Labor Outcomes Research Articles

Impact of Lamaze Breathing on Childbirth- Comparison Between Primigravid and Multigravid Women

Introduction: The most basic function of life, breathing promotes awareness, attentiveness, alertness, and focus in women. The Lamaze technique's goals are to promote, maintain, and protect a healthy pregnancy and a safe delivery. In this study, primigravid and multigravida women were compared with respect to the effects of the Lamaze technique on duration of labor and neonatal outcomes. Methodology: Primigravid and multigravid women who met the eligibility criteria were randomized into intervention and standard care groups in a parallel group randomized controlled study. After 36 weeks of pregnancy, the researcher introduced the women in the experimental groups the Lamaze techniques. The length of labor and neonatal outcomes between the primigravid and multigravid women in the intervention group and the standard care group were used to measure the result. Results: The mean duration of labor was shorter in the intervention groups. The Mann-Whitney U test indicated a statistically significant difference in the duration of labor between women who practiced Lamaze breathing during pregnancy and those who did not (U = 5742, p < 0.05). Conclusion: The present study concludes that Lamaze techniques during the antenatal period shortens labor duration and accelerates labor progress, hence facilitating natural childbirth.

Trend analysis of caesarean sections using modified Robson’s classification in a teaching institution in Uttarakhand

ABSTRACT Background: Globally, the rising caesarean section (CS) rate is of great concern as it is associated with increased maternal morbidity and mortality in subsequent pregnancies. It is essential to reanalyze the CS trend and curb the rising menace using a standardized uniform auditing system. This study aimed to analyze and evaluate the trend of CS using Modified Robson’s Ten Group classification system (RTGCS) in a teaching institution in Uttarakhand. Methodology: This cross-sectional study from October 2022 to March 2023 included 260 women undergoing elective or emergency CS. Data on maternal demographics, obstetrics, labour, and fetal outcomes were recorded. Indications for CS were analyzed using modified RTGCS. Results: The overall CS rate for the study period at our hospital was 31.4%. The major contributors to CS were Group 2 (21.5%), Group 10 (21.5%), and Group 5 (20.7%), while Group 6 and Group 8 contributed 10% and 7.6%, respectively. Group 9 had the least share (1%) in the study population. The two main indications for which CS was performed were prior Lower Section Caesarean Section (LSCS) and fetal distress, contributing to 24.6% and 19.2%, respectively. CS for breech presentation was done in 16% of the total cases. Conclusion: Modified RTGCS is an easy and effective method for auditing CS, preventing unnecessary procedures, and improving maternal care. Its implementation is crucial in addressing the increasing prevalence of CS and ensuring better maternal and fetal outcomes.

Maternal and neonatal outcome in pregnant women undergone induction of labor at Muhimbili National Hospital, Dar Es Salaam, Tanzania

IntroductionLabor induction is a common obstetric intervention aimed at initiating labor when spontaneous onset is delayed or deemed necessary for maternal or fetal well-being. Despite its widespread use, the practice’s impact on maternal and neonatal outcomes remains a subject of ongoing research and debate. This study aims to evaluate the maternal and neonatal outcomes associated with labor induction in a tertiary hospital setting in Tanzania.MethodologyA descriptive analytical cross-sectional study was conducted over a seven-month period from January 2021 to July 2021 at Muhimbili National Hospital in Dar es Salaam, Tanzania. A total of 120 pregnant women who underwent labor induction during this period were included in the analysis. Data on maternal demographics, obstetric characteristics, indications for induction, methods of induction, labor outcomes, and neonatal outcomes were collected from medical records and analyzed descriptively.ResultsAmong 4773 deliveries during the study period, 120 women underwent labor induction, accounting for 120 (2.5%) of all deliveries. The most common indications for induction were postdate pregnancy 60 (50%), hypertensive disorders of pregnancy 38 (31.7%), and premature rupture of membranes 22 (17.5%). The majority of induced women 74 (61.7%) delivered vaginally, with 46 (38.3%) undergoing cesarean section. Maternal complications were minimal, with the most common being failed induction of labor 17 (14.2%). Neonatal outcomes were generally positive, with 120 (100%) of neonates having Apgar scores of 7 or higher at five minutes, although 10 (8.3%) required admission to the neonatal ward for further care.ConclusionLabor induction at Muhimbili National Hospital demonstrated favorable maternal and neonatal outcomes, with low rates of maternal complications and positive neonatal Apgar scores. Postdate pregnancy emerged as the most common indication for induction. While the study highlights the benefits of labor induction, its retrospective nature and single-center setting limit the generalizability of findings. Prospective studies with larger sample sizes are warranted to validate these findings and inform evidence-based obstetric practices.

