Women In Labor Research Articles

Women in the Sky: Gender and Labor in the Making of Modern Korea

Women in the Sky: Gender and Labor in the Making of Modern Korea

Implementation of glucose 5% supplementation protocol to reduce the duration of labor among women with cervical ripening by prostaglandins: The GLUCOSHORT before-and-after study.

Previous publications have shown that glucose supplementation could reduce labor duration in women with induction of labor with a favorable cervix but none have shown it for women with an unfavorable cervix. The purpose of our study was to assess the impact on labor duration of a protocol of glucose supplementation used for induction of labor in women with an unfavorable cervix. The protocol implemented in November 2017 added glucose supplementation by 5% dextrose at 125mL/h to Ringer lactate for women with an unfavorable cervix with labor induced with dinoprostone gel. The study included women who underwent this protocol with a singleton, term, cephalic fetus from June 2017 through April 2018. The primary outcome was the labor duration. The secondary outcomes were mode of delivery, postpartum hemorrhage rate, neonatal outcomes, and durations other stage of labor. These outcomes were compared between the pre-intervention (from June 1 to October 31, 2017) and post-intervention (from December 1, 2017 to April 30, 2018) periods. The pre-intervention period included 116 women, and the post-intervention period 123. The characteristics of women and the induction of labor were similar in the two periods. The median duration from induction to delivery was not significantly different between the two periods (13.2h, IQR 9.1-18.6 versus 13.6h IQR 9.3-18.3, P=.67). The secondary outcomes did not differ significantly between the two groups. Glucose supplementation administered to women with an unfavorable cervix undergoing induction does not appear to reduce the induction-delivery duration.

A descriptive study to assess the difference between estimated fetal weight using Johnsons formula and the actual birth weight of newborn babies born to women availing maternity services in a tertiary care hospital, Haryana

Introduction: Knowledge about weight of the fetus in-utero is important for the health care professionals to decide upon the antepartum as well as intrapartum initiatives and thereby reducing fetal complications. Johnson’s formula is one of the important and easiest methods of clinical estimation of fetal weight. The aim of the study was to assess the difference between estimated fetal weight calculated by Johnson’s formula and actual birth weight of newborns, to associate and correlate selected maternal and fetal variables with the estimated fetal weight and actual birth weight. Methods: The study sample was 110 term pregnant women in labour and their just born babies. Research approach - quantitative non-experimental descriptive. Tool - data sheet. Data analyzed using descriptive and inferential statistics.Result: The difference between estimated fetal weight and Actual birth weight had a mean of 774.9 and SD ± 403.21. Study revealed that the estimated fetal weight using Johnson’s formula had a difference in comparison with the actual birth weight of babies (371.69 to 1178.1).Discussion: Obstetric Score (OS) Mean 1.59 SD ± 0.76, Period of Gestation (POG) Mean 39 SD ± 1.2. Pre-delivery Weight Mean 64.5 SD ± 9.839. Post-delivery Weight Mean 61.4 SD ± 9.28. Estimated fetal weights (EFW) range 2945 to 4340gms. (Mean 3800.7 SD ± 295.9), Actual birth weight (ABW) range 2120gms to 4145gms (Mean 3025.8 SD± 388.5). Placental Weight Mean 516 SD ± 112.7. Chi square test revealed that there was no association between obstetric score, period of gestation and estimated fetal weight. Similarly Fisher’s exact test revealed that there was no association between obstetric score, period of gestation and actual birth weight.

UNDERSTANDING THE PHENOMENON OF LABOUR ROOM VIOLENCE AGAINST PREGNANT WOMEN: PERCEPTIONS AND PRACTICES OF HCP'S AND CHANGES AFTER RMC PRACTICES

