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Cervical Examination in Labor

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61. Evaluation of the Role of Vaginal Progesterone in Prevention of Preterm Labor in Twin Gestation With Short Cervix: Randomised Controlled Trial

of prevention of preterm labour in twin gestations with short cervix . Study Design: The study is designed as randomized ,placebo-controlled, clinical trial . All women with dichorionic diamniotic twin pregnancy will be followed up in the antenatal care at the out patient clinic. Randomization of cases will be done by computer method . 130 women with dichorionic diamniotic twin pregnancy and cervical length 10mm to 25mm discovered on transvaginal sonogram between 20w to 24w gestational age will be enrolled (...) labour in twin gestations with short cervix . Study Design: The study is designed as randomized ,placebo-controlled, clinical trial . All women with dichorionic diamniotic twin pregnancy will be followed up in the antenatal care at the out patient clinic. Randomization of cases will be done by computer method . 130 women with dichorionic diamniotic twin pregnancy and cervical length 10mm to 25mm discovered on transvaginal sonogram between 20w to 24w gestational age will be enrolled in the study

2016 Clinical Trials

62. Comparison Between Vaginal and Sublingual Misoprostol 50 µg for Cervical Ripening Prior to Induction of Labor

Comparison Between Vaginal and Sublingual Misoprostol 50 µg for Cervical Ripening Prior to Induction of Labor Comparison Between Vaginal and Sublingual Misoprostol 50 µg for Cervical Ripening Prior to Induction of Labor - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved (...) studies (100). Please remove one or more studies before adding more. Comparison Between Vaginal and Sublingual Misoprostol 50 µg for Cervical Ripening Prior to Induction of Labor (CMVS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02732522 Recruitment Status : Completed First Posted : April 8, 2016

2016 Clinical Trials

63. A Comparison of Oral Misoprostol and Vaginal Misoprostol for Cervical Ripening and Induction of Labor

Induction of labor for a single live intrauterine pregnancy Greater than or equal to 37 weeks gestational age Cephalic presentation 20 minute reassuring fetal heart rate (reactive nonstress test (NST)) Bishop score based on sterile vaginal exam of less than or equal to 6, for which the cervical dilation is less than or equal to 2 cm. Equal to 3 or less uterine contractions over 10 minutes Exclusion Criteria: Previous uterine scar Contraindication to vaginal delivery Patients with preeclampsia Grand (...) A Comparison of Oral Misoprostol and Vaginal Misoprostol for Cervical Ripening and Induction of Labor A Comparison of Oral Misoprostol and Vaginal Misoprostol for Cervical Ripening and Induction of Labor - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please

2016 Clinical Trials

64. Guideline for Admission to Midwife-led Units in Northern Ireland & Northern Ireland Normal Labour & Birth Care Pathway

required social services input and there is no related impact on the pregnancy or the woman’s health 9. Previous extensive vaginal, cervical, or third degree perineal trauma following individual assessment 13. Previous congenital abnormality, with no evidence of reoccurrence 10. Prostaglandin induction resulting in the onset of labour (6g) 14. Non-significant (light) meconium in the absence of any other risk (6b) 11. Group B Streptococcus positive in this pregnancy with no signs of infection (6h) 15 (...) Guideline for Admission to Midwife-led Units in Northern Ireland & Northern Ireland Normal Labour & Birth Care Pathway 2 1 4 5 7 2 6 3 8 1 3 Altnagelvin AMU Craigavon AMU Mater FMU South Western Acute Hospital AMU Daisy Hill AMU Lagan Valley FMU Ulster AMU Downe FMU 4 6 5 7 Revised and Updated September 2018 8 GUIDELINE FOR ADMISSION TO MIDWIFE-LED UNITS IN NORTHERN IRELAND & NORTHERN IRELAND NORMAL LABOUR & BIRTH CARE PATHWAY INTRODUCTION 2 METHODOLOGY 4 PLANNING PLACE OF BIRTH 9 NORTHERN

2016 Regulation and Quality Improvement Authority

65. Systematic review with meta analysis: Uncertainty in evidence synthesis limits clinical applicability of a clinical and cost-effectiveness analysis of induction of labour methods

. . Context The goal of induction of labour (IOL) is to achieve vaginal delivery by stimulation of uterine contractions before the spontaneous onset of labour. Variations in the management of IOL likely affect rates of caesarean delivery (CD), particularly the use of cervical ripening agents for the unfavourable cervix. This systematic review and meta-analysis looks at the various methods of labour induction and compares them from a clinical and cost-effectiveness perspective. Methods This was a review (...) of randomised controlled trials (RCTs) examining pharmacological, mechanical and complementary (ie, acupuncture) interventions to induce labour. Outcomes included were vaginal delivery not achieved within 24 hours (VD24); uterine hyperstimulation with fetal heart rate (FHR) changes; CD; serious maternal and neonatal morbidity or … Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You

