Women In Labor Research Articles

Pregnancy, labor, postpartum and neonatal outcomes in women with new coronavirus infection and preterm labor

Pregnancy, labor, postpartum and neonatal outcomes in women with new coronavirus infection and preterm labor

Serial Cervical Length Measurement for Determining the Risk of Preterm Labor: A Prospective Study

Objective: This study aimed to evaluate whether serial evaluations of cervical length (CL) have the potential to determine preterm labor in women with threatening preterm labor (TPL). Materials and Methods: This prospective study included pregnant women at 24 to 37 weeks of gestation referred to our institute because of TPL. Cervical length was measured at three successive time points using transvaginal sonography (upon admission, one-, and two-weeks post-admission). Data were analyzed using both parametric and non-parametric statistics. Results: The mean age of the 126 patients included was 25.60 ± 6.48 years, with age ranging from 14 to 42 years. The mean pregnancy age, at the time of the sonogram, was 33.54 ± 2.78 weeks. The initial CL had an area under the receiver operating characteristic curve (AUROC) of 0.854. The CLs measured one and two weeks later had AUROCs of 0.868 and 0.870, respectively. Based on these data, the cut-off points of 28.5 and 27.5 mm were identified for the initial and subsequent two-week CL measurements, respectively, capable of predicting preterm delivery. If the CL measured at initial admission was >28.5 mm, the likelihood of timely delivery was 92.22%. However, if the CL measured at initial admission was <28.5 mm, the chance of premature preterm delivery increased by 2.3 times. Patients with a CL <27.5 mm in the second week were 18.75% more likely to have a preterm delivery. If the CL was >27.5 mm, the probability of timely delivery was 89.7%. Conclusion: In this cohort of women, serially measured CLs taken during transvaginal sonography demonstrated promise as a method for indicating the possible risk of preterm delivery. Thus, measured CL may be a useful diagnostic component for prenatal care, as well as for classifying the risk of preterm delivery. Nevertheless, further studies are required to confirm the effectiveness and safety of these sonographic measures in larger and more diverse patient cohorts.

Tending to the machine: The impact of intrapartum fetal surveillance on women in Australia

Qualitative research about women and birthing people’s experiences of fetal monitoring during labour and birth is scant. Labour and birth is often impacted by wearable or invasive monitoring devices, however, most published research about fetal monitoring is focused on the wellbeing of the fetus. This manuscript is derived from a larger mixed methods study, ‘WOmen’s Experiences of Monitoring Baby (The WOMB Study)’, aiming to increase understanding of the experiences of women and birthing people in Australia, of being monitored; and about the information they received about fetal monitoring devices during pregnancy. We constructed a national cross-sectional survey that was distributed via social media in May and June, 2022. Responses were received from 861 participants. As far as we are aware, this is the first survey of the experiences of women and birthing people of intrapartum fetal monitoring conducted in Australia. This paper comprises the analysis of the free text survey responses, using qualitative and inductive content analysis. Two categories were constructed, Tending to the machine, which explores participants’ perceptions of the way in which clinicians interacted with fetal monitoring technologies; and Impressions of the machine, which explores the direct impact of fetal monitoring devices upon the labour and birth experience of women and birthing people. The findings suggest that some clinicians need to reflect upon the information they provide to women and birthing people about monitoring. For example, freedom of movement is an important aspect of supporting the physiology of labour and managing pain. If freedom of movement is important, the physical restriction created by a wired cardiotocograph is inappropriate. Many participants noticed that clinicians focused their attention primarily on the technology. Prioritising the individual needs of the woman or birthing person is key to providing high quality woman-centred intrapartum care. Women should be provided with adequate information regarding the risks and benefits of different forms of fetal monitoring including how the form of monitoring might impact her labour experience.

Racial capitalism and women’s horticultural labour in Senegal: neo-housewifisation and the micro-politics of paternalism

ABSTRACT The article addresses the social relations of labour in Senegal a decade after the land rush. Based on an intersectional feminist analysis of three firms, the study found that workers’ subjugation to patriarchal control in their households and workplace capitalists indicate the emergence of labour control associated with settler colonies of Africa. I argue that strategic alliances between patriarchy and racial capitalism influence the mobilisation and control of labour classes: i) through the subordination of women and younger male workers to farm management through the micropolitics of paternalism; and ii) through new spatial fixation forms of previously mobile footloose labour of women and junior workers staying close to their families for work such that they become a compliant and tied labour force. This occurs simultaneously with an urban exodus to the rural and peri-urban areas where the commercial horticultural farms are located. Class consciousness is stymied so resistance is circumscribed, taking limited, individualised forms.

