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Prevention of Labor Dystocia

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1. Prevention of Labor Dystocia

Prevention of Labor Dystocia Prevention of Labor Dystocia 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 Prevention of Labor Dystocia (...) Prevention of Labor Dystocia Aka: Prevention of Labor Dystocia , Labor Dystocia Prevention From Related Chapters II. Management: General Measures Avoid early hospitalization in See for management Consider (SIA) Preferred over Consider using only in high risk pregnancies regarding increases risk of ceserean Avoid epidural and intrathecal anesthesia until >4 cm Encourage ambulation Avoid induction if unripe if possible See Bishops Score See Antepartum labor classes (e.g. Lamaze) on what to expect in labor

2018 FP Notebook

2. Human Chorionic Gonadotropin Has Anti-Inflammatory Effects at the Maternal-Fetal Interface and Prevents Endotoxin-Induced Preterm Birth, but Causes Dystocia and Fetal Compromise in Mice (PubMed)

Human Chorionic Gonadotropin Has Anti-Inflammatory Effects at the Maternal-Fetal Interface and Prevents Endotoxin-Induced Preterm Birth, but Causes Dystocia and Fetal Compromise in Mice Human chorionic gonadotropin (hCG) is implicated in the maintenance of uterine quiescence by down-regulating myometrial gap junctions during pregnancy, and it was considered as a strategy to prevent preterm birth after the occurrence of preterm labor. However, the effect of hCG on innate and adaptive immune (...) %, proving the effectiveness of this hormone as an anti-inflammatory agent. However, hCG administration alone caused dystocia and fetal compromise, as proven by Doppler ultrasound. These results provide insight into the mechanisms whereby hCG induces an anti-inflammatory microenvironment at the maternal-fetal interface during late gestation, and demonstrate its effectiveness in preventing preterm labor/birth. However, the deleterious effects of this hormone on mothers and fetuses warrant caution.© 2016

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2016 Biology of reproduction

3. The impact of extending the second stage of labor to prevent primary cesarean section on maternal and neonatal outcomes. (PubMed)

The impact of extending the second stage of labor to prevent primary cesarean section on maternal and neonatal outcomes. A low rate of primary cesarean delivery is expected to reduce some of the major complications that are associated with a repeat cesarean delivery, such as uterine rupture, adhesive placental disorders, hysterectomy, and even maternal death. Since 2014, and in alignment with the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, we (...) changed our approach to labor dystocia, defined as abnormal progression of labor, by allowing a longer duration of the second stage of labor.To examine the effect of prolonging the second stage of labor on the rate of cesarean delivery, and maternal and neonatal outcomes.In a historical control group, we compared maternal and neonatal outcomes over 2 periods. Period I (9300 patients): from May 2011 until April 2014, when a prolonged second stage in nulliparous women was considered after 3 hours

2018 American Journal of Obstetrics and Gynecology

4. Dystocia (Primiparous women with lack of progress)

. The participants therefore agreed on this modification: Concerning primiparous women with dystocia in the first and second stage • If the clinician considers lack of progression in the cervical condition to be caused by ineffective labor contractions, i.e. they are of short duration or insufficient strength, she may consider oxytocin stimulation even when the frequency of labor contractions is 5 per 10 min. However, she must ensure that the frequency does not exceed 5 contractions per 10 min during (...) assumes that pre- ferences may vary among parturients, the group has not given any strong or weak evidence-based recommendations, but exclusively good practice recommendations. 38 / 112 6 Intravenous fluid therapy for the prevention of dystocia 6.1 Focused question 7 Does intravenous fluid therapy prevent the need of oxytocin augmentation in pri- miparous women? 6.2 Recommendation ? Consider offering intravenous therapy using isotonic Ringer's lactate as an add- on to free oral fluid intake in case