Objectives: To understand the phenomenon of labour room violence against women and HCP's perceptions of behaviours constituting mistreatment in labour room, to study the factors responsible for mistreatment in labour rooms and to study the changes after training of RMC practices. Methods: This study analyses mixed-methods data obtained through systematic clinical observations and open-ended comments recorded by the observers to describe care and in -depth interview to capture HCPs perception of labour room violence. Findings: There are 7 major categories of disrespect and abuse that women encountered during childbirth in health facilities which are verbal abuse, non-consented clinical care, non-condential care (including denial of privacy), non-dignied care, discrimination based on specic patient attributes, abandonment or denial of care and detention in facilities.(1) According to the present study, these forms of mistreatment has been drastically reduced in our institute in addition to which good RMC practices are adopted, so that a woman can experience decent & ethical but an honourable start towards her motherhood. Conclusions: Training of HCPs to understand the concept of respectful maternity care, development of a handbook with standard operating protocols(14) for women in labour, introduction of different birthing positions as well as birth companions were described as key components to inculcating respectful maternity care. The programme was on going one, with respectful maternity care practices being passed on from older to newer staff through a system of continuous teaching and guidance on the job, hence institutionalising these new practices through constant engagement, supervision and incremental.

A descriptive study to assess the difference between estimated fetal weight using Johnsons formula and the actual birth weight of newborn babies born to women availing maternity services in a tertiary care hospital, Haryana

Introduction: Knowledge about weight of the fetus in-utero is important for the health care professionals to decide upon the antepartum as well as intrapartum initiatives and thereby reducing fetal complications. Johnson’s formula is one of the important and easiest methods of clinical estimation of fetal weight. The aim of the study was to assess the difference between estimated fetal weight calculated by Johnson’s formula and actual birth weight of newborns, to associate and correlate selected maternal and fetal variables with the estimated fetal weight and actual birth weight. Methods: The study sample was 110 term pregnant women in labour and their just born babies. Research approach - quantitative non-experimental descriptive. Tool - data sheet. Data analyzed using descriptive and inferential statistics.Result: The difference between estimated fetal weight and Actual birth weight had a mean of 774.9 and SD ± 403.21. Study revealed that the estimated fetal weight using Johnson’s formula had a difference in comparison with the actual birth weight of babies (371.69 to 1178.1).Discussion: Obstetric Score (OS) Mean 1.59 SD ± 0.76, Period of Gestation (POG) Mean 39 SD ± 1.2. Pre-delivery Weight Mean 64.5 SD ± 9.839. Post-delivery Weight Mean 61.4 SD ± 9.28. Estimated fetal weights (EFW) range 2945 to 4340gms. (Mean 3800.7 SD ± 295.9), Actual birth weight (ABW) range 2120gms to 4145gms (Mean 3025.8 SD± 388.5). Placental Weight Mean 516 SD ± 112.7. Chi square test revealed that there was no association between obstetric score, period of gestation and estimated fetal weight. Similarly Fisher’s exact test revealed that there was no association between obstetric score, period of gestation and actual birth weight.

Planned vaginal delivery versus planned caesarean section for breech presentation at term

Unless favourable conditions are present, breech vaginal deliveries are less commonly performed. The aim of this study was to compare the neonatal outcomes of women with breech fetuses who underwent trial of labor for breech delivery versus women who had a planned caesarean section.

Procalcitonin levels in pregnancy: A systematic review and meta-analysis of observational studies.

The utility of procalcitonin to identify obstetric sepsis is unknown. To calculate the mean (range) procalcitonin in pregnancy among healthy women not in labor (group 1), healthy women in labor (group 2), and women with preterm prelabor rupture of membranes (PPROM) without clinical chorioamnionitis (group 3). NLM PubMed, Elsevier Embase, and Wiley Cochrane Central Register of Controlled Trials from inception to February 21, 2022. Ten or more pregnant women with procalcitonin reported at more than 20 weeks of pregnancy, with information on labor, PPROM, and infection. Exclusions were major medical comorbidities. Each abstract and full-text review was independently reviewed by the same two authors. Quality was reviewed using the Newcastle-Ottawa Scale. A meta-analysis was performed using a random effects model. The systematic review included 25 studies: 10 (40%) of good quality and 15 (60%) of poor quality. The meta-analysis included 21 studies. Mean procalcitonin in group 1 was 0.092 ng/mL (range 0.036-0.049 ng/mL), in group 2 it was 0.130 ng/mL (range 0.049-0.259 ng/mL), and in group 3 it was 0.345 ng/mL (range 0.005-1.292 ng/mL). Among healthy pregnant women not in labor, procalcitonin levels are comparable to those in non-pregnant adults and may be useful in identifying infection. Procalcitonin levels in other groups overlap abnormal values of procalcitonin in non-pregnant adults, and may not discriminate infection among women in labor or with obstetric comorbidities. CRD42020157376, registered 4/28/2020.