Role of mitochondrial DNA level in epidural-related maternal fever: a single-centre, observational, pilot study

IntroductionEpidural analgesia has been associated with intrapartum maternal fever development. Epidural-related maternal fever (ERMF) is believed to be based on a non-infectious inflammatory reaction. Circulating cell-free mitochondrial deoxyribonucleic acid (mtDNA) is one of the possible triggers of sterile inflammatory processes; however, a connection has not been investigated so far. Therefore, this study aimed to investigate cell-free mtDNA alterations in women in labour with ERMF in comparison with non-febrile women.Material and methodsA total of 60 women in labour were assessed for maternal temperature every 4 h and blood samples were obtained at the beginning and after delivery. Depending on the analgesia and the development of fever (axillary temperature ≥ 37.5 °C), the women were allocated either to the group of no epidural analgesia (n = 17), to epidural analgesia no fever (n = 34) or to ERMF (n = 9). Circulating cell-free mtDNA was analysed in the maternal plasma for the primary outcome whereas secondary outcomes include the evaluation of inflammatory cytokine release, as well as placental inflammatory signs.ResultsOf the women with epidural analgesia, 20% (n = 9) developed ERMF and demonstrated a decrease of circulating mtDNA levels during labour (p = 0.04), but a trend towards higher free nuclear DNA. Furthermore, women with maternal pyrexia showed a 1.5 fold increased level of Interleukin-6 during labour. A correlation was found between premature rupture of membranes and ERMF.ConclusionsThe pilot trial revealed an evident obstetric anaesthesia phenomenon of maternal fever due to epidural analgesia in 20% of women in labour, demonstrating counterregulated free mtDNA and nDNA. Further work is urgently required to understand the connections between the ERMF occurrence and circulating cell-free mtDNA as a potential source of sterile inflammation.Trial registrationNCT0405223 on clinicaltrials.gov (registered on 25/07/2019).

The nonlinear road to happiness: Making sense of ESGD impacts on well-being

This study examines the heterogeneous impact of environmental, social, governance, and digital (ESGD) factors on subjective well-being across 86 countries from 2005 to 2019, using Method of Moments Quantile Regression. The results reveal complex, nonlinear relationships between ESGD factors and well-being. CO2 emissions display an inverted U-curve, suggesting eventual negative impacts after initial gains. Our findings suggest that renewable energy only benefits higher quantiles, revealing affordability issues. Social and governance factors like labor participation and women's political participation relate nonlinearly to well-being across income levels, reflecting employment quality and social norms differences. Similarly, digital factors improve well-being in high-income countries but not lower-middle-income nations, due to economic complexity gaps and the digital divide. A “digital economy paradox” emerges where more digital skills combined with limited digital economies decrease well-being in lower-middle income countries signifying the need for tailored digital policies. This study enhances understanding of links between ESGD factors and well-being patterns.

Relationships Among Mode of Birth, Onset of Labor, and Bishop Score

ObjectiveTo investigate mode of birth in relation to onset of labor and Bishop score. DesignRetrospective observational cohort design. SettingA 434-bed Magnet redesignated community hospital. ParticipantsNulliparous women, 18 years of age or older, who gave birth at 37 to 41 weeks gestation to live, singleton fetuses in the vertex presentation (N = 701). MethodsWe conducted a retrospective chart review and used chi-square analysis to measure the associations among mode of birth, onset of labor, and Bishop score. We used logistic regression to test the probability of cesarean birth for women undergoing elective induction of labor. ResultsMost participants (n = 531, 75.7%) gave birth vaginally. Significant findings included the following relationships: spontaneous onset of labor and vaginal birth (χ2 = 22.2, Ø = 0.18, p < .001) and Bishop score of greater than or equal to 8 and vaginal birth (χ2 = 4.9, Ø = .14, p = .028). Induction of labor was a significant predictor in cesarean birth when controlling for age and body mass index (OR = 2.1, 95% confidence interval [1.5, 3.1], p < .001). ConclusionReducing elective induction of labor in women with low-risk pregnancies may help lower the risk of cesarean birth. Clinically, Bishop score and mode of birth have a weak association, particularly when induction includes cervical ripening.

