Occurrence Of Labor Research Articles

Role of hydroxyprogesterone caproate injection in prevention of preterm labour in high risk patients for preterm delivery.

Preterm labour is occurrence of labour after 24 completed weeks of gestation and before 37 weeks of gestation are completed. In Asia preterm birth rate is quoted to be 9.1% while in Pakistan it is 15.7%. To establish role of hydroxyprogesterone caproate injection in prevention of preterm labour in high risk patients for pre-term delivery. Study Design: Descriptive case series. Setting: Obstetrics & Gynaecology Department at Nishtar Hospital Multan. Period: 25th October 2017 to 25th April 2018. Materials and Methods: 148 pregnant patients who were at high risk of pre-term delivery, women with any parity and singleton pregnancy and ongoing pregnancy between 24 to 36 gestational weeks were taken in the study. Patients having multiple pregnancy, fetal membrane rupture, having any contraindication to progesterone or taking medicines having interaction with progesterone were excluded from the study. All patients included in the study were given 250mg/ml hydroxyprogesterone caproate injection on weekly basis by intramuscular route. Injections were given till 36 completed gestational weeks or till the time of delivery which ever happened earlier. Patients who had pre-term delivery were managed as per standard protocol. Information was recorded in form of efficacy on a specially design proforma. Results: In the study range of age was 18-35 years and mean was 28.486 ± 2.79 years. 30.405 ± 2.42 weeks was mean for gestational age. Mean for prior pre-term delivery was 0.520 ± 0.83 and 26.398± 1.44 kg/m2 was mean BMI. 70.3% patients showed efficacy of drug. Conclusion: Results of study showed that hydroxyprogesterone caproate injection given as 250mg/ml on weekly basis causes significant decline in occurrence of recurrent pre-term delivery in high risk patients for pre-term delivery.

, (Occurrence of Labor and Conflict Conflicts in the Organization, Decisions at a Mobbing Situation)

Bulgarian Abstract: От правна гледна точка терминът „моббинг означава несправедливо отношение (съзнателно създаващо неблагоприятни условия на служителя), освобождаване на служителя или дискриминация срещу него от страна на работодателя или други работници. Това е ситуация, при която асистентите на организацията са изправени пред конфронтация от колеги и често от ръководството“. Последиците от „моббинг са предсказуеми, не само за здравето на работника или служителя. Известно е, че една трета от нашия живот е посветен на работа и ако нещо се обърка, качеството на живота ни се намалява. В същото време последствията за самата организация, в която се прилага този „моббинг . Всичко това е свързано с разход на енергия. Всички участници във веригата се концентрират върху този процес и истинската работа остава на второ място. Много от проблемите са междуличностна основа, те просто могат да бъдат решени чрез изслушване. Целта на настоящата разработка е да се натрупат достатъчно доказателства и аргументи, за да получи обществото необходимата степен на увереност, че по пътя на промени в мисленето и най-вече на ефикасно практическо приложение на обосновани от адаптирането на управленски модели могат да бъдат достигнати високи нива на ефективност на всички йерархически нива в ключови системи за обществото и държавата. English Abstract: From the legal point of view, the term mobbing means unfair treatment (consciously creating for the employee unfavorable conditions), dismissing the employee or discriminating against him by the employer or other workers. This is a situation where the organization's assistants face confrontation by colleagues, and often by management. The consequences of the mobbing are predictable not only for the health of the employee. It is known that one-third of our life is devoted to work, and if something goes wrong, the quality of our life is reduced. At the same time, loss is incurred by the very organization in which this mobbing is applied. All this is related to energy consumption. All participants in the intrigue concentrate on this process and the real work remains second. Many problems of interpersonal interaction can simply be solved by talking to each other as human beings. The aim of the present paper is to gather sufficient evidence and arguments in order to get for the society the necessary degree of assurance that following the path of changes in thinking and, most of all, following the effective practical application of management models, high levels of effectiveness can be achieved on all hierarchical levels in key systems for society and the state.

Mother-to-child transmission of human immunodeficiency virus in aten years period

Objectivesto evaluate mother-to-child transmission (MTCT) rates and related factors in HIV-infected pregnant women from a tertiary hospital between 2000 and 2009.Subjects and methodcohort of 452 HIV-infected pregnant women and their newborns. Data was collected from recorded files and undiagnosed children were enrolled for investigation. Statistical analysis: qui-square test, Fisher exact test, Student t test, Mann-Whitney test, ANOVA, risk ratio and confidence intervals.ResultsMTCT occurred in 3.74%. The study population displayed a mean age of 27 years; 86.5% were found to have acquired HIV through sexual contact; 55% were aware of the diagnosis prior to the pregnancy; 62% were not using HAART. Mean CD4 cell-count was 474 cells/ml and 70.3% had undetectable viral loads in the third trimester. HAART included nevirapine in 35% of cases and protease inhibitors in 55%; Zidovudine monotherapy was used in 7.3%. Mean gestational age at delivery was 37.2 weeks and in 92% by caesarian section; 97.2% received intravenous zidovudine. Use of AZT to newborn occurred in 100% of them. Factors identified as associated to MTCT were: low CD4 cell counts, elevated viral loads, maternal AIDS, shorter periods receiving HAART, other conditions (anemia, IUGR (intra uterine growth restriction), oligohydramnium), coinfecctions (CMV and toxoplasmosis) and the occurrence of labor. Use of HAART for longer periods, caesarian and oral zidovudine for the newborns were associated with a decreased risk. Poor adhesion to treatment was present in 13 of the 15 cases of transmission; in 7, coinfecctions were diagnosed (CMV and toxoplasmosis).ConclusionUse of HAART and caesarian delivery are protective factors for mother-to-child transmission of HIV. Maternal coinfecctions and other conditions were risk factors for MTCT.

