How to Trip Rapid Review

Step 1: Select articles relevant to your search (remember the system is only optimised for single intervention studies)

Step 2: press

Step 3: review the result, and maybe amend the or if you know better! If we're unsure of the overall sentiment of the trial we will display the conclusion under the article title. We then require you to tell us what the correct sentiment is.

194 results for

Prevention of Labor Dystocia

by
...
Alerts

Export results

Use check boxes to select individual results below

SmartSearch available

Trip's SmartSearch engine has discovered connected searches & results. Click to show

141. The Fetus as a Patient: Prenatal Diagnosis and Fetal Therapy (Treatment)

, assessment of fetal well-being in the third trimester, when preterm birth appears imminent, and in labor may include the following diagnostic tests: Amniocentesis Nonstress test (NST) Biophysical profile test: Combines the NST with an assessment of amniotic fluid volume (AFV), fetal breathing movements, fetal activity, and fetal muscle tone Contraction stress test Doppler study: Assesses fetal umbilical arterial blood flow velocity or resistance to flow Radiologic studies Diagnostic imaging modalities (...) fetal exposure, to monitor both patients, to prevent , and to prevent the leak of amniotic fluid Knowledge gaps - The maternal-placental-fetal physiology and metabolism presents distinct challenges that preclude mere extrapolation of common medical fundamentals Fetal treatment center The fetal treatment center has been established as a solution to these problems. These centers offer many advantages. One such advantage is that the fetal treatment center is staffed with fetal surgeons, either

2014 eMedicine Pediatrics

142. Pregnancy, Delivery (Follow-up)

Pregnancy, Delivery (Follow-up) Labor and Delivery in the Emergency Department Treatment & Management: Prehospital Care, Emergency Department Care, Consultations Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzk2Mzc5LXRyZWF0bWVudA== processing > Labor and Delivery in the Emergency Department Treatment & Management Updated: Jul 26, 2017 Author: Thomas E Benzoni, DO, MT(ASCP); Chief Editor: Mark A Clark, MD Share Email Print Feedback Close Sections Sections Labor and Delivery in the Emergency Department Treatment Prehospital Care Provide oxygen. Obtain intravenous access. Generally, transport the patient in the left lateral recumbent position; use this position especially if the expectant mother's blood pressure decreases

2014 eMedicine Emergency Medicine

143. Pregnancy, Breech Delivery (Follow-up)

as the breech is squeezed through the birth canal. This is usually not associated with meconium aspiration because the meconium passes out of the vagina and does not mix with the amniotic fluid. Assisted vaginal breech delivery. The Ritgen maneuver is applied to take pressure off the perineum during vaginal delivery. Episiotomies are often performed for assisted vaginal breech deliveries, even in multiparous women, to prevent soft tissue dystocia. Assisted vaginal breech delivery. No downward or outward (...) , aspiration, anesthesia risk), especially with emergency delivery. Fetus and infant mortality increases to 9%, compared with 3% in cephalic presentations. Average Apgar score, especially at 1 minute, is lower. Congenital abnormalities increase to 6%, compared with 2.4% in infants with cephalic presentations. Factors for increased adverse fetal outcome include the following: [ ] Older mothers Footling presentation Hyperextended fetal head Birth weight less than 2500 g or greater than 4000 g Prolonged labor

2014 eMedicine Emergency Medicine

144. Pregnancy, Breech Delivery (Overview)

. Episiotomies are often performed for assisted vaginal breech deliveries, even in multiparous women, to prevent soft tissue dystocia. Assisted vaginal breech delivery. No downward or outward traction is applied to the fetus until the umbilicus has been reached. Assisted vaginal breech delivery. With a towel wrapped around the fetal hips, gentle downward and outward traction is applied in conjunction with maternal expulsive efforts until the scapula is reached. An assistant should be applying gentle fundal (...) the Table below). However, the overall frequency is 3-4% at delivery. [ ] Table. Gestational age and frequency of breech birth Gestational Age, Weeks Breech, % 21-24 33 25-28 28 29-32 14 33-36 9 37-40 3-4 International The international incidence has been reported at 3-4%. [ ] Mortality/Morbidity See the list below: Many complications are associated with a breech presentation in labor. This may be due to the underlying etiology of the breech presentation, such as fetal anomalies or polyhydramnios