Nulliparous women’s lived experiences of the prolonged passive stage of labour: A thematic analysis based on descriptive phenomenology

IntroductionProlonged progress can occur in the first and second stages of labour and may contribute to a negative birth experience. However, previous studies have mainly focused on quantitative aspects or overall birth experience, and little is known about women’s experiences of a prolonged passive second stage. ObjectiveTo describe the lived experiences of a prolonged passive second stage of labour in nulliparous women. MethodsA qualitative study was conducted with 15 nulliparous women with a passive second stage lasting three hours or more. Data were analysed using thematic analysis based on descriptive phenomenology. ResultsThe analysis resulted in four themes: “An unknown phase” that entailed remaining in a phase that the women lacked an awareness of. “Trust and mistrust in the body’s ability” represents the mindset for vaginal birth as well as feelings of powerlessness and self-guilt. The theme “Loss of control” included experiences of frustration, fatigue, and having to deny bodily instincts. “Support through presence and involvement” signifies support through the midwife’s presence in the birthing room, although there were also descriptions of emotional or physical absence. ConclusionsThe findings contribute to the understanding of prolonged labour based on women’s lived experiences and add to the body of knowledge about the prolonged passive second stage. This study highlights that women need support through information, presence, and encouragement to remain in control. It can be beneficial during birth preparation to include knowledge about the passive second stage together with unexpected or complicated situations during birth, such as prolonged labour.

Contribution of Family Labour in Mixed Farming System

Indian economy largely depends on the agriculture. Agriculture is the main source of income in the nation as most of the people choose their livelihood from agriculture. But this source of income is under threat as agriculture has become very risky due to extreme climate changes and highly volatile agricultural markets. Mixed farming system is one way of handling such problems because it provides better income returns to farm owners as well as higher productivity. Mixed farming is defined as a system of farming in which both crop and livestock farming are combined for the purpose of meeting family requirements and profiting from both enterprises. The case for integrating these two is based on the premises that bye –products from the two systems are used on the same farm. Mixed farming system is helpful in decreasing the cost of production per unit area, increasing income and productivity and reducing the risk of farmers. The contribution of family labour in these farming systems cannot be neglected. Mixed family farms produce almost half of the world food. Increasing food supply in developing countries requires increasing productivity of both land and farmers’ labour as key to increase household income, food security and reduce poverty. So the present study focuses on contribution of family labour in mixed farming system and gender wise comparison of family labour towards mixed farming. From the study it can be concluded that mixed farming system is highly dependent on family labour. So that mixed farming can also be called as family farming. The mixed farming is a farming system which is managed and operated by a family and predominantly reliant on family labour both women’s and men’s. The family and farm are linked and can be concluded that family labour is critical resource of mixed farming system.

Characterization and Identification of Major Constraints and Potentials of Kiltu Sorsa Watershed, in Guji Zone, Southern Ethiopia

Ethiopia is a country seriously affected by different natural resource degradation that included soil, vegetation, biodiversity and water degradation and climate deterioration. The study was conducted at Adola Rede District of Guji Zone, in Southern Ethiopia. The objectives of the study were to document baseline information on socioeconomic aspects and to document major biophysical and socio-economic constraints and potentials of the study watershed. The survey data were collected using key informant interview, focus group discussions, semi-structured interviews and guided field observations. A total of 60 respondents were selected for semi-structured interviews by means of simple random sampling methods. The majority (65%) of the respondent households were practiced physical and biological soil and water conservation activities. However, about 35% of the sampled households were not practiced soil and water conservation activities due to lack of awareness, lack of materials and labor. In the study watershed five major constraints such as land and soil related constraints, production related constraints, institutional and infrastructure related constraints, livestock related constraints and socio-economic related constraints were identified. However, suitable agro-ecology, availability of labor force, youth and women associations and informal institutions were the major identified potentials in the study watershed. Therefore, by using the potentials/opportunities of the study watershed and through providing quality extension services and training on soil and water conservation practices it is possible to enhance farmers participation and technical limitations. Moreover, for sustainable watershed management of the study area different soil and water conservation structures are very significant in various land use system of the study watershed through active participation of the local communities.

