Onset Of Labor In Pregnancies Research Articles

The effect of mode of delivery and duration of labour on subsequent pregnancy outcomes: a retrospective cohort study.

To assess whether delivery mode and duration of labour in a first labour of spontaneous onset is associated with gestational length, delivery mode and neonatal outcome in the subsequent pregnancy. Retrospective analysis of prospectively collected data. 15 Maternity units in North West London (1988-2000). 30 840 women with spontaneous onset of labour in pregnancy 1 and a subsequent birth reported in the same database. Assessment of outcomes by mode of delivery in pregnancy 1, restricting the analysis to the difference in the gestational length between pregnancy 1 and 2. Gestational length, mode of delivery and neonatal unit admission in pregnancy 2. Caesarean section (CS) in the first or second stage of labour in pregnancy 1 was associated with pregnancy 2 being a median of 5 and 8 days shorter and a preterm birth rate of 6.0% and 10.1%, respectively, whereas following a normal or instrumental vaginal birth in pregnancy 1, the median duration was similar, with preterm delivery rates of 4.5% and 3.9%. In all, 56.2% of women with a CS in pregnancy 1 had a repeat CS and 12.5% of their babies were admitted to a neonatal unit, compared with 5.3% of women with vaginal birth. Longer labours were associated with shorter gestations in pregnancy 2. Compared with vaginal birth, an emergency CS in the first-term pregnancy is associated with a shorter gestational length, increased rate of repeat CS and increased risk of NNU admission in the next pregnancy. An emergency caesarean section in the first-term pregnancy affects the duration and outcome of the next pregnancy.

Prevalence of Preterm Premature Rupture of Membrane and Its Associated Factors among Pregnant Women Admitted in Debre Tabor General Hospital, North West Ethiopia: Institutional-Based Cross-Sectional Study.

Background In Ethiopia, preterm premature rupture of membrane is defined as loss of amniotic fluid before the onset of labor in pregnancy >28 weeks of gestation but before 37 weeks. It is a significant cause of perinatal, neonatal, and maternal morbidity and mortality both in high- and low-income countries. Due to different factors associated with the quality of health care given and socioeconomic factors, the effect of preterm premature rupture of membrane is worsen in low-income countries. Little evidence is available about the problem in the study area. Therefore, this study was aimed to determine the prevalence of preterm premature rupture of membrane and its associated factors among pregnant women admitted in Debre Tabor General Hospital. Methods Facility-based cross-sectional study was conducted. A total of 424 mothers were included in the study. Systematic random sampling was used to select study participants. A combination of chart review and interview was used to collect the data. Both descriptive and analytical statistics were computed. Result The prevalence of preterm premature rupture of membrane was found to be 13.7%. Pregnant women with abnormal vaginal discharge (AOR = 5.30, 95% CI = 2.07–13.52), urinary tract infection (AOR = 2.62, 95% CI = 1.32–5.19), history of premature rupture of membrane (AOR = 3.31, 95% CI = 1.32–8.27), vaginal bleeding (AOR = 2.58, 95% CI = 1.14–5.82), and mid-upper arm circumference <23 cm (AOR = 6.26, 95% CI = 3.21–12.20) were associated with preterm premature rupture of membrane. Conclusions The prevalence of preterm premature rupture of membrane was high. Abnormal vaginal discharge, urinary tract infection, vaginal bleeding, previous premature rupture of membrane, and mid-upper arm circumference <23 cm were associated with preterm premature rupture of membrane. Thus, early screening and treatment of urinary tract infections and abnormal vaginal discharges were recommended to reduce the risk of preterm premature rupture of membrane.

Comparative study of oral Nifedipine tablet and transdermal Nitroglycerin patch in preterm labour

Preterm labour (PTL) is defined as the onset of labour in pregnancy from 28 weeks to 36weeks and 6 days. One of the most challenging problem of obstetrician in the era of modern obstetrics is the management of preterm labour and preterm births (PTB); Being the most common cause of perinatal morbidity and mortality PTB accounts for 70-80% of perinatal deaths. More than a million preterm infants die per year, worldwide. Aim: To Compare the Tocolytic effect of Oral Nifedipine tablet and Transdermal Nitroglycerin (TDN) patch in preterm labour and its effect on maternal and fetal outcome. Materials and Methods: It was a Double Blinded placebo controlled study conducted at Dr. D. Y. Patil Medical College, Hospital & Research Center, Pimpri, from November 2018 to April 2019. The study population comprised of patients who attended the casualty and outpatient department. Eighty-eight women with singleton pregnancy from 28weeks to 36weeks 6 days in preterm labour with intact membranes and cervical dilatation from 1 up to 3 cm; without contraindication for tocolysis were enrolled in the study. After taking the informed consent, subjects were randomised into two groups; 46 subjects in group A received oral Nifedipine tablet, out of which 4 left the study and 46 in group B received TDN patch. The variables analysed were, delay in delivery for 48 hours, 7 days or more than 7 days, period of gestation at delivery, effect on maternal and fetal outcome and side-effect profile of drugs. Result: The percentage of women delivering after 48 hours of administration of oral Nifedipine were 66.67% and TDN patch were 76%. Failure of tocolysis, defined as delivery within 48 hours, was significantly more with Nifedipine group (8/42-19.05%) as compared to TDN patch group (3/46-6.5%). Headache was significantly higher in group B as compared to group A (p< 0.001). Maternal tachycardia was more common in group A compared to group B (p< 0.001). Conclusion: Transdermal Nitroglycerin (TDN) patch is more effective than oral tablet Nifedipine in suppression of preterm labour and prolonging pregnancy. Although the rate of side effects were more with Nitroglycerin, most common was headache which can be controlled with analgesics. Cardiovascular side effect were nil compared with Nifedipine. Nitroglycerin is well tolerated and safe for the mother and fetus.