2016 Evidence-Based Medicine

66. Guideline Supplement: Preterm labour and birth

review • Updated title to Preterm labour and birth • Added risk reduction measures • Added consumer advice after threatened preterm labour • Guideline supplement created October 2015 MN14.6-V6-R19 Amendment to Section 3.2 Cervical cerclage. • Clarified recommendation that multiple dilation and evacuations, cervical surgery or other abnormalities are not themselves indications for cerclage. Amendment to Section 4 Clinical assessment of PTL • Clarified purpose of sterile speculum examination (...) with a singleton gestation and a prior spontaneous PTB 4 A 5. Consider progesterone therapy for asymptomatic women with an incidentally diagnosed short cervix on transvaginal cervical length (TVCL) assessment in the second trimester 4 A 6. Consider cervical cerclage for women with prior PTB and/or second- trimester losses related to painless cervical dilation and in the absence of labour or abruptio placentae or prior cerclage due to painless cervical dilation in the second trimester 5,6 B 7. Consider cervical

2016 Queensland Health

67. Immersion in Water During Labor and Delivery

in duration of the first stage of labor (mean difference, –32.4 minutes; 95% CI, –58.7 to –6.13). However, considering each of these effects, it is difficult to know how factors other than immersion, such as the structure of care (including the presence of an obstetrician–gynecologist and other health care providers and timing and frequency of examinations), affected the outcome. Furthermore, there were no differences in the incidence or severity of perineal trauma (RR, 1.16; 95% CI, 0.99–1.35; five (...) during labor or delivery (10). In a subsequent systematic review and meta-analysis, newborn outcomes after second-stage immersion and birth in water were compared with land birth. Data from the 12 included studies (two randomized trials, three prospective and two retrospective cohort, and five case–control studies) showed no neonatal benefits associated with immersion (18). The most recent and largest meta-analysis and systematic review examining this question included 29 studies. Although

2016 American College of Obstetricians and Gynecologists

68. Flowchart: Assessment and management of preterm labour and birth

• Vaginal loss – mucous, blood, fluid • Regular uterine activity Physical examination • Vital signs • Abdominal palpation • Fetal surveillance – FHR, CTG • Sterile speculum exam o Identify if ROM o Visualise cervix/membranes o High vaginal swab o Test for fFN • Low vaginal/anorectal GBS swab • Cervical dilatation o Sterile digital vaginal exam unless ROM, placenta praevia • Ultrasound – if available o Fetal growth and wellbeing Laboratory • High vaginal swabs for MC&S • One swab (low vaginal + anal (...) Flowchart: Assessment and management of preterm labour and birth Queensland Health State of Queensland (Queensland Health) 2016 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au Queensland Clinical Guidelines www.health.qld.gov.au/qcg Assessment and management of preterm labour Review History • Medical, surgical, obstetric, social Assess for signs and symptoms • Pelvic pressure • Lower abdominal cramping • Lower back pain

2016 Queensland Health

69. Core Competencies for Management of Labour

, frequent uterine contractions accompanied by progressive cervical changes (dilatation and effacement) from 3-4 cm to full dilatation and effacement of the cervix Fetal Fibronectin – glycoprotein found in extracellular matrix of amniotic membranes which binds chorion to the underlying decidua. It is normally found in cervico-vaginal secretions until 22 weeks gestation and again near the time of labour. Latent Phase – first phase of labour in the presence of uterine activity resulting in progressive ef (...) movement and auscultate FHR Assess fetal heart rate and response to contractions Assess contractions for onset, strength, length and frequency, including resting tone Perform a vaginal examination unless contraindicated Active First Stage of Labour – Ongoing Assessment Initiate BC Labour Partogram Commence one-to-one care Check FHR q 15 - 30 min (see DST FHS) Palpate contractions q 15 - 30 min for frequency, strength, length of contractions, and uterine resting tone Check pulse, BP, respirations, temp

2014 British Columbia Perinatal Health Program

70. Monitoring your baby during labour: A decision aid for women having a vaginal birth

is picked up and you will be able to hear this regular sound at the same rate as your baby’s heart beat. A cardiotocograph may also be used to record your baby’s heart beat directly using electrocardiography (ECG). The thin cable which is used to monitor your baby can be inserted into your vagina by your care provider during an examination of your vagina and passed through the opening in your cervix and attached to your baby’s scalp using a tiny wire screw also called a scalp clip. This method (...) Monitoring your baby during labour: A decision aid for women having a vaginal birth Monitoring your baby during labour A decision aid for women having a vaginal birthThis decision aid has been written to support women planning a vaginal birth to know what to expect, and to have a say in making decisions about how their baby will be monitored during labour and birth. This decision aid provides information about two options: 1. Choose to have intermittent monitoring 2. Choose to have continuous