Intrapartum pyrexia, cardiotocography traces and histologic chorioamnionitis: a case-control study.

To compare characteristics of labor, cardiotocography traces, and maternal and neonatal outcomes, in a cohort of pregnancies at term complicated by maternal intrapartum pyrexia, with or without a histologic diagnosis of chorioamnionitis. This is a retrospective case-control study including pregnancies at term with detection of maternal intrapartum pyrexia, delivered between January 2020 and June 2021. Cardiotocography traces were entirely evaluated, since admission till delivery, and classified according to the International Federation of Obstetrics and Gynecology (FIGO) guideline. Maternal and neonatal outcomes were also recorded as secondary outcomes. Placentas have been studied according to the Amniotic Fluid Infection Nosology Committee. Forty four patients met the inclusion criteria and were included in the study cohort. There was a significant association between the use of oxytocin augmentation in labor and the histologic diagnosis of chorioamnionitis. A significative recurrence of loss and/or absence of accelerations at the point of pyrexia was also documented in women with histological chorioamnionitis compared to the others. Chorioamnionitis appears to be associated with myometrial disfunction, as suggested by the increased use of oxytocin augmentation during active labor of women at term with intrapartum pyrexia and histologic diagnosis of chorioamnionitis.

Artificial Intelligence, Intrapartum Ultrasound and Dystocic Delivery: AIDA (Artificial Intelligence Dystocia Algorithm), a Promising Helping Decision Support System.

The position of the fetal head during engagement and progression in the birth canal is the primary cause of dystocic labor and arrest of progression, often due to malposition and malrotation. The authors performed an investigation on pregnant women in labor, who all underwent vaginal digital examination by obstetricians and midwives as well as intrapartum ultrasonography to collect four "geometric parameters", measured in all the women. All parameters were measured using artificial intelligence and machine learning algorithms, called AIDA (artificial intelligence dystocia algorithm), which incorporates a human-in-the-loop approach, that is, to use AI (artificial intelligence) algorithms that prioritize the physician's decision and explainable artificial intelligence (XAI). The AIDA was structured into five classes. After a number of "geometric parameters" were collected, the data obtained from the AIDA analysis were entered into a red, yellow, or green zone, linked to the analysis of the progress of labor. Using the AIDA analysis, we were able to identify five reference classes for patients in labor, each of which had a certain sort of birth outcome. A 100% cesarean birth prediction was made in two of these five classes. The use of artificial intelligence, through the evaluation of certain obstetric parameters in specific decision-making algorithms, allows physicians to systematically understand how the results of the algorithms can be explained. This approach can be useful in evaluating the progress of labor and predicting the labor outcome, including spontaneous, whether operative VD (vaginal delivery) should be attempted, or if ICD (intrapartum cesarean delivery) is preferable or necessary.

Prediction of bleeding in labor in women with uterine scar as a tool to prevent massive blood loss: an observational cohort study