Quantitative cervicovaginal fetal fibronectin as a predictor of cervical ripening and induced labour duration in late-term pregnancy

We evaluated quantitative cervicovaginal foetal-fibronectin as a predictor of cervical ripening and labour duration in late-term pregnant women with an unfavourable cervix. This was an analytical cross-sectional study wherein 152 women, with late-term pregnancy and unfavourable cervix, at 41weeks3days gestational age, had pre-induction quantitative cervicovaginal foetal-fibronectin determined using ELISA. Data were compared in nulliparas and multiparas at a significance level < 0.05. The mean age of late-term pregnant women was 30.4 ± 4.3 years. Median cervicovaginal foetal-fibronectin levels in nulliparous and multiparous women were 45.35 ng/ml and 46.93 ng/ml respectively(p = 0.289). The correlation between foetal-fibronectin levels and cervical ripening duration was poor in nulliparous(r = 0.014) and multiparous(r = 0.024) women. The Youden’s foetal-fibronectin cut-off level had a sensitivity of 53.5% and specificity of 71.6% in predicting cervical ripening duration of > 12 hours in late-term pregnancy with an area under the ROC curve of 0.634. Quantitative cervicovaginal foetal-fibronectin is a poor correlate and predictor of cervical ripening and induced labour duration in late-term pregnancy. IMPACT STATEMENT What is already known on this subject? Cervicovaginal foetal fibronectin is useful in the prediction of preterm delivery but its role in prolonged pregnancy is unclear. What the results of this study add? Cervicovaginal foetal fibronectin is a poor correlate and predictor of cervical ripening and induced labour duration in late-term pregnancy What the implications are of these findings for clinical practice and/or further research? Cervicovaginal fibronectin should not be used to predict ease and success of cervical ripening and induction of labour in women with late-term pregnancy.

Use of External Uterine Electromyography Across Stage I Labor.

Highly sensitive, external uterine electromyography (EMG) measures myometrial electrical activity and is noninvasive compared with the clinical intrauterine pressure catheter. Most experimental studies have measured EMG in 30-minute epochs, limiting the utility of this instrumentation in intrapartum clinical practice. To test proof of concept, surface uterine EMG contraction activity was continuously collected throughout the first stage of labor from healthy women at term gestation with (n = 3) and without (n = 1) epidural or combined spinal-epidural analgesia for a maximal length of 11 hours and 24 minutes. EMG activity was recorded concurrently with tocodynamometer (toco) signals, using a pair of electrodes on the left and right sides of the maternal umbilicus with grounds attached to both hips of the reclining woman in labor. The preamplifier cutoff frequency settings were appropriate to monitor smooth muscle contraction in labor, with the analog high-pass filter set at 0.05 Hz and the low-pass filter at 1.50 Hz. Signals were sampled at 100 Hz, transmitted to a computer, and visualized by Chart 4.2 software. EMG data from epochs at baseline, during the pre-epidural fluid bolus and at the 60-minute post-epidural test dose, and at 3, 5, 6, and 8 cm dilatation were analyzed for burst power spectrum peak frequency (Hz), burst power spectrum amplitude (mV2 ), and burst duration (seconds). Uterine EMG contractile bursts were preceded and followed by a stable baseline and coincided with toco contractions. Movement artifacts were negligible, and large movement artifacts were easily distinguishable. The EMG bursts and toco contractions remained clearly identifiable, even when one woman without epidural analgesia stood beside the bed laboring for approximately 10 minutes. Burst spectral components fell within the expected 0.34-to-1.00 Hz range for term labor. High-quality data demonstrate that EMG instrumentation effectively and accurately measures uterine contraction parameters across the first stage of term labor.