A double-blinded randomised controlled study of fluid restriction versus liberal fluid during induction of labour: A pilot study.

Excess intravenous fluid for women requiring an induction of labour may adversely affect the duration of labour and maternal/neonatal outcomes. This study aimed to determine the difference in duration of labour and outcomes with a low background infusion rate, compared to liberal background intravenous fluid management. A double blind randomised controlled pilot study was performed on 200 women who underwent induction of labour at a single institution. Women were randomised to an intravenous rate of 40 mL/h versus 250 mL/h of Hartmann's solution. Fluid boluses were strictly controlled to limit bias. This trial was registered with the Australian clinical trial registry: ACTRN12621001298808. Analysis of the total amount of fluid received showed good separation with Group 1 (40 mL/h) receiving 1,736 mL less than Group 2 (250 mL/h), median (interquartile range) 841 mL (458, 1691) versus 2,577 mL (1620, 4326) (P < 0.001). Median duration of labour was shorter in Group 1 by 24 min (P = ns). Subset analysis of nulliparous women showed that duration of labour was shorter in Group 1 by 83.5 min (P = ns). As this was a pilot study, a significant difference in duration of labour or secondary outcomes was not seen. Given the increasing numbers of nulliparous women having an induction of labour, potential for adverse maternal and neonatal outcomes and the associated higher rate of operative birth, this study guides power calculations and supports proof of concept for future research into optimum fluid management during induction of labour for these women.

“A Study to Assess the Effectiveness of Video Assisted Teaching Programme on Knowledge Regarding Evidence Based Practice in Labour Practices among Final Year Bsc Nursing Students at Selected College of Nursing, Mysuru.”

Pregnancy-related complications are the second global leading cause of death among women of reproductive age. In 2015, approximately 3,03,000 maternal deaths occurred worldwide, most of which could have been prevented. The application of evidence-based practices in labour at maternity units has shown changes in pregnancy and labour outcomes, hence the researcher undertaken this study. Methods: The research approach adopted for the present study was pre-experimental one group pre-test post-test research design. The 60 samples were selected by nonprobability purposive sampling technique. The self-structured knowledge questionnaires were used to gather the data. The data was analyzed by using the descriptive and inferential statistics. Result: In the pre-test the overall mean percentage of knowledge score was 50.66% with mean and SD of 15.20±1.48 and in post-test the mean percentage of post-test knowledge was 91.76% with mean and SD of 27.53±1.17. The mean difference was 12.33 with SD of 1.90. The calculated paired ‘t’ test value was 50.24 at the degree of freedom 59, the p value was 0.0001. There was no significant association between the demographic variables with pretest knowledge score. Interpretation and Conclusion: The video assisted teaching program was effective in enhancing the knowledge of the samples regarding evidence-based practices in labor. The study recommends to conduct a study on use of evidence-based practices among staff nurses in labor room.

Effectiveness of Childbirth Education and Hypnobirthing Assistance in Improving Labor Outcome

Background: Childbirth education and assistance with hypnobirthing is an autohypnosis technique, namely an effort to instill positive intentions through suggestion into the soul or subconscious mind during pregnancy and preparation for childbirth. This study aims to analyze the effectiveness of childbirth education and assistance with hypnobirthing in improving childbirth outcomes. Subjects dan Methode: The Randomized Controlled Trial (RCT) study was conducted at the Pratama D'Maryam Clinic, Yogyakarta from August to December 2023. A total of 154 pregnant women were selected for this study. Dependent variables are anxiety, depression, complications, and delivery time. The independent variables are childbirth education and assistance with hypnobirthing. Therapy is given 2 times a week with a duration of 3 hours. The study instrument is a questionnaire. Data analysis used Independent T-Test. Results: Providing childbirth education accompanied by assistance with hypnobirthing is effective in reducing anxiety levels in pregnant women (Effect Size= 1.22; p&lt;0.001), reducing depression levels (Effect Size= 1.19; p&lt;0.001), and shortening labor time (Effect Size= 0.08; p = 0.016). Conclusion: Providing childbirth education accompanied by assistance with hypnobirthing is effective in reducing anxiety levels in pregnant women, reducing depression levels, and shortening labor time.

