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Cervical Examination in Labor

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141. Safety Study of Hyoscine N Butyl Bromide in Active Management of Labor

by (Responsible Party): Nazlı YENIGUL, Sisli Hamidiye Etfal Training and Research Hospital Study Details Study Description Go to Brief Summary: Although Hyoscine N butyl bromide (HBB) is used liberally to facilitate cervical dilatation, there is little and inconclusive data about its efficacy. The aim of this study was to determine the efficacy and safety of HBB on the augmentation of labor.420 of total 1640 pregnant women admitted to the investigators clinic (Sisli Ethal Training and Research Hospital (...) , Obstetrics and Gynecology Department Obstetrics Service ) between 37-41 gestational weeks, active phase (cervical dilatation: 4 cm, cervical effacement: %50 or more) of spontaneous labor with vertex presentation enrolled to study. 382 of them were included in this study. Patients were randomized to receive intravenously(IV) either 20 mg/ml HBB or a similar amount of placebo (1 ml 0.9% NaCl) at the beginning of the active phase of labor. The medications applied as single dose. The time elapsed until

2014 Clinical Trials

142. Individualized Dosing of Nifedipine For Tocolysis in Preterm Labor

to decide what amount of nifedipine women need to best treat preterm contractions. This study will also examine the effect of pregnancy on how fast nifedipine is removed from the woman's body. This study will be conducted on two phases. The first will study women who are starting nifedipine for treatment of preterm labor. Nifedipine dose will be determined by the patient's physician. Blood samples will be obtained from the mother to determine the concentration of nifedipine and its metabolite, oxidized (...) is prevention of delivery for 48 hours with attainment of uterine quiescence, defined by 12 hours of six or fewer contractions per hour and no further cervical change. Failure of the primary outcome occurs if, in the first 48 hours, patients deliver, rupture membranes, experience recurrent preterm labor, continue to contract or experience cervical change, or required the use of alternate tocolytics. Secondary outcomes include time to uterine quiescence (≤6 contractions/hour), birth weight, gestational age

2014 Clinical Trials

143. Dilapan-S/Dilasoft E-Registry in Induction of Labor

Description Go to Brief Summary: International Observational E-Registry on the use of DILAPAN-S® osmotic dilator / DILASOFT® osmotic dilator for cervical ripening prior to labour induction. Condition or disease Intervention/treatment Labour Onset and Length Abnormalities Labor; Forced or Induced, Affecting Fetus or Newborn Device: Dilapan-S Detailed Description: International Observational E-Registry to monitor current common clinical practice of use of Dilapan-S / Dilasoft for cervical ripening (...) and following procedures of labour induction with the main focus on the duration of induced labor procedure . Study Design Go to Layout table for study information Study Type : Observational Actual Enrollment : 444 participants Observational Model: Case-Only Time Perspective: Prospective Official Title: International Observational E-Registry on the Use of Dilapan-S / Dilasoft Osmotic Dilators for Cervical Ripening Prior to Labour Induction Study Start Date : May 2015 Actual Primary Completion Date

2014 Clinical Trials

144. Management of Labor in Patients With Previous Cesarian Section

Center Information provided by (Responsible Party): Hillel Yaffe Medical Center Study Details Study Description Go to Brief Summary: Induction of labor in women desiring TOLAC has long been a topic of controversy. The paucity of published data on mechanical cervical ripening in the setting of TOLAC and term PROM has led us to undertake the present clinical trial. Condition or disease Intervention/treatment Phase Pregnancy Previous Cesarian Section Premature Rupture of Membranes (PROM) Device: Double (...) balloon cervical catheter Phase 2 Phase 3 Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 200 participants Allocation: Randomized Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: Management of Labor in Patients With Previous Cesarian Section and Premature Rupture of Membranes Who Desire TOLAC: Comparison Between the Use of Standard Expectant Management

2014 Clinical Trials

145. Normal Labor and Delivery (Overview)

by 1-2 mili IU/min every 20-30 minutes until adequate uterine contraction is obtained. [ ] The second method, or active management of labor, involves a protocol of clinical management that aims to optimize uterine contractions and shorten labor. This protocol includes strict criteria for admission to the labor and delivery unit, early amniotomy, hourly cervical examinations, early diagnosis of inefficient uterine activity (if the cervical dilation rate is < 1.0 cm/h), and high-dose oxytocin (...) contractions and ends with complete cervical dilatation at 10 cm Divided into a latent phase and an active phase The latent phase begins with mild, irregular uterine contractions that soften and shorten the cervix Contractions become progressively more rhythmic and stronger The active phase usually begins at about 3-4 cm of cervical dilation and is characterized by rapid cervical dilation and descent of the presenting fetal part Second stage of labor Begins with complete cervical dilatation and ends

