Height Of Uterine Fundus Research Articles

PENGARUH PENGUATAN OTOT RECTUS ABDOMINIS TERHADAP PENURUNAN TFU PADA IBU POSTPARTUM PERVAGINAM DI BPM KABUPATEN SLEMAN

Complications that occur during childbirth usually experience bleeding, sub involusio uteri, swollen breast, nipple blisters etc. By handling and supervising the correct and precise complications during the puerperium will decrease so that morbidity and mortality in the mother will decrease. This study aims to determine the effect of rectus abdominis muscle strengthening on the decrease in uterine fundus height in vaginal postpartum mothers in BPM Sleman District. The purpose of this research is to know the decrease of fundus uteri level (TFU) before and after intervention of rectus abdominis muscle strengthening. The sample in this study amounted to 15 respondents and 15 respondents with the control group. This research method uses quasi experimental with non-randomized pretest-posttes group design. The sampling technique uses total sampling. Different test results of pre test and post test in experimental or non experimental group using Wilcoxon and Mann Whitney. The result of this research shows that the majority of TFU decrease in intervention group is fast 10 (66.6%) while in the control group decrease TFU is slow 9 (60%), and based on bivariate analysis results obtained p-value 0,003 which means there is influence of rectus abdominis to decreased TFU of postpartum mother. The main suggestion for postpartum mothers is expected to be able to perform early and regular early mobilization, especially the strengthening of abdominal rectus abdominal muscles that can decrease TFU so that the period of uterine involution can run faster.

Effectiveness of the Otaria's Postpartum Gymnastic Model and Caregiver Assistance on Decreasing of Uterine Fundal Height in Postpartum Mothers

Effectiveness of the Otaria's Postpartum Gymnastic Model and Caregiver Assistance on Decreasing of Uterine Fundal Height in Postpartum Mothers

Effectiveness of the Otaria's Postpartum Gymnastic Model and Caregiver Assistance on Decreasing of Uterine Fundal Height in Postpartum Mothers

Effectiveness of the Otaria's Postpartum Gymnastic Model and Caregiver Assistance on Decreasing of Uterine Fundal Height in Postpartum Mothers

The effect of oxytocin massage on changing of Symphysis-Fundal height (SFH) in post normal and post caesarean birth delivery

Background: Maternal Mortality Rate (MMR) in Indonesia is 81% due to complications during pregnancy and childbirth and 25% during delivery where one of the causes of bleeding is the occurrence of sub uterine involution. This can be prevented by giving oxytocin massage when providing care to normal postpartum mothers and post-cesarean section. Methods: The population was all postpartum mothers in the midwifery room of Ahmad Yani Hospital, Metro City, Indonesia. Determination of the sample is by accidental sampling technique by including all subjects who meet the sample selection criteria until the number of research subjects is fulfilled, namely 17 exposed groups and 13 not exposed groups. The research instrument used was a questionnaire. Data were analyzed by univariate and bivariate analysis with a statistical test of Chi-square. Results: The results showed that the proportion of normal uterine fundus in normal postpartum mothers was 64.7% and the post-cesarean section was 61.5%, whereas ordinary postpartum mothers who performed oxytocin massage were 53% and post-cesarean section mothers who completed oxytocin massage were 46.1%. Conclusion: The oxytocin massage effect on changes in uterine fundus height in ordinary postpartum mothers with p = 0.002 with OR = 4.000 and the oxytocin massage effect on changes in uterine fundus height in post-cesarean mothers with p = 0.016 with OR = 3.500. Midwives are expected to be able to teach mothers how to measure the height of the uterine fundus in the first week using their fingers at home to ensure normal fundus uterine height before delivering babies. Keywords - Fundal Height, Oxytocin Massage, Post- Partum, Caesar Section

Outcomes of Neonates in Pregnancies with Intrauterine Growth Restriction in Developing Countries: A Cross-sectional Study Over a Period of 6 Months

