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Cervical Examination in Labor

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81. Preterm Induction of Labor Timing of Amniotomy: A Randomized Controlled Trial

with or without oxytocin or 2) misoprostol. Prior to amniotomy, the obstetric provider will assess whether or not the fetal head is engaged. If the fetal head is not engaged (applied to the cervix), amniotomy will be deferred. The patient will be examined every 2 hours until amniotomy can be safely performed (in keeping with our institutional standard of care to examine women every 2-4 hours in labor). Procedure: Early Amniotomy This intervention involves using an amniotomy hook to rupture the membranes (...) during a sterile vaginal exam. This intervention will be performed prior to the cervix being dilated 4cm. Experimental: Late amniotomy Women randomized to late amniotomy will have their membranes ruptured once the cervix reaches at least 4cm dilation. This will occur after cervical ripening has taken place, with 1) a cervical Foley balloon catheter with or without oxytocin or 2) misoprostol. If the cervix fails to reach 4cm dilation 12 hours following cervical ripening, amniotomy will be performed

2018 Clinical Trials

82. A Comparison Between the Effect of Oxytocin Only and Oxytocin Plus Propranolol on Induction of Labor in Term Pregnancy

placebo), a similar capsule as a placebo will be administrated orally by researcher before beginning of induction of labour. Induction will be initiated at a dose of 2 mIu/min and it will be increased 2 mIu / minute every 15 minutes until good contractions are obtained (3 forceful contractions within 10 minutes) or to a maximum dose of 30 mIu/min; then, it will be continued at this rate for 8 hours. If patients enter the active phase of labour (cervical dilatation = 3-4 cm), induction (...) of patients will be determined. The first vaginal examination will be performed by the investigator, and then the induction will be initiated by the same researcher. Continuation of induction and the control of patients will be monitored by a coworker who knew nothing about the method of initiation of induction, neither did the patients (double blind) Primary Purpose: Treatment Official Title: A Comparison Between the Effect of Oxytocin Only and Oxytocin Plus Propranolol on Induction of Labor in Term

2018 Clinical Trials

83. Gastric Emptying During the Labour

). Parturient group : adult females less than 40 years old with no significant medical history (American Society of Anesthesiologists ASA class 1, in labour in the delivery room, receiving effective epidural analgesia, having an empty stomach on the initial ultrasound examination, and authorised to ingest solid foods during labour (cervical dilatation strictly less than 8cm) according to local guidelines. Exclusion Criteria: Refusal to participate in this study Patient unable to speak French Oesophageal (...) control group). The investigator propose the hypothesis that the gastric emptying of a light, solid meal is slowed by 30% during labour. Condition or disease Intervention/treatment Phase Pregnancy Healthy Volunteers Parturition Other: Ultrasound assessment of gastric emptying of a flavoured yoghourt. Not Applicable Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 30 participants Allocation: Non-Randomized Intervention Model

2018 Clinical Trials

84. Placental Drainage Versus no Placental Drainage After Vaginal Delivery in the Management of Third Stage of Labour

malpresentation, history of postpartum hemorrhage, preterm delivery, multiple pregnancy, fetal anomaly, uterine malformation, fetal demise, women with immediate delivery indications, unable to give written informed consent, a clinically estimated fetal weight >4500, preeclampsia, antepartum hemorrhage, previous cesarean section, instrumental delivery and known coagulation disorders. Patients were recruited regardless of using cervical ripening agents. General physical and obstetric examination were performed (...) after a detailed history taking. A sample of venous blood was obtained for hemoglobin concentration on admission. Labour was conducted according to the hospital protocol. Labour was augmented with oxytocin in active phase of labour. All patients were monitored with cardiotocography (CTG) before induction of labor and CTG was used continuously during labor. Oxytocin infusion was continued until delivery of both child and placenta, unless complications occurred. For all patients, blood lost

2018 Clinical Trials

85. Induction of Labour in Advanced Abdominal Pregnancy with Fetal Demise due to Cord Round Neck: A Case Report of a Missed Diagnosis Full Text available with Trip Pro

to cord round neck in a 29-year-old G3P2002 at 39-week and 1-day gestation. She noticed reduced fetal movements for which upon examination fetal death was diagnosed. Cervical ripening was started which eventually failed, and surgery was indicated. Findings were an abdominal pregnancy with a third-degree macerated fetus with cord round neck. She was discharged on day 8 postoperation to continue follow-up as an outpatient with regular βHCG and ultrasound checks.This case illustrates the need (...) Induction of Labour in Advanced Abdominal Pregnancy with Fetal Demise due to Cord Round Neck: A Case Report of a Missed Diagnosis There are increasing reports of term live abdominal pregnancies even though the diagnosis of abdominal pregnancy is made preoperatively only in 45% of cases which partly explains the high maternal and perinatal morbidity and mortality associated with abdominal pregnancy.We report a rare case of misdiagnosed term abdominal pregnancy complicated by fetal demise due