2014 eMedicine.com

146. Preterm Labor (Treatment)

are indicative of active preterm labor. If the diagnosis of preterm labor is suspected, but not confirmed, it may be prudent to first obtain a vaginal fetal fibronectin (FFN) sample before pelvic cervical examination. If the diagnosis of preterm labor becomes obvious after the pelvic examination, the FFN specimen can be subsequently discarded. However, if the diagnosis remains in doubt, the FFN specimen can be sent to the lab for analysis. Criteria that indicate consideration of tocolytic therapy include (...) . Risk of preterm labor The exact mechanisms of preterm labor are largely unknown but are believed to include the following: Decidual hemorrhage such as abruption and mechanical factors such as uterine overdistention from multiple gestation or polyhydramnios Cervical incompetence (eg, trauma, cone biopsy) Uterine distortion (eg, müllerian duct abnormalities, fibroid uterus) Cervical inflammation as a result of, for example, bacterial vaginosis (BV) or trichomonas Maternal inflammation/fever (eg

2014 eMedicine.com

147. Normal Labor and Delivery (Treatment)

by 1-2 mili IU/min every 20-30 minutes until adequate uterine contraction is obtained. [ ] The second method, or active management of labor, involves a protocol of clinical management that aims to optimize uterine contractions and shorten labor. This protocol includes strict criteria for admission to the labor and delivery unit, early amniotomy, hourly cervical examinations, early diagnosis of inefficient uterine activity (if the cervical dilation rate is < 1.0 cm/h), and high-dose oxytocin (...) contractions and ends with complete cervical dilatation at 10 cm Divided into a latent phase and an active phase The latent phase begins with mild, irregular uterine contractions that soften and shorten the cervix Contractions become progressively more rhythmic and stronger The active phase usually begins at about 3-4 cm of cervical dilation and is characterized by rapid cervical dilation and descent of the presenting fetal part Second stage of labor Begins with complete cervical dilatation and ends

2014 eMedicine.com

148. Preterm Labor (Overview)

are indicative of active preterm labor. If the diagnosis of preterm labor is suspected, but not confirmed, it may be prudent to first obtain a vaginal fetal fibronectin (FFN) sample before pelvic cervical examination. If the diagnosis of preterm labor becomes obvious after the pelvic examination, the FFN specimen can be subsequently discarded. However, if the diagnosis remains in doubt, the FFN specimen can be sent to the lab for analysis. Criteria that indicate consideration of tocolytic therapy include (...) . Risk of preterm labor The exact mechanisms of preterm labor are largely unknown but are believed to include the following: Decidual hemorrhage such as abruption and mechanical factors such as uterine overdistention from multiple gestation or polyhydramnios Cervical incompetence (eg, trauma, cone biopsy) Uterine distortion (eg, müllerian duct abnormalities, fibroid uterus) Cervical inflammation as a result of, for example, bacterial vaginosis (BV) or trichomonas Maternal inflammation/fever (eg

2014 eMedicine.com

149. Normal Labor and Delivery (Follow-up)

by 1-2 mili IU/min every 20-30 minutes until adequate uterine contraction is obtained. [ ] The second method, or active management of labor, involves a protocol of clinical management that aims to optimize uterine contractions and shorten labor. This protocol includes strict criteria for admission to the labor and delivery unit, early amniotomy, hourly cervical examinations, early diagnosis of inefficient uterine activity (if the cervical dilation rate is < 1.0 cm/h), and high-dose oxytocin (...) contractions and ends with complete cervical dilatation at 10 cm Divided into a latent phase and an active phase The latent phase begins with mild, irregular uterine contractions that soften and shorten the cervix Contractions become progressively more rhythmic and stronger The active phase usually begins at about 3-4 cm of cervical dilation and is characterized by rapid cervical dilation and descent of the presenting fetal part Second stage of labor Begins with complete cervical dilatation and ends

2014 eMedicine.com

150. Preterm Labor (Follow-up)

are indicative of active preterm labor. If the diagnosis of preterm labor is suspected, but not confirmed, it may be prudent to first obtain a vaginal fetal fibronectin (FFN) sample before pelvic cervical examination. If the diagnosis of preterm labor becomes obvious after the pelvic examination, the FFN specimen can be subsequently discarded. However, if the diagnosis remains in doubt, the FFN specimen can be sent to the lab for analysis. Criteria that indicate consideration of tocolytic therapy include (...) . Risk of preterm labor The exact mechanisms of preterm labor are largely unknown but are believed to include the following: Decidual hemorrhage such as abruption and mechanical factors such as uterine overdistention from multiple gestation or polyhydramnios Cervical incompetence (eg, trauma, cone biopsy) Uterine distortion (eg, müllerian duct abnormalities, fibroid uterus) Cervical inflammation as a result of, for example, bacterial vaginosis (BV) or trichomonas Maternal inflammation/fever (eg