Background: Intrauterine growth restriction (IUGR) in developing countries is a major health problem. Maternal risk factors play a huge role in causing IUGR, many of which are preventable or modifiable. Aim: To find out the risk factors and outcomes of IUGR infants in pregnant women coming for delivery in a developing country. Method: A cross sectional observational study was conducted at the department of Obstetrics and Gynaecology, Assam Medical College and hospital from July 2016 to December 2016. IUGR was diagnosed clinically by a lag of 4 weeks between actual gestational age and uterine fundal height. Total of 200 pregnant women with IUGR coming for delivery were included. Information regarding occupation, gestational age, maternal risk factors, mode of delivery and neonatal outcome were recorded on predesigned proforma. Mothers were followed up till delivery and neonates were followed up till discharge or death. Results: Out of 200 clinically diagnosed pregnancies with IUGR, 148 neonates were IUGR as per Fenton’s Growth Chart, significant risk factors for IUGR were gestational hypertension (p=0.0001), anaemia (p=0.0001), ethnicity (p<0.05). Our method of clinically selecting patients was highly accurate (p<0.05) when compared with birth weight as per Fenton’s chart. Of 143 IUGR neonates, 6(4%) were still born, 10(6.7%) had died at birth due to resuscitation failure, 45(30%) had sepsis while 70(47%) needed NICU admission for some morbidity. Conclusion: As anaemia and gestational hypertension being the prime and treatable causes of IUGR, proper antenatal care would be the key to reducing the IUGR burden in our setup.

Obstetrical situations with a high risk of anal sphincter laceration in vacuum‐assisted deliveries

To determine risk factors for anal sphincter laceration and define situations with a high risk for such trauma in vacuum-assisted deliveries. Retrospective observational study of 1961 vacuum-assisted deliveries over a period of 5 years. French university hospital. All women who delivered with vacuum assistance. Third- and fourth-degree perineal tears were reviewed. The factors studied through univariate and multivariate logistic regression were the mother's age, parity, history of assisted delivery, cesarean section, gestational age, uterine fundal height, duration of the second stage of labor, head position at expulsion, epidural anesthesia, episiotomy, biparietal diameter and birthweight. Third- and fourth-degree perineal tears. There were 1.9% third-degree and no fourth-degree perineal tears. Risk factors identified were occipito-posterior position (odds ratio 4.7, p < 0.001), biparietal diameter (odds ratio 2.0 for each 5 mm increase, p= 0.004), duration of second stage (only significant when parity was ≥ 1; odds ratio 1.3 for each 10 min increase, p= 0.004) and nulliparity (decreasing effect according to duration of the second stage). The patterns of the association between these factors and the risk of perineal tears were different for nulli- and multiparous women. In a targeted population of women having vacuum-assisted deliveries, the association of specific risk factors allows clinicians to identify women who are at high risk of anal sphincter laceration.

Abdominal muscle electrical activity during labor expulsive stage: a cross-sectional study

During the second stage of labor, the progression of the fetal expulsion depends on many factors related to maternal and fetal parameters, including the voluntary abdominal pushing. This study aimed to correlate the maternal and fetal parameters that may influence the voluntary maternal pushes during the second stage of labor by using surface electromyography. The electromyographic activity of the rectus abdominis and external oblique muscles were measured during the second stage of labor in 24 Brazilian pregnant women. The diastasis of the rectus abdominis, the body mass index and the uterine fundal height were analyzed as maternal parameters and the fetal weight, cephalic circumference, APGAR scores and arterial pH and CO2 were analyzed as fetal parameters. The oxytocin usage and the expulsive phase duration were considered. A negative correlation between the rectus abdominis diastasis and the rectus abdomini muscle electromyographic parameters was found (r=-0.407 p=0.04). No statistically significant correlations were found among the rectus abdominis and external oblique muscles electromyography and the other maternal or fetal parameters, as well as among expulsive phase duration and the oxytocin usage. This study suggests that the rectus abdominis diastasis may be an influential parameter in generating voluntary pushes during the second stage of labor, however it cannot be considered the only necessary parameter for a successful labor.

Challenges in defining and classifying the preterm birth syndrome

In 2009, the Global Alliance to Prevent Prematurity and Stillbirth Conference charged the authors to propose a new comprehensive, consistent, and uniform classification system for preterm birth. This first article reviews issues related to measurement of gestational age, clinical vs etiologic phenotypes, inclusion vs exclusion of multifetal and stillborn infants, and separation vs combination of pathways to preterm birth. The second article proposes answers to the questions raised here, and the third demonstrates how the proposed system might work in practice.

Monitoramento do processo de assistência pré-natal entre as usuárias do Sistema Único de Saúde em município do Sudeste brasileiro