2018 Case reports in obstetrics and gynecology

86. Exploring fetal fibronectin testing as a predictor of labour onset: In parturient women from isolated communities Full Text available with Trip Pro

Exploring fetal fibronectin testing as a predictor of labour onset: In parturient women from isolated communities To investigate whether the fetal fibronectin assay would be useful for determining if a woman was close to a term delivery. If effective, this test would allow parturient women to stay in their communities longer.This feasibility study used a prospective cohort design to examine the negative predictive value of the fetal fibronectin test at term.Iqaluit, NU.A total of 30 parturient (...) fibronectin in cervical secretion did not predict term delivery.This project indicated that the fetal fibronectin test did not have adequate sensitivity or specificity as a diagnostic measure to predict a delay of labour at term.Copyright© the College of Family Physicians of Canada.

2018 Canadian Family Physician

87. Does progesterone prophylaxis to prevent preterm labour improve outcome? A randomised double-blind placebo-controlled trial (OPPTIMUM). Full Text available with Trip Pro

Does progesterone prophylaxis to prevent preterm labour improve outcome? A randomised double-blind placebo-controlled trial (OPPTIMUM). Progesterone prophylaxis is widely used to prevent preterm birth but is not licensed and there is little information on long-term outcome.To determine the effect of progesterone prophylaxis in women at high risk of preterm birth on obstetric, neonatal and childhood outcomes.Double-blind, randomised placebo-controlled trial.Obstetric units in the UK and Europe (...) between February 2009 and April 2013.Women with a singleton pregnancy who are at high risk of preterm birth because of either a positive fibronectin test or a negative fibronectin test, and either previous spontaneous birth at ≤ 34 weeks+0 of gestation or a cervical length of ≤ 25 mm.Fibronectin test at 18+0 to 23+0 weeks of pregnancy to determine risk of preterm birth. Eligible women were allocated (using a web-based randomisation portal) to 200 mg of progesterone or placebo, taken vaginally daily

2018 Health technology assessment (Winchester, England) Controlled trial quality: predicted high

88. Progression of the first stage of spontaneous labour: A prospective cohort study in two sub-Saharan African countries. Full Text available with Trip Pro

labour practices. As part of the World Health Organization's Better Outcomes in Labour Difficulty (BOLD) project, which aimed to develop a new labour monitoring-to-action tool, we examined the patterns of labour progression as depicted by cervical dilatation over time in a cohort of women in Nigeria and Uganda who gave birth vaginally following a spontaneous labour onset.This was a prospective, multicentre, cohort study of 5,606 women with singleton, vertex, term gestation who presented at ≤ 6 cm (...) of cervical dilatation following a spontaneous labour onset that resulted in a vaginal birth with no adverse birth outcomes in 13 hospitals across Nigeria and Uganda. We independently applied survival analysis and multistate Markov models to estimate the duration of labour centimetre by centimetre until 10 cm and the cumulative duration of labour from the cervical dilatation at admission through 10 cm. Multistate Markov and nonlinear mixed models were separately used to construct average labour curves

2018 PLoS medicine

89. Balloon Induction of Labor in PROM for TOLAC

, Affecting Fetus or Newborn Prelabor Rupture of Membranes Device: Double Balloon catheter for induction of labor Not Applicable Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 200 participants Allocation: Randomized Intervention Model: Parallel Assignment Intervention Model Description: 200 pregnant women with one previous cesarean section and PROM along with an unfavourable cervix (Bishop Score ≤ 6) are expected to be entered (...) into the study. All eligible women will be presented with the study protocol by a study coordinator.The following screening medical procedures will be completed: Medical and gynecological history, physical and vaginal speculum examination, Ultrasonography and a non-stress test (NST). For eligible patients, and following an informed consent, group randomization will take place: GROUP 1: Expectant management (standard protocol). GROUP 2: Insertion of a balloon cervical catheter (study group). The randomization

2018 Clinical Trials

90. Best Cutoff Value of Lactate Concentration in Vaginal Fluid to Predict Time of Spontaneous Onset of Labor in PPROM

Time of Spontaneous Onset of Labor in PPROM Actual Study Start Date : February 15, 2018 Estimated Primary Completion Date : October 2018 Estimated Study Completion Date : November 2018 Resource links provided by the National Library of Medicine available for: Groups and Cohorts Go to Intervention Details: Diagnostic Test: Lactate concentration in vaginal fluid Lactate concentration in vaginal fluid Outcome Measures Go to Primary Outcome Measures : Time from examination to spontaneous onset of labor (...) [ Time Frame: 48 hours ] Time from examination to spontaneous onset of labor < or > 48 hours according to concentration of lactate in vaginal fluid Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below

