Women In Normal Labor Research Articles

Analgesic Effects, Birth Process, and Prognosis of Pregnant Women in Normal Labor by Epidural Analgesia Using Sufentanil in Combination with Ropivacaine: A Retrospective Cohort Study.

Objective The objective is to evaluate the analgesic, labor, and prognostic effects of patient-controlled epidural analgesia (PCEA) versus sufentanil in conjunction with ropivacaine in normal labor. Methods Sixty pregnant women who had a normal delivery at our hospital between February 2019 and April 2021 were included. Pregnant women were arbitrarily assigned to a control group and a research group. Pregnant women in the control group received lidocaine analgesia and PCEA with sufentanil combined with ropivacaine in the research group. Satisfaction with care, fetal umbilical artery blood flow, VAS score, labor and bleeding, neonatal Apgar score and incidence of adverse events were analyzed. Results First, we made a comparison of satisfactory performance of nursing care. The satisfaction rate of the research group was 100.00%, compared to 83.33% for the control group. Nursing satisfaction was higher in the research group, and the difference was statistically significant (P < 0.05). Following analgesia, PI, RI, and S/D values of umbilical artery blood flow were lower in the research group than those in the control group, but the difference was not statistically significant (P > 0.05). The VAS scores at 10 min, 20 min, and 30 min were found to be lower in the research group than in the control group after analgesia, and the difference was statistically significant (P < 0.05). Bleeding was significantly lower in the research group for all stages of labor, and the difference was statistically significant (P < 0.05). Apgar scores at 1 minute, 5 minutes, and 10 minutes postpartum were greater in the research group than in the control group, and the difference was statistically significant (P < 0.05). As a final note, the incidence of pruritus, hypotension, respiratory depression, nausea, and vomiting was found to be lower in the research group than in the control group, and the difference was statistically significant (P < 0.05). Conclusion PCEA with sufentanil coupled with ropivacaine was used to perform labor analgesia. With significant reduction in maternal pain and assurance of labor, ropivacaine combined with sufentanil epidural labor analgesia did not reduce fetal umbilical artery blood flow without extended labor. It could not affect the labor process or the safety of the fetus, which is safe for the mother and fetus.

Empleo Clínico de un Betamimetico (Orciprenalina) en Obstetricia (Comunicación Preliminar)

Se empleó la Orciprenalina, un agente beta-adrenérgico, en 48 casos de patología obstétrica y 12 mujeres en trabajo de parto normal. A las dosis de 10-20 microgramos por minuto, la Orciprenalina inhibió la contractilidad del útero en 59 pacientes, en tanto que en un caso de desprendimiento placentario con feto muerto no surtió el efecto esperado. Se observó muy leve descenso de la presión arterial, incremento de la frecuencia cardíaca materna (sin sintomatología asociada) y aumento de la frecuencia cardíaca fetal. Se expresa de manera gráfica y comparativa el comportamiento de los distintos parámetros evaluados en los casos de parto normal, pacientes con hipersistolía y con taquisistolía.

Effecting change in midwives' waterbirth practice behaviours on labour ward: An action research study

Introductionthe use of water immersion for labour and birth has been shown to be beneficial for women in normal labour (Cluett et al, 2009). It was decided to use problem solving coordinator workshops to change in the way waterbirth practice was promoted and organised on labour ward. Findings from the first Action Research phase (Russell, 2011) led to the development of a waterbirth questionnaire to measure midwives' personal knowledge of waterbirth practice, waterbirth self-efficacy, social support and frequency of hydrotherapy and waterbirth practice. The aim of this paper is to share the questionnaire findings from an on-going action research study. Methodprior to the first workshop 62 questionnaires were distributed to midwives (Bands 5, 6 and 7) working on labour ward. Subsequent questionnaires (n=53) were sent to Bands 5/6 midwives not involved in the workshops, at four (Group 2) and eight months (Group 3). N.B only Bands 5/6 midwives completed post workshop questionnaires. In total 169 questionnaires were distributed. One-way ANOVA with Tukey post-hoc test and the χ2 test were used to determine statistical significance. Findings96 questionnaires were returned (57%). Midwives' personal knowledge of waterbirth practice differed significantly between groups, (F2,85=3.67, p<0.05) with midwives in Group 1 giving significantly higher scores (X¯=45.6, 95% CI [43.0, 48.2]), than those in Group 3, (X¯=41.7, 95% CI [40.0, 43.3]), p<0.05. Midwives' waterbirth self-efficacy did not differ significantly between groups (F2,88=3.15, p>0.05). However scores for social support did differ (F2,75=4.011, p=0.022), with midwives in Group 1 giving significantly lower scores (X¯=8.0, 95% CI [6.4, 9.5]) than those in Group 3 (X¯=10.5, 95% CI [9.4, 11.6]), p=0.016. Fifty-five per cent of Group 1 midwives facilitated a waterbirth in the previous three months compared with 87% in Group 3. Changes in the frequency of waterbirth for these groups were statistically significant (x2=4.369, p<0.05, df=1). Conclusionsit appears that the co-ordinators were able to influence waterbirth practice because of changes in social support and frequency of waterbirth practice. Given the widespread and continued impact of the intervention, on midwives who attended workshops and those that did not, we feel it likely that a significant proportion of this change could be attributed to the introduction of problem solving waterbirth workshop. The findings from this study suggest that problem solving waterbirth workshops based on an action research format have the potential to normalise midwifery care within medically dominated hospital birthing environments.

