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Fetal Malpresentation

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121. Location of Childbirth For Rural Women: Implications For Maternal Levels Of Care. Full Text available with Trip Pro

Location of Childbirth For Rural Women: Implications For Maternal Levels Of Care. A recent American Congress of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine (MFM) consensus statement on levels of maternity care lays out designations that correspond to specific capacities available in facilities that provide obstetric care. Pregnant women in rural and remote areas receive particular attention in discussions of regionalization and levels of care, owing to the challenges (...) cross-sectional analysis of administrative hospital discharge data for all births to rural women in 9 states in 2010 and 2012. Multivariate logistic regression models were used to predict the odds of childbirth in a nonlocal hospital (at least 30 road miles from the patient's residence). We examined patient age, race/ethnicity, payer, rurality, clinical diagnoses (diabetes, hypertension, hemorrhage during pregnancy, placental abnormalities, malpresentation, multiple gestation, preterm delivery

2015 American Journal of Obstetrics and Gynecology

122. Pregnancy outcome and uterine fibroids. (Abstract)

Pregnancy outcome and uterine fibroids. Myomas are observed in about 3-12% of pregnant women. Uterine fibroids may affect the outcome of pregnancy. The presence of myomas - in particular of myomas that distort the uterine cavity and larger intramural myomas - has been associated with infertility. In the case of pregnancy, it has been linked to an increased risk of spontaneous abortion, fetal malpresentation, placenta previa, preterm birth, cesarean section, and peripartum hemorrhage. Although

2015 Best practice & research. Clinical obstetrics & gynaecology

123. Obstetric Care Consensus No. 3 Summary: Periviable Birth. (Abstract)

delivery, for concern regarding fetal well-being or fetal malpresentation. Whenever possible, periviable births for which maternal or neonatal intervention is planned should occur in centers that offer expertise in maternal and neonatal care and the needed infrastructure, including intensive care units, to support such services. This document describes newborn outcomes after periviable birth, provides current evidence and recommendations regarding interventions in this setting, and provides an outline (...) are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth. These include, but are not limited to, nonmodifiable factors (eg, fetal sex, weight, plurality), potentially modifiable antepartum and intrapartum factors (eg, location of delivery, intent to intervene by cesarean delivery or induction for delivery, administration of antenatal corticosteroids

2015 Obstetrics and Gynecology

124. Obstetric Care Consensus No. 3: Periviable Birth. (Abstract)

, for concern regarding fetal well-being or fetal malpresentation. Whenever possible, periviable births for which maternal or neonatal intervention is planned should occur in centers that offer expertise in maternal and neonatal care and the needed infrastructure, including intensive care units, to support such services. This document describes newborn outcomes after periviable birth, provides current evidence and recommendations regarding interventions in this setting, and provides an outline for family (...) with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth. These include, but are not limited to, nonmodifiable factors (eg, fetal sex, weight, plurality), potentially modifiable antepartum and intrapartum factors (eg, location of delivery, intent to intervene by cesarean delivery or induction for delivery, administration of antenatal corticosteroids and magnesium

2015 Obstetrics and Gynecology

125. ACOG/SMFM Obstetric Care Consensus: Periviable birth. (Abstract)

delivery, for concern regarding fetal well-being or fetal malpresentation. Whenever possible, periviable births for which maternal or neonatal intervention is planned should occur in centers that offer expertise in maternal and neonatal care and the needed infrastructure, including intensive care units, to support such services. This document describes newborn outcomes after periviable birth, provides current evidence and recommendations regarding interventions in this setting, and provides an outline (...) are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth. These include, but are not limited to, nonmodifiable factors (eg, fetal sex, weight, plurality), potentially modifiable antepartum and intrapartum factors (eg, location of delivery, intent to intervene by cesarean delivery or induction for delivery, administration of antenatal corticosteroids

