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Prevention of Labor Dystocia

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1. Randomised controlled trial: Induction of labour at 37?38?weeks in women with large fetuses decreases the likelihood of shoulder dystocia; however, overall benefit of early-term delivery has not been demonstrated

are here Induction of labour at 37–38 weeks in women with large fetuses decreases the likelihood of shoulder dystocia; however, overall benefit of early-term delivery has not been demonstrated Article Text Therapeutics/Prevention Randomised controlled trial Induction of labour at 37–38 weeks in women with large fetuses decreases the likelihood of shoulder dystocia; however, overall benefit of early-term delivery has not been demonstrated Lawrence M Leeman , Nicole Yonke Statistics from Altmetric.com (...) Randomised controlled trial: Induction of labour at 37?38?weeks in women with large fetuses decreases the likelihood of shoulder dystocia; however, overall benefit of early-term delivery has not been demonstrated Induction of labour at 37–38 weeks in women with large fetuses decreases the likelihood of shoulder dystocia; however, overall benefit of early-term delivery has not been demonstrated | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content

2015 Evidence-Based Medicine

2. 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

3. Early amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care. Full Text available with Trip Pro

Early amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care. Caesarean section rates are over 20% in many developed countries. The main diagnosis contributing to the high rate in nulliparae is dystocia or prolonged labour. The present review assesses the effects of a policy of early amniotomy with early oxytocin administration for the prevention of, or the therapy for, delay in labour progress.To estimate the effects (...) of early augmentation with amniotomy and oxytocin for prevention of, or therapy for, delay in labour progress on the caesarean birth rate and on indicators of maternal and neonatal morbidity.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2013), MEDLINE (1966 to 4 July 2013), Embase (1980 to 4 July 2013), CINAHL (1982 to 4 July 2013), MIDIRS (1985 to 4 July 2013) and contacted authors for data from unpublished trials.Randomized and quasi-randomized controlled trials

2013 Cochrane

4. The impact of extending the second stage of labor to prevent primary cesarean section on maternal and neonatal outcomes. Full Text available with Trip Pro

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

5. Dystocia (Primiparous women with lack of progress)

questions 2 and 3 for the period 2006 through 6 May 2014. The searches were performed during the period 13 January through 6 May 2014. The search protocols with the search strategies are available on the DHMA's web- site (in Danish only). General search terms English: labor, labour, delivery, birth, oxytocin, syntocinon, dystocia, obstructed, delayed, prolonged, slow progress, duration, intervention, obstetric complications, high dose, low dose, epidural, acupuncture, fluid, rebozo, amniotomy, augmenta (...) 55: Intrapartum Care. United Kingdom 2007 (10) . 7 Included 6 6 ACOG Practice Bulletin: Dystocia and augmenta- tion of labour. USA 2003 (53) . 4 Excluded 3 ICSI Institute for Clinical Systems Improvement. Health Care Guideline: Management of Labor. USA 2013 (4) . 5 Excluded 3 The Ottawa Hospital’s Clinical Practice Guideline for The Second Stage of Labour. Canada 2006. 4 Excluded 4 3 105 / 112 The working group's AMSTAR assessments of systematic reviews are available here (in Danish only

2015 Nordic Federation of Societies of Obstetrics and Gynecology

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 (...) ) • Threatening preterm labor/PPROM B-C Temperature measurement during labor is recommended every 2-4 hours in case of afebrilia, subfebrilia (37.5-38,0°C) and after placement of epidural analgesia D If the woman in labour has a fever or developes fever, the temperature measurement should be repeated as a minimum every hour D In case of intrapartum fever the following actions are recommended: • Assessment by physician, possibly including physical examination in order to find explanation of fever and plan

2018 Nordic Federation of Societies of Obstetrics and Gynecology

7. 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 (...) are overrepresented in the ED population. While we want to transfer all pregnant women to an obstetric centre, in some situations this is the WRONG decision 1) Describe the difference between false and true labor Whenever a woman in the third trimester shows up to the ER: ask whether this could be labour. A wide array of nonspecific symptoms may herald the onset of labor. Abdominal pain, back pain, cramping, nausea, vomiting, urinary urgency, stress incontinence, and anxiety can be symptoms of labor. After 24

