aim of this study was to compare maternal and neonatal outcomes in the care provided by Doula, trained lay companion, and routine midwifery care in the labor and obstetric units. In this study, only results related to maternal outcomes were presented.MethodThis is a quasi-experimental study, which was conducted on 150 women with low-risk pregnancies who had been selected for vaginal birth at private clinics and public hospitals of Arak, Iran. Participants were divided into three groups, two intervention groups, doula and trained lay companion, and one control group, midwife’s routine care. The intervention groups, in addition to receiving routine care from the labor and maternity units, also received support and training by doula or a trained lay companion, but 50 the control group received only routine midwifery care. In the control group and the trained companion, the samples were taken from 10 clinics of different parts of the city by random sampling method using the SIB center system. Then, among selected numbers, we randomly selected samples for each group. But in Doula group, because of limited number of samples, convenience sampling was used and all women enrolled in doula care were included in the study until the number reached 50. In each group, outcomes such as the duration of active phase and second stage of labor, as well as the severity of pain, anxiety and maternal satisfaction with birth were measured and compared with other groups. Data were collected by a researcher-made checklist, the Spielberger’s State-Trait Anxiety Inventory (STAI), the Pain Visual Assessment Scale (VAS), and the Hollins Martin’s Birth Satisfaction Scale-Revised (BSS-R). Data were analyzed by SPSS-22 statistical software using Kruskal Wallis, Chi-Square, ANOVA and Fisher’s exact tests.FindingsBased on the results, the mean duration of active phase between three groups was 234.68 ± 118.74, 256.66 ± 108.75 and 279 ± 94.37 min, respectively (p = 0.022). Also, the mean duration of second stage in three groups was 10 ± 5.61, 10.35 ± 5.1 and 22.30 ± 75.57 min, respectively (p < 0.001). The difference between mean pain scores in the first, second, third, fourth and fifth hours was not statistically significant. The average difference in anxiety score in the two stages of labor was higher in the lay companion group, and this difference was statistically significant (p < 0.001); however, the level of satisfaction in doula group was higher compared to the lay companion and control groups (p < 0.00 1).ConclusionAccording to present study, doula care has a greater effect on reducing the duration of labor than other care models. Based on the study, there was no statistically significant difference between the three groups in terms of variables such as the severity of labor pain. However, the level of anxiety of pregnant mothers in the group supported by lay companion was lower than the other two groups, which indicates the positive effect of mothers’ training on increasing maternal comfort and satisfaction. It is suggested that further research investigate the severity of labor pain in groups supported by different care models and also we recommend the use of lay companion’ support during childbearing of mothers who could not afford doula.Trail registrationThis article has been registered in Iran’s Clinical Trial Center with the code: IRCT20230620058548N1. 2023/08/29.

Comparative Study: Yoga and Pregnancy Exercise on First Stage Pain and Length of Labor in Tapanuli Regency

Labor pain is pain that comes from uterine contractions trying to expel the baby. The mother's perception of pain during labor can influence the length of the labor process. Pregnant women should be supported to carry out physical exercise to obtain benefits during pregnancy and childbirth. There are several physical exercises during pregnancy, which pregnant women often participate in, such as pregnancy exercises and pregnancy yoga. The aim of this research is to develop yoga exercises and pregnancy exercises to overcome pain in the first stage and duration of labor, as well as to conduct a trial of a combination of yoga exercises and pregnancy exercises which can be developed to reduce pain in the first stage and duration of labour. This study used a prospective cohort design with consecutive sampling technique. The research subjects were pregnant women in the third trimester who were in the working area of North Tapanuli and Central Tapanuli Regencies. The research sample consisted of 50 people taking part in pregnancy exercise and 50 people taking part in pregnancy yoga during April - June 2023. Data analysis used the Mann Withney test. The Mean Rank value for duration of labor for respondents who did yoga exercise was 44.70 and for respondents who did pregnancy exercise was 56.30. Based on the results of statistical tests, a p value of 0.044 was obtained. The Mean Rank value of labor pain for respondents who did yoga exercise was 32.80 and for respondents who did pregnancy exercise was 68.20. Based on the results of statistical tests, a p value of 0.000 was obtained. so it can be concluded that there is a difference in the length of labor and labor pain between pregnant women who were given yoga training and pregnant women who were given pregnancy exercise training.