A comparative study between dinoprostone pessary and dinoprostone gel for induction of labor and neonatal outcome

This study compares the safety and efficacy of two dinoprostone formulations – a pessary and a gel. A retrospective randomised observational study was conducted to compare Dinoprostone controlled release pessary and Dinoprostone gel for induction of labor at term in women with unfavourable cervix at Apollo Hospitals BGS, Mysuru during August 2018 – May 2020. Among study participants 50 expectant mothers received Dinoprostone pessary while 50 women received Dinoprostone gel for induction of labour. Both groups were compared and the outcomes were analysed. The primary outcomes of the study were induction to delivery interval, successful vaginal delivery, need for operative vaginal delivery and need for caesarean section. Secondary outcomes were observed for neonatal morbidity and uterine hyperstimulation. There was a significant (p=&amp;#60;0.001) improvement in Bishop scores after induction in both groups. When only the post-induction scores for the two formulations were compared, the pessary helped to improve the bishops score (or helps in cervical ripening) better than the gel formulation and therefore can help to improve the chances of vaginal delivery(because there is a significant change in post induction bishop score in pessary group). The mean interval from induction to delivery for the pessary group was 11.03±4.648 hours and for the gel it was 21.18±9.127 hours with a significant p value &amp;#60;0.005The pessary showed a significant improvement in the post-induction Bishop score and a shorter induction to delivery time compared to the gel. Differences in the mode of delivery were not significant. Fortunately, no serious side effects to the mother or fetus were observed with both products. Both formulations of dinoprostone are safe for induction of labor at term. However, pessary achieves comparitively a higher rate of spontaneous vaginal delivery with a shorter labor induction time. Ease of administration, single application and thus decreased chance of infections are its additional benefits.

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

Management, Utilization, and Outcomes of Preterm Labor in an Integrated Health Care System.

Fetal fibronectin (fFN) testing and transvaginal ultrasound (TVUS) are diagnostic tools used to predict impending spontaneous preterm birth (sPTB) among women presenting with preterm labor (PTL). We evaluated the association between fFN testing or TVUS cervical length (CL) measurement in predicting sPTB, respiratory distress syndrome (RDS), neonatal intensive care unit (NICU) admission, and sPTB-related costs. We conducted a retrospective cohort study using data from the Kaiser Permanente Southern California electronic health system (January 1, 2009-December 31, 2020) using diagnostic and procedure codes, along with a natural language processing algorithm to identify pregnancies with PTL evaluations. PTL evaluation was defined as having fFN and/or TVUS assessment. Outcomes were ascertained using diagnostic, procedural, and diagnosis-related group codes. Multivariable logistic regression assessed the association between fFN and/or TVUS results and perinatal outcomes. Compared with those without PTL evaluations, those with positive fFN tests had higher adjusted odds ratio (adj.OR) for sPTB (2.95, 95% confidence interval [CI]: 2.64, 3.29), RDS (2.34, 95% CI: 2.03, 2.69), and NICU admission (2.24, 95% CI: 2.01, 2.50). In contrast, those who tested negative had lower odds for sPTB (adj.OR: 0.75, 95% CI: 0.70, 0.79), RDS (adj.OR: 0.67, 95% CI: 0.61, 0.73), and NICU admission (adj.OR: 0.74, 95% CI: 0.70, 0.79). Among those with positive fFN results, the odds of sPTB was inversely associated with CL. Health care costs for mothers and neonates were lowest for those with fFN testing only. This study demonstrates that positive fFN results were associated with an increased odds of sPTB, RDS, and NICU admission and the association with sPTB was inversely proportional to CL. Additionally, negative fFN results were associated with decreased odds of sPTB, RDS, and NICU admissions. fFN testing may predict these and other sPTB-related adverse outcomes hence its utility should be explored further. Moreover, fFN testing has some cost savings over TVUS. · Patients with positive fFN tests had higher odds of sPTB, RDS, and NICU admission.. · Inverse relationship between sPTB and CL among those with positive fFN tests was observed.. · Health care costs for mothers and neonates were lowest for those with fFN testing only..

