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Cervical Examination in Labor

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1. Cervical Examination in Labor

Cervical Examination in Labor Cervical Examination in 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 Cervical Examination (...) in Labor Cervical Examination in Labor Aka: Cervical Examination in Labor , Uterine Cervical Length From Related Chapters II. Technique Mnemonic: 5C's Clean (Sterile technique) Catheterize or empty before examination Cervical evaluation (See ) Cervical Dilation Cervical Effacement Caput forming? Cord Indicated by pulsations behind membranes III. Evaluation: (Mnemonic 5P's) Presentation See Position See Place (Station) See See Puncture (Assess for ) IV. Interpretation: Cervical Length based

2018 FP Notebook

2. The induction of labor by mechanical cervical dilation plus misoprostol compared to misoprostol alone: a systematic review and meta-analysis

The induction of labor by mechanical cervical dilation plus misoprostol compared to misoprostol alone: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration (...) into the relationship between study characteristics (e.g. species, sex or drug class or dose) and effect size. They should be considered hypothesis-generating. Ideally, a threshold describing the number of studies per subgroup required for analysis should be specified. For further guidance please refer to the and to pre-clinical meta-analysis. Example: The following study characteristics will be examined as potential source of heterogeneity: species (stratified per species); sex (stratified per sex); duration

2019 PROSPERO

3. A comparative randomized study on effect of vaginally administered glyceryl trinitrate placebo on cervical ripening prior to induction of labor in overdue pregnancies. Full Text available with Trip Pro

A comparative randomized study on effect of vaginally administered glyceryl trinitrate placebo on cervical ripening prior to induction of labor in overdue pregnancies. The aim of this study is to examine the effectiveness and adverse effects of local glyceryl trinitrate (GTN) application during labor compared with a placebo group.The study consisted of 70 pregnant women with overdue pregnancies who presented to the hospital for labor induction between January 2009 and January 2011 (...) in the Obstetrics Clinic of Istanbul Süleymaniye Gynecology and Obstetrics Education and Training Hospital. Vaginal suppositories-containing GTN (36/70) or placebo (34/70) was administered to the participants in a randomized fashion. The placebo and GTN involving vaginal ovules used in the study were prepared in the Pharmacy Department of Istanbul University Faculty of Pharmacy. Maternal effects during labor, rates of normal vaginal and C/S deliveries, the interval between the initial medication and delivery

2019 Indian journal of pharmacology Controlled trial quality: uncertain

4. Transvaginal sonographic assessment of cervical length for predicting the outcome of labor induction in nulliparous women

Transvaginal sonographic assessment of cervical length for predicting the outcome of labor induction in nulliparous women Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence (...) the number of studies per subgroup required for analysis should be specified. For further guidance please refer to the and to pre-clinical meta-analysis. Example: The following study characteristics will be examined as potential source of heterogeneity: species (stratified per species); sex (stratified per sex); duration of index ischemia (linear); stem cell dose (linear); blinding of outcome assessment reported (stratified yes vs no). For stratified analyses, a minimum number of 8 studies per subgroup

2018 PROSPERO

5. Intrapartum ultrasound assessment of cervical dilatation and its value in detecting active labor Full Text available with Trip Pro

Intrapartum ultrasound assessment of cervical dilatation and its value in detecting active labor We aimed to examine the agreement between ultrasound and digital vaginal examination in assessing cervical dilatation in an African population and to assess the value of ultrasound in detecting active labor.A cross-sectional study was conducted in a teaching hospital in Ghana between April and September of 2016. Anterior-posterior and transverse diameters of cervical dilatation were measured (...) - 2.01 to 1.95 cm. Ultrasound predicted active labor with 0.87 (95% CI 0.75-0.99) as the area under the ROC curve.Ultrasound measurements showed good agreement with digital vaginal examinations in assessing cervical dilatation during labor and ultrasound may be used to detect active labor.

2018 Journal of ultrasound

6. Comparative Evaluation of Arabin Pessary and Cervical Cerclage for the Prevention of Preterm Labor in Asymptomatic Women with High Risk Factors Full Text available with Trip Pro

of this study was to examine cervical findings for the prediction and the comparative use of Arabin pessary or cerclage for the prevention of preterm birth in asymptomatic women with high risk factors for preterm labor.The study group was composed of singleton pregnancies (spontaneously conceived) with high risk factors for preterm labor. Cervical length, dilatation of the internal cervical os and funneling, were estimated with transvaginal ultrasound during the first and the second trimesters (...) Comparative Evaluation of Arabin Pessary and Cervical Cerclage for the Prevention of Preterm Labor in Asymptomatic Women with High Risk Factors Preterm labor is one of the most significant obstetric problems associated with high rate of actual and long-term perinatal complications. Despite the creation of scoring systems, uterine activity monitoring, cervical ultrasound and several biochemical markers, the prediction and prevention of preterm labor is still a matter of concern. The aim