Intravenous fluid rate of 250 mL/h versus 125 mL/h in nulliparous women: A systematic review and meta-analysis of randomized controlled trials.

Evidence regarding the type and rate of intravenous (IV) fluid administration during labor is still inconclusive and the studies assessing the impact of IV fluids had mixed results. To evaluate the effects of IV fluids at an infusion rate of 250 mL/h as compared with 125 mL/h on labor outcomes in nulliparous women. We searched six databases for relevant studies through a search strategy containing the relevant keywords "IV hydration", "IV fluids", and "labor" from the inception of these databases to May 1, 2023, without any applied restrictions. Search results were imported to Covidence for screening of eligible articles for this review. Randomized controlled trials (RCTs) assessing the impact of IV fluids at 250 mL/h on the outcomes of labor in nulliparous women at term (>37 weeks) as compared with 125 mL/h were included only. Data regarding the characteristics of included studies, participant's baseline characteristics, and concerned outcomes were collected in an Excel spreadsheet and all the concerned outcomes were pooled as risk ratios (RR) or mean difference (MD) with 95% confidence interval (CI) in the meta-analysis models using RevMan 5.4. Pooled data from 11 RCTs with 1815 patients showed that 250 mL/h infusion rate had a significant reduction in cesarean section rate (RR 0.70, 95% CI 0.56-0.88, P = 0.002), the first stage of labor duration (MD -46.97, 95% CI -81.79 to -12.14, P = 0.008), the second stage of labor duration (MD -2.69, 95% CI -4.34 to -1.05, P = 0.001), prolonged labor incidence (RR 0.72, 95% CI 0.58-0.89, P = 0.003), as compared with 125 mL/h. Also, the vaginal delivery rate (RR 1.07, 95% CI 1.02-1.12, P = 0.009) was higher with a 250 mL/h infusion rate. IV fluids at an infusion rate of 250 mL/h during labor in nulliparous women decreased the cesarean delivery rate, increased the vaginal delivery rate, shortened the first and second-stage labor duration, decreased the incidence of prolonged labor as compared with 125 mL/h. These findings suggest enhanced labor progression and a lower risk of labor complications with higher infusion rates. However, future research involving a more diverse population and exploring the potential benefits of combining IV infusion rates with other interventions, such as adding dextrose or less restrictive oral intake during labor, is needed.

Duration of the active first stage of labour and severe perineal lacerations and maternal postpartum complications: a population-based cohort study.

The impact of first stage labour duration on maternal outcomes is sparsely investigated. We aimed to study the association between a longer active first stage and maternal complications in the early postpartum period. A population-based cohort study. Regions of Stockholm and Gotland, Sweden, 2008-2020. A cohort of 159 459 term, singleton, vertex pregnancies, stratified by parity groups. The exposure was active first stage duration, categorised in percentiles. Poisson regression analysis was performed to estimate the adjusted relative risk (aRR) and the 95% confidence interval (95% CI). To investigate the effect of second stage duration on the outcome, mediation analysis was performed. Severe perineal lacerations (third or fourth degree), postpartum infection, urinary retention and haematoma in the birth canal or ruptured sutures. The risks of severe perineal laceration, postpartum infection and urinary retention increased with a longer active first stage, both overall and stratified by parity group. The aRR increased with a longer active first stage, using duration of <50th percentile as the reference. In the ≥90th percentile category, the aRR for postpartum infection was 1.64 (95% CI 1.46-1.84) in primiparous women, 2.43 (95% CI 1.98-2.98) in parous women with no previous caesarean delivery (CD) and 2.33 (95% CI 1.65-3.28) in parous women with a previous CD. The proportion mediated by second stage duration was 33.4% to 36.9% for the different outcomes in primiparous women. The risk of haematoma or ruptured sutures did not increased with a longer active first stage. Increasing active first stage duration is associated with maternal complications in the early postpartum period.