Bouncing your way to labour and birth using biomechanics and fetal optimal positioning

Background/Aims ‘Labour hopscotch’ is a visual tool that encourages activity during pregnancy and childbirth. It has been used in one advanced midwife practitioner service since 2017 and more widely across in Ireland since 2020. The biomechanics for birth toolkit was added to advanced midwife practitioner care in 2022. This study's aim was to ascertain if the biomechanics for birth toolkit impacted gestation of spontaneous onset of labour rates and birth outcomes. Methods A retrospective study of onset of labour and birth outcomes was conducted for women before (n=155) and after (n=154) the biomechanics for birth toolkit was incorporated into care. Results Before the toolkit was included, there was a 57.2% spontaneous onset of labour rate, with 33.2% birthing before 41 weeks. After the kit's inclusion, there was a 72.2% spontaneous onset of labour, with 91.8% birthing before 41 weeks. Induction rates dropped from 42.8% to 27.8%, with emergency caesarean section rates following induction dropping from 33.1% to 23.8%. Conclusions Using the biomechanics for birth toolkit alongside the labour hopscotch tool could increase spontaneous onset of labour rates, optimise physiological birth, reduce inductions and emergency caesarean section following induction.

EFFECTIVENESS OF THE BRADLEY METHOD ON LABOUR OUTCOME IN PRIMIGRAVIDA WOMEN

During pregnancy, women and birthing people build an entourage of support, including a birth companion of choice to provide individualised care by actively participating in the childbirth process. This article examines the Bradley Method, which teaches the birth companion (husband) to coach birthing people using hands-on approaches, including massages, breathing exercises, relaxation techniques and verbal encouragement and its effect on labour outcome, coping response and maternal satisfaction with the childbirth experience.

The Association of Second-Trimester Cervical Length and Gestational Age at Delivery [ID 2683538

INTRODUCTION: Second-trimester transvaginal cervical length (TVCL) under 2.5 cm is a well-established risk factor for preterm birth, although few studies have evaluated delivery outcomes in “normal” cervical length groups. We aimed to evaluate the association of normal TVCL (2.5 cm or greater) tertiles on gestational age (GA) at delivery. METHODS: This is a retrospective cohort study of patients eligible for vaginal birth with singleton term gestations and normal TVCL (at 16–24 weeks of gestation) delivering at a tertiary care center June 2022 to June 2023. Mean GA at delivery and rates of term deliveries were compared by TVCL tertiles (T1: 2.5–3.49 cm, T2: 3.5–4.49 cm, and T3: 4.5 cm or greater). Multivariable logistic regression was used to control for potential confounders. Institutional review board approval was obtained. RESULTS: Of 1,034 eligible deliveries, 984 (95.2%) were term (37 0/7 weeks or greater). Patients with TVCLs in T2 and T3 were significantly more likely to have a term delivery than patients with TVCL in T1 (T2 96.0% versus T1 90.9%, P=.007; T3 96.2%, P=.03). Compared to T1, those with TVCLs in T2 and T3 also had increased odds ratio (OR) of a term birth (OR 2.4 [CI, 1.2–4.8] and OR 2.55 [CI, 1.03–6.7], respectively). After adjusting for confounders, this relationship remained statistically significant (T2 adjusted OR 3.05 [CI, 1.4–6.6]; T3 3.91 [CI, 1.3–11.4]). CONCLUSION: Patients with longer TVCL measured at anatomy ultrasound are significantly more likely to have a term delivery, even after adjusting for confounders. These results can be used to guide patient counseling and expectations for labor and delivery outcomes.