2018 International journal of environmental research and public health

7. Devices for Measuring Cervical Dilation During Labor: Systematic Review and Meta-analysis. (Abstract)

Devices for Measuring Cervical Dilation During Labor: Systematic Review and Meta-analysis. Measurement of cervical dilation is one of the major indicators of labor progression. At present, the criterion standard for this evaluation is digital examination, which results are sometimes inaccurate and extremely dependent on the subject (ie, obstetrician or midwife) experience.In this systematic and meta-analysis review, the authors have gathered the vast majority of the instruments used (...) for measuring cervical dilation and their clinical application; main features, potentialities, and the most significant constraints are underlined for each device.Three of the most popular databases (ie, Web of Science, PubMed, and ClinicalTrials.gov) were used to identify all available cervimeters, by using single or combinations of the following keywords: "cervical," "dilation or dilatation," "cervimetry," "cervix," "uterine," "measurement," "labour or labor," "birth," and "monitoring." Only articles

2018 Obstetrical & Gynecological Survey

8. Effectiveness of Labor Cervical Examination Simulation in Medical Student Education. (Abstract)

Effectiveness of Labor Cervical Examination Simulation in Medical Student Education. To estimate whether simulation training improves medical students' cervical examination accuracy.The training paradigm for the labor cervical examination exposes patients to additional examinations, lacks a gold standard, and does not objectively assess trainee competence. To address these issues and optimize training, we assessed the effectiveness of cervical examination simulation in third-year medical (...) . On average, competence was achieved with 27-44 repetitions.Simulation training dramatically improved student accuracy in labor cervical examinations. Because not all students achieved competence, the cumulative summation analyses suggest that more than 100 repetitions would be needed if the goal was for the entire class of students to achieve competence.II.

2015 Obstetrics and Gynecology

9. Agreement between transperineal ultrasound measurements and digital examinations of cervical dilatation during labor. Full Text available with Trip Pro

Agreement between transperineal ultrasound measurements and digital examinations of cervical dilatation during labor. To compare 2D transperineal ultrasound assessment of cervical dilatation with vaginal examination and to investigate intra-observer variability of the ultrasound method.A prospective observational study was performed at Skane University Hospital, Lund, Sweden between October 2013 and June 2014. Women with one fetus in cephalic presentation at term had the cervical dilatation (...) assessed with ultrasound and digital vaginal examinations during labor. Inter-method agreement between ultrasound and digital examinations and intra-observer repeatability of ultrasound examinations were tested.Cervical dilatation was successfully assessed with ultrasound in 61/86 (71 %) women. The mean difference between cervical dilatation and ultrasound measurement was 0.9 cm (95 % CI 0.47-1.34). Interclass correlation coefficient (ICC) was 0.83 (95 % CI 0.72-0.90). Intra-observer repeatability

2015 BMC Pregnancy and Childbirth

10. SMFM Statement: Elective induction of labor in low-risk nulliparous women at term: The ARRIVE trial

nulliparous women, reduces the risk of a composite outcome ofperinataldeathor severeneonatalmorbidity. Nulliparouswomenwithreliabledatingandnoobstetricor medical complications were eligible, regardless of favor- ability of cervical examination. Of the 22,533 women who were eligible for participation, 27% (n¼6106) enrolled. Recruitment occurred at 41 academic and community- based hospitals, with 3062 women randomly assigned to the IOL group and 3044 women randomly assigned to the expectant treatment group (...) SMFM Statement: Elective induction of labor in low-risk nulliparous women at term: The ARRIVE trial SMFMStatementonElectiveInductionof LaborinLow-RiskNulliparousWomenatTerm: theARRIVETrial Society of Maternal-Fetal (SMFM) Publications Committee ARandomizedTrialofInductionVersusExpectantManagement(ARRIVE)wasconductedbytheEunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network from March 2014 to August 2017.This large multicenter