A comparative study of methylergonovine and 15-methyl prostaglandin F2α in active management of third stage of labor.

ObjectivePostpartum hemorrhage is most common cause of maternal mortality. Active management of third stage of labor minimizes the risk of postpartum hemorrhage. To compare the effect of methylergonovine and 15-methyl prostaglandin F2α (15-methyl PGF2α) in active management of third stage of labor.MethodsA randomized open labelled parallel study with 50 women in normal labor, 25 in each group were included. The drugs methylergonovine (0.2 mg) intravenous and 15-methyl PGF2α (250 µg) intramuscular were administered at the time of delivery of anterior shoulder. Main outcomes measured were amount of blood loss during the first four hours of delivery and objective measurement of hemoglobin and hematocrit levels before delivery and third day postpartum.ResultsThere was no statistically significant difference in the blood loss between the two groups at delivery (P = 0.130), at 1 hour of delivery (P = 0.453). The blood loss with 15-methyl PGF2α was significantly less as compared to that of blood loss with methylergonovine at four hours of delivery (P = 0.014) and the total, i.e., during first four hours, amount of blood loss was significantly less with 15-methyl PGF2α (P = 0.026). There was no statistically significant difference in the hemoglobin and hematocrit levels measured predelivery and postpartum third day between both the drugs.ConclusionBoth the drugs were effective in controlling the amount of blood loss during the third stage of labor, 15-methyl PGF2α being more efficacious.

Organochlorine pesticides in colostrums in case of normal and preterm labor (IASI, Romania)

Assessment of organochlorine pesticides (OCPs) in human body is important for human health because they have weak estrogenic or antiestrogenic effects and are considered endocrine disrupters. We used colostrum of women as indicator for levels of OCPs in human body for mothers with normal and preterm labor from eastern part of Romania. Sixty- three samples of colostrum were extracted by solid-phase extraction. Analyses were carried out using gas chromatography coupled to mass spectrometry (GC-MS). OCPs have been detected in all samples, with p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) and gamma-hexachlorocyclohexane (gamma-HCH) being at the highest concentrations. Of the organochlorines measured in clostrum samples from women in preterm labor, median levels of DDTs (470 ng/g) and HCHs (99 ng/g) were higher than for the same compounds from women in normal labor (median of DDTs=268 ng/g and median of HCHs=96 ng/g). Normal labor had higher median concentrations of HCB (19.5 ng/g) versus preterm labor (14 ng/g). Statistical data show high Spearman correlation coefficients between various OCPs. We found a good correlation between alpha-, gamma-, beta- and delta- HCH isomers (p<0.001) for both normal and preterm labor. The most abundant target compound was p,p'-DDE (median value 96 ng/g, and 137 ng/g for mother with normal and preterm labor, respectively) in all colostrum samples. The estimated daily intakes of HCHs by infants exceeded corresponding Health Canada guidelines.

Routine prophylactic drugs in normal labour for reducing gastric aspiration and its effects.