2015 Nordic Federation of Societies of Obstetrics and Gynecology

5. CRACKCast E180 – Labor & Delivery

, early, and late. These terms refer to the timing of the deceleration relative to the uterine contraction. The clinical implications: Vary based on each issue. g. ominous signs mandating rapid delivery: Bradycardia Late decels Sinusoidal tracing Persistent variable decels More on this in the Wisecracks. 5) What are causes of inadequate contractions or “labour arrest” Dystocia, or abnormal labor progression, accounts for one-third of all cesarean sections and half of primary cesarean sections. We (...) genitourinary (appendectomy) Infectious UTIs Nonuterine infections Genital tract infections Management Preterm labor should not be postponed with medical management in the cases of fetal compromise, major congenital anomalies, intrauterine infection, placental abruption, eclampsia, significant cervical dilation, or PROM. In women with an acute episode of preterm labor, bedrest, hydration, sedatives, antibiotics, and supplementation are ineffective for preventing preterm birth. – Uptodate. But we still

2018 CandiEM

6. Fever during labor

(A) Intrapartum fever/ fever during labor is defined as: 2 rectal temperature measurements of >38.0ºC 30 minutes apart or 1 rectal temperature measurement of = 39°C B Temperature should be measured during labor in the following circumstances: • Suspicion of fever • PROM • ROM = 18 hours • Dystocia • Foul-smelling vaginal discharge/amniotic fluid • FHR > 150 beats per minute or rising baseline • Maternal tachycardia =100 beats per minute • Placement of epidural analgesia (before and after placement (...) 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

7. Shoulder Dystocia

3 Evidence level 2+ Evidence level 2+ and Evidence level 3 Evidence level 2+ Evidence level 3 and 4 Evidence level 4 Evidence level 4 Evidence level 3© Royal College of Obstetricians and Gynaecologists 3of 18 RCOG Green-top Guideline No. 42 2. Purpose and scope The purpose of this guideline is to review the current evidence regarding the possible prediction, prevention and management of shoulder dystocia; it does not cover primary prevention of fetal macrosomia associated with gestational (...) and must always be alert to the possibility of shoulder dystocia. Risk assessments for the prediction of shoulder dystocia are insufficiently predictive to allow prevention of the large majority of cases. A number of antenatal and intrapartum characteristics have been reported to be associated with shoulder dystocia (table 1), but statistical modelling has shown that these risk factors have a low positive predictive value, both singly and in combination. 29,30 Conventional risk factors predicted only

2012 Royal College of Obstetricians and Gynaecologists

8. Prevention of Labor Dystocia

Prevention of Labor Dystocia Prevention of Labor Dystocia 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 Prevention of Labor Dystocia (...) Prevention of Labor Dystocia Aka: Prevention of Labor Dystocia , Labor Dystocia Prevention From Related Chapters II. Management: General Measures Avoid early hospitalization in See for management Consider (SIA) Preferred over Consider using only in high risk pregnancies regarding increases risk of ceserean Avoid epidural and intrathecal anesthesia until >4 cm Encourage ambulation Avoid induction if unripe if possible See Bishops Score See Antepartum labor classes (e.g. Lamaze) on what to expect in labor

2015 FP Notebook

9. Immersion in Water During Labor and Delivery

and perinatal benefits and risks of this choice have not been studied sufficiently to either support or discourage her request. She also should be informed of the rare but serious neonatal complications associated with this choice. The opinions expressed in this document should not be interpreted in such a manner as to prevent the conduct of well-designed prospective studies of the maternal and perinatal benefits and risks associated with immersion during labor and delivery. Facilities that plan to offer (...) been reported, but the actual incidence has not been determined in population-based analyses. Therefore, until such data are available, it is the recommendation of the College that birth occur on land, not in water. The College supports conducting well-designed prospective studies of the maternal and perinatal benefits and risks associated with immersion during labor and delivery. Specifically, this document is not intended to prevent the conduct of such studies. Furthermore, the College recognizes

2016 American College of Obstetricians and Gynecologists

10. Peripartum Ultrasound-Guided Drainage of Cystic Fetal Sacrococcygeal Teratoma for the Prevention of the Labor Dystocia: A Report of Two Cases (PubMed)

Peripartum Ultrasound-Guided Drainage of Cystic Fetal Sacrococcygeal Teratoma for the Prevention of the Labor Dystocia: A Report of Two Cases Fetal sacrococcygeal teratoma (SCT) is the most common tumor in the neonatal period and is easily detected by modern ultrasound techniques, mostly during the second-trimester screening. It can cause significant fetal/neonatal morbidity and mortality due to its size, vascular loading, possible rupture, and labor dystocia. Mostly cystic teratomas have (...) , encouraging, safe, and efficient procedure and enables normal vaginal delivery, thus avoiding labor dystocia and possible complications of the cesarean delivery and the risk of tumor rupture.