2019 Society for Maternal-Fetal Medicine

11. Approaches to Limit Intervention During Labor and Birth

difference that exceeded the effect of amniotomy with oxytocin (mean difference, 21.11 hours). Women in upright positions also were less likely to have a cesarean delivery (RR, 0.71; 95% CI, 0.54–0.94) (43). A second Cochrane meta-analysis of RCTs that examined the effect of position during the second stage of labor found that upright or lateral positions compared with supine positions are associated with fewer “abnormal” fetal heartratepatterns(RR,0.46;95%CI,0.22–0.93),areduc- tion in episiotomies (RR (...) , Blanchard MH, Mercer BM. Outcomes of women presenting in active versus latent phase of spon- taneous labor. Obstet Gynecol 2005;105:77–9. 3. Neal JL, Lamp JM, Buck JS, Lowe NK, Gillespie SL, Ryan SL. Outcomes of nulliparous women with spontaneous labor onset admitted to hospitals in preactive versus active labor. J Midwifery Womens Health 2014;59:28–34. 4. Wood AM, Frey HA, Tuuli MG, Caughey AB, Odibo AO, Macones GA, et al. Optimal admission cervical dilation in spontaneously laboring women. Am J

2019 American College of Obstetricians and Gynecologists

12. 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 (...) . At this point, reduce the infusion rate to 1 to 2 mL/min. 7) List 8 factors linked to pre-term labor. Describe the management of premature labor in the ED. List 3 tocolytics. Preterm labor is defined as uterine contractions with cervical changes before 37 weeks of gestation. Early maternal signs and symptoms include an increase or change in vaginal discharge, pain resulting from uterine contractions (sometimes perceived as back pain), pelvic pressure, vaginal bleeding, and fluid leak. Box 181.2 – Factors

2018 CandiEM

13. Fever during labor

) • Threatening preterm labor/PPROM B-C Temperature measurement during labor is recommended every 2-4 hours in case of afebrilia, subfebrilia (37.5-38,0°C) and after placement of epidural analgesia D If the woman in labour has a fever or developes fever, the temperature measurement should be repeated as a minimum every hour D In case of intrapartum fever the following actions are recommended: • Assessment by physician, possibly including physical examination in order to find explanation of fever and plan (...) Fever during labor Fever during labor DSOG (Danish Society of Obstetrics and Gynecology) Approved on January 2018 by the participants at the yearly obstetric guideline meeting in DSOG Page 2-4: Clinical recommendations in English Page 5-8: Flow charts in English Page 9 – 68: Entire guideline I Danish Clinical Recommendations Summary of the clinical recommendations regarding handling of intrapartum feber Clinical recommendations Strength A-D Temperature should be a rectal measurement B

2018 Nordic Federation of Societies of Obstetrics and Gynecology

14. Labor Curve Analysis of Medically Indicated Early Preterm Induction of Labor. (Abstract)

examinations available during labor. Prior cesarean delivery, 5-minute Apgar score less than 5, and arterial cord pH less than 7.0 were exclusions. The course of cervical dilation was modeled using repeated measures analysis, and smoothed curves for nulliparous and parous women were generated separately. Estimates of the median (5th-95th percentile) traverse times between two dilations were computed using interval censored regression. Traverse times (ie, the elapsed time between two given dilation measures (...) Labor Curve Analysis of Medically Indicated Early Preterm Induction of Labor. To analyze the labor curves of nulliparous and multiparous women between 23.0 and 34.0 weeks of gestation who underwent induction of labor and achieved vaginal delivery.This is a retrospective cohort study of all live singletons delivered vaginally after medically indicated induction of labor between 23.0 and 34.0 weeks of gestation from 2011 through 2014 at our institution. We excluded those with one or no cervical

2019 Obstetrics and Gynecology

15. Labor progress determined by ultrasound is different in women requiring Cesarean delivery from those who experience a vaginal delivery following induction of labor. (Abstract)

way.The objective of the study was to determine the differences in labor progress by the use of serial transperineal ultrasound assessment of fetal head descent between women having vaginal and Cesarean delivery.This was a prospective longitudinal study performed in 315 women with singleton pregnancy undergoing labor induction at term between December 2016 and December 2017. Paired assessment of cervical dilatation and fetal head station by vaginal examination and transperineal ultrasonographic (...) vaginal examination and ultrasound assessments was 1,198 with a median of three per woman. The median assessment-to-assessment interval was 4.6 hours (interquartile range 4.3-5.1). Women achieving vaginal delivery (n=261) had steeper slopes of para-sagittal angle of progression and head-perineum distance against fetal head station and cervical dilatation than those achieving Cesarean delivery (n=54). Objectively, an additional decrease of 5.11° and 1.37° in para-sagittal angle of progression

2019 American Journal of Obstetrics and Gynecology

16. Factors that affect ultrasound-determined labor progress in women undergoing induction of labor. (Abstract)

by the transperineal ultrasonographic parameters, in women achieving vaginal delivery.This was a prospective longitudinal study performed in 315 Chinese women with singleton pregnancy undergoing labor induction at term between December 2016 and December 2017. Paired assessment of cervical dilatation and fetal head station by vaginal examination and transperineal ultrasonographic assessment of fetal head descent (para-sagittal angle of progression and head-perineum distance) were made serially following (...) the commencement of labor induction until full cervical dilatation. The researchers were blinded to the findings of the clinical team's vaginal examination and vice versa. The repeated measure data were analyzed by mixed effect models to identify the significant factors (age ≥35 years, obesity, parity, methods of labor induction, and epidural anesthesia) affecting the relationship between para-sagittal angle of progression and head-perineum distance against fetal head station and cervical dilatation.The total

