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Arrest of the Second Stage of Labor

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1. Arrest of the Second Stage of Labor

Arrest of the Second Stage of Labor Arrest of the Second Stage of Labor Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Arrest (...) of the Second Stage of Labor Arrest of the Second Stage of Labor Aka: Arrest of the Second Stage of Labor From Related Chapters II. Definition Arrest of the Second Stage of Labor No descent or rotation after a fixed time interval or pushing Multiparous No epidural: 2 hours Epidural: 3 hours Nulliparous No epidural: 3 hours Epidural: 4 hours III. Exam See ( ) IV. Complications: Prolonged second stage of labor V. Management position (or Occipitotransverse Position) See Consider assisted VI. References Images

2018 FP Notebook

2. The impact of extending the second stage of labor to prevent primary cesarean section on maternal and neonatal outcomes. Full Text available with Trip Pro

with regional anesthesia or 2 hours if no such anesthesia was provided. Second-stage arrest was defined in multiparous women after 2 hours with regional anesthesia or 1 hour without it. Period II (10,531 patients): from May 2014 until April 2017, allowed nulliparous and multiparous women continuing the second stage of labor an additional 1 hour before diagnosing second-stage arrest. Singleton deliveries at or beyond 37 weeks' gestation were initially considered for eligibility. We excluded women with high (...) The impact of extending the second stage of labor to prevent primary cesarean section on maternal and neonatal outcomes. A low rate of primary cesarean delivery is expected to reduce some of the major complications that are associated with a repeat cesarean delivery, such as uterine rupture, adhesive placental disorders, hysterectomy, and even maternal death. Since 2014, and in alignment with the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, we

2018 American Journal of Obstetrics and Gynecology

3. First Stage of Labor Progression in Women with Large-for-Gestational Age Infants. (Abstract)

First Stage of Labor Progression in Women with Large-for-Gestational Age Infants. Women with suspected large-for-gestational age (LGA) fetuses have higher rates of dysfunctional labor and labor arrest diagnoses, and consequently higher rates of cesarean deliveries. Identifying factors that significantly affect labor progression of women with LGA infants may better inform expected duration of labor for certain subgroups of this population.As standards for the first stage of labor when LGA (...) progressed slower in nulliparous compared to multiparous women (3.28 hours [0.71-15.16] vs. 2.03 hours [0.44-9.39]; p<0.01), and in obese compared to non-obese women (2.36 hours [0.51-10.91] vs. 1.79 hours [0.39-8.31]); p<0.01). Labor curves did not differ between LGA and AGA groups when stratified by labor onset (non-augmented spontaneous labor vs. induced labor) or the presence of DM/GDM.After 3cm cervical dilation, the time required to reach the second stage of labor is greater in women with LGA

2019 American Journal of Obstetrics and Gynecology

4. Routine Maternal Leg Movements During the Second Stage and the Rate of Operative Deliveries

indication for cesarean delivery, Maternal position during the second stage of labor has been suggested to affect the risk of instrumental vaginal delivery. A Cochrane review of position in the second stage of labor in women without epidural showed a reduction in instrumental vaginal delivery in the upright group, although the quality of the included trials was reported to be generally poor, A Cochrane review of position in the second stage of labour for women with epidural analgesia was published (...) in 2017, This review included trials that compared upright with recumbent positions and suggested no effect. No prior studies examined whether maternal legs movement during the second stage of labor has any effect on the rate of operative deliveries. Condition or disease Intervention/treatment Phase Cesarean Delivery Affecting Fetus or Newborn Other: Routine leg movement Not Applicable Detailed Description: A randomized controlled trial to determine whether routine maternal leg movement during

2018 Clinical Trials

5. Success of trial of labor in women with a history of previous cesarean section for failed labor induction or labor dystocia: a retrospective cohort study. Full Text available with Trip Pro