2018 CandiEM

8. Shoulder Dystocia

, Yeh P , Impey L. Antenatal and intrapartum prediction of shoulder dystocia. Eur J Obstet Gynecol Reprod Biol 2010;151:134–9. 36. Centre for Reviews and Dissemination, NHS National Institute for Health Research. Expectant management versus labor induction for suspected fetal macrosomia: a systematic review. Database of Abstracts of Reviews of Effectiveness 2004;2:2. 37. Irion O, Boulvain M. Induction of labour for suspected fetal macrosomia. Cochrane Database Syst Rev 2000;2: CD000938. 38. Horvath (...) 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

2012 Royal College of Obstetricians and Gynaecologists

9. Systematic review with meta analysis: Induction of labour at 37 weeks for suspected fetal macrosomia may reduce birth trauma Full Text available with Trip Pro

For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Induction of labour at 37 weeks for suspected fetal macrosomia may reduce birth trauma Article Text Therapeutics/Prevention Systematic review with meta analysis Induction of labour (...) delivery. They may also sustain perineal injury or more seriously the head may deliver and the shoulders get stuck, so-called shoulder dystocia. This severe complication may cause birth injury, including brachial plexus injury (2%–16%) which may be permanent and disabling. Finally, the baby may suffer bony fractures or birth asphyxia with risk of neurological damage or death. Obstetricians have wondered whether inducing labour early might make birth easier and reduce injury, … Request Permissions

2017 Evidence-Based Medicine

10. 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

11. Induction of labour at or near term for suspected fetal macrosomia. Full Text available with Trip Pro

, and fewer birth fractures and shoulder dystocia. The unexpected observation in the induction group of increased perineal damage, and the plausible, but of uncertain significance, observation of increased use of phototherapy, both in the largest trial, should also be kept in mind.Findings from trials included in the review suggest that to prevent one fracture it would be necessary to induce labour in 60 women. Since induction of labour does not appear to alter the rate of caesarean delivery (...) Induction of labour at or near term for suspected fetal macrosomia. Women with a suspected large-for-dates fetus or a fetus with suspected macrosomia (birthweight greater than 4000 g) are at risk of operative birth or caesarean section. The baby is also at increased risk of shoulder dystocia and trauma, in particular fractures and brachial plexus injury. Induction of labour may reduce these risks by decreasing the birthweight, but may also lead to longer labours and an increased risk

2016 Cochrane

12. 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 Full Text available with Trip Pro

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

2016 Biology of reproduction

13. Management of Spontaneous Labour at Term in Healthy Women

dystocia to increase the likelihood of a vaginal birth and optimize birth outcomes. Evidence Published literature was retrieved through searches of PubMed and the Cochrane Library in October 2011 using appropriate, controlled vocabulary (e.g., labour pain; labour, obstetric; dystocia) and key words (e.g., obstetric labor, perineal care, dysfunctional labor). When appropriate, results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies (...) . Results were limited to the last 10 years. Searches were updated on a regular basis and incorporated in the guideline up to June 15, 2015. Values The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care ( Table 1 ). Summary Statements 1. The duration of the first stage of labour increases with maternal age and body mass index. (II-2) 2. In low-risk nulliparous women in the active phase of labour (i.e., equal

2016 Society of Obstetricians and Gynaecologists of Canada

14. [Composite prevention strategy for shoulder dystocia: meta-analysis]. (Abstract)

[Composite prevention strategy for shoulder dystocia: meta-analysis]. To investigate the composite prevention strategy for shoulder dystocia.The published articles of randomized controlled trial (RCT) of comparison about the prevention of shoulder dystocia were searched in PubMed, EMBASE, EBSCO databases and Cochrane Library, and these studies were screened under inclusion and exclusion criteria. The quality of included studies were evaluated. And the Meta-analysis using statistic software (...) articles, it was found that the incidence of shoulder dystocia was reduced significantly by intensive intervention(diet control combined with insulin if necessary)versus less intensive intervention (only diet control), OR = 0.29 (95%CI:0.11-0.73, P = 0.009). (3) To the non-GDM patients with suspected macrosomia, reviewed from 4 articles, it was found that the incidence of shoulder dystocia was not reduced by early artificial induction of parturition (OR = 0.85, 95%CI:0.41-1.75, P = 0.660). (4

2015 Zhonghua fu chan ke za zhi

15. [Composite prevention strategy for shoulder dystocia: meta-analysis]. (Abstract)