Extending the Effect of Doulas: Digital Health Platforms as an Effective Mechanism for Improving Nonbirth Outcomes [ID 2683473

INTRODUCTION: Doulas are nonmedical trained professionals who provide physical, emotional, and educational support to birthing people throughout their pregnancy and postpartum journey including being present at labor and delivery. In this comprehensive role, doulas help patients advocate for their needs and are able to drive effect on birthing and nonbirthing outcomes. Despite their value, there are significant financial, logistical, and geographical challenges to accessing doula services. This analysis evaluated the association between virtual doula use on Maven, a virtual clinic for women’s and family health, with users’ nondelivery outcomes. METHODS: This retrospective cohort study used data from 8,989 Maven users who gave birth between January 1, 2020, and April 22, 2023. Logistic regression models estimated the association between total number of doula appointments on the digital health platform with odds of reporting that Maven helped with 1) managing anxiety and/or depression and 2) feeling strongly supported throughout pregnancy. This research was deemed exempt by WCG IRB. RESULTS: In adjusted models, attending one or two or more Maven doula appointments was significantly associated with users reporting Maven helped them manage their mental health (one appointment: odds ratio [aOR] 1.28; 95% CI, 1.05–1.56; two or more appointments: aOR 1.78; 95% CI, 1.40–2.26) and helped them feel supported throughout their pregnancy (one appointment: aOR 1.99; 95% CI, 1.74–2.28; two or more appointments: aOR 3.26; 95% CI, 2.70–3.94). CONCLUSION: Digitally accessed doulas drive effects beyond labor and delivery outcomes and break down barriers to accessible holistic care.

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.

Raspberry leaf (Rubus idaeus) use in pregnancy: a prospective observational study

BackgroundRaspberry leaf use during pregnancy in Australia is widespread. There has been little research exploring the potential beneficial or harmful effects of raspberry leaf on pregnancy, labour, and birth. More research is needed to appropriately inform childbearing women and maternity healthcare professionals on the effects of raspberry leaf so that women can make informed choices.MethodsThis study aimed to determine associations between raspberry leaf use in pregnancy and augmentation of labour and other secondary outcomes. Data was derived from questionnaires which captured demographic information and herbal use in pregnancy. Clinical outcomes were accessed from the maternity services’ clinical database. Data analysis was conducted in R via package ‘brms’ an implementation for Bayesian regression models.ResultsA total of 91 completed records were obtained, 44 exposed to raspberry leaf and 47, not exposed. A smaller proportion of women in the raspberry leaf cohort had augmentation of labour, epidural anaesthesia, instrumental births, caesarean section, and postpartum haemorrhage. A larger proportion had vaginal birth and length of all phases of labour were shorter. Under these conditions the use of raspberry leaf was strongly predictive of women not having their labours medically augmented.ConclusionsWhile our study demonstrated that raspberry leaf was strongly predictive of women not having their labours medically augmented, the results cannot be relied on or generalised to the wider population of pregnant women. While there were no safety concerns observed in our study, this should not be taken as evidence that raspberry leaf is safe. A randomised controlled trial is urgently needed to provide women and healthcare providers with robust evidence on which to base practice.

Adequate cardiorespiratory fitness during pregnancy for a better quality of childbirth

Inadequate Cardiorespiratory Fitness (CRF) during childbirth can lead to potential problems, including preterm birth, hypertensive disorders of pregnancy, pain and discomfort during pregnancy, cesarean birth, and postpartum weight gain. This study aimed to assess the relationship between cardiorespiratory fitness during pregnancy and the quality of childbirth. An observational analytic study with a prospective cohort design was conducted among 52 pregnant women in their third trimester of gestation. Respondents were selected based on the purposive sampling technique. The variables - cardiorespiratory fitness, indicated by VO2max value, and the quality of childbirth - were respectively measured using the six-minute walk test and the Quality Childbirth Questionnaire, modified from the Pregnancy and Childbirth Outcome Set (PCB), the Childbirth Experience Questionnaire (CEQ), and the Birth Satisfaction Scale (BSS), which were declared valid and reliable. Data analysis used descriptive and bivariate analysis with the Chi-Square test with a Risk Ratio (RR). The results showed a p-value of less than 0.001, confirming the hypothesis. There is a meaningful link between high VO2 max scores and improved childbirth experiences, with a RR of 6.882 at a 95% confidence interval. This suggests that pregnant women with better cardiorespiratory fitness are 6.882 times less likely to have an adverse labor and delivery outcome. Improving cardiorespiratory fitness through strategic antenatal physical activity with aerobic exercises is recommended to gain a positive childbirth experience.