% in women with a history of labor arrest in the second stage of labor, and 59.0% in women with previous failed induction. The adjusted risk factors for recurrent failed induction or labor dystocia were maternal height < 160 cm (OR 1.9 95% CI 1.1-3.1), no prior vaginal delivery (OR 8.3 95% CI 3.5-19.8), type 1 or gestational diabetes (OR 1.8 95% CI 1.0-3.0), IOL for suspected non-diabetic fetal macrosomia (OR 10.8 95% CI 2.1-55.9) and birthweight ≥4500 g (OR 3.3 95% CI 1.3-7.9).TOLAC is a feasible option (...) cohort study of 660 women with a prior CS for failed labor induction or labor dystocia undergoing TOLAC was carried out in Helsinki University Hospital, Finland, between 2013 and 2015. Data on the study population was obtained from the hospital database and analyzed using SPSS.The rate of vaginal delivery was 72.9% and the rate of repeat CS for failed induction or labor dystocia was 17.7%. The rate of successful TOLAC was 75.6% in women with a history of labor arrest in the first stage of labor, 73.1

2019 BMC Pregnancy and Childbirth

6. Arrest of the Second Stage of Labor

Arrest of the Second Stage of Labor Arrest of the Second Stage of Labor Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Arrest (...) of the Second Stage of Labor Arrest of the Second Stage of Labor Aka: Arrest of the Second Stage of Labor From Related Chapters II. Definition Arrest of the Second Stage of Labor No descent or rotation after a fixed time interval or pushing Multiparous No epidural: 2 hours Epidural: 3 hours Nulliparous No epidural: 3 hours Epidural: 4 hours III. Exam See ( ) IV. Complications: Prolonged second stage of labor V. Management position (or Occipitotransverse Position) See Consider assisted VI. References Images

2015 FP Notebook

7. Approaches to Limit Intervention During Labor and Birth

.CD003934.pub4. 44. Carbonne B, Benachi A, Leveque ML, Cabrol D, Papiernik E. Maternal position during labor: effects on fetal oxygen saturation measured by pulse oximetry. Obstet Gynecol 1996;88:797–800. 45. Abitbol MM. Supine position in labor and associated fetal heart rate changes. Obstet Gynecol 1985;65:481–6. 46. Gupta JK, Sood A, Hofmeyr GJ, Vogel JP. Position in the second stage of labour for women without epidural anaes- thesia. Cochrane Database of Systematic Reviews 2017, Issue 5. Art (...) or obstetric complications. c When not coached to breathe in a specific way, women push with an open glottis. In consideration of the limited data regarding superiority of sponta- neous versus Valsalva pushing, each woman should be encouraged to use her preferred and most effec- tive technique. c Collectively, and particularly in light of recent high- quality study findings, data support pushing at the start of the second stage of labor for nulliparous women receiving neuraxial analgesia. Delayed pushing

2019 American College of Obstetricians and Gynecologists

8. CRACKCast E180 – Labor & Delivery

● Progression ● Bloody show / mucus ● Plug expelled ● Cervical dilation and/or effacement (first stage of labour) When in doubt, ask for obstetric assessment; wait and see; and get fetal/electrical monitoring! 2) Describe the 4 phases of labor Phase 1 Phase 2 Phase 3 Phase 4 Latent phase Active phase (cervix >3cm) ● Where we determine what the presenting part is Fully dilated cervix Urge to push Usually lasts < 1 hr Get ready for delivery! Signs of placental separation include the following: the uterus (...) , early, and late. These terms refer to the timing of the deceleration relative to the uterine contraction. The clinical implications: Vary based on each issue. g. ominous signs mandating rapid delivery: Bradycardia Late decels Sinusoidal tracing Persistent variable decels More on this in the Wisecracks. 5) What are causes of inadequate contractions or “labour arrest” Dystocia, or abnormal labor progression, accounts for one-third of all cesarean sections and half of primary cesarean sections. We