Delivery features of pregnant women with a uterine scar

Vaginal delivery after a Caesarean section remains a controversial topic: there is a lack of reliable data to help doctors and women in labour to determine the best option for delivery during subsequent pregnancy. The review analyzed and summarized the results of the studies devoted to childbirth of pregnant women with scars on the uterus, considered the advantages and disadvantages of vaginal childbirth and repeat Caesarean section, the frequency of complications in the attempt of vaginal childbirth in women with scars on the uterus has been assessed. The modern medical literature available in open sources has been studied: Russian-language scientifc electronic libraries eLibrary and CyberLeninka, Englishlanguage database of medical and biological publications PubMed. It is necessary to consider the data of anamnesis and clinical-instrumental data when choosing the best management tactics of pregnancy and delivery for women with scars on the uterus. Attempting to deliver vaginally helps to reduce maternal and neonatal morbidity, and a large number of studies on this issue should help to reduce the number of unwarranted repeat Caesarean sections. Vaginal delivery after a Caesarean section is an opportunity to avoid severe abdominal surgery and negative consequences associated with repeated Caesarean sections.

Atosiban-induced acute pulmonary edema: A rare but severe complication of tocolysis

BackgroundAtosiban is commonly used to delay premature labor in pregnant women and is thought to have few side effects. ObjectivesTo report a case of acute pulmonary edema (APE) following administration of atosiban and conduct a systematic review to identify common characteristics and risk factors of atosiban-associated APE. MethodsSearches were performed in Pubmed, Embase, and Web of Science using the keyword “Atosiban” combined with the terms “Pulmonary edema” or “Dyspnea” or “Hypoxia” on 9th July 2022. Only case reports of atosiban-associated APE were included without language restrictions. Data were extracted from the reports, and median, range, and percentages were calculated as applicable. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for case reports. ResultsSeven cases of atosiban-associated APE were included in the systematic review, including our case. APE occurred at a median gestational age of 32 + 6 weeks. Most patients were nulliparous (6/7, 85.7%) and were in multiple pregnancies (5/7, 71.4%). All patients were prescribed antenatal corticosteroids and tocolytics, with three (42.9%) receiving only atosiban and four (57.1%) receiving atosiban and other tocolytics. The median interval from starting atosiban administration to APE onset was about 40 h, and three patients (42.9%) showed symptoms 2–10 h after the end of atosiban treatment. Radiographic examinations (chest X-ray and/or computer tomography scan) confirmed APE in all patients and pleural effusion in four patients (57.1%). Five patients (71.4%) underwent emergency cesarean section, one patient (14.3%) with twin pregnancy had vaginal delivery with the help of suction cup and forceps, and another patient (14.3%) continued the pregnancy. All patients recovered well after administration of oxygen, diuresis, and other supportive therapy. ConclusionAtosiban may cause acute pulmonary edema in patients with underlying risk factors. This complication remains rare, but caution during tocolytic treatment using atosiban is recommended.

Pregnancy complicated by iron deficiency anemia: does the problem have a solution?

Introduction. The problem of iron deficiency anemia by pregnant women remains relevant due to the wide spread of this complication (up to 40%) and requires the search for effective drugs with a minimum number of side effects.Aim. To improve perinatal outcomes in patients with iron deficiency anemia.Materials and methods. A retrospective analysis was done for 2020 of the medical records of patients, including an exchange card and birth histories. The patients were selected by a continuous sampling method. The study was conducted at the clinical base of the Department of Obstetrics and Gynecology with the course of perinatology of the Peoples’ Friendship University of Russia (Head of the Department, Corresponding Member of the Russian Academy of Sciences, Professor V.E. Radzinsky). All the patients (n = 114) were divided into three groups: the first group (n = 54) – a study group, which included pregnant women who had iron deficiency anemia in the II or III trimesters and received antianemic treatment; the second group (n = 30) – pregnant women with iron deficiency anemia (diagnosed in the 2nd trimester) who did not take iron supplements, the third group (n = 30) – a control group of women with normal hemoglobin levels during pregnancy and delivery.Results. The use of ferrous sulfate (Sorbifer durules) at a dose of 200 mg per day by pregnant women with IDA led to the fact that the weight-height parameters in newborns did not differ from those of children from healthy puerperas. At the same time, the volume of blood loss was greater in patients with IDA, however, there were no massive bleedings and moderate IDA in the postpartum period. The level of hemoglobin was significantly higher in women in labor who received ferrous sulfate (Sorbifer Durules) from the II trimester compared with pregnant women who had IDA in the III trimester. Thus, further research and the search for optimal dosages are required, as well as determining the most effective period for the use of iron supplements.Conclusions. Good tolerability and high efficacy of Sorbifer Durules in relation to a significant increase in hemoglobin and the absence of severe complications of pregnancy and childbirth associated with anemia allow us to recommend it for the treatment of IDA in pregnant women and puerperas.