2015 EUnetHTA

71. Point of Care Tests to exclude preterm labour: Phosphorylated Insulin-like Growth Factor Binding Protein test

membranes on sterile speculum examination of the cervix. MSAC compared the phIGFBP-1 test with routine clinical care with and without the use of transvaginal ultrasound (TVUS) to assess cervical length (CL) across several scenarios presented in the application: ? standard clinical management and phIGFBP-1 test with or without TVUS to measure CL versus cervical assessment with or without TVUS to measure CL ? standard clinical management and fFN test with or without TVUS to measure CL versus cervical (...) to the intervention is suggested for pregnant women, between 24 and 33 weeks and 6 days gestation who present with the symptoms of threatened preterm labour and are found to have intact amniotic membranes on sterile speculum examination of the cervix. The application proposed that it will be physicians, participating nurse practitioners or participating midwives, who are speculum trained, who will perform the phIGFBP-1. No additional specialised training or qualifications are required by these practitioners

2014 Medical Services Advisory Committee

72. Outpatient versus inpatient induction of labour for improving birth outcomes. (Full text)

settings.To assess the effects on outcomes for mothers and babies of induction of labour for women managed as outpatients versus inpatients.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2013).Published and unpublished randomised and quasi-randomised trials in which inpatient and outpatient methods of cervical ripening or induction of labour have been compared.Two review authors independently assessed trial reports for inclusion. Two review authors carried out data (...) Outpatient versus inpatient induction of labour for improving birth outcomes. More than 20% of women undergo induction of labour in some countries. The different methods used to induce labour have been the focus of previous reviews, but the setting in which induction takes place (hospital versus outpatient settings) may have implications for maternal satisfaction and costs. It is not known whether some methods of induction that are effective and safe in hospital are suitable in outpatient

2013 Cochrane PubMed abstract

73. Cervical Ripening Balloon in Induction of Labour at Term

Cervical Ripening Balloon in Induction of Labour at Term Cervical Ripening Balloon in Induction of Labour at Term - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Cervical Ripening Balloon in Induction (...) ): Tagore Shephali, KK Women's and Children's Hospital Study Details Study Description Go to Brief Summary: About 1 in 6 deliveries in KKH are induced with prostaglandins. Inpatient induction can be a lengthy process especially when cervical priming is required. Although mechanical method of induction of labour (IOL) is established, its use in Singapore is uncommon. Systematic reviews comparing mechanical method against pharmacological and surgical IOL showed that mechanical method has similar efficacy

2015 Clinical Trials

74. Cervical condition and cerebral Doppler as determinants of adverse perinatal outcomes after labour induction for late-onset small for gestational age fetuses. (Abstract)

Cervical condition and cerebral Doppler as determinants of adverse perinatal outcomes after labour induction for late-onset small for gestational age fetuses. To estimate the combined value of fetal cerebral Doppler examination and Bishop score for predicting perinatal outcome after labor induction for small-for-gestational-age (SGA) fetuses in the presence of normal umbilical artery Doppler recordings.We conducted a cohort study in two tertiary centers, including 164 women with normal (...) umbilical artery Doppler recordings who underwent induction of labor because of an estimated fetal weight < 10(th) percentile. The fetal middle cerebral artery pulsatility index and cerebroplacental ratio (CPR) were obtained in all cases within 24 h before induction. Cervical condition was assessed at admission using the Bishop score. A predictive model for perinatal outcomes was constructed using a decision-tree analysis algorithm.Both a very unfavorable cervix, defined as a Bishop score < 2, (odds

2015 Ultrasound in Obstetrics and Gynecology

75. Elastography for Evaluating Cervical Maturity in Preparation for Labor Induction at 37 to 42 Weeks of Gestation

Date : September 2018 Resource links provided by the National Library of Medicine related topics: Groups and Cohorts Go to Group/Cohort Intervention/treatment The study population The study population is composed of pregnant women with a medical indication for the induction of pre-term (37-42 weeks of gestation) labor and who are consulting in the participating center. Intervention: Cervical ultrasound with elastography Device: Cervical ultrasound with elastography Following routine vaginal exam (...) The patient must be insured or beneficiary of a health insurance plan Pregnant woman with a medical indication for pre-term labor induction: 37 to 42 weeks of gestation. Exclusion Criteria: The patient is in an exclusion period determined by a previous study The patient is under judicial protection, under tutorship or curatorship The patient refuses to sign the consent It is impossible to correctly inform the patient History of cervical surgery Malformation of the cervix Contacts and Locations Go