2014 eMedicine.com

151. Labor and Delivery, Normal Delivery of the Newborn

, the number of patients who go into spontaneous labor has decreased, and the percentage of inductions (iatrogenic labor) has increased to 22% of all pregnancies. [ ] Labor and delivery is divided into 3 stages. In the first stage, the cervix dilates as a result of progressive rhythmic uterine contractions. This is typically the longest stage of labor. Cervical effacement, or thinning, occurs throughout the first stage of labor, and is graded 0-100%. The first stage of labor is divided into the latent (...) and active phases. The latent phase can last for many hours. The cervix dilates, usually slowly, from closed to approximately 4-5 cm. The active phase lasts from the end of the latent phase until delivery. It is characterized by rapid cervical dilation. The cervix usually dilates at a rate of 1.0 cm/h in nulliparous women and 1.2 cm/h in multiparous women during the active phase. The second stage of labor is the time between complete cervical dilation and delivery of the neonate. This phase lasts minutes

2014 eMedicine.com

152. Normal Labor and Delivery (Diagnosis)

by 1-2 mili IU/min every 20-30 minutes until adequate uterine contraction is obtained. [ ] The second method, or active management of labor, involves a protocol of clinical management that aims to optimize uterine contractions and shorten labor. This protocol includes strict criteria for admission to the labor and delivery unit, early amniotomy, hourly cervical examinations, early diagnosis of inefficient uterine activity (if the cervical dilation rate is < 1.0 cm/h), and high-dose oxytocin (...) contractions and ends with complete cervical dilatation at 10 cm Divided into a latent phase and an active phase The latent phase begins with mild, irregular uterine contractions that soften and shorten the cervix Contractions become progressively more rhythmic and stronger The active phase usually begins at about 3-4 cm of cervical dilation and is characterized by rapid cervical dilation and descent of the presenting fetal part Second stage of labor Begins with complete cervical dilatation and ends

2014 eMedicine.com

153. Preterm Labor (Diagnosis)

are indicative of active preterm labor. If the diagnosis of preterm labor is suspected, but not confirmed, it may be prudent to first obtain a vaginal fetal fibronectin (FFN) sample before pelvic cervical examination. If the diagnosis of preterm labor becomes obvious after the pelvic examination, the FFN specimen can be subsequently discarded. However, if the diagnosis remains in doubt, the FFN specimen can be sent to the lab for analysis. Criteria that indicate consideration of tocolytic therapy include (...) . Risk of preterm labor The exact mechanisms of preterm labor are largely unknown but are believed to include the following: Decidual hemorrhage such as abruption and mechanical factors such as uterine overdistention from multiple gestation or polyhydramnios Cervical incompetence (eg, trauma, cone biopsy) Uterine distortion (eg, müllerian duct abnormalities, fibroid uterus) Cervical inflammation as a result of, for example, bacterial vaginosis (BV) or trichomonas Maternal inflammation/fever (eg

2014 eMedicine.com

154. Indomethacin and antibiotics in examination-indicated cerclage: a randomized controlled trial. (PubMed)

Anti-Bacterial Agents 0 Anti-Inflammatory Agents, Non-Steroidal IHS69L0Y4T Cefazolin XXE1CET956 Indomethacin AIM IM Obstet Gynecol. 2014 Jun;123(6):1311-6 24807330 Obstet Gynecol. 2014 Sep;124(3):637 25162276 Anti-Bacterial Agents administration & dosage Anti-Inflammatory Agents, Non-Steroidal therapeutic use Cefazolin administration & dosage Cerclage, Cervical Female Humans Indomethacin therapeutic use Obstetric Labor, Premature prevention & control Pregnancy 2014 8 28 6 0 2014 8 28 6 0 2015 2 24 (...) Indomethacin and antibiotics in examination-indicated cerclage: a randomized controlled trial. 25162275 2015 02 20 2018 12 02 1873-233X 124 3 2014 Sep Obstetrics and gynecology Obstet Gynecol Indomethacin and antibiotics in examination-indicated cerclage: a randomized controlled trial. 637 10.1097/AOG.0000000000000443 Burwick Richard M RM Division of Maternal Fetal Medicine, Oregon Health & Science University, Portland, OR. eng Letter Comment United States Obstet Gynecol 0401101 0029-7844 0