2014 eMedicine Emergency Medicine

145. Pregnancy, Breech Delivery (Diagnosis)

. Episiotomies are often performed for assisted vaginal breech deliveries, even in multiparous women, to prevent soft tissue dystocia. Assisted vaginal breech delivery. No downward or outward traction is applied to the fetus until the umbilicus has been reached. Assisted vaginal breech delivery. With a towel wrapped around the fetal hips, gentle downward and outward traction is applied in conjunction with maternal expulsive efforts until the scapula is reached. An assistant should be applying gentle fundal (...) the Table below). However, the overall frequency is 3-4% at delivery. [ ] Table. Gestational age and frequency of breech birth Gestational Age, Weeks Breech, % 21-24 33 25-28 28 29-32 14 33-36 9 37-40 3-4 International The international incidence has been reported at 3-4%. [ ] Mortality/Morbidity See the list below: Many complications are associated with a breech presentation in labor. This may be due to the underlying etiology of the breech presentation, such as fetal anomalies or polyhydramnios

2014 eMedicine Emergency Medicine

147. Teratology and Drug Use During Pregnancy (Diagnosis)

of these medications. [ ] Thus, the 5-letter system is being phased out over the next 3 years in favor of a more comprehensive system with a narrative summary of the risks posed by drugs. The FDA, the government agency that oversees the safety of drugs, provides the most widely used system to grade the teratogenic effects of medications. Each drug summary will have three sections: pregnancy, lactation, and females and males of reproductive potential. “Pregnancy” merges previous categories of “pregnancy” and “labor (...) . If there is more than one risk based on human data, the information should be placed in order of clinical importance. Clinical Considerations See the list below: Relevant information is presented under the following five headings, to the extent information is available: - Disease-associated maternal and/or embryo/fetal risk - Dose adjustments during pregnancy and the postpartum period - Maternal adverse reactions - Fetal/Neonatal adverse reactions - Labor or Delivery Data --Under the subheading Data, labeling

2014 eMedicine.com

148. Postpartum Hemorrhage (Diagnosis)

usually has a single cause, but more than one cause is also possible, most likely following a prolonged labor that ultimately ends in an operative vaginal birth. Previous Next: Prevention High-quality evidence suggests that active management of the third stage of labor reduces the incidence and severity of PPH. [ ] Active management is the combination of (1) uterotonic administration (preferably oxytocin) immediately upon delivery of the baby, (2) early cord clamping and cutting, and (3) gentle cord (...) . . Vaid A, Dadhwal V, Mittal S, Deka D, Misra R, Sharma JB. A randomized controlled trial of prophylactic sublingual misoprostol versus intramuscular methyl-ergometrine versus intramuscular 15-methyl PGF2alpha in active management of third stage of labor. Arch Gynecol Obstet . 2009 Mar 11. . Tunçalp Ö, Hofmeyr GJ, Gülmezoglu AM. Prostaglandins for preventing postpartum haemorrhage. Cochrane Database Syst Rev . 2012 Aug 15. 18;(3):CD000494. . Winikoff B, Dabash R, Durocher J, Darwish E, Nguyen TN, León

2014 eMedicine.com

149. Postterm Pregnancy (Diagnosis)

weeks gestation including meconium and meconium aspiration, neonatal acidemia, low Apgar scores, macrosomia, and, in turn, birth injury. For example, since postterm infants are larger than term infants, with a higher incidence of fetal macrosomia (defined as estimated fetal weight ≥ 4,500 g) [ ] , they are, in turn, at greater risk for other complications. [ , ] Such complications associated with fetal macrosomia include prolonged labor, cephalopelvic disproportion, and shoulder dystocia (...) elective induction of labor to expectant management of pregnancy. [ ] However, elective induction of labor is increasingly being used as a management strategy. [ , ] While this management may be reasonable in a practice that allows 48 hours or more for the management of the latent phase and the first stage of labor overall, in a setting where induction of labor is called a failure after 18-24 hours, it will likely further increase the cesarean delivery rate. Previous Next: Prevention of Postterm

2014 eMedicine.com

150. Prenatal Nutrition (Diagnosis)

weight is defined as a BMI of 18.5-24.9 kg/m 2 . Overweight is defined as a BMI of 25-29.9 kg/m 2 . Obesity is defined as a BMI that exceeds 30 kg/m 2 . [ ] Birth weight is affected by pre-pregnancy BMI, independent of actual weight gain during pregnancy. Women who are underweight are at increased risk for low birth weight babies; women who are overweight or obese are at increased risk for macrosomic infants. Macrosomic infants are at increased risk for shoulder dystocia and brachial plexus injuries (...) women. Folate supplements should be administered 3 months prior to conception and throughout the first trimester. If the mother had a prior child affected by a neural tube defect, supplementation in the subsequent pregnancy should be increased to 4 mg/d. [ ] The US Preventative Services Task Force recommends a daily supplement of folic acid (0.4 to 0.8 mg) for all women who are planning or capable of pregnancy. [ ] Niacin Niacin is a water-soluble vitamin involved in the release of energy from cells