2018 CandiEM

9. Trial of IV NTG for CD After Second Stage Arrest for the Prevention of Uterine Extension

of California, San Francisco Information provided by (Responsible Party): University of California, San Francisco Study Details Study Description Go to Brief Summary: Randomized controlled clinical trial of IV nitroglycerin at cesarean delivery for second stage arrest of descent to prevent or uterine extension at the hysterectomy site. Condition or disease Intervention/treatment Phase Prolonged Second Stage of Labor Drug: intravenous nitroglycerin Phase 4 Detailed Description: Intravenous nitroglycerin (...) resulting in uterine relaxation has been standardly utilized for various obstetrics conditions, e.g. breech extraction of second twin in vaginal deliveries, uterine relaxation after tachysystole in labor, prior to external cephalic version, and during difficult fetal extraction during cesarean delivery for arrest of descent in labor. Currently the use of nitroglycerin is at equipoise in obstetrics for difficult cesarean delivery after second stage arrest in labor. The clinical trial will randomize women

2014 Clinical Trials

10. Approaches to Limit Intervention During Labor and Birth

Database of Systematic Reviews 2013, Issue 10. Art. No.: CD003934. DOI: 10.1002/14651858.CD003934.pub4. Carbonne B, Benachi A, Leveque ML, Cabrol D, Papiernik E. Maternal position during labor: effects on fetal oxygen saturation measured by pulse oximetry. Obstet Gynecol 1996;88:797–800. Abitbol MM. Supine position in labor and associated fetal heart rate changes. Obstet Gynecol 1985;65:481–6. Gupta JK, Sood A, Hofmeyr GJ, Vogel JP. Position in the second stage of labour for women without epidural (...) data regarding superiority of spontaneous versus Valsalva pushing, each woman should be encouraged to use her preferred and most effective technique. Collectively, and particularly in light of recent high-quality study findings, data support pushing at the start of the second stage of labor for nulliparous women receiving neuraxial analgesia. Delayed pushing has not been shown to significantly improve the likelihood of vaginal birth and risks of delayed pushing, including infection, hemorrhage

2017 American College of Obstetricians and Gynecologists

11. Labor induction abortion in the second trimester

Labor induction abortion in the second trimester Clinical Guidelines Labor induction abortion in the second trimester Release date February 2011 SFP Guideline 20111 Abstract Labor induction abortion is effective throughout the second trimester. Patterns of use and gestational age limits vary by locality. Earlier gestations (typically 12 to 20 weeks) have shorter abortion times than later gestational ages, but differences in complication rates within the second trimester according to gestational (...) to abortion. While isolated case reports and retrospective reviews document uterine rupture during second-trimester induction with misoprostol, the magnitude of the risk is not known. The relationship of individual uterotonic agents to uterine rupture is not clear. Based on existing evidence, the Society of Family Planning recommends that, when labor induction abortion is performed in the second trimester, combined use of mifepristone and misoprostol is the ideal regimen to effect abortion quickly

2011 Society of Family Planning

12. Descent of the Fetal Head (Station) During the First Stage of Labor. (Abstract)

Descent of the Fetal Head (Station) During the First Stage of Labor. High station at specific points in the first stage of labor, such as a floating head on admission, or at 4-cm dilation or when arrest of dilation occurs, is associated with higher rates of failure to deliver vaginally. Therefore it could be useful to know if station is within an expected range at a given dilation during first stage. Arrest of descent disorders have been defined thus far on criteria applicable in the second (...) between station and dilation in the first stage of uncomplicated births and then determine if such a model would have identified births with complications related to poor labor progress. Given the complex nature of labor data, especially the imprecision of dilation and station measurement, it is not immediately evident that such a model is identifiable or what its precision would be.We sought to characterize in mathematical terms the relationship of station to dilation during the first stage of labor