Characteristics of childbirth in highly productive sows

The purpose of this work was to analyze the prevalence of normal and pathological births in highly productive sows and the impact of their course on further reproductive function. The research was carried out in an industrial complex on 260 highly productive Yorkshire Landrace sows of Danish breeding. It was found that in highly productive sows in 32.69% of cases, pathological labor is recorded, including weak contractions and attempts - in 20.0% and manual labor – in 12.69%. With the clinical manifestation of weak labor activity in women in labor and with the provision of manual labor, 16.32% and 15.20% more piglets were received from them than during normal childbirth. At the same time, there is an increase in the duration of labor by 31.09% (p&lt;0.001) and by 43.15% (p&lt; 0.001), respectively. In pathological childbirth, women in labor are observed to breed more stillborn and mummified piglets than in normal childbirth. Providing obstetric care during childbirth increases the risk of developing inflammatory diseases of the uterus and breast in animals in the early postpartum period. The most common postpartum pathology with primary weakness of labor and manual labor is inflammation of the uterine mucosa, and with manual labor it is supplemented by an increase in the number of sick animals with postpartum dysgalactia. In the next reproductive cycle, the sows, in which the physiological course of the birth process and weak contractions and attempts were recorded, had identical reproduction indicators. However, in animals that had a history of primary weakness of labor activity during the last birth, an increase in the unproductive period was recorded. In sows, after manual care, there is a violation and delay in the restoration of sexual cyclicity, a decrease in fertilization.

Effects of 0.15% ropivacaine alone and combination with sufentanil on epidural labor analgesia and adverse reactions.

The aim of this study was to compare the impacts of 0.15% ropivacaine alone and 0.15% ropivacaine combined with sufentanil on epidural labor analgesia. A total of 297 eligible primiparae were randomly divided into group A (n=149, 0.15% ropivacaine + sufentanil) and group B (n=148, 0.15% ropivacaine). Visual analogue scale (VAS) scores prior to analgesia and 20 min following epidural medication, the maximum VAS score during labor, dosage of analgesic drugs, modified Bromage score, satisfaction degree, labor duration, delivery mode, 1-min and 5-min Apgar scores of newborns, adverse reactions during analgesia, and fever during labor were recorded. Group A and B had similar VAS scores 20 min following epidural medication and maximum score during labor (P>0.05), which significantly fell compared with those before labor analgesia (P<0.05). The occurrence rates of nausea and vomiting were of significant difference (P<0.05). 0.15% ropivacaine alone achieves a comparable epidural labor analgesia effect to that of 0.15% ropivacaine + 0.05 µg/mL sufentanil on primiparae.

Delivery Progress, Labor Interventions and Perinatal Outcome in Spontaneous Vaginal Delivery of Singleton Pregnancies between Nulliparous and Primiparous Women with One Previous Elective Cesarean Section: A Retrospective Comparative Study.

This is a retrospective comparative study. Data were collected in a four-year period at the departments of Obstetrics and Gynecology at Kristianstad and Ystad hospitals in Sweden. Out of 14,925 deliveries, 106 primipara women with one previous elective LSCS and a spontaneous labor onset in the subsequent singleton pregnancy were identified. Of these women, 94 (88.7%) delivered vaginally and were included in the study (VBAC group). The comparison group included 212 randomly selected nulliparous women that had a normal singleton pregnancy, spontaneous labor onset and delivered vaginally. The rate of cervical dilation during the active first stage of labor as well as the duration of the second stage did not differ between the two groups. When adjusting for cervical dilation at admission, there was no significant difference between the two groups regarding the duration of the active phase of the first stage of labor. No significant differences were found in maternal-neonatal outcomes between the two groups except for higher birth weight in the VBAC group. The use of epidural analgesia was associated with slower dilation rhythm over the duration of the active phase and second stage of labor, need for labor augmentation, postpartum bleeding and need for transfusion at higher rates, irrespective of parity when epidural was used. Our study provides evidence that in women with one previous elective LSCS undergoing TOLAC in the subsequent pregnancy resulting in vaginal birth, the progress and duration of labor are not different from those in nulliparous women when labor is spontaneous and the it is a singleton pregnancy. The use of epidural was associated with prolonged labor, need for labor augmentation and higher postpartum bleeding, irrespective of parity. This information may be useful in patient counseling and labor management in TOLAC.

Maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals of the South West Shewa Zone, Ethiopia, 2022.

Maternal satisfaction with intrapartum care is a multidimensional assumption of satisfaction with self and with the physical environment of the delivery ward and quality of care. Maternal satisfaction with intrapartum care affects the selection of birthplace and helps to identify gaps between actual and intended healthcare outcomes. This study aims to assess factors that affect maternal satisfaction with intrapartum care. To assess maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals in the South-west Shewa Zone, Ethiopia, 2022. A cross-sectional study approach among 420 mothers was conducted between April 14 and June 14, 2022. Systematic random sampling was used to select mothers for face-to-face interviews every two intervals. Bivariate and multivariable logistic regression analyses were carried out. P-values of <0.25 in association with study variables were transferred to multivariable logistic regression models. An adjusted odds ratio with a 95% confidence interval was computed, and p-values of <0.05 were considered statistically significant in the multivariable model. The results of this study are presented using text, tables, and charts. Data were collected from 420 participants, and 413 mothers completed the interview, giving a response rate of 98.33%. The overall maternal satisfaction with intrapartum care was 245 (59.32%) [95% CI: 55-64]. Mothers who were considered normal during labor and delivery (AOR = 2.57 (95% CI: 1.30-5.07), had a labor duration of 12 h or less (AOR = 1.59 (95% CI: 1.03-2.44), and experienced a waiting time of <15 min (AOR = 2.06 (95% CI: 1.21-3.52) were significantly associated with maternal satisfaction with intrapartum care. More than half of mothers were satisfied with the overall intrapartum care they received. Health facility managers and healthcare providers work together to improve maternal satisfaction with intrapartum care.

Predictors of Uterine Rupture After One Previous Cesarean Section: An Unmatched Case-Control Study.

Uterine rupture is a rare occurrence but has catastrophic complications during pregnancy. The incidence is relatively higher in scarred uteri because there is a promotion of labor after cesarean section. There is a scarcity of evidence from low-income countries regarding the predictors of uterine rupture after trial labor. To assess factors determining uterine rupture during labor after the previous cesarean section among mothers delivered at Hawassa University Comprehensive Specialized Hospital from September 2017 to September 2022. A facility-based unmatched case-control study was done by reviewing 105 patients, which included 35 cases and 70 controls in a 1:2 case-to-control ratio. The association between dependent and independent variables was sought with running binary and multivariate analyses by using the cut point of a p value < 0.05 and 95% CI. The prevalence of uterine rupture is 1.6%. The factors significantly associated with uterine rupture after trial of labor are fetal weight >3.8 kg (AOR: 5.21), antenatal care 4 (AOR: 3.6), labor duration >15 hours (AOR: 10.7), and previous successful vaginal delivery (AOR: 3.4). Poor fetal-maternal outcomes like 91.4% fetal death, 29 hysterectomies, 22 blood transfusions, and 1 death. The prevalence is relatively higher than in developed countries. The number of antenatal care, labor duration, and lower fetal weight are not common findings associated with uterine rupture after trial of labor across the literature, so large-scale studies are needed to develop guidelines for the Ethiopian setup. Improving the quality of obstetrics care given in each level of health system.