2019 American Journal of Obstetrics and Gynecology

17. Approaches to Limit Intervention During Labor and Birth

, with recumbent, lateral, or supine positions during the first stage of labor found that upright positions shorten the duration of the first stage of labor by approximately 1 hour and 22 minutes (mean difference, –1.36; 95% CI, –2.22 to –0.51), a mean difference that exceeded the effect of amniotomy with oxytocin (mean difference, –1.11 hours). Women in upright positions also were less likely to have a cesarean delivery (RR, 0.71; 95% CI, 0.54–0.94) (43). A second Cochrane meta-analysis of RCTs that examined (...) , Dierker L, Blanchard MH, Mercer BM. Outcomes of women presenting in active versus latent phase of spontaneous labor. Obstet Gynecol 2005;105:77–9. Neal JL, Lamp JM, Buck JS, Lowe NK, Gillespie SL, Ryan SL. Outcomes of nulliparous women with spontaneous labor onset admitted to hospitals in preactive versus active labor. J Midwifery Womens Health 2014;59:28–34. Wood AM, Frey HA, Tuuli MG, Caughey AB, Odibo AO, Macones GA, et al. Optimal admission cervical dilation in spontaneously laboring women. Am J

2017 American College of Obstetricians and Gynecologists

18. Cervical Length and Bishop Score in Preinduction Cervical Assessment Prior to Induction of Labor

of Medicine related topics: Groups and Cohorts Go to Group/Cohort Intervention/treatment Induction of labor 200 women all are primigravida between 37-42 weeks gestation to whom induction of labor will be carried out in the casualty of Ain Shams University Maternity Hospital. All participants will have an assessment of the cervix by both Bishop score system and transvaginal measurement of cervical length. Other: Bishop score calculation of modified Bishop score in numbers by digital vaginal examination (...) Other: cervical length measuring cervical length by trans-vaginal ultrasound Outcome Measures Go to Primary Outcome Measures : Cervical Length Prior to Labor Induction [ Time Frame: 24 hours ] median cervical length measured by transvaginal ultrasound in centimetres Bishop Score Prior to Induction of Labor [ Time Frame: 72 hours ] median Bishop score assessed by digital vaginal examination as follows: Cervical dilatation in centimeters will be given a score of zero if closed, a score of 1 if 1-2 cm

2016 Clinical Trials

19. AIUM Practice Parameter for the Performance of Limited Obstetric Ultrasound Examinations by Advanced Clinical Providers

in a laboring patient. A limited obstetric ultrasoundexamina- tion may also be performed in patients requiring serial examinationsinwhichasubsequentanatomicevaluation maybeunnecessaryorimpractical. When a patient undergoes a limited ultrasound examination, it is important that she understands why a limited scan is being done and that she has appropriate expectationsregardingtheinformationbeingsought. Clinical judgment should be used to determine the propertypeofultrasoundexaminationperformed. I (...) number, car- diac activity, presentation, placental location with respect to the internal cervical os, and amniotic ?uid volume. If requested, a limited obstetric ultrasound examination may include fetal biometry. Reliable fetal biometric measurementsrequire anatomic familiarity withthe mid- line falx, thalami, cavum septi pellucidi, columns of the fornix, cerebellum, stomach, umbilical vein as it courses throughthe liver,andfemoraldiaphysis. C. Specialized Obstetric Ultrasounds A biophysical pro?le

2018 American Institute of Ultrasound in Medicine

20. Cervical length screening for prevention of preterm birth in singleton pregnancies with threatened preterm labor: a Cochrane systematic review and meta-analysis of randomized controlled trials using individual patient-level data

Cervical length screening for prevention of preterm birth in singleton pregnancies with threatened preterm labor: a Cochrane systematic review and meta-analysis of randomized controlled trials using individual patient-level data Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any (...) . They should be considered hypothesis-generating. Ideally, a threshold describing the number of studies per subgroup required for analysis should be specified. For further guidance please refer to the and to pre-clinical meta-analysis. Example: The following study characteristics will be examined as potential source of heterogeneity: species (stratified per species); sex (stratified per sex); duration of index ischemia (linear); stem cell dose (linear); blinding of outcome assessment reported (stratified

2016 PROSPERO

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