2015 American Journal of Obstetrics and Gynecology

13. Core Competencies for Management of Labour

for transfer or transport to a higher level of care • Selecting the appropriate method of intrapartum maternal and fetal assessment (appropriate use of technology) • Valuing childbirth as a healthy, normal physiologic event • Providing Woman- Centred Care • Respecting the woman’s preferences, choice, and cultural beliefs • Demonstrating self- awareness of own beliefs and values and their impact on perinatal care 1 Labour and birth include the first, second, third and fourth (end of first hour) stages (...) : Managing Labour 7 Perinatal Services BC Copyright © 2011 - PSBC 2. Assessment in Labour and Birth The following section outlines the nursing assessment required to care for a healthy woman and her fetus/ newborn during the first, second, third and fourth stages of labour. Initial Labour Assessment Initiate BC Perinatal Triage and Assessment Record Listen to the woman Take a history; ask her why she came to the hospital, rupture of membranes, vaginal loss and contractions Ask the woman about her plans

2014 British Columbia Perinatal Health Program

14. Sealants for Preventing and Arresting Pit-and-fissure Occlusal Caries in Primary and Permanent Molars: A systematic Review

the citation in question at this stage and resolved the disagreement at the full-text screening stage. In the second stage, 2 reviewers independently screened the full text of all potentially eligible studies. They resolved any disagree- ment by means of discussion. When consensus was elusive, a third reviewer (C.E.), acting as an arbiter, decided final eligibility. Data extraction and management. Using a standardized form, 2 reviewers (M.T., L.G.) independently extracted data from all the included studies (...) Sealants for Preventing and Arresting Pit-and-fissure Occlusal Caries in Primary and Permanent Molars: A systematic Review SYSTEMATIC REVIEW 282 SEALANTS’ SYSTEMATIC REVIEW PEDIATRIC DENTISTRY V 38 / NO 4 JUL / AUG 16 O 1 Dr. Wright is a Dr. James W. Bawden Distinguished Professor and the director of stra- tegic initiatives, Department of Pediatric Dentistry, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, N.C.; 2 Ms. Tampi is a research assistant, Center

2016 American Academy of Pediatric Dentistry

15. Clinical Practice Guideline on management of patients with diabetes and chronic kidney disease stage 3b or higher (eGFR <45 mL/min) Full Text available with Trip Pro

the inclusion criteria. Any discrepancies at this stage were resolved by consensus. In a second round, full texts of potentially relevant studies were retrieved and independently examined for eligibility and final inclusion in the data extraction step. Any discrepancies were resolved by consensus. If no consensus could be reached, the disagreement was settled by group arbitrage. The flow of the paper selection is presented for each question in Appendix 5. 6.6.3. Data extraction and critical appraisal (...) Clinical Practice Guideline on management of patients with diabetes and chronic kidney disease stage 3b or higher (eGFR <45 mL/min) We use cookies to enhance your experience on our website. By continuing to use our website, you are agreeing to our use of cookies. You can change your cookie settings at any time. Clinical Practice Guideline on management of patients with diabetes and chronic kidney disease stage 3b or higher (eGFR <45 mL/min) | Nephrology Dialysis Transplantation | Oxford

2015 European Renal Best Practice

16. New Labor Management Guidelines and Changes in Cesarean Delivery Patterns. Full Text available with Trip Pro

, rates of arrest of dilation disorders have decreased, leading to a decrease in the rate of cesarean delivery; (2) in the second stage, pushing duration prior to diagnosis of arrest of descent has increased, also leading to a reduction in the rate of cesarean delivery for this indication. As a secondary aim, we investigated changes in maternal and neonatal morbidity.This was a secondary analysis of a prospective cohort study of all patients presenting at ≥37 weeks' gestation from 2010 through 2014 (...) with a nonanomalous vertex singleton and no prior history of cesarean delivery. Rates of cesarean delivery, arrest of dilation, and changes in rates of maternal and neonatal morbidity were calculated in crude and adjusted models. Cervical dilation at diagnosis of the arrest of dilation, time spent at the maximal dilation prior to diagnosis of arrest of dilation, and time in the second stage prior to the diagnosis of arrest of descent were compared over the study period.There were 7845 eligible patients