to evaluate the evolution of adequacy of the care process among pregnant users of the Brazilian Single Health System (SUS, acronym in Portuguese) and to consolidate a methodology for monitoring the prenatal care. this is a multiple time series study with auditing of prenatal cards of pregnant women who were attended for prenatal care in a city of the Brazilian Southeast (Juiz de Fora, Minas Gerais) in the initial semesters of 2002 and 2004 (370 and 1,200 cards, respectively) and gave birth using SUS services in term pregnancies (p < 0.05). A three complementary level sequence was respected: utilization of prenatal care (beginning and number of visits) at level 1; utilization of prenatal care and obligatory clinical-obstetric procedures during prenatal visits (assessment of blood pressure (BP), weight, uterine fundal height (FH), gestational age (GA), fetal heart rate (FHR) and fetal presentation) at level 2; and utilization of prenatal care, obligatory clinical-obstetric procedures and basic laboratory tests, according to the Humanization Program of Prenatal Care and Birth (PHPN, acronym in Portuguese) (ABO/Rh, hemoglobin/hematocrit (Hb/Htc), VDRL, glycemia and urinalisys) at level 3. it was confirmed the high prenatal care coverage (99%), the increased mean number of visits per pregnant woman (6.4 versus 7.2%) and the decreased gestational age at the time of the first visit (17.4 versus 15.7 weeks). The proper registration of procedures and exams (exceptions: fetal presentation and blood typing) has significantly increased: BP (77.8 versus 83.9%); weight (75.4 versus 83.5%); FH (72.7 versus 81.3%); GA (58.1 versus 71.5%); FHR (79.5 versus 86.7%); Hb/Htc (14.9 versus 29%), VDRL (11.1 versus 20.7%), glycemia (16.5 versus 29%) and urinalisys (13.8 versus 29.8%). As a result, there was significant (p < 0.001) improvement of the adequacy between 2002 and 2004: 27.6 versus 44.8% (level 1); 7.8 versus 15.4% (level 2); 1.1 versus 4.5% (level 3). This trend was also noted in care provided by the majority of the municipal services/teams. the persistence of low adequacy, despite good coverage and PHPN implementation, confirmed the need to increase health managers, professionals and users' compliance with the rules and routines of care, including the institutionalization of a monitoring program of prenatal care.

A randomized trial comparing 2 outpatient educational settings for clerkship students: private practice office vs hospital clinic

The purpose of this study was to compare medical students' experiences in 2 outpatient educational settings. For their 2-week ambulatory rotation, all 76 medical students were randomized to either a hospital clinic or a private office. Seventy students completed the survey. When compared to students working in a private office setting, hospital clinic students reported more breast exams, speculum exams, uterine fundal height measurements, wet mount reading, contraceptive counseling, and first obstetrical and gynecologic patient visits. Students in the hospital clinic were more likely to report having educationally valuable opportunities to interview and examine patients and to discuss the differential diagnosis with their preceptor. Nevertheless, medical students randomized to the private office were more likely to report considering obstetrics and gynecology as a career. The hospital clinic provided students with more clinical experiences. Medical students assigned to a private office, however, were more likely to consider obstetrics and gynecology as a career.

Maternal nutritional determining factors in twin pregnancies

Background Nutritional recommendations and weight gain patterns associated with optimal outcomes for singleton pregnancy (SP) are well documented but this information is deficient for multiple pregnancy (MP). Objective To identify the maternal nutritional determining factors in women with MP that gave birth products with an adequate birth weight. Method A case control nested in a cohort study was performed. Healthy pregnant women were evaluated monthly, since wk 20 until birth. Height, weight, skinfolds, uterine fundus height, and REE (by indirect calorimetry) were measured at baseline and during the following visits. Cases were women with MP that delivered products > 2100 g and controls were SP women that gave birth a product > 2900 g. GLM repeated measures were used for analyzing changes in all response variables throughout pregnancy (intra subjects comparisons) and between either MP vs SP or pregestational BMI (pBMI): < 25 and > 25. The protocol was approved by the INPer’s Research and Ethics Committees and women gave a written, informed consent. Results 19 MP and 20 SP women were followed with no significant differences between groups. 10 MP were defined as cases and 11 SP as controls. When analyzed by pBMI, women with BMI > 25 gained less weight than those with pBMI < 25 (Inter=F (1,19) 5.8 ; p=0.026, Intra =F(2, 38) 3.9; p=0.028). REE was no different between groups (p>0.05). SP women gained more body fat than those with MP (p>0.05). Conclusions The maternal nutritional determining factors in twin pregnancy depend on pBMI and not on pregnancy type. Women with MP gained less body fat during pregnancy to allow fetal growth.