[Composite prevention strategy for shoulder dystocia: meta-analysis]. To investigate the composite prevention strategy for shoulder dystocia.The published articles of randomized controlled trial (RCT) of comparison about the prevention of shoulder dystocia were searched in PubMed, EMBASE, EBSCO databases and Cochrane Library, and these studies were screened under inclusion and exclusion criteria. The quality of included studies were evaluated. And the Meta-analysis using statistic software (...) articles, it was found that the incidence of shoulder dystocia was reduced significantly by intensive intervention(diet control combined with insulin if necessary)versus less intensive intervention (only diet control), OR = 0.29 (95%CI:0.11-0.73, P = 0.009). (3) To the non-GDM patients with suspected macrosomia, reviewed from 4 articles, it was found that the incidence of shoulder dystocia was not reduced by early artificial induction of parturition (OR = 0.85, 95%CI:0.41-1.75, P = 0.660). (4

2015 Zhonghua fu chan ke za zhi

16. Shoulder Dystocia

unspecified , shoulder dystocia (diagnosis) , shoulder dystocia , Shoulder Dystocia , dystocia shoulder , shoulder impact , dystocia shoulders , Shoulder dystocia unspecified (disorder) , Shoulder dystocia NOS (disorder) , Shoulder (girdle) dystocia during labour and delivery , Impacted shoulders , Shoulder girdle dystocia , Shoulder dystocia , Shoulder girdle dystocia (disorder) , dystocia; shoulder , impaction; shoulder , shoulder; dystocia , shoulder; impaction , Impacted shoulders during labor Italian (...) 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

2018 FP Notebook

17. Induction of labour for suspected fetal macrosomia: review and reflections

, 60 women would need to be induced to prevent one fracture. Fewer in the induction group had shoulder dystocia. There was no clear difference between groups for low Apgar score, low arterial cord pH, or brachial plexus injury –although the trials were too small to show any meaningful change in the incidence of this rare event. There was no information about mothers’ pain or sexual function, nor about long-term disability in children. Quality of the evidence Overall, the quality of the evidence (...) cannot recommend induction as a means of avoiding the risks of an operative birth. We know that routine caesarean is not recommended for macrosomia (Ozmen et al, 2012). Timing If induction of labour decreases the incidence of fractures and shoulder dystocia then surely this would be evidence in favour of routine induction. However, the review shows that “the exact gestation at which doctors and parents will decide on induction cannot be specified from these data” (Boulvain et al, 2016: 17

2016 Evidently Cochrane

18. 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

19. Core Competencies for Management of Labour

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 3. Assessment and Immediate Management of Preterm Labour . . . . . . . . . . . . . . . . . . . . 31 4. Evaluation of Progress of Labour/Dystocia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 5. Discomfort and Pain in Labour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 5A. Administration of Nitrous Oxide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 6. Birth in the Absence (...) if the Primary Maternal Care Provider is Absent 1 . Obstetrical T riage and Assessment 2. Intrapartum Fetal Health Surveillance 3. Assessment and Immediate Management of Preterm Labour/Birth 4. Evaluation of Progress of Labour/Dystocia 5. Discomfort and Pain in Labour 5a . Administration of Nitrous Oxide 6. Birth in the Absence of a Primary Care Provider 7 . Postpartum Hemorrhage 8a . Obstetrical Emergencies – Cord Prolapse 8b . Obstetrical Emergencies – Shoulder DystociaCore Nursing Practice Competencies

2014 British Columbia Perinatal Health Program

20. Induction of Labour at Term in Older Mothers

defined FGR as growth 12 hours) and surgical intervention because of dystocia approximately one third higher in spontaneously labouring nulliparous women aged = 35 years compared to younger women. 29 This group employed a strict ‘active management of labour’ policy which may have removed any bias resulting from obstetricians intervening earlier in older women. The need for oxytocin augmentation of labour also increased with age until 30–34 years. Others have found women = 35 years of age require (...) labour induced for the prevention of stillbirth due to post maturity. 36 There is increasing evidence that induction of labour from 37 weeks of gestation also improves perinatal outcomes without increasing rates of caesarean section. 37–39 This goes against the commonly held belief that induction of labour leads to an increase in caesarean section rates. Studies alluding to the latter have compared elective induction of labour (without medical indication) with spontaneous SIP Opinion Paper No. 34 ©

2013 Royal College of Obstetricians and Gynaecologists

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