Umbilical cord hematoma – a successful case of a non-frequent acute fetal distress etiology

Background: Umbilical cord hematoma is a rare condition, with mortality rates up to 50%. Most of the literature describes cases with poor prognosis. Case description: In this case, a healthy pregnant woman in labor presented some variable decelerations on the fetal heart rate monitoring ending in sustained bradycardia. An emergency C-section was performed, giving birth to a 40-weeks male newborn with an umbilical cord hematoma until placental insertion and, slightly stump bleeding. Newborn got pale and, had respiratory distress in the first hour of life. He presented transient metabolic acidosis with hyperlacticaemia and, anemia. There was a favorable evolution with supportive therapy. No risk factor was identified and, histological examination confirmed the diagnosis. The patient remained asymptomatic and, presented normal neurodevelopment during follow-up. Discussion: This case report aims to demonstrate a good outcome when a high level of suspicion is taken and immediate medical and, surgical interventions are performed

Alternative Birthing Positions Compared to the Conventional Position in the Second Stage of Labor: A Review.

The position in which the woman delivers has a lot of impact on the ease of delivery.Women's satisfaction with their birthing experience and the care they receive is significantly impacted by the fact that giving birth is frequently a challenging experience. Birthing positions refer to various postures which can be assumed at the time of delivery by a pregnant woman.Currently, the majority of women give birth either while lying flat on their backs or in a semi-sitting position.Upright positions, which include standing, sitting, or squatting along with side-lying and hands-and-knees, are less common birth positions. Doctors, nurses, and midwives are among the most important healthcare professionals, having a significant influence in deciding which position the woman will give birth in and on the physiological and psychological effects of the experience of a woman in labor. There isn't much research to back up the best position for mothers during the second stage of labor. This review article aims to review and compare the advantages and risks of common birthing positions and know about the knowledge of alternative birthing positions among pregnant women.

Prevalence and risk factors for serious birth concerns in unselected population of mothers.

The aim of the study was to determine the prevalence of severe fear of childbirth in a group of pregnant women, to determine the risk factors, and to prove the impact of the fear of childbirth on various obstetrics outcomes in this group. The study population consists of pregnant women who gave birth at the 2nd Gynecology and Obstetrics Department of the Faculty of Medicine, Comenius University and University Hospital Bratislava, from January 1st, 2022, until April 31st, 2022. After signing an informed consent, the pregnant women were given a Slovak version of the Wijma Delivery Expectancy Questionnaire (S-WDEQ), which is a psychometric tool to evaluate the prevalence of severe fear of childbirth. They were given the S-WDEQ during the 36th and 38th week of gestational age. The childbirth data were collected from the hospital information system after the delivery of the baby. The studied group consists of 453 pregnant women who fulfilled the inclusion criteria. Extreme fear of childbirth was identified using S-WDEQ in 10.6% (48) of them. Level of education and age were not considered to be significant predictors of fear of childbirth. Statistically significant difference was not found in terms of the age groups and groups with different levels of education. At the edge of the statistical significance were primiparas, who made up 60.4% (RR: 1.29; 95% CI: 1.00-1.68; P = 0.0525) of all women with severe fear of childbirth. Women with a history of cesarean section were significantly more frequent in the group of women with serious concerns about childbirth (RR: 3.83; 95% CI: 1.56-9.40; P = 0.0033). Women who gave birth by cesarean section due to the indication of non-progressive labour were also more often represented in the group of women with serious concerns about childbirth (RR: 3.01; 95% CI: 1.07-8.42; P = 0.0358). A higher S-WDEQ score at the 36th week of gestational age in a group of primiparous women increased the statistical probability of cesarean delivery (P = 0.0030). The statistical results are not showing the impact of fear of childbirth on the induction success and the duration of the first stage of labour in primiparous women. The fear of childbirth prevalence is relatively high and it has impact on the outcome of childbirth. The use of a validated questionnaire as a screening tool to search for women with childbirth fear could positively influence their concerns by following psychoeducational interventions in clinical care settings.