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2011 AJP Reports

11. The REDUCED Trial: REDucing the Utilization of CEsarean Sections for Dystocia

increasing maternal or neonatal morbidity. The guidelines were developed from data from the Consortium for Safe Labor. The unit of randomization will be sites in Alberta that deliver Condition or disease Intervention/treatment Phase Cesarean Section, Dystocia Other: Knowledge Translation of labor management guidelines Not Applicable Detailed Description: Cluster randomized controlled trial of a knowledge translation intervention of new guidelines for the diagnosis of poor progress in labor (...) : Other Study ID Numbers: REB16-1576 First Posted: August 22, 2016 Last Update Posted: January 16, 2019 Last Verified: January 2019 Additional relevant MeSH terms: Layout table for MeSH terms Dystocia Obstetric Labor Complications Pregnancy Complications

2016 Clinical Trials

12. Shoulder Dystocia

Shoulder Dystocia Shoulder Dystocia 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 Shoulder Dystocia Shoulder Dystocia Aka: Shoulder (...) of Multiparity Postterm delivery Maternal abnormal or History of prior Shoulder Dystocia Prolonged first or second stage of labor IV. Signs: Warning signs suggestive of Shoulder Dystocia Prolonged second stage of labor Recoil of head on perineum (turtle's sign) V. Prognosis Shoulder Dystocia results in cord compression Arterial pH drops 0.04 per minute Arterial pH drops 0.28 in seven minutes Arterial pH drops 0.14 per minute on trunk delivery Arterial pH below 7.0 makes difficult VI. Complications

2018 FP Notebook

13. Mouth Guard Use in the Second Stage of Labor

in contact sports, and have been demonstrated to reduce or prevent injury to the teeth. Additionally, it has been proposed that wearing a mouth guard increases the strength of different muscle groups. A recent randomized controlled pilot study including women with their first pregnancy using a dental support device (DSD) during the second stage of labor evaluated the length of the second stage and outcomes. They found a significant decrease of 38% in the length of pushing time in the group that used (...) outcomes. Condition or disease Intervention/treatment Phase Dystocia; Fetal Labor Long Cesarean Section, Affecting Fetus or Newborn Device: Mouth Guard Not Applicable Detailed Description: Optimizing the second stage of labor is important for positive maternal and neonatal outcomes. Dystocia of labor refers to a lack of progress of labor for any reason, and it is the most common indication for cesarean delivery in nulliparous women and the second most common indication for cesarean delivery

2018 Clinical Trials

14. Randomised Controlled Trial of the Efficacy of Acupuncture Versus Placebo on the Caesarean Section Rate in Case of Cervical Dystocia in Full-term Pregnancy

that acupuncture could reduce the caesarean section rate for cervical dystocia. Secondary objectives: To demonstrate that acupuncture can: reduce morbidity, fetal mortality and duration of childbirth; reduce the cost of care, due to diminution of caesarean sections and duration of obstetric labor; to evaluate the tolerance. Condition or disease Intervention/treatment Phase Cervical Dystocia Device: Acupuncture Device: Sham acupuncture Not Applicable Detailed Description: In this trial, pregnant women (...) chinese medicine for the induction of obstetric labor, according to the professional recommendations of the French Acupuncture and Traditional Chinese Medicine College. Each patient will have a 5-week follow-up in this trial. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 142 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double (Participant, Care Provider) Primary Purpose: Prevention Official

2015 Clinical Trials

15. Cooling the Uterus in C-section After Dysfunctional Labor

between the two groups. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 100 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Prevention Official Title: Can Cooling the Uterus During Cesarean Delivery Reduce Blood Loss, Reduce Drug Use, and Decrease the Risk for Hysterectomy in Women With Dysfunctional Labor? Study Start Date : September 2016 Estimated Primary (...) for additonal information Responsible Party: Baylor Research Institute ClinicalTrials.gov Identifier: Other Study ID Numbers: 015-028 First Posted: September 21, 2016 Last Update Posted: June 12, 2017 Last Verified: June 2017 Individual Participant Data (IPD) Sharing Statement: Plan to Share IPD: No Additional relevant MeSH terms: Layout table for MeSH terms Hemorrhage Uterine Inertia Dystocia Pathologic Processes Obstetric Labor Complications Pregnancy Complications Oxytocin Oxytocics Reproductive Control

