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Prevention of Labor Dystocia

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161. Screening and diagnosing gestational diabetes mellitus. (PubMed)

Screening and diagnosing gestational diabetes mellitus. There is uncertainty as to the optimal approach for screening and diagnosis of gestational diabetes mellitus (GDM). Based on systematic reviews published in 2003 and 2008, the U.S. Preventive Services Task Force concluded that there was insufficient evidence upon which to make a recommendation regarding routine screening of all pregnant women.(1) Identify properties of screening tests for GDM, (2) evaluate benefits and harms of screening (...) not receive treatment; any treatment for GDM with no treatment. We conducted a descriptive analysis for all studies and meta-analyses when appropriate. Key outcomes included preeclampsia, maternal weight gain, birth injury, shoulder dystocia, neonatal hypoglycemia, macrosomia, and long-term metabolic outcomes for the child and mother.The search identified 14,398 citations and included 97 studies (6 randomized controlled trials, 63 prospective cohort studies, and 28 retrospective cohort studies

2012 Evidence report/technology assessment

162. Assessing Childbirth-related Complications at the Community Level in Kenya

: Other Study ID Numbers: P141/03/2012 First Posted: August 15, 2012 Last Update Posted: April 28, 2014 Last Verified: April 2014 Keywords provided by Wilson Liambila, Kenyatta National Hospital: complications Additional relevant MeSH terms: Layout table for MeSH terms Hemorrhage Pre-Eclampsia Postpartum Hemorrhage Eclampsia Breech Presentation Placenta, Retained Dystocia Pathologic Processes Hypertension, Pregnancy-Induced Pregnancy Complications Obstetric Labor Complications Puerperal Disorders (...) . Information provided by (Responsible Party): Wilson Liambila, Kenyatta National Hospital Study Details Study Description Go to Brief Summary: Kenya is one of the countries in sub-Saharan Africa that still experience high maternal mortality. For instance, in 2008/09 maternal mortality ratio was estimated to be 488/100,000 live births. Direct obstetric complications such as puerperal sepsis, postpartum hemorrhage, pre-eclampsia and eclampsia, obstructed labor and indirect causes including HIV, malaria

2012 Clinical Trials

163. Failure to Progress

: Failure to Progress , Labor Dystocia , Cephalopelvic Disproportion , CPD From Related Chapters II. Epidemiology Labor Dystocia is responsible for 50% of Cesereans Primary Ceserean rate: 20% in U.S. III. Criteria: Active phase delay or arrest Background Based on Assumes dilated to 6 cm and (prior criteria was 4 cm) Frequent contractions Protracted labor (slow rate of dilation and descent) Nulliparous women : <1 cm/hour Cervical Dilation: <1 cm/hour Multiparous women Cervical Dilation: <1.5 cm/hour : <2 (...) ) Ontology: Dystocia (C0013418) Definition (NCI) Uterine contractions (less than 3 in 10 minutes or inadequate strength) that do not result in progressive cervical dilation.(NICHD) Definition (MSH) Slow or difficult OBSTETRIC LABOR or CHILDBIRTH. Concepts Finding ( T033 ) MSH ICD9 661.9 ICD10 SnomedCT 45757002 , 199746004 , 111448009 , 237323007 , 289255001 , 199816006 , 289261003 English Dystocias , Unspecified abnormality of labor , dysfunctional labor (physical finding) , dysfunctional labor

2015 FP Notebook

164. Probiotics (Lactobacillus Rhamnosus) in Reducing Glucose Intolerance During and After Pregnancy

OUTCOMES:( :( assessed at the time of delivery and postpartum) Maternal Mortality Maternal Weight Gain Preeclampsia Induction of labor Mode of Delivery FETAL/NEONATAL safety [ Time Frame: assessed at the time of delivery till 6-8 weeks postpartum ] Death This will include: Still births Neonatal death Pre-term birth. Birth Trauma Macrosomia Small for Gestational Age Polyhydramnios Recurrent Hypoglycemia Large for Gestational Age Shoulder Dystocia 5-minute Apgar score: <7 Hyperbilrubinemia Respiratory (...) : Parallel Assignment Masking: Triple (Participant, Care Provider, Investigator) Primary Purpose: Prevention Official Title: Effects of Probiotics (Lactobacillus Rhamnosus) In Reducing Glucose Intolerance During and After Pregnancy: A Double Blind Randomized Controlled Trial in Antenatal Clinic of Karachi-Pakistan (GRIP) Study Start Date : October 2011 Estimated Primary Completion Date : November 2012 Estimated Study Completion Date : May 2013 Resource links provided by the National Library of Medicine

2011 Clinical Trials

165. Overview of High-Risk Pregnancy

WHO, UNICEF, UNFPA, The World Bank, and the United Nations Population Division. Trends in Maternal Mortality: 1990 to 2015. Geneva, World Health Organization, 2015. The most common causes of maternal death worldwide are Hemorrhage Preeclampsia Sepsis Abortion (including induced abortion, miscarriage, and ectopic pregnancy) Pulmonary embolism Obstetric complications Other disorders (eg, preexisting disorders such as HIV infection [ ]) Nearly half of maternal deaths are preventable. Perinatal (...) that increase the risk of perinatal mortality include maternal age (much younger or older than average), unmarried status, smoking, and multiple gestations. Reference 1. : Global causes of maternal death: A WHO systematic analysis. Lancet Glob Health 2 (6):e323–33, 2014. doi: 10.1016/S2214-109X(14)70227-X. Risk Assessment During Pregnancy Risk assessment is part of routine prenatal care. Risk is also assessed during or shortly after labor and at any time that events may modify risk status. are assessed