2018 Clinical Trials

91. Membrane Sweeping in Early Labor and Delivery Outcomes

of cesarean section. Condition or disease Intervention/treatment Phase Early Labor Procedure: Membrane sweeping Not Applicable Detailed Description: This is a non-blinded randomized controlled trial. Participants will be recruited at time of presentation to triage for labor evaluation after cervical exam. Patients with a term, singleton pregnancy who present with regular, painful contractions and a Bishop score < 7 will be recruited to the study. A random number generator will be used to create a list (...) of random binary numbers. If the patient agrees to the study, the random number list will be used to assign the participant to membrane sweeping or no membrane sweeping. Participants assigned to membrane sweeping will have an additional exam during their initial evaluation in which the membranes will be separated from the cervix and lower part of the uterus with a finger inserted into the cervical os. This would be done with at least one rotation counterclockwise and one rotation clockwise. Those

2018 Clinical Trials

92. Effect Of Intravenous Hyoscine -N-Butyl Bromide In Management Of Prolonged Labor In Nulliparous

or more. Group A will receive injection Hyoscine butyl bromide 20 mg first dose at the time of amniotomy, and second dose 2 hours after. Group B, will receive normal saline same volume first dose at the time of amniotomy, and second dose 2 hours after. Labor will be monitored by Vaginal examination every two hours. The duration of the first stage was calculated from the time of cervical dilatation of three to four centimeters in active labor until a fully dilated cervix was observed. Condition (...) of amniotomy, and second dose 2 hours after. Group B, will receive normal saline same volume first dose at the time of amniotomy, and second dose 2 hours after. Labor will be monitored by Vaginal examination every two hours. The duration of the first stage was calculated from the time of cervical dilatation of three to four centimeters in active labor until a fully dilated cervix was observed. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated

2018 Clinical Trials

93. SMFM Statement on Elective Induction of Labor in Low-Risk Nulliparous Women at Term: the ARRIVE Trial. Full Text available with Trip Pro

with expectant management among low-risk nulliparous women, reduces the risk of a composite outcome of perinatal death or severe neonatal morbidity. Nulliparous women with reliable dating and no obstetric or medical complications were eligible, regardless of favorability of cervical examination. The purpose of this document is to review the findings of the recent randomized trial and to provide guidance for implementation of the study findings.Copyright © 2018 Elsevier Inc. All rights reserved. (...) SMFM Statement on Elective Induction of Labor in Low-Risk Nulliparous Women at Term: the ARRIVE Trial. A Randomized Trial of Induction Versus Expectant Management (ARRIVE) was conducted by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network from March 2014 to August 2017.This large multicenter, unmasked, randomized controlled trial was performed to test the hypothesis that elective IOL at 39 weeks of gestation, compared

2018 American Journal of Obstetrics and Gynecology Controlled trial quality: uncertain

94. Obstetrical Gel and Its Impact in Shortening the Duration of Labor in Women Undergoing a Vaginal Birth After Cesarean (VBAC)

Outcome Measures : length of the second stage of labor [ Time Frame: 1 hour ] the length of the second stage of labor starting from full cervical dilatation till delivery of the fetus will be recorded. Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study (...) Obstetrical Gel and Its Impact in Shortening the Duration of Labor in Women Undergoing a Vaginal Birth After Cesarean (VBAC) Obstetrical Gel and Its Impact in Shortening the Duration of Labor in Women Undergoing a Vaginal Birth After Cesarean (VBAC) - 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

2018 Clinical Trials

95. WHO recommendations for augmentation of labour

constitutes delay in the progress of the first stage of labour, but it is most often dependent on the rate of cervical dilatation. A cervical dilatation rate of less than 0.5 cm to 1 cm per hour during the active phase (i.e. the period of labour associated with dilatation of the cervix from approximately 3–4 cm to 10 cm) is commonly considered to be slow progress of labour, with the trigger for intervention stipulated at a variable period following such deviation. While it is widely acknowledged (...) WHO recommendations for augmentation of labour WHO recommendations for WHO recommendations for augmentation of labourWHO Library Cataloguing-in-Publication Data WHO recommendations for augmentation of labour. 1.Dystocia – prevention and control. 2.Labor, Induced – methods. 3.Labor, Induced - standards. 4.Labor Presentation. 5.Perinatal Care – methods. 6.Guideline. I.World Health Organization. ISBN 978 92 4 150736 3 (NLM classification: WQ 440) © World Health Organization 2014 All rights