Background. Postpartum hemorrhage is recognized as a leading cause of maternal mortality and morbidity in the world. Predicting postpartum hemorrhage in high-risk patients with uterine scar enables preventive measures to be scheduled and costs of treatment and rehabilitation to be reduced.Objective. To determine antenatal predictors of high postpartum hemorrhage risk in pregnant women with uterine scar in order to improve the prevention of massive blood loss.Methods. An observational cohort study involves the medical records of 4494 maternity women with uterine scar (pregnancy and delivery histories) of the Perinatal Center of Regional Clinical Hospital No. 2, Krasnodar Krai. The study sample included data of maternity women coded O34.2 according to International Classification of Diseases, 10th Edition, for the period from 2017 to 2020. The sample participants were distributed into two groups depending on the blood loss during delivery, determined in compliance with clinical recommendations: a group of patients without massive blood loss during delivery and a group of patients with massive blood loss in labor/early postpartum period. The study was mainly focused on parameters of the prediction performance of bleeding in labor and early postpartum period in pregnant women with uterine scar using a multiparametric, logistic regression models. The study considered demographic data, comorbidity, obstetric history, pregnancy course, ultrasound data, and volume of blood loss at delivery. The performance of prediction for postpartum hemorrhage was calculated using multivariate binary logistic regression. Descriptive statistical analysis was carried out by means of statistical software package SPSS Version 26 (IBM, USA). Two-sided p-value &lt; 0.05 was taken as a statistically significant difference. A prognostic significance of predictors was determined by binary logistic regression. The Wald statistic was used to determine an observed significance. In order to define the performance of the model, the study involved calculating sensitivity, specificity, positive and negative predictive value, Nagelkerke coefficient of determination, as well as performing ROC analysis. The DeLong test was used for paired comparisons of ROC curves.Results. In the retrospective follow-up group (2017–2020) (n = 502), postpartum hemorrhage with massive blood loss occurred in 41 cases (8.17%). For the model based on clinical-anamnestic predictors, the prediction performance for postpartum hemorrhage comprised: sensitivity = 12.2% (95% confidence interval (CI) 4.1–26.2); specificity = 99.3% (95% CI 98.1–99.9); positive predictive value = 62.5% (95% CI 24.5–91.5); negative predictive value = 92.6% (95% CI 89.9–94.8); area under the ROC curve = 0.864 (95% CI 0.807–0.920), p &lt; 0.001. The prediction performance for the model based on three ultrasound predictors (asymmetry coefficient of placental thickness, uterine wall bulging in the scar and myometrial thickness in the placentation zone) comprised: sensitivity = 85.4% (95% CI 70.8–94.4); specificity = 98.5% (95% CI 96.9–99.4); positive predictive value = 83.3% (95% CI 68.6–93.0); negative predictive value = 98.7% (95% CI 97.2–99.5); area under the ROC curve = 0.919 (95% CI 0.855–0.983), p &lt; 0.001. No significant difference was revealed for the performance of the models ( p = 0.170). For the model based on ultrasound predictors and placenta previa, the prediction performance comprised: sensitivity = 85.4% (95% CI 70.8–94.4); specificity = 98.5% (95% CI 96.9–99.4); positive predictive value = 83.3% (95% CI 68.6–93.0); negative predictive value = 98.7% (95% CI 97.2–99.5); area under the ROC curve = 0.955 (95% CI 0.912–0.999), p &lt; 0.001. The model based on clinical-anamnestic and ultrasound indicators predicted postpartum hemorrhage with sensitivity equal to 85.4% (95% CI 70.8–94.4); specificity — 98.9% (95% CI 97.4–99.6); positive predictive value — 87.5% (95% CI 73.2–95.8); negative predictive value — 98.7% (95% CI 97.1–99.5); area under the ROC curve — 0.984 (95% CI 0.966–1.0), р &lt; 0,001. Thus, this model outperformed the model based on clinical-anamnestic data (p &lt; 0.001), based on ultrasound predictors (p = 0.006) and revealed no difference with the model considering placenta previa and ultrasound predictors (p = 0.127). Using prenatal prediction of postpartum hemorrhage based on ultrasound features, the incidence of massive blood loss at delivery decreased from 6.88/1000 deliveries (2019–2020) to 4.18/1000 deliveries (2021–2022) (p &lt; 0.001).Conclusion. Ultrasound predictors in pregnant women with uterine scar increase the sensitivity of antenatal prediction of postpartum hemorrhage based on the assessment of clinical and anamnestic risk factors, thereby enabling preventive measures to be scheduled in the risk group and incidence of massive blood loss to be reduced.

Midwifery: legends and myths of Ancient Russia through the eyes of contemporaries

The article presents some data on maternity care in Ancient Russia. The connection of myths and legends of Ancient Russia, Ancient Greece and Rome with modern elements of medical care for women in labor and newborns is traced.

Birth outcomes associated with a natural delivery approach in a perinatal center: A comparative retrospective study.

At our center, natural home-like delivery settings have been established in or near conventional labor wards, for the care of pregnant women who prefer little or no medical intervention during labor and birth. We compared obstetrical and neonatal outcomes of women in active spontaneous labor, between those who chose to deliver in a natural-delivery setup and those who chose a conventional setting. This retrospective study included low-risk women who delivered at term between March 1, 2020 and December 31, 2022, in a single tertiary university affiliated medical center. Birth outcomes were compared between 124 women who delivered by natural birth (the study group) and 244 who gave birth in a conventional setting (the control group). No cesarean deliveries were performed in the study group, compared to 18 (7.4%) of the control group, p = 0.004. Intrapartum fever, postpartum hemorrhage, and uterotonic administration were similar between the groups. For the study compared to the control group, breastfeeding was more common (71.3% vs. 12.3%, p < 0.001), analgesia administration within 48 h delivery was lower (4.1% vs. 10.7%, p = 0.033), and maternal and neonatal length of hospitalization were shorter. Of the women initially admitted to the natural-delivery room, 14 (11.5%) were transferred to a conventional-delivery room. Birth in a hospital natural-delivery setting was associated with increased likelihood of vaginal birth, increased immediate breastfeeding and breastfeeding at discharge, and lower postpartum pain.