2015 American Journal of Obstetrics and Gynecology

126. Cervical Ripening With Cook Catheter Plus Low Dose Oxytocin

will be placed by either Resident or Attending Physicians and left in place for 12 hours (protocol) in both groups or until it falls out. After either 12 hours or the Balloon falls out, oxytocin will be used for the remainder of the induction per current hospital protocol. Time to delivery, mode of delivery, average number of hours Balloon remained in place, non-reassuring fetal heart tracings, adverse outcomes (ie fetal malpresentation, postpartum hemorrhage) will be recorded. Condition or disease (...) . To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 16 Years to 40 Years (Child, Adult) Sexes Eligible for Study: Female Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria: singleton pregnancy reassuring fetal status at time of presentation Bishop Score <6 Exclusion Criteria: Closed cervix Breech presentation Multiple gestations

2015 Clinical Trials

127. Effect of Adjunctive Misoprostol Treatment on Blood Loss at Vaginal Delivery

completed weeks) live singleton gestation in cephalic presentation and has been admitted to the Labor and Delivery Unit She is in the latent phase of labor or has been admitted for induction of labor or at prenatal clinic visit She has had fewer than four prior vaginal deliveries. She reports no allergy to misoprostol. The following factors or conditions will exclude a patient from consideration as a subject: The fetus has a known major fetal malformation or chromosome abnormality The gestation (...) is multiple. There is a breech or other malpresentation The patient reports involvement in another clinical trial currently or previously in this pregnancy. The patient is expected to have a cesarean delivery. The patient had a prior cesarean delivery. There has been an intrauterine fetal death. There is polyhydramnios (amniotic fluid index >22 cm). Presence of acute or chronic renal disease Presence of preeclampsia Of subjects who enter the study, the development of certain conditions will exclude them

2015 Clinical Trials

128. Effect of Uterine Massage Versus Sustained Uterine Compression on Blood Loss After Vaginal Delivery

, with a singleton pregnancy, gestational age of 36 or more weeks, and with fewer than or equal to three previous childbirths. Exclusion Criteria: Exclusion criteria include multiple gestation, fetal malpresentation, the third stage of labor lasting more than 30 minutes, a previous cesarean delivery, chorioamnionitis, three or more previous induced abortions, preeclampsia, fetal death, polyhydramnios, hemoglobin of 9 g/L or less before delivery, coagulopathy, on magnesium sulfate infusion, abruptio placentae

2015 Clinical Trials

129. Cervical Ripening for Obese Women: A Randomized, Comparative Effectiveness Trial

/Failure to progress = Cord prolapse = Non-reassuring fetal tracing = Malpresentation = Placental abruption = Other Induction-to-delivery interval in hours [ Time Frame: Induction to delivery ] Number of participants with a need for oxytocin augmentation [ Time Frame: Induction to delivery ] Number of participants exhibiting tachysystole requiring terbutaline or Pitocin cessation [ Time Frame: Induction to delivery ] Tachysystole is indicated ≥ 5 contractions in a 10 minute period averaged over a 30 (...) that obese women experience increased labor duration and oxytocin needs when compared to normal-weight women. This in turn results in increased rates for unplanned cesarean delivery (CD) as a result of failed induction of labor (IOL), arrest disorders and non-reassuring fetal heart rate tracing, that is dose-dependent with increasing class of obesity. The investigators hypothesize that obese pregnant women and unfavorable cervix (Bishop score ≤ 6), IOL ≥ 24 weeks gestation using the Foley balloon plus

2015 Clinical Trials

130. A Randomized Comparison of Transcervical Foley Bulb With Vaginal Misoprostol to Vaginal Misoprostol Alone for Induction of Labor

to 60 Years (Adult) Sexes Eligible for Study: Female Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria Term 37 weeks or more, singleton in cephalic presentation Age 18 years and older Patient admitted for induction of labor Exclusion Criteria: Malpresentation Preterm labor less than 37 weeks of gestation Patients with fetal anomalies Premature rupture of membranes If the cervix is closed and unable to place the foley bulb Multiple gestation Non-reassuring fetal heart tracing