2017 American Journal of Obstetrics and Gynecology

17. Impact of recommended changes in labor management for prevention of the primary cesarean delivery. (Abstract)

with amniotomy and epidural anesthesia to no change after 4 hours of adequate or 6 hours of inadequate contractions in women with an epidural. The definition of second-stage arrest of labor changed simultaneously from lack of progress for 3 hours with adequate contractions in women with epidural anesthesia to no progress for ≥4 hours in nulliparas or 3 hours in multiparas with an epidural. We compared maternal and neonatal outcomes over two 1 year periods: from March 2013 to February 2014 (before (...) delivery rate decreased significantly from 9.4% in the preguideline to 6.9% in the postguideline period (odds ratio, 0.71; 95% confidence interval, 0.59-0.85; P < .01). The cesarean delivery rate for arrest of first-stage labor fell by half, from 1.8% to 0.9% (odds ratio, 0.51; 95% confidence interval, 0.31-0.81; P < .01) but was significant only among nulliparous women. The cesarean delivery rate for second-stage arrest of labor decreased but not significantly between periods (1.3% vs 1.0%; odds ratio

2017 American Journal of Obstetrics and Gynecology

18. The Effects of Increased IV Hydration on Nulliparous Women Undergoing an Induction of Labor

intravascular volume), but also in reduced delivery of nutrients and elimination of waste products from the contracting myometrium. Inadequate maternal hydration has been postulated to be a contributing factor to prolonged or dysfunctional labor, in which uterine contractions are not sufficiently strong or are inappropriately coordinated to cause adequate cervical dilation and effacement. Even in patients who completely dilate, sufficient voluntary and involuntary muscle effort is required during the second (...) stage of labor to achieve a vaginal delivery. Prolonged labors can not only lead to increased hospitalization cost, but also to increased risks of cesarean delivery for indications such as "failure to progress," chorioamnionitis (intrauterine infection), and postpartum hemorrhage. Establishing techniques to optimize the length and duration of labor has therefore been an area of particular research interest. To date, several randomized, controlled studies have demonstrated that with higher

2016 Clinical Trials

19. Elevated amniotic fluid lactate predicts labor disorders and cesarean delivery in nulliparous women at term. Full Text available with Trip Pro

a standard oxytocin regimen up to a maximum dose of 30 mU/min was applied. AFL was measured using a point-of-care device (LMU061; ObsteCare, Stockholm, Sweden). Labor arrest in the first stage of labor was defined as the need for oxytocin when cervical dilatation was <1 cm/h over 2 hours and in the second stage of labor by poor descent and rotation over 1 hour. Standard statistical analysis included analysis of variance, Pearson correlations, and binary logistic regression. Unsupervised decision tree (...) Elevated amniotic fluid lactate predicts labor disorders and cesarean delivery in nulliparous women at term. We sought to assess amniotic fluid lactate (AFL) at diagnosis of spontaneous labor at term (≥37 weeks) as a predictor of labor disorders (dystocia) and cesarean delivery (CD).This was a single-institution, prospective cohort study of 905 singleton, cephalic, term (≥37 weeks) nulliparous women in spontaneous labor. A standard management of labor (active management of labor) including

2015 American Journal of Obstetrics and Gynecology

20. Amniotomy and Oxytocin for Augmentation of Labour

uterine action , fetal head malposition , and or abnormal pelvis either due to bone or soft tissue obstruction. Arrested or prolonged labor is a frequent indication of cesarean delivery.Prolonged labor is also associated with increased pain and negative birth experience. Women with a prolonged first stage of labor have experienced a higher rate of postpartum hemorrhage, chorioamnionitis and neonatal admission to the intensive care unit. Caesarean section rates are over 20% in many developed countries (...) of oxytocin to augment labor Drug: Oxytocin Outcome Measures Go to Primary Outcome Measures : Rate of cervical dilatation [ Time Frame: every hour up to full cervical dilatation ] The rate of cervical dilation cm/ hour Secondary Outcome Measures : Augmentation delivery time [ Time Frame: Time ( in minutes) between the start of augmentation of labor up to the delivery of the head ] the duration between Augmentation of labor and the end of the second stage if labor Apgar score at 10 minutes [ Time Frame

2014 Clinical Trials

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