Knowledge and attitudes of health care professionals regarding birth preparedness of women in labour at selected Hospitals in KwaZulu-Natal, South Africa: A qualitative study

Introduction Low and middle-income countries account for the largest proportion of women’s deaths as a result of pregnancy or childbirth-related complications. The sub-Saharan region is the most affected with approximately 70% (202 000) of maternal deaths between 2000 and 2020. These deaths could have been prevented if expectant mothers were prepared for childbirth. Birth preparedness is perceived as a better strategy that helps attain a substantial reduction in maternal mortality. This is achieved by attending early antenatal classes, receiving skilled care during childbirth, and care and support right after birth. The latest survey on antenatal class attendance conducted in South Africa provides an estimated 30.8% of expectant mothers in public healthcare facilities. Methods Based on the action research method, this study employed a qualitative approach to collect data, as a result, one focus group discussion with five (N=5) participants and two others with six (N=6) participants each (n=6X2=12) and twenty individual interviews were conducted. The study sought to explore and describe the knowledge and attitudes of healthcare professionals regarding the birth preparedness of women in labour at selected Hospitals in Durban KwaZulu-Natal. Results It was found that expectant mothers were unprepared for both labour and postnatal care. The unprepared expectant mothers were uncooperative and made the task of midwives difficult to the extent of endangering the life of their expected newborn and their own. Factors such as finance, heterogeneity, staff shortage, language barrier, lack of family support, lack of interest, cultural beliefs, and confusion caused by various sources of information were responsible for birth unpreparedness. Conclusion Therefore, the synergy between expectant mothers and midwives appears to be an important factor in achieving better birth preparedness.

Effectiveness of Single Fetal Membrane Sweeping in Reducing Elective Labor Induction for Postdate Pregnancies (38+0 to 40+6 Weeks): A Randomized Controlled Trial.

Postdate pregnancy is characterized by a heightened risk for both maternal and perinatal complications. Owing to the risks, clinicians frequently turn to elective labor induction as a management strategy for postdate pregnancies. However, patients are increasingly informed and apprehensive about this approach and its associated risks. This has prompted a search for alternative management methods that may encourage spontaneous labor in pregnant women. One such approach is the use of fetal membrane sweeping, a method known to increase the likelihood of spontaneous labor onset. Yet, it remains unclear whether a single fetal membrane sweeping procedure can effectively reduce the need for elective labor induction in postdate pregnancies while minimizing risks to both the mother and fetus. The primary objective of this study was to assess the efficacy of a single fetal membrane sweeping procedure conducted between 38+0 and 40+6 weeks of gestation in reducing the rate of elective labor induction among postdate pregnancies at Central Hospital Benin City, Nigeria. Secondary objectives included evaluating the impact of membrane sweeping on maternal and perinatal outcomes. This open-label superiority randomized controlled study was carried out from June 2020 to March 2021, following ethical approval from the Hospital Management Board (HMB). One hundred and forty eligible participants, without contraindications to vaginal delivery, were randomly assigned to one of two groups. The first group received a single fetal membrane sweeping procedure between 38+0 and 40+6 weeks of gestation, while the control group underwent vaginal examination only to assess the Bishop score. Participants weremonitored until delivery.Data analysis was performed. Results were considered statistically significant at p < 0.05. The implementation of a single fetal membrane sweeping procedure effectively reduced the incidence of elective labor induction. Specifically, the membrane sweep group exhibited a significantly lower rate of elective labor induction compared to the control group (9.0% vs. 27.1%; p=0.0083). Moreover, a substantial proportion of the treatment group (91.4%) experienced spontaneous labor, while the control group reported a rate of 72.9%. Thedifference was statistically significant (p=0.0054). Notably, the control group exhibited a significantly longer mean time interval from recruitment to delivery (10.67±3.51 days) than the membrane sweeping group (3.64±4.123 days; p<0.05). Also, postdate women in the membrane sweep group were less likely to require cervical ripening with Foley's catheter than those in the control group (33.3% vs. 100%; RR: 0.33 (0.11-1.03); p=0.0057). Still, maternal satisfaction was significantly higher in the membrane-sweeping group (p<0.01). No significant differences were noted across the groups in maternal and neonatal outcomes. In low-risk term pregnancies, a single fetal membrane sweeping procedure is a superior alternative to no membrane sweeping in reducing the rate of elective labor induction for postdate pregnancies and in shortening the duration of term pregnancy.