2015 Clinical Trials

131. Cervical Ripening Balloon in Induction of Labour at Term

at term will be will be identified by doctors and clinical research coordinator in the subsidized clinic or labour ward or obstetric subsidized wards, and screened accordingly with inclusion criteria and exclusion criteria. Inclusion criteria: Pregnant women aged 21 - 40 years old, singleton pregnancy, no major fetal anomaly, planned induction of labour at 37+0 weeks to 41+6 weeks gestation, vaginal delivery is appropriate, patient able to give informed consent to participate in the trial Exclusion (...) criteria: Spontaneous labour at start of planned induction, Bishop score <6 and cervical dilatation >=3 cm at start of induction, confirmed rupture of membrane, abnormal CTG at start of induction, caesarean section delivery is indicated, scarred uterus such as previous caesarean section, malpresentation in labour, patient withdraw consent to participate in the trial. Latex allergy, severe asthma and glaucoma. Study Design Go to Layout table for study information Study Type : Interventional (Clinical

2015 Clinical Trials

132. The Effect of Intravenous Oxytocin Infusion Using Different Diluents on Neonatal Bilirubin & Sodium Levels

to 40 weeks (confirmed by a reliable date for the last menstrual period and 1st trimester ultrasound scan), vertex presentation of the fetus & intact membranes Exclusion Criteria: Women who had chronic or pregnancy induced diseases or any contraindication to vaginal delivery (e.g. malpresentation, contracted pelvis & placenta previa) were excluded. Additional exclusion criteria included rhesus (Rh) negative or (O) blood group mothers, prolonged labour (> 12h), fetal distress, instrumental delivery (...) A that included 109 women in whom labour was augmented by IV infusion of oxytocin using isotonic saline 0.9%, Drug: Oxytocin different oxytocin diluents and effect on fetal bilirubin&sodium levels. Other Name: syntocinon Active Comparator: 2 group B that included 109 women in whom labour was augmented by IV infusion of oxytocin using glucose 5% . Drug: Oxytocin different oxytocin diluents and effect on fetal bilirubin&sodium levels. Other Name: syntocinon Placebo Comparator: 3 Group C in which 109 women

2015 Clinical Trials

133. Effect of the Length of Second Stage of Labor in Primigravidae on Maternal & Neonatal Outcomes

Criteria: All patients admitted in the first stage of labor with cervical dilatation of 4 cm at least: Women age 18-35 years. 37-41 weeks gestation pregnancy. Singleton pregnancy and vertex presentation. Women have no chronic or pregnancy-induced illnesses. Women are in established, spontaneous labor. Exclusion Criteria: Malpresentation. Women with previous uterine scar. Multiple pregnancy Ante partum hemorrhage. Cephalopelvic disproportion. Women have chronic illnesses. Women with abnormal antenatal (...) period. Patients with foetal distress Premature rupture of membrane Woman having any contraindication to vaginal delivery. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02676505 Sponsors and Collaborators Kasr El Aini Hospital Investigators Layout

2015 Clinical Trials

134. Titrated Oral Misoprostol Compared to Vaginal Dinoprostone for Induction of Labor

Adult Sexes Eligible for Study: Female Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria: Single vertex presentation. Gestational age > 37 weeks calculated from last menstrual period or U/S scanning. Bishop score <8 . Not in labor. Reassuring fetal heart rate (CTG for 20 min on the day of induction). Valid indication for Induction of labor. Exclusion Criteria: Gestational age <37 weeks. Patients with rupture of membranes. Previous uterine scar. Fetal malpresentation. Multiple pregnancy (...) , 2014 Last Update Posted : February 19, 2014 Sponsor: Ain Shams University Information provided by (Responsible Party): Sherif Essam, Ain Shams University Study Details Study Description Go to Brief Summary: To test the safety and efficacy of titrated oral misoprostol compared to vaginal dinoprostone for labor induction. Condition or disease Intervention/treatment Phase Medical Induction of Labor Affecting Fetus Drug: Misotac® Sigma Pharmaceutical Industries Drug: Dinoprostone 3 mg Phase 3 Detailed

2014 Clinical Trials

135. Middle Cerebral To Umbilical Artery Doppler Ratio And Amniotic Fluid Volume Measurement In Post-date Pregnancies

or Rh isoimmunization) Prelabor rupture of membranes Polyhydramnios Women with multiple pregnancy Congenital fetal anomalies Antepartum hemorrhage Previus cesarean section Fetal malpresentation Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov identifier (NCT number (...) the adverse perinatal fetal outcome in uncomplicated postdate pregnancy Condition or disease Intervention/treatment Pregnancy, Prolonged Other: ultrasound and Doppler examination Detailed Description: The Study Will be a case-control study that will be conducted at Banha University Hospital after the approval of Institutional ethical committee. One hundred pregnant women will be recruited from antenatal clinic. Starting from November 2013. An informed consent will be obtained from the patients