2014 World Health Organisation Guidelines

96. Cervical ripening balloon with and without oxytocin in multiparas: a randomized controlled trial (Abstract)

Cervical ripening balloon with and without oxytocin in multiparas: a randomized controlled trial The optimal method for induction of labor for multiparous women with an unfavorable cervix is unknown.We sought to determine if induction of labor with simultaneous use of oxytocin and a cervical ripening balloon, compared with sequential use, increases the likelihood of delivery within 24 hours in multiparous women.We performed a randomized controlled trial from November 2014 through June 2017 (...) . Eligible participants were multiparous women with a vertex presenting, nonanomalous singleton gestation ≥34 weeks undergoing induction of labor. Women were excluded for admission cervical examination >2 cm, ruptured membranes, chorioamnionitis or evidence of systemic infection, placental abruption, low-lying placenta, >1 prior cesarean delivery, or contraindication to vaginal delivery. Patients were randomly allocated to the following cervical ripening groups: simultaneous (oxytocin with cervical

2018 EvidenceUpdates

97. Cerclage On LOw Risk Singletons: Cervical Cerclage for Prevention of Spontaneous Preterm Birth in Low Risk Singleton Pregnancies With Short Cervix

losses between 160 and 366 weeks TVU CL ≤25mm between 180 and 236 weeks Exclusion Criteria: Multiple pregnancy Prior SPTB or second trimester losses between 160 and 366 weeks Cerclage in situ Painful regular uterine contraction and/or preterm labor Rupture membranes Major fetal anomaly or aneuploidy Active vaginal bleeding Placenta previa and/or accreta Cervical dilation >1.0 cm and/or visible membranes by pelvic exam Suspicion of chorioamnionitis Contacts and Locations Go to Information from (...) Cerclage On LOw Risk Singletons: Cervical Cerclage for Prevention of Spontaneous Preterm Birth in Low Risk Singleton Pregnancies With Short Cervix Cerclage On LOw Risk Singletons: Cervical Cerclage for Prevention of Spontaneous Preterm Birth in Low Risk Singleton Pregnancies With Short Cervix - 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

2017 Clinical Trials

98. The impact of sweeping the membranes on cervical length and labor: a randomized clinical trial. (Abstract)

(Sweeping Group) (n = 69) or no membrane sweeping (Control Group) (n = 71). Cervical length was measured (cervix1) in both groups by examiner 1 and the Bishop Score was determined in the control group and sweeping was performed in the sweeping group by examiner 2. Two days later the patients had another cervical length measurement (cervix 2) by examiner 1, blinded to the group and results of the examiner 2. t test, Mann-Whitney U test and Chi-square test were used for statistical analyses.Cervix 1 (...) was 27.4 +/- 8.4 mm and 29.6 +/- 8.9 mm (p = 0.14), cervix 2 was 23.3 +/- 8.8 mm and 23.8 +/- 8.5 mm (p = 0.28) and cervical shortening was 5 +/- 4 mm and 5 +/-4 mm (p = 0.446), time to onset of labor was 6.3 +/- 4.6 and 5.7 +/- 4.7 (p = 0.38) and duration of labor was 5.8 +/- 2.89 and 5.7 +/- 2.4 (p = 0.82) for the sweeping and the control groups, respectivelySweeping of the membranes does not reduce cervical length and does not shorten time to onset of labor and duration of the active phase of labor

2014 Ginekologia polska Controlled trial quality: uncertain

99. Transperineal versus transvaginal ultrasound cervical length measurement and preterm labor. (Abstract)

Transperineal versus transvaginal ultrasound cervical length measurement and preterm labor. The aim was to evaluate the agreement between and the reproducibility of transperineal and transvaginal ultrasound cervical length measurements performed by the duty obstetrical team in case of preterm labor. The acceptability of transperineal ultrasonography was also assessed.Pregnant patients between 25 and 34 weeks of gestation with contractions and a clinically modified cervix were included. Order (...) of ultrasonography examination (transperineal or transvaginal first) and rank of operator (resident or senior) were allocated randomly. Agreement was assessed using the intraclass correlation coefficient (ICC) and the Bland and Altman plot. The patient's discomfort and preference for either method were assessed with a questionnaire.62 patients admitted for preterm labor between 25 and 34 weeks of gestation were included. Six seniors and nine residents took part in the study. Among the 51 patients

2014 Archives of gynecology and obstetrics Controlled trial quality: uncertain

100. Sonoelastography of the Uterine Cervix Before Induction of Labor

Sonoelastography of the Uterine Cervix Before Induction of Labor Sonoelastography of the Uterine Cervix Before 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. Sonoelastography (...) of the Uterine Cervix Before Induction of Labor (SUCI) 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: NCT02283606 Recruitment Status : Unknown Verified September 2015 by Rami Aviram, Meir Medical Center. Recruitment status was: Not yet recruiting First Posted : November 5, 2014 Last Update Posted : September 23

2014 Clinical Trials

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