The duration of labor in spontaneous preterm deliveries: A retrospective observational study in a tertiary Irish maternity hospital

BackgroundPreterm deliveries account for 10% of all births, and are the most important cause of neonatal mortality globally. Despite their frequency, there is a paucity of information known about usual patterns of preterm labor, as previous studies which critically defined the normal progression of labor excluded preterm gestations. ObjectiveTo compare the durations of the first, second and third stages of spontaneous preterm labor in nulliparous and multiparous women at varying preterm gestations. MethodsA retrospective observational study was undertaken of women admitted in spontaneous preterm labor from January 2017 to December 2020 with viable singleton gestations between 24 and 36 + 6 weeks’ gestation who then proceeded to have a vaginal delivery. There were 512 cases following exclusion of preterm inductions of labor, instrumental vaginal deliveries, provider-initiated pre-labor Caesarean sections and emergency intrapartum Caesarean sections. The data was then examined to determine our outcomes of interest including the durations of the first, second and third stages of preterm labor, analyzing results by parity and gestation. For comparison, we reviewed data of term spontaneous labors and spontaneous vaginal deliveries during the same study period, identifying 8339 cases. Findings97.6% of participants achieved a spontaneous cephalic vaginal delivery with the remainder undergoing an assisted breech birth. 5.7% of gestations delivered spontaneously between 24 + 0 and 27 + 6 weeks, with most births at gestations greater than 34 weeks (74%). The second stage duration (mean 15 vs 32 vs 32 mins respectively) was significantly different across the three gestation periods (p < 0.05), but was notably much quicker in extremely preterm labors. The first and third stage durations were similar between all gestational age groups with no statistically significant differences in results. There was a significant influence of parity on the first and second stages of labor, with multiparous women progressing more quickly than nulliparae (p < 0.001). ConclusionThe duration of spontaneous preterm labor is described. Multiparous women progress more quickly in the first and second stages of preterm labor than nulliparous women.

Effect of spinal anesthesia with sufentanil on length of stages I and II of labor in singleton pregnant women: a randomized controlled trial

BackgroundLabor pain is one of the most painful experiences in a women's life. One of the methods of pain relief is spinal anesthesia. The purpose of this study was to evaluate the effect of spinal anesthesia with sufentanil on the length of the first and second stages of labor in singleton pregnant women. MethodsA randomized clinical trial was conducted involving 56 women who had to be at least 37 weeks pregnant with a singleton pregnancy and 20 to 35 years of age, as well as seeking a spontaneous natural delivery. They were randomized into an intervention group (spinal anesthesia with sufentanil) of 28 subjects and a control group (no spinal anesthesia) of 28 subjects. Statistical analysis was performed using SPSS software program 20.0. ResultsMean duration of stage I of labor was 152.32 ± 92.01 and 187.68 ± 121.01 minutes in the intervention and control groups, respectively (p=0.34), whereas mean duration of stage II of labor in the 2 groups was 15.96 ± 14.26 and 26.43 ± 20.90 minutes, respectively (p=0.06). Twenty five percent of women in the intervention group and 35.71% of women in the control group experienced a long stage I, whereas 21.43% of women in the intervention group and 35.71% of women in the control group experienced a long stage II (p&gt;0.05). ConclusionThis study suggests that spinal anesthesia with sufentanil does not increase the duration of labor stages. It is recommended that more studies be performed in the future using larger sample sizes to allow for the drawing of solid conclusions.