A study on the effect of husbands' attendance in the delivery ward on the duration of labor and mode of delivery in primigravid women

A study on the effect of husbands' attendance in the delivery ward on the duration of labor and mode of delivery in primigravid women

EFFECT OF PRELABOUR BMI ON THE MODE OF DELIVERY

Aim:To analyze the effect of Body Mass Index on the Mode of Delivery Design : Cross sectional study Methodology : Sample Size : 100 Patients Inclusion Criteria: Antenatal patients in Active phase of Labour proceeding for delivery Procedure: After ethical comittee approval and written consents from the patients, this comparative cross sectional study was conducted at a Tertiary hospital at CHRI and performed on a total of 100 antental patients who attended the pre labour unit. Their basic information such as age, height, weight, gestational age, and cervical dilatation were noted. Maternal Body Mass Index was noted from pre pregnancy weight from the pregnancy health card.This study is completely a non invasive study Study Duration : 4 months Results : The study population included 100 participants admitted in pre labour unit in a tertiary care hospital. The results obtained showed healthy Body mass Index group had the favourable outcome, whereas the antenatal patients with increased Prepregnancy Body Mass Index had the worst outcome like Cesarean delivery, increased duration of first stage labour, increased duration of second stage labour, APGAR 1to 5, NICU admission, postpartum hemorrhage. Conclusion : This study concludes that Antenatal patients with Increased Body Mass Index have poorer outcomes when compared to Antenatal Patients with normal values of Body Mass Index. This study can be useful in assessing and reducing the poorer materno-fetal outcomes.

The Effectiveness of the Birthing Ball (Gym Ball) on the Progress of Opening the First Stage of Labor in the Working Area of Muka Health Center, Purwakarta District, Purwakarta Regency, Indonesia

The birthing ball allows gravity to help the baby descend into the pelvis, which can speed up the opening of the cervix. Apart from that, the Birthing Ball also provides extra comfort and support to pregnant women, which can reduce pain and anxiety during the birthing process. This study aimed to determine the effectiveness of the birthing ball (gym ball) on the progress of the opening the first stage of labor in the Muka Health Center Working Area, Purwakarta District, Purwakarta Regency, Indonesia. This study is experimental research with a post-test approach with the control group and uses primary data, namely measuring the length of the first stage of labor. A total of 30 research subjects took part in this study. The birth ball showed the potential to increase the speed of duration of the first stage of labor statistically significantly, p&lt;0.05. The duration of the first stage of labor in the intervention group was around 195.83 ± 16.76 minutes, while the duration of labor in the control group was 345.83 ± 26.76 minutes. In conclusion, there is the effectiveness of the birthing ball (gym ball) in the progress of the opening the first stage of labor in the Muka Health Center Working Area, Purwakarta District, Purwakarta Regency, Indonesia.

The Intervention Effect of Full-Responsibility Midwifery in Conjunction with Guided Labor Accompaniment on Maternal Birth Outcome

Objective: To investigate and analyze the intervention effect of full responsibility midwifery with guided labor accompaniment on maternal birth outcomes. Methods: 68 cases of labor and delivery from January 2021 to December 2022 in Yancheng Dafeng People’s Hospital were selected and grouped into the study group (n = 34) and the control group (n = 34). The pregnant women in the control group were in full-responsibility midwifery nursing intervention, and the pregnant women in the study group were in full-responsibility midwifery with guided labor accompaniment. The duration of labor, the rate of spontaneous delivery, the incidence of adverse pregnancy outcomes, and satisfaction with nursing care between the two groups were recorded and evaluated. Results: The duration of labor in the study group was lower than that in the control group (P &lt; 0.05); the rate of spontaneous delivery in the study group was higher than that in the control group (P &lt; 0.05); the incidence of adverse pregnancy outcomes in the study group was lower than that in the control group (P &lt; 0.05); and the nursing care satisfaction in the study group was higher than that in the control group (P &lt; 0.05). Conclusion: Full-responsibility midwifery with guided labor accompaniment can shorten the duration of labor, increase the rate of spontaneous delivery, reduce the incidence of adverse pregnancy outcomes, and achieve higher satisfaction of maternal care, which is of value for popularization and application.