2014 eMedicine.com

151. Hand, Brachial Plexus Surgery

for diagnosing obstetric brachial plexus injuries. [ ] These evaluations can be difficult in young patients and infants because of their inability to cooperate. The surgeon must acquire information about the pregnancy, neonatal period, and delivery as they pertain to gestational age, birth weight, presentation, type of and length of labor, use of forceps, shoulder dystocia or fractures, and Apgar scores, among other factors. The treatment team must look at the patient's arm at rest and evaluate the chest (...) of the Procedure The renowned British obstetrician Smellie is attributed with providing the first medical description of obstetrica brachial plexus palsy. In his 1768 treatise on midwifery, he reported a case of transient bilateral arm paralysis in a newborn after difficult labor. In 1861, Duchenne invented the term obstetric palsy of the brachial plexus after examining 4 infants with paralysis of identical muscles in the arm and shoulder. He described the physical findings and recognized that traction

2014 eMedicine Surgery

152. Pregnancy, Breech Delivery (Treatment)

the perineum during vaginal delivery. Episiotomies are often performed for assisted vaginal breech deliveries, even in multiparous women, to prevent soft tissue dystocia. Wrap the legs with a towel to aid in grasping the fetus (see image below). Assisted vaginal breech delivery. With a towel wrapped around the fetal hips, gentle downward and outward traction is applied in conjunction with maternal expulsive efforts until the scapula is reached. An assistant should be applying gentle fundal pressure to keep (...) delivery. The Ritgen maneuver is applied to take pressure off the perineum during vaginal delivery. Episiotomies are often performed for assisted vaginal breech deliveries, even in multiparous women, to prevent soft tissue dystocia. Assisted vaginal breech delivery. No downward or outward traction is applied to the fetus until the umbilicus has been reached. Assisted vaginal breech delivery. With a towel wrapped around the fetal hips, gentle downward and outward traction is applied in conjunction

2014 eMedicine Emergency Medicine

153. Pregnancy, Delivery (Treatment)

Pregnancy, Delivery (Treatment) Labor and Delivery in the Emergency Department Treatment & Management: Prehospital Care, Emergency Department Care, Consultations Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzk2Mzc5LXRyZWF0bWVudA== processing > Labor and Delivery in the Emergency Department Treatment & Management Updated: Jul 26, 2017 Author: Thomas E Benzoni, DO, MT(ASCP); Chief Editor: Mark A Clark, MD Share Email Print Feedback Close Sections Sections Labor and Delivery in the Emergency Department Treatment Prehospital Care Provide oxygen. Obtain intravenous access. Generally, transport the patient in the left lateral recumbent position; use this position especially if the expectant mother's blood pressure decreases

2014 eMedicine Emergency Medicine

154. Birth Trauma (Diagnosis)

of labor must be appropriate. Occasionally, injury may be sustained in utero. Previous Next: Bone Injury Fractures are most often observed following breech delivery, shoulder dystopia, or both in infants with excessive birth weights. Clavicular fracture The clavicle is the most frequently fractured bone in the neonate during birth; this is most often an unpredictable, unavoidable complication of normal birth. [ ] Some correlation with birth weight, midforceps delivery, and shoulder dystocia (...) damage, edema, hemorrhage, or fracture in the neonate. The use of obstetric instrumentation may further amplify the effects of such forces or may induce injury alone. Under certain conditions, cesarean delivery can be an acceptable alternative but does not guarantee an injury-free birth. Factors predisposing to injury include the following: Prima gravida Cephalopelvic disproportion, small maternal stature, maternal pelvic anomalies Prolonged or rapid labor Deep, transverse arrest of descent

2014 eMedicine Pediatrics

155. The Fetus as a Patient: Prenatal Diagnosis and Fetal Therapy (Overview)

, assessment of fetal well-being in the third trimester, when preterm birth appears imminent, and in labor may include the following diagnostic tests: Amniocentesis Nonstress test (NST) Biophysical profile test: Combines the NST with an assessment of amniotic fluid volume (AFV), fetal breathing movements, fetal activity, and fetal muscle tone Contraction stress test Doppler study: Assesses fetal umbilical arterial blood flow velocity or resistance to flow Radiologic studies Diagnostic imaging modalities (...) fetal exposure, to monitor both patients, to prevent , and to prevent the leak of amniotic fluid Knowledge gaps - The maternal-placental-fetal physiology and metabolism presents distinct challenges that preclude mere extrapolation of common medical fundamentals Fetal treatment center The fetal treatment center has been established as a solution to these problems. These centers offer many advantages. One such advantage is that the fetal treatment center is staffed with fetal surgeons, either