Snoezelen therapy for pain, labor outcome and maternal satisfaction among parturient at tertiary hospital, South India

IntroductionLabor is a physiological process that causes severe discomfort, leading to maternal dissatisfaction. Snoezelen therapy, a multisensory complementary therapy, promotes comfort and relaxation by releasing endorphins, thereby improving satisfaction during the labor process. ObjectiveTo assess the effectiveness of Snoezelen therapy on pain perception, labor outcomes, and maternal satisfaction among parturients. MethodsAn experimental pretest-posttest control design was conducted among 74 parturient selected using consecutive sampling techniques in South India. Baseline observations were obtained at the beginning of the active stage, after which the study group parturient were subjected to Snoezelen therapy until reaching 10cm of cervical dilatation. Hourly assessments of pain, using a numerical pain scale, were performed. Labor outcomes were measured in terms of labor duration and mode of delivery. Maternal satisfaction with the birth experience and satisfaction with Snoezelen therapy components were collected 24 h after delivery. Descriptive and inferential statistics were used for data analysis. ResultsA statistically significant decrease in pain perception (p < 0.001) and an increase in maternal satisfaction (p < 0.001) were noted among parturient who underwent Snoezelen therapy. Parturient expressed high satisfaction with the use of aroma, music, and massage. There was no statistical significance in the duration of delivery and mode of delivery between the study and control groups. ConclusionSnoezelen therapy reduces pain perception and increases maternal satisfaction during the active stage of labor. Thus, Snoezelen therapy can be implemented as part of nursing care during the labor process.

Efficacy of Prophylactic Intravenous Tranexamic Acid in Preventing Postpartum Haemorrhage in Parturients with Risk Factors: A Randomized Control Trial

This study aims to compare the effectiveness of prophylactic intravenous Tranexamic acid (TXA) dosages of 0.5g and 1.0g in the prevention of postpartum haemorrhage (PPH) among parturient with risk factors. The research followed a randomized, double-blind, controlled experimental design, spanning nine months. Simple random sampling was used to select 154 participants to each arm. The research objectives encompassed comparing labour outcomes of the two groups and measuring blood loss via pre and post-delivery packed cell volume. Statistical analysis employed Student's t-test. Result revealed a slight non-significant difference in PCV change between 0.5g and 1.0g TXA group. The study also found that the risk of developing primary PPH when using 0.5g TXA was approximately twice the risk when using 1.0g TXA. These findings suggest that the prophylactic use of 1.0g TXA may be more effective in preventing PPH compared to 0.5g TXA. Further research is warranted to validate these results and refine recommendations for clinical practice.

Evaluation of the Effect of Body Mass Index on Labor Progress in Mothers Undergoing Epidural Analgesia: A Double-Blind Randomized Clinical Trial

The present study evaluates the association between epidural analgesia and the duration of the active phase of labor and pregnancy outcomes in mothers with high body mass index (BMI). All term pregnant women undergoing epidural analgesia for pain-free labor entered the study from September 2016 to March 2020. After recruiting 300 subjects into the study, mothers were categorized into six groups based on their BMI levels. Each BMI sub-group was analyzed regarding the duration of the active phase of labor and delivery mode. In addition, the relationship between BMI and labor outcome and characteristics was studied. Overall, 300 laboring women with epidural analgesia were included. 79.3% had a vaginal delivery, and 20.7% undergo cesarean section. Different BMI sub-groups showed no significant difference regarding the duration of the active phase of labor under epidural analgesia. Cox regression analysis revealed that BMI had no significant effect on the length of the active phase of labor (P=0.787). No significant association was found between BMI and the cesarean delivery rate, uterine atony, maternal pyrexia, neonatal Apgar score, and NICU hospitalization rate. However, BMI was significantly associated with the incidence of dystocia and headache. labor with dystocia exhibited a significantly higher Mother’s BMI (P&lt;0.05). The results suggest no significant association between epidural analgesia and the active phase of labor duration in mothers with high BMI.