Regendering Childbirth: Catholicism, Medical Activism, and Birth Preparation in Post-War Poland

This article examines the work of the gynecologist Włodzimierz Fijałkowski, the key promoter of preparation for childbirth in Communist and early democratic Poland. From the late 1950s until the 1990s, Fijałkowski developed a childbirth preparation training protocol that served as an inspiration for childbirth preparation schools across the country. Through analysis of Fijałkowski's publications in medical journals, books aimed at both professional and lay readers, visual aids for childbirth training, and archival material, we demonstrate that a specific vision of gender roles and relationships lay at the core of Fijałkowski's psychoprophylactic project. This vision represented a re-definition and re-essentialization of femininity and masculinity, and motherhood and fatherhood, while simultaneously advocating for radical change in the relationship between women in labor and obstetric professionals. Fijałkowski's ideas and advocacy were intimately connected with a humanization of the embryo and fetus from the earliest stages of pregnancy, and we show how his work became an important transmission medium for the gradual mainstreaming of anti-abortion ideas within public discourse in late-Communist Poland.

Correlation of Cardiotocography with neonatal outcome in term pregnancies at a tertiary care centre in Bihar, India: A prospective observational study

Early recognition of foetal distress by intrapartum cardiotocography (CTG) has a pivotal role in the improvement of perinatal outcome. So, the aim of this study was to correlate the findings of CTG with neonatal outcome.This Prospective Observational study was conducted on 300 pregnant women in labour having singleton term pregnancy with cephalic presentation. Intrapartum cardiotocography was done. CTG pattern was correlated with neonatal outcomes by analysing Apgar score, NICU admission and neonatal mortality rate. Statistical analysis was done by using chi square test and Fisher Exact test and p value &amp;#60; 0.05 was considered as statistically significant.Out of 300 patients, reactive CTG pattern was observed in 67% while suspicious and pathological pattern was observed in 22% and 11% of pregnancies respectively. The percentage of caesarean deliveries were significantly more among abnormal CTG group as compared to reactive group (p value &amp;#60; 0.0001). The sensitivity and specificity of CTG for predicting foetal distress and NICU admission was 80 % and 78.75% respectively. There was high NPV of 94.03%, and the diagnostic accuracy of test was 79%.Reactive CTG is more predictive of favourable neonatal outcomes while Pathological CTG tracing requires immediate intervention. Suspicious CTG requires close observation during intrapartum period after correcting underlying causes and taking conservative measures and Immediate delivery is not required unless it became pathological and hence caesarean section rate can be reduced in this group Overall, intrapartum CTG is an important screening tool for early identification of foetal distress.

Pain Intensity, coping and maternal satisfaction in Low-Risk labouring Women: A prospective descriptive correlational study

ObjectivesThe primary aim of the study was to explore pain intensity (PI) and pain coping (PC) scores and the relationship between them. The secondary aim was to explore the correlation between PI and PC scores with labour progress, parity, labour acceleration, labour augmentation and maternal satisfaction. MethodsA prospective descriptive correlational study was conducted in a maternity hospital in Northern Italy. The sample included 54 low-risk women in active labour at term of pregnancy. A data record sheet was used to collect the relevant variables and the Italian Birth Satisfaction Scale Revised (I-BSS-R) was administered to participants at least 24 h after birth. ResultsIn the first labour stage, the average PI score was 6.99 (SD = 1.95) and the average PC score was 6.5 (SD = 2.22). During the second labour stage, the average PI score was 7.75 (SD = 1.74) and the average PC score was 4.97 (SD = 2.76). The average PI score trend increased with labour progress. The average PC score improved between 4 and 7 cm of cervical dilatation. A significant positive correlation between PI scores and oxytocin augmentation (p < 0.001) and labour progression (p < 0.001) was noted. A significant positive correlation between PC scores and oxytocin augmentation (p = 0.02) was also observed. No significant differences were found for maternal satisfaction in regard to PI and PC scores. Conclusioncoping in labour do not solely depend on PI but also on labour progress and oxytocin augmentation. Additional support to empower women to cope with pain may be required in case of labour augmentation.