More than just joy: A qualitative analysis of participant experiences during nitrous oxide sedation.

Nitrous oxide use is shifting from general anesthesia to sedation and pain control. Interest in novel uses of nitrous oxide in psychiatry is also growing. Thus, understanding the consequences of using nitrous oxide remains relevant. Previous quantitative research might not have fully captured the whole spectrum of nitrous oxide, whereas qualitative analysis can provide a more comprehensive description. This qualitative study aims to describe the subjective experiences of nitrous oxide use in healthy volunteers who have no prior history of recreational substance misuse. Twenty healthy male volunteers inhaled 50% nitrous oxide for 20 min. Females were excluded due to higher incidence of nausea with nitrous oxide. Afterwards, all participants answered an open-ended question about their experiences during sedation. The answers were then analyzed with inductive qualitative content analysis to identify emergent subcategories, categories, and overarching themes. We identified two themes: nitrous oxide is mind-altering and produces sensory overload. The mind-altering properties were represented by dreamlike states and heightened emotions. Dreamlike states comprised changes in consciousness and scary, bizarre, or transcendental dreams. Pleasant dreams were not reported. Heightened emotions included euphoria, anxiety, and fear of losing control. Sensory overload consists of distorted perception, bodily sensations, and a heightened sense of surroundings. Experiences under nitrous oxide sedation are extremely variable and not always pleasant. These findings can improve our understanding of the likes/dislikes of patients undergoing nitrous oxide sedation. Further qualitative studies should focus on the experiences of other groups, such as children or women in labor.

Asymmetric effects of macro policies on women’s and men’s incomes. An empirical investigation of the eurozone crisis in a gender perspective

We study how macro policies affected women’s and men’s incomes during the financial crisis in Europe. We consider the monetary stance, proxied by benchmark interest rates, and the fiscal stance, measured by the variation in public expenditures and public revenues, and investigate how they are associated to women’s and men’s labor and capital incomes, using microdata for 27 European countries between 2008 and 2016. We individualize household-level data by considering four scenarios of intra-household sharing of resources. We also explore how and to what extent macro-policies affect the distribution of labour incomes for men and women by applying a conditional quantile regression approach. Results highlight that the ECB’s expansionary policies had a positive effect on both labor and capital incomes for both men and women, while austerity policies had a mixed impact. Reductions in public expenditure had the effect of reducing labor incomes for both men and women, particularly at the median of the wage and labor distributions. In contrast, increases in public revenues benefited capital incomes, for all income quantiles.

Prevalence of Bacterial Vaginosis and Its Association With Preterm Birth in a Tertiary Care Hospital in Chennai: A Cross-Sectional Study.

Background The most common preventive cause of premature labour is ascending infections.This study was conducted to evaluate the association between bacterial vaginosis (BV) and preterm labour in antenatal women and determine the significance of using the Amsel criteria to screen for BV. Methods This was a hospital-based cross-sectional study conducted among 100 antenatal mothers in the second trimester attending the antenatal OPD at a tertiary care hospital in Chennai from October 2019 to September 2021 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Data were entered in Excel (Microsoft Corporation, Redmond, WA) and analysed in SPSS (IBM Corp., Armonk, NY). Results According to the Amsel criteria, BV was detected in 21 women (21%). Neither maternal age nor parity had an effect on the study group. There was a statistically significant relationship (p < 0.05) between the mode of delivery, preterm labour, and the study group. Of the 21 positive BV cases, 95% were positive for clue cells and only 5% were positive for gram-negative bacteria. Consequently, BV was found to be associated with early labour. There is no association between BMI and BV (p > 0.005). Conclusion In the current study, BV was shown to be associated with preterm labour. Our study underscores the significance of the Amsel criteria as a valuable tool for screening BV in antenatal women.