2015 Obstetrics and Gynecology Controlled trial quality: uncertain

155. Balloon Catheter for Cervical Ripening

milliunits/minute while the Foley is in place. After expulsion of the balloon, the resident or attending physician will performed a cervical examination to document the time and the cervical examination, and the oxytocin will be titrated to achieve acceptable contraction rates without tachysystole -this is standard care. The patient's labor and delivery will be managed according to routine obstetric and institutional protocols. All patients will have continuous fetal heart rate and uterine activity (...) Balloon Catheter for Cervical Ripening Balloon Catheter for Cervical Ripening - 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. Balloon Catheter for Cervical Ripening (25148) The safety and scientific

2015 Clinical Trials

156. Cervical Pessary vs. Vaginal Progesterone for Preventing Premature Birth in IVF Twin Pregnancies

: This will be a randomized controlled trial. Women with twin pregnancies, at 16-22 weeks of gestation, will be invited to participate into the study. Subjects meeting the study criteria will be randomized into two groups: (1) treated with cervical pessary (Arabin) or (2) treated with 400mg vaginal progesterone, once daily. Randomization will be done by third party via telephone, using a computer generated random list, with a variable block size of 2, 4 or 8. Apart from randomization, patients will be examined (...) Update Posted: December 22, 2017 Last Verified: December 2017 Keywords provided by Manh Tuong Ho, Vietnam National University: Cervical pessary Vaginal progesterone Twins Premature birth Additional relevant MeSH terms: Layout table for MeSH terms Premature Birth Obstetric Labor, Premature Obstetric Labor Complications Pregnancy Complications Progesterone Progestins Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs

2015 Clinical Trials

157. Cervical Pessary vs Vaginal Progesterone in Preventing Preterm Birth Among Women Presenting With Short Cervix: An Open-label Randomized Controlled Trial

vaginal progesterone is superior to vaginal progesterone alone in decreasing preterm delivery rate, and improving perinatal outcome, among women presenting with an asymptomatic mid-pregnancy short cervix, in singleton and twin gestations. All women with singleton or twin pregnancies undergoing routine ultrasonography up to 24 completed weeks of gestation (for examination of fetal anatomy and growth) and diagnosed with cervical length of ≤25 mm in singleton, or ≤38 mm in twins, will be invited (...) detailed in the exclusion criteria. Willingness to comply with the protocol for the duration of the study. Have signed an informed consent. Exclusion Criteria: Fetal factors: major fetal abnormalities, death of one or both of the fetuses, twins- twin-to-twin transfusion syndrome, and severe growth retardation. Maternal factors: prophylactic cervical cerclage in situ, painful regular uterine contractions, active labor, active vaginal bleeding, maternal age under 18, uterine abnormalities (i.e. two

2015 Clinical Trials

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

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

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2015 Ultrasound in Obstetrics and Gynecology

159. Hemodynamic Stability of Bupivacaine With and Without Adrenaline for Paracervical Block for Cervical Conization

local bleeding and reduce toxicity of bupivacaine by reducing absorption, but might affect cardiovascular function. This study will examine this effect. Condition or disease Intervention/treatment Phase Cervical Intraepithelial Neoplasia Drug: Bupivacaine Drug: Adrenaline Phase 4 Detailed Description: Most patients scheduled for cervical conization are healthy, young women. Some do this procedure with local anesthesia (paracervical block) and sedation, others general anesthesia combined with local (...) for analgesia in first stage of labor, but may give foetal bradycardia in 3-4 % and may affect the cardiotocogram in 10-12%. This effect is observed with bupivacaine and the less toxic levobupivacaine. Because of fear for complications and foetal injury this block has been replaced by more effective and safer methods like epidural and spinal anesthesia. In gynecological practice the para-cervical block is still used for termination of pregnancy, cervical conization and for instrumentation of uterus. We have

2015 Clinical Trials

160. Fetal Adrenal Gland Volume Estimation Compared to Cervical Length Assessment in Prediction of Preterm Birth

. Convincing data have shown that 2-dimensional (2D) ultrasound measurement of cervical length (CL) can identify women at risk for PTB. Accordingly, CL is now widely used in clinical practice for risk estimation. However, as understanding of the mechanisms of preterm labor (PTL) have evolved, obstetricians have learned that, in some women, cervical shortening is a phenomenon that carries no increased risk for prematurity. Therefore, the search for early and accurate markers that distinguish between (...) to the date of last menstrual period & confirmed by first trimester ultrasonography . Women who are diagnosed as having threatened preterm labour based on the American college of obstetricians and gynaecologists guidelines (ACOG,2003) : Presence of uterine contractions ( at least 4 in 20 minutes or 8 in 60 minutes ) Cervical dilataion >1cm, &/or Cervical effacement ≥ 80% 4. Women having one or more of the following: Multifetal pregnancy . Previous preterm labor or premature birth, particularly in the most

2015 Clinical Trials

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