2016 Clinical Trials

16. Active Management of Labor

Active Management of Labor Active Management of 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 Active Management of Labor (...) Active Management of Labor Aka: Active Management of Labor , Labor Dystocia Management From Related Chapters II. Indications III. Management: Stage 1 See Consider Active Management of Labor See Augmentation Consider amniotomy Indications for cesarean delivery (arrested labor) Cervical dilation 6 cm AND No cervical change At 4 hours if adequate contractions (>200 Montevideo Units) or At 6 hours if inadequate contractions IV. Management: Stage 2 Consider Augmentation Avoid exhausting mother early

2018 FP Notebook

17. Safe Prevention of the Primary Cesarean Delivery

. In order to understand the degree to which cesarean deliveries may be preventable, it is important to know why cesareans are performed. In a 2011 population-based study, the most common indications for primary cesarean delivery included, in order of frequency, labor dystocia, abnormal or indeterminate (formerly, nonreassuring) fetal heart rate tracing, fetal malpresentation, multiple gestation, and suspected fetal macrosomia ( ) ( ). Arrest of labor and abnormal or indeterminate fetal heart rate (...) . The most common indications for primary cesarean delivery include, in order of frequency, labor dystocia, abnormal or indeterminate (formerly, nonreassuring) fetal heart rate tracing, fetal malpresentation, multiple gestation, and suspected fetal macrosomia. Safe reduction of the rate of primary cesarean deliveries will require different approaches for each of these, as well as other, indications. For example, it may be necessary to revisit the definition of labor dystocia because recent data show

2014 American College of Obstetricians and Gynecologists

18. Shoulder Dystocia

Shoulder Dystocia Shoulder Dystocia 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 Shoulder Dystocia Shoulder Dystocia Aka: Shoulder (...) of Multiparity Postterm delivery Maternal abnormal or History of prior Shoulder Dystocia Prolonged first or second stage of labor IV. Signs: Warning signs suggestive of Shoulder Dystocia Prolonged second stage of labor Recoil of head on perineum (turtle's sign) V. Prognosis Shoulder Dystocia results in cord compression Arterial pH drops 0.04 per minute Arterial pH drops 0.28 in seven minutes Arterial pH drops 0.14 per minute on trunk delivery Arterial pH below 7.0 makes difficult VI. Complications

2015 FP Notebook

19. Enhanced vs. Routine Clear Liquid Intake in Labor

standard clear liquid diet, which includes ginger ale, variety of fruit juices, and plain soup broth. The experimental arm will receive the standard clear liquid diet, and in addition will receive Accel Gel every 3 hours while in labor. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 76 participants Allocation: Randomized Intervention Model: Single Group Assignment Masking: Single (Outcomes Assessor) Primary Purpose: Prevention (...) for MeSH terms Ketosis Dystocia Acidosis Acid-Base Imbalance Metabolic Diseases Obstetric Labor Complications Pregnancy Complications

2014 Clinical Trials

20. Induction of Labor Versus Expectant Management of Large for Gestational Age/Macrosomic Babies at Term. A Multi-center Trial

: Induction of labor group (Group I) Not Applicable Detailed Description: Background: Macrosomia at term is associated with increased maternal and neonatal morbidity, including a higher rate of shoulder dystocia and cesarean section (CS). Induction of labor (IOL) has been suggested as a means to prevent further fetal weight gain and therefore to reduce possible neonatal and maternal complications which are related to fetal weight. Working hypothesis and aims: The aims of this study are: 1) to determine (...) at term pregnancy is not solved yet. Only 2 relatively small studies were conducted to answer this clinically important question. The investigators will conduct a randomized controlled, multi-center study large enough to confirm or refute our assumption that induction of labor at term reduces the shoulder dystocia prevalence significantly compared to expectant management. Condition or disease Intervention/treatment Phase Macrosomia Induction of Labor Expectant Management Shoulder Dystocia Procedure

2014 Clinical Trials

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