Influência do tipo de parto sobre a concentração de imunoglobulinas A, G e M no colostro materno

To investigate the association between type of delivery and immunoglobulin concentration in maternal colostrum. We studied 82 women who were giving birth. Age was between 21 and 41 years, gestational age was 37 or more weeks and parity up to IV pregnancies. The women were in good nutritional condition and did not have any pregnancy or puerperium- associated diseases. The following aspects were also considered as inclusion criteria for the newborn: weight > or = 2,500 g, Apgar score > 7 in the first minute and exclusive breastfeeding until discharge from the nursery. The women were divided into three groups: A - vaginal delivery, B - caesarean section with labor and C - elective caesarean section. Colostrum was collected manually between 48 and 72 h after delivery. Immunoglobulins were dosed using the ELISA technique. There were no differences between the three groups in terms of time of colostrum collection. The shorter the time of colostrum collection, the greater the concentration of immunoglobulin A. Primiparous women had higher concentrations of IgA and IgM in maternal colostrum than did multiparous women. The group submitted to caesarean section with labor had higher concentrations of IgA in maternal colostrum than did the normal delivery group. IgM and IgG concentrations in colostrum were not influenced by type of delivery. The occurrence of labor together with surgical stress induce higher IgA concentrations in the colostrum of women submitted to caesarean section with labor.

Randomized study of pre-induction cervical ripening with sequential use of intravaginal prostaglandin E 2 gel

To evaluate the safety and efficacy of serial frequent intravaginal prostaglandin (PG) E2 gel applications in shortening the time required to achieve an inducible cervix. From May 1, 1993, through April 30, 1994, 101 pregnant women with medical indications for induction of labor and Bishop scores less than 7 were randomized to receive intravaginal 2.5 mg of PGE2 gel every 6 hours or as often as every hour until the Bishop score was at least 7 or intervention was required. The mean total number of PGE2 gel applications was significantly different between the 1- and 6-hour groups, 6.5 and 4.4 PGE2 applications, respectively. The mean time from PGE2 application to delivery was similar, 42 and 45 hours, for the 1- and 6-hour groups, respectively. The intervention rate, occurrence of labor during ripening, and neonatal outcomes were also similar. Intravaginal application of 2.5 mg PGE2 gel as frequently as every hour appears to be safe, but it does not decrease the time interval to induction or delivery, nor does it decrease the cesarean rate.

Preterm infants born to women who had an elevated prepregnancy body mass index appear to be at increased risk of germinal matrix hemorrhage.

In a sample of 449 infants of birthweight ≤ 1.5 kg, the risk of germinal matrix hemorrhage increased monotonically with increases in maternal body mass index (BMI, wt/ht2 ). This relationship was repeated in many strata of the sample, including those defined by the occurrence of labor, maternal preeclampsia, route of delivery, intubation of the baby and acidosis, as well as strata defined by birthweight and gestational age. Even though the dose-response relationship is prominent, caution is advised in drawing inferences from these findings until confirmation is provided that preterm infants born to mothers of high BMI are at increased risk of germinal matrix hemorrhage. © 1992 Wiley-Liss, Inc.

The prevalence and distribution of acute placental inflammation in uncomplicated term pregnancies

The clinical relevance of histologic evidence of acute ascending intrauterine infection has been called into question by descriptions of "silent" chorioamnionitis. The described frequencies of silent chorioamnionitis in normal and abnormal pregnancies vary widely because of differences in the definition of a normal pregnancy, methods of placental examination, and pathologic criteria. Therefore, we examined placentas from 161 uncomplicated gestations for the presence and severity of acute inflammation in the amnion, chorion-decidua, chorionic plate, and umbilical cord using strict gross and microscopic protocols. Indicators of amniotic fluid infection, specifically umbilical cord inflammation, amnionitis, and inflammation within the chorionic plate were present in 0, 1.2, and 4% of the cases, respectively. Silent chorioamnionitis was rare. There was a statistical association between the presence of acute inflammation and the occurrence of labor at term. Methods of tissue sampling that included a more extensive examination of the site of membrane rupture resulted in an increased frequency of diagnosis of acute inflammation at the site of rupture in vaginal deliveries at term.

The Effect of Type of Delivery on Neonatal Outcome in Singleton Infants of Birth Weight of 1,000 g or Less

To evaluate the relationship between management of delivery and neonatal outcome in singleton neonates with birth weights between 501 and 1,000 g, a retrospective analysis was performed. In the 54-month period ending June 30, 1981, a total of 109 singleton neonates were born at Vanderbilt University Hospital, Nashville, Tenn, with birth weights between 501 and 1,000 g, 31 weighing 501 through 750 g, and 78 weighing 751 through 1,000 g. The overall neonatal survival rate was 60%, 39% in the group weighing 501 through 750 g and 69% in the group weighing 751 through 1,000 g. In terms of morbidity and mortality, there was no difference between neonates delivered by cesarean section compared with those delivered vaginally. The only significant factor found relating to neonatal mortality was the occurrence of labor. In the 17 newborns delivered without occurrence of labor, the frequency of neonatal death was significantly decreased, although this difference may be caused by differing risk factors in the infants delivered without occurrence of labor. When labor was present and the fetus had a cephalic presentation, cesarean section was not found to be superior to vaginal delivery in terms of neonatal morbidity or mortality for neonates of 1,000 g or less.