2014 Clinical Trials

136. Diazepam at the Active Phase of Labor

by (Responsible Party): Yunhai Chuai, Navy General Hospital, Beijing Study Details Study Description Go to Brief Summary: Prolonged labour can lead to increased maternal and neonatal mortality and morbidity due to increased risks of maternal exhaustion, postpartum haemorrhage and sepsis, fetal distress and asphyxia and requires early detection and appropriate clinical response. The risks for complications of prolonged labour are much greater in poor resource settings. Active management of labour versus (...) complications previous uterine scarring, or cervical surgery cervical dilatation of more than 5 cm other antispasmodics in the first stage malpresentation, macrosomia, cephalopelvic disproportion Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02232035

2014 Clinical Trials

137. Indications for Caesarean sections in a rural hospital in the Highlands of Papua New Guinea. (Abstract)

Indications for Caesarean sections in a rural hospital in the Highlands of Papua New Guinea. We retrospectively documented indications for Caesarean sections in a rural district level hospital in the highlands of Papua New Guinea. Over a 53-month study period, 745 Caesarean sections were performed. Prolonged labour, previous history of Caesarean section, cephalopelvic disproportion, malpresentation and fetal distress accounted for over 88% of Caesarean sections performed. In older mothers (aged

2014 Tropical Doctor

138. A descriptive analysis of the indications for caesarean section in mainland China. Full Text available with Trip Pro

overall rate of CS in mainland China was 54.90%. The most common indication for CS was caesarean delivery on maternal request (CDMR; 28.43%), followed by cephalo-pelvic disproportion (14.08%), fetal distress (12.46%), previous CS (10.25%), malpresentation and breech presentation (6.56%), macrosomia (6.10%) and other indications (22.12%). CDMR accounted for 15.53% of all the deliveries and 28.43% of all CS deliveries in mainland China.CDMR appears to be a considerable driver behind the increasing CS

2014 BMC Pregnancy and Childbirth

139. Obstetrical catastrophe averted: successful outcome of an abdominal pregnancy. (Abstract)

]. These pregnancies are seen more commonly in developing countries and poses special challenges to the clinician. Advanced abdominal pregnancy is life-threatening condition and carries high risk of hemorrhage, disseminated intravascular coagulation, bowel injury, and fistulae [5]. The perinatal outcome is mainly influenced by the availability of blood supply and site of implantation [6]. Most of the fetus die in utero because of compromised environment, and those who survive face problems due to congenital (...) malformations [3,7]. Patients of abdominal pregnancy can have variable clinical presentation, and physical examination may be inconclusive for making diagnosis [7,8]. Clinical features like irregular bleeding per vaginum, abdominal pain, dyspepsia, altered bowel habits, malpresentation, and extremely anteriorly placed cervix should raise the suspicion [2,3,8,9]. Diagnostic challenge with oxytocin stimulation, abdominal x-ray, hysterosalpingography, and ultrasonography has been used as tools to assist

2014 American Journal of Emergency Medicine

140. Uterine Rupture in Pregnancy (Diagnosis)

either occur in women with (1) a native, unscarred uterus or (2) a uterus with a surgical scar from previous surgery. Uterine rupture occurs when a full-thickness disruption of the uterine wall that also involves the overlying visceral peritoneum (uterine serosa) is present. By definition, it is associated with the following: Clinically significant uterine bleeding Fetal distress Protrusion or expulsion of the fetus and/or placenta into the abdominal cavity Need for prompt cesarean delivery Uterine (...) -existing uterine scar. In addition, in cases of uterine dehiscence (as opposed to uterine rupture), the fetus, placenta, and umbilical cord remain contained within the uterine cavity. If cesarean delivery is needed, it is for other obstetrical indications and not for fetal distress attributable to the uterine disruption. Although a uterine scar is a well-known risk factor for uterine rupture (most of which arise from prior cesarean delivery), the majority of events involving the disruption of uterine

2014 eMedicine.com

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