Meta-analysis on the Usefulness in Postpartum Control by Kyukichoketsuin with Methylergometrine Maleate as Control

[Purposes] Evidence-based medicine (EBM) is now the established standard for selecting appropriate treatment, the basic ideas of which cannot be ignored even in the field of Kampo medicines. With this in mind, we conducted a meta-analysis (MA) for those Kampo medicines which had been administered in randomized clinical trials, as a method of establishing the evidence for Kampo medicines, and then examined the resulting data obtained for the present study. Here, we focused on the assessing the usefulness in postpartum control, using Kyukichoketsuin (KCI), with methylergometrine maleate (MME) as control.[Methods] We searched and collected articles published before September 2004 in Igaku Chuo Zasshi (Japana Centra Revuno Medicina) and Medline using keywords such as “Kyukichoketsuin”, etc. First we selected target articles for analysis in accordance with our inclusion criteria and examined the quality of those articles using a score system adopted by Chalmers, in 1981. Then we extracted target data from the articles in accordance with meta-analytic methods, integrated the resulting data using the DerSimonian-Laird method, and implemented sensitivity analysis to them.[Results and Discussion] We selected four articles for our target analysis. All four were of similar quality. When we set post-labor pains as an assessment item, and integrated three of the four articles, KCI showed that it more significantly decreased those pains compared to MME, with an integrated odds ratio of 0.32 (95%CI, 0.17-0.60). The one remaining independent article, however, in which KCI exerted statistically significant effect in height of day-five uterine fundus, indicated no higher significance through integration with the first three articles. Also, even integrating the height of the uterine fundus shown in the articles, on day four as well as the height before integration, had no significance. These results indicate that the effect of KCI for the involution of the uterus may be the same as that of MME. Regarding the volume of breast-milk lactation on day four in comparison between two test drugs, some articles showed more volume in both the KCI and MME. groups, despite reaching no significant decreases in volume, with an integrated odds ratio of -8.20 (95%CI, -16.17--0.23). However, contrary to this, results for the integration of day-five breast-milk lactation volume showed an increase in the KCI group, although without reaching significant difference. Therefore, the effectiveness of KCI for breast-milk lactation could not be generally categorized as less than that of MME.[Conclusion] MA demonstrated that KCI was more effective in decreasing post-labor pains than was MME. We could not implement the comparable study in safety at this time. Therefore, further analysis on KCI including safety may be required to argue total effectiveness on postpartum control.

Adequação do processo de assistência pré-natal entre as usuárias do Sistema Único de Saúde em Juiz de Fora-MG

OBJETIVOS: avaliar a adequação do processo da assistência pré-natal oferecida às usuárias do SUS em Juiz de Fora/MG e comparar o atendimento nos principais serviços municipais. MÉTODOS: estudo transversal desenvolvido com auditoria em 370 Cartões da Gestante selecionados por amostragem sistemática entre as pacientes a termo que utilizaram o SUS no atendimento ao parto, no primeiro semestre de 2002 e com pré-natal freqüentado em Juiz de Fora. Foi utilizado o teste do c² para comparar os serviços de procedência das pacientes (nível de significância: 5%). A avaliação obedeceu a uma seqüência em três níveis complementares, sendo examinados: a utilização da assistência pré-natal (índice de Kessner: início e freqüência dos atendimentos) no nível 1; a utilização do pré-natal e dos exames laboratoriais básicos, segundo o Programa de Humanização no Pré-natal e Nascimento (tipagem ABO/Rh, hemoglobina/hematócrito, VDRL, glicemia e exame de urina tipo 1), no nível 2; e a utilização de exames laboratoriais básicos e de procedimentos clínico-obstétricos obrigatórios numa consulta pré-natal (aferições de pressão arterial, peso, edema, altura uterina, idade gestacional, batimentos cardiofetais e apresentação fetal), no nível 3. RESULTADOS: a adequação do processo foi de apenas 26,7% (nível 1), 1,9% (nível 2) e 1,1% (nível 3). Foram também observados cobertura pré-natal de 99,04%, média de 6,4 consultas/gestante, além da média de 17,4 semanas de idade gestacional na primeira consulta. Não houve diferenças significativas entre os diversos serviços municipais analisados. CONCLUSÕES: o pré-natal das usuárias do SUS na cidade deve ser revisto qualitativamente, recomendando-se avaliações periódicas como instrumentos imprescindíveis de aperfeiçoamento. Aos gestores e profissionais de saúde cabem ações que aumentem a adesão às normas/rotinas do programa - principalmente a solicitação/registro dos exames complementares básicos - e propiciem melhor utilização do pré-natal pelas pacientes.

’n Vergelyking van verskillende metodes om swangerskapstadiums te bepaal

A group of 208 antenatal women at a primary health care clinic in Bloemfontein was selected for the study. Fundal height was determined by measuring the height of the fundus as well as using the uterine fundus height in relation to weeks method. The above-mentioned methods were compared with a sonar date to determine whether a specific method is more accurate in a specific stage of pregnancy. It seems as if measuring of the height of the fundus is more accurate in the second trimester. In the third trimester of pregnancy a tendency exists for both the uterine fundus height in relation to weeks method and measuring of the height of the fundus to be accurate until the 36th week of pregnancy. After the 36th week of pregnancy the uterine fundus height in relation to weeks method seems to be more accurate.