2014 eMedicine Pediatrics

156. Birth Trauma (Follow-up)

of labor must be appropriate. Occasionally, injury may be sustained in utero. Previous Next: Bone Injury Fractures are most often observed following breech delivery, shoulder dystopia, or both in infants with excessive birth weights. Clavicular fracture The clavicle is the most frequently fractured bone in the neonate during birth; this is most often an unpredictable, unavoidable complication of normal birth. [ ] Some correlation with birth weight, midforceps delivery, and shoulder dystocia (...) damage, edema, hemorrhage, or fracture in the neonate. The use of obstetric instrumentation may further amplify the effects of such forces or may induce injury alone. Under certain conditions, cesarean delivery can be an acceptable alternative but does not guarantee an injury-free birth. Factors predisposing to injury include the following: Prima gravida Cephalopelvic disproportion, small maternal stature, maternal pelvic anomalies Prolonged or rapid labor Deep, transverse arrest of descent

2014 eMedicine Pediatrics

157. Birth Trauma (Treatment)

of labor must be appropriate. Occasionally, injury may be sustained in utero. Previous Next: Bone Injury Fractures are most often observed following breech delivery, shoulder dystopia, or both in infants with excessive birth weights. Clavicular fracture The clavicle is the most frequently fractured bone in the neonate during birth; this is most often an unpredictable, unavoidable complication of normal birth. [ ] Some correlation with birth weight, midforceps delivery, and shoulder dystocia (...) damage, edema, hemorrhage, or fracture in the neonate. The use of obstetric instrumentation may further amplify the effects of such forces or may induce injury alone. Under certain conditions, cesarean delivery can be an acceptable alternative but does not guarantee an injury-free birth. Factors predisposing to injury include the following: Prima gravida Cephalopelvic disproportion, small maternal stature, maternal pelvic anomalies Prolonged or rapid labor Deep, transverse arrest of descent

2014 eMedicine Pediatrics

158. Management of Pregnancy

labor include: home uterine activity monitoring, salivary estriol, screening for periodontal disease, and bacterial vaginosis (I-60) testing. However, the efficacy of these modalities has not been clearly demonstrated and their use remains controversial. Historically, the lack of an effective treatment to prevent preterm birth has rendered any prediction scheme impotent. The ability of cervical cerclage to prevent preterm birth or lengthen gestation likewise remains questionable with conflicting (...) reports of efficacy in the obstetric literature. Antimicrobial therapy, including treatment of bacterial vaginosis, does not appear to meaningfully reduce the preterm birth rate. Tocolysis of preterm labor with various agents remains unproven in the prevention of preterm delivery but is often used to prolong latency to allow the administration of antenatal corticosteroids. In contrast to these controversial or minimally effective treatments, recent data suggest that the administration of progesterone

2009 VA/DoD Clinical Practice Guidelines

159. A Randomized Trial of Induction Versus Expectant Management

requiring antibiotics Pneumonia Pyelonephritis Bacteremia - unknown source Septic pelvic thrombosis Number of Participants With Venous Thromboembolism [ Time Frame: delivery through discharge ] Maternal deep venous thrombosis or pulmonary embolism Number of Participants With Indications for Cesarean Delivery [ Time Frame: Labor and delivery ] Number of participants with indications for cesarean delivery including dystocia, non-reassuring fetal status or other indication Duration of Respiratory Support (...) Postpartum Length of Hospital Stay [ Time Frame: delivery through hospital discharge ] Neonatal Length of Hospital Stay [ Time Frame: delivery through hospital discharge ] Number of Participants With Indications for Operative Vaginal Delivery [ Time Frame: Labor and delivery ] Number of participants with indications for operative vaginal delivery including dystocia, non-reassuring fetal status and other indications Number of Participants and Breastfeeding Status at 4-8 Weeks After Delivery [ Time Frame

2013 Clinical Trials

160. Comparison of IV Ergonovine With IM Carboprost, With Oxytocin IV, During Cesarean Section for Failure to Progress

Additional relevant MeSH terms: Layout table for MeSH terms Hemorrhage Postpartum Hemorrhage Dystocia Pathologic Processes Obstetric Labor Complications Pregnancy Complications Puerperal Disorders Uterine Hemorrhage Oxytocin Ergonovine Carboprost Carboprost tromethamine Oxytocics Reproductive Control Agents Physiological Effects of Drugs Abortifacient Agents, Nonsteroidal Abortifacient Agents (...) Identifier: NCT01869556 Recruitment Status : Recruiting First Posted : June 5, 2013 Last Update Posted : January 15, 2019 See Sponsor: Samuel Lunenfeld Research Institute, Mount Sinai Hospital Information provided by (Responsible Party): Samuel Lunenfeld Research Institute, Mount Sinai Hospital Study Details Study Description Go to Brief Summary: Patients having Cesarean section after they have been in labor for many hours bleed much more, in average twice as much, as compared with patients having

2013 Clinical Trials

To help you find the content you need quickly, you can filter your results via the categories on the right-hand side >>>>