Women in normal labour may sometimes go on to have general anaesthesia if labour becomes abnormal, for example if a caesarean section is required. General anaesthesia carries a very small risk of regurgitation and inhalation of stomach contents into the lungs. This can cause inflammation, particularly if the fluid is acidic, and can lead to severe morbidity and very occasionally mortality. Labour hormones increase the risk of gastric aspiration or Mendelsohn's syndrome, though the exact incidence is unknown. The routine administration of acid prophylaxis drugs to all women in normal labour is commonly practiced worldwide, to reduce gastric aspiration by reducing the volume and acidity of stomach contents. To assess the effectiveness of routine prophylaxis drugs for women in normal labour to reduce gastric aspiration and its effects. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (December 2005), EMBASE (1974 to April 2005) and CINAHL (1982 to April 2005). Randomised and quasi-randomised controlled trials of women in normal labour assessing the routine administration of drugs (antacids, H(2) receptor antagonists, dopamine antagonists and proton-pump inhibitors) compared with placebo/no treatment, and compared with other drugs for reducing gastric aspiration. Two review authors independently assessed eligibility, quality, extracted data and performed double-data entry. Three trials were included, involving 2465 women, assessing the effects of antacids, H(2) receptor antagonists and dopamine antagonists. There were no trials on proton-pump inhibitors. None of the trials were of good quality, and none assessed the incidence of gastric aspiration, Mendelsohn's syndrome or their consequences. All the studies assessed vomiting, and there was limited evidence that vomiting may be reduced by antacids (relative risk (RR) 0.46, 95% confidence interval (CI) 0.27 to 0.77, n = 578, one trial) or by dopamine antagonists given alongside pethidine (RR 0.40, 95% CI 0.23 to 0.68, n = 584, one trial). Comparisons between different drugs showed no significant differences, though the number of participants was small. There was no evidence that H(2) receptor antagonists improved outcomes compared with antacids, though only one trial addressed this issue. There is no good evidence to support the routine administration of acid prophylaxis drugs in normal labour to prevent gastric aspiration and its consequences. Giving such drugs to women once a decision to give general anaesthesia is made, is assessed in another Cochrane review.

Guia de Apoio à Decisão em Enfermagem Obstétrica: aplicação da técnica da Lógica Fuzzy

A Lógica Fuzzy tem sido utilizada como uma forma de representação de conhecimento e uma técnica para a modelagem de Sistemas de Apoio à Decisões Clínicas. Ao considerar a pouca utilização desta técnica para modelar decisões clínicas de enfermagem, este ensaio objetiva apresentar noções gerais sobre esta técnica e por meio dela desenvolver uma formulação teórica, em forma de guia prático, para o apoio à decisão nos casos de amniotomia em gestantes pimíparas em trabalho de parto normal.

Part four: Fetal monitoring should be controlled

The continued widespread use of electronic fetal monitoring in normal labour is illustrative of technology becoming our master, not our servant. It is one of the clearest examples of iatrogenesis as false positive rates continue to result in unnecessary caesarean sections. The opportunity now presents itself to remove monitors from women in normal labour as clinical governance advocates evidence-based practice in maternity care. For many midwives, whether it achieves this will be an acid test. Will clinical governance herald a new dawn in the sensitive application of proven treatments (and the banishment of the ineffective), or will it become just another control mechanism where selective interventions are endorsed or rejected but those that challenge entrenched practices and vested interests are quietly ignored?

The effect of uterine contractions on fetal oxygen saturation

To find out what happens to fetal arteriolar oxygen saturation during a uterine contraction. Prospective observational study. Labour ward, St James's University Hospital, Leeds. Eighteen women in normal labour monitored with a fetal scalp surface pulse oximetry sensor, an intrauterine pressure catheter, and a head to cervix force transducer. The effect of intrauterine pressure and head to cervix force on fetal arteriolar oxygen saturation was examined using time series analysis and a regression model of 159 contractions. Fetal oxygen saturation during a contraction. The average oxygen saturation drops after a contraction. The greatest drop in oxygen saturation is reached 92 s after the peak of a contraction and takes approximately 1 min 30 s to recover (P = 0.036). Uterine contractions during normal labour affect fetal oxygen saturation.

Cytokines in normal and abnormal parturition: Elevated amniotic fluid interleukin-6 levels in women with premature rupture of membranes associated with intrauterine infection

The participation of interleukin-6 (IL-6) in the pathophysiology of normal and abnormal human parturition was evaluated by determining IL-6 concentrations in amniotic fluid (AF). Biologically active IL-6 was determined (in U/ml) using the B9 hybridoma growth factor assay, while the concentrations of immunoreactive IL-6 species (in pg/ml) were assessed using a monoclonal antibody (moAb)-based ELISA. Two hundred and twenty-seven AF samples from women in normal labor and from those presenting with a clinical diagnosis of premature rupture of membranes (PROM) were assayed. In selected instances, IL-6 levels were evaluated simultaneously in AF and in maternal and fetal plasma. Women with a normal pregnancy had low titers of biologically active IL-6 in AF both at midtrimester (group 1, n = 27; median IL-6 concentration = 16 U/ml) and at term (group 2, n = 33; median = 15 U/ml). There was an increase in the IL-6 bioactivity in AF from women in normal labor at term (group 3, n = 40; median = 74 U/ml; p less than 0.001). In order to distinguish between the relative contributions of parturition per se and of intrauterine infection to the elevation of biologically active IL-6 levels in AF, IL-6 titers were compared in four different groups of women with PROM.(ABSTRACT TRUNCATED AT 250 WORDS)