A comparison of Caucasian and Southeast Asian Hmong uterine fundal height during pregnancy

Fundal height measurement is a standard clinical assessment tool used in prenatal care. This study compared the fundal heights growth curves of two ethnically distinct groups of pregnant women. We were motivated by our clinical experience with one group where fundal heights seemed 'small for date' and by the reluctance of this group to undergo further testing, especially ultrasound. A prospective cohort study compared the fundal heights growth curve of 48 Caucasian and 40 Hmong women from two clinics in central Wisconsin (USA). Southeast Asian Hmong women were found to have a slower rate of fundal height growth than Caucasian women (significantly different average slopes of .88 vs. .95, respectively). An expectation of linear growth appeared more valid for Caucasian than Hmong women. At 40 weeks, regression based estimates overestimated the Caucasian sample by 1.3 weeks and the Hmong sample by 2.7 weeks. ANCOVA procedures remained significant while controlling for group differences in height. Fundal height measurements were moderately predictive of birth weight for the Hmong sample but not the Caucasian sample (multiple r=.39). Considerable differences emerged between fundal height measures for the Hmong and Caucasian samples. The improved ability to differentiate groups following control of variance due to height as well as the ability to predict birth weight from fundal height curve in the Hmong group argue for value of normative development using more homogeneous groups. Clinicians should consider the applicability of fundal height norms to their clinical populations and may be able to have more confidence in using fundal height as an evaluative tool with more appropriate norms.

A comparison of Caucasian and Southeast Asian Hmong uterine fundal height during pregnancy

A comparison of Caucasian and Southeast Asian Hmong uterine fundal height during pregnancy

Correlation of Uterine Fundal Height with Ultrasonic Measurements in Twin Gestations

Owing to the lack of fundal height (FH) nomograms for normal twin gestations, it has been a standard recommendation to use frequent ultrasound examinations in order to diagnose discordant fetal growth. The validity of such a practice, however, has not been established. The purpose of this study was to establish a nomogram for FH measurements in normal twin gestations and to evaluate it as a means of detecting discordant growth in twins.This is a prospective cross-sectional study of 160 twin pregnancies between 16 and 36 weeks presenting for an ultrasound. FH measurements were obtained by both the Division of Maternal-Fetal Medicine attending physician and fellow. Maternal age, gravidity, parity, height and weight, gestational age (GA), fetal presentation, placentation, amniotic fluid volume, estimated fetal weight, and percent discordance were also recorded. A nomogram for FH in normal twin gestations (n = 143) was developed and it was used to see if FH can detect discordant growth in twins (n = 17).The 1...

Methods for timing of pregnancy and monitoring of fetal body and brain growth in squirrel monkeys

In order to obtain timed pregnancies in squirrel monkeys and to monitor development of the size of the fetus and its brain, tests were made of various combinations of vaginal examination, bioassay of chorionic gonadotropin (CG), measurement of maternal body weight and uterine fundus height during pregnancy, and determination of fetal biparietal diameter by ultrasonography and magnetic resonance imaging. The usefulness of these methods in developmental and teratological studies is discussed.

186 Correlation of Uterine Fundal Height with Ultrasound in Twin Gestations

186 Correlation of Uterine Fundal Height with Ultrasound in Twin Gestations

A CASE REPORT OF TOTAL PARENTERAL NUTRITION FOR THE PATIENT WITH ACUTE PANCREATITIS DURING PREGNANCY AND THE POSTPARTUM PERIOD

A 21-year-old female with acute pancreatitis at 28 weeks of gestation was treated by means of total parenteral nutrition (TPN). Subjective symptoms such as nausea, vomiting, and abdominal pain were alleviated soon after the initiation of TPN, and no tenderness was complained on physical examination of the abdomen. Rash was observed in the face and trunk from about 19 days after the initiation of TPN. Measurements of blood vitamin and serum zinc, and analysis of serum fatty acid levels showed lower biotin and linoleic acid levels and serum zinc level at the lower border line. Trace mineral (2A/day) and 10% lipid emulsion (250 m/day) were administered, but the rash persisted for the rest of the pregnancy. During TPN, the body weight of the patient, height of uterine fundus, and the fetal bitemporal diameter revealed normal increase. Since the fetus showed pelvic presentation from 36 weeks of gestation, cesarean section was performed at 37 weeks and 5 days gestation with delivery of a healthy male infant.