2015 Clinical Trials

76. Manipal Cervical Scoring System by Transvaginal Ultrasound in Predicting Successful Labour Induction (Full text)

Manipal Cervical Scoring System by Transvaginal Ultrasound in Predicting Successful Labour Induction Induction of labour (IOL) nowadays is a common procedure in obstetric practice. The success of IOL largely depends upon "favourability" or "readiness" cervix which is traditionally assessed by manual examination and Scored as Bishop Score. However, this method is limited by subjectivity and reproducibility and though done in all the patients prior to IOL, several studies have demonstrated poor (...) fetus. Bishop Score was assessed by pervaginal examination and was compared with preinduction TVS cervical Score (parameters being cervical length, funneling, position of cervix and distance of presenting part from external os). Labour was induced within one hour of cervical assessment. The labour induction was considered successful if patient could get into active labour i.e., onset of regular uterine contractions (at interval of 2-3 minutes) and cervical dilatation of 4 cm or greater within 24

2015 Journal of clinical and diagnostic research : JCDR PubMed abstract

77. Sonographically accessed funneling of the uterine cervix as a predictor of successful labor induction (Full text)

Sonographically accessed funneling of the uterine cervix as a predictor of successful labor induction The Bishop score and length of the uterine cervix are good predictors of successful labor induction. However, little is known about the association between the funneling of the uterine cervix and successful labor induction. The study aimed to evaluate cervical funneling as a predictor of successful labor induction.This study was designed as a prospective observational study. Subjects who (...) delivered a baby by labor induction were enrolled in the study from July 2011 to August 2013. Cervical funneling and length were examined with transvaginal ultrasonography. The Bishop score was rated by digital pelvic examination.A total of 163 primigravida women were recruited for the study. Of these, 137 participants (84.0%) delivered vaginally by labor induction. Cervical funneling was observed in 93 women (57.1%). Successful labor induction was significantly higher in patients with cervical

2015 Obstetrics & gynecology science PubMed abstract

78. Derivation and validation of a model predicting the likelihood of vaginal birth following labour induction. (Full text)

recognized, but existing models are limited in scope and generalizability. Our objective was to derive and internally validate a clinical prediction model that uses variables readily accessible through maternal demographic data, antenatal history, and cervical examination to predict the likelihood of vaginal birth following IOL.Data was extracted from electronic medical records of consecutive pregnant women who were induced between April and December 2016, at Mount Sinai Hospital, Toronto, Canada (...) accessible through maternal demographic data, antenatal history, and cervical examination. Once prospectively validated in diverse settings, and if shown to be acceptable to pregnant women and healthcare providers as well as clinically and cost-effective, this model has potential for widespread use in clinical practice and research for enhancing patient autonomy, improving induction outcomes, and optimizing allocation of resources.

2019 BMC Pregnancy and Childbirth PubMed abstract

79. Labor patterns in Asian American women with vaginal birth and normal perinatal outcomes. (Abstract)

Labor patterns in Asian American women with vaginal birth and normal perinatal outcomes. The pattern of normal labor progression can help to define prolonged labor and dystocia. Several studies had tried to establish the process of normal labor in different races. Previous findings in Asian women were limited and often incomparable. Our aim was to examine labor patterns in Asian American women.A total of 3079 women with singleton term gestation, vertex presentation, vaginal delivery (...) , and a normal perinatal outcome were extracted from the Consortium on Safe Labor study. A repeated measure analysis and an interval-censored regression were applied to depict the average labor curves and estimate the time interval of cervical dilation by 1 cm, respectively. A sensitivity analysis was conducted to assess the impact of oxytocin augmentation. The cumulative duration of the 1st stage of labor was calculated to draw a partograph.It took an average of 5.2 hours for nulliparous Asian women

2019 Birth

80. Effect of Nursing Intervention Integrating an Islamic Praying Program on Labor Pain and Pain Behaviors in Primiparous Muslim Women. (Full text)

Effect of Nursing Intervention Integrating an Islamic Praying Program on Labor Pain and Pain Behaviors in Primiparous Muslim Women. Labor pain has always been a priority issue for primiparous women. Pain behaviors appear as a response to labor pain. This study aimed at examining the effect of nursing interventions integrating an Islamic praying (NIIIP) program on labor pain and pain behavior.In this experimental design, 42 women in the control group received the usual care; 41 (...) in the experimental group received the usual care and an NIIIP program from the 32nd week of pregnancy. This was done by providing childbirth education which they then practiced at home every day until they entered the labor room in the Bhinneka Bhakti Husada Hospital and Community Health Center Pamulang, Indonesia. They conducted 30 min of reciting from the Quran, stroking, positioning during their inter contractions, just breathing during contractions at the 1st, 2nd, 3rd h after cervical dilation of 3-4 cm

2019 Iranian journal of nursing and midwifery research Controlled trial quality: uncertain PubMed abstract

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