2013 Merck Manual (19th Edition)

166. Diabetes Mellitus in Pregnancy (Gestational Diabetes)

insulin once or twice a day and insulin aspart immediately before breakfast, lunch, and dinner. ‡ During labor and delivery Vaginal delivery at term is possible if women have documented dating criteria and good glycemic control. Amniocentesis is not done unless indicated for another problem or requested by the couple. Cesarean delivery should be reserved for obstetric indications or fetal macrosomia (> 4500 g), which increases risk of shoulder dystocia. Delivery should occur by 39 weeks. During (...) increases near term. Thus, if labor does not begin spontaneously by 39 weeks, induction is often necessary; also, delivery may be induced between 37 to 39 weeks without amniocentesis if adherence to therapy is poor or if blood glucose is poorly controlled. Dysfunctional labor, fetopelvic disproportion, or risk of shoulder dystocia may make cesarean delivery necessary. Blood glucose levels are best controlled during labor and delivery by a continuous low-dose insulin infusion. If induction is planned

2013 Merck Manual (19th Edition)

167. Postterm Pregnancy

risks for the woman and fetus. Risks include Abnormal fetal growth ( and ) Meconium-stained amniotic fluid Nonreassuring fetal test results Fetal and neonatal death Need for neonatal intensive care Dystocia (abnormal or difficult labor) Perineal lacerations refers to the condition of the fetus that results when the placenta can no longer maintain a healthy environment for growth and development, usually because the pregnancy has lasted too long. The fetus may have dry, peeling skin, overgrown nails (...) How to do and Repair an Episiotomy SOCIAL MEDIA Add to Any Platform Loading , MD, The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Postterm pregnancy refers to gestation that lasts ≥ 42 wk. Antenatal surveillance should be considered at 41 wk. Induction of labor should be considered after 41 wk and is recommended after 42 wk. Accurate gestational age estimation is essential

2013 Merck Manual (19th Edition)

168. Uterine Rupture

. Other predisposing factors include congenital uterine abnormalities, trauma, and other uterine surgical procedures such as myomectomies or open fetal surgery. Causes of uterine rupture include Uterine overdistention ( , , fetal anomalies) External or internal fetal version Iatrogenic perforation Excessive use of uterotonics Failure to recognize labor dystocia with excessive uterine contractions against a lower uterine restriction ring If women who have had a prior cesarean delivery wish to try (...) SOCIAL MEDIA Add to Any Platform Loading , MD, The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Uterine rupture is spontaneous tearing of the uterus that may result in the fetus being expelled into the peritoneal cavity. Uterine rupture is rare. It can occur during late pregnancy or active labor. Uterine rupture occurs most often along healed scar lines in women who have had prior

2013 Merck Manual (19th Edition)

169. Risk Factors for Complications During Pregnancy

Gynecol 115 (1):152-155, 2010. doi: 10.1097/AOG.0b013e3181c51908. Maternal Height Short (about < 152 cm) women are more likely to have a small pelvis, which can lead to dystocia with fetopelvic disproportion or shoulder dystocia. For short women, preterm labor and intrauterine growth restriction are also more likely. Exposure to Teratogens Common teratogens (agents that cause fetal malformation) include infections, drugs, and physical agents. Malformations are most likely to result if exposure occurs (...) forces during labor or malposition during the last weeks of pregnancy. Previous is a risk factor for future dystocia, and the delivery records should be reviewed for potentially modifiable risk factors (eg, fetal macrosomia, operative vaginal delivery) that may have predisposed to the injury. Last full review/revision March 2017 by Raul Artal, MD NOTE: This is the Professional Version. CONSUMERS: © 2018 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA) Was This Page

2013 Merck Manual (19th Edition)

170. Elective caesarean section

the mother and baby became common. Contents Uses [ ] A 7-week old caesarean section and visible on a 31-year-old mother: Longitudinal incisions are still sometimes used. Caesarean section is recommended when might pose a risk to the mother or baby. C-sections are also carried out for personal and social reasons on in some countries. Medical uses [ ] Complications of labor and factors increasing the risk associated with vaginal delivery include: abnormal presentation ( or ). prolonged or a failure (...) to progress ( , also known as dystocia) or an elevated risk thereof in the mother or baby after (the waters breaking) in the mother or baby after amniotic rupture (the waters breaking) problems ( , or ) failed failed instrumental delivery (by or (Sometimes, a trial of forceps/ventouse delivery is attempted, and if unsuccessful, the baby will need to be delivered by caesarean section.) large baby weighing > 4,000 grams ( ) umbilical cord abnormalities ( , multilobate including bilobate and succenturiate

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2012 Wikipedia

171. Caesarean section

. Contents Uses [ ] A 7-week old caesarean section and visible on a 31-year-old mother: Longitudinal incisions are still sometimes used. Caesarean section is recommended when might pose a risk to the mother or baby. C-sections are also carried out for personal and social reasons on in some countries. Medical uses [ ] Complications of labor and factors increasing the risk associated with vaginal delivery include: abnormal presentation ( or ). prolonged or a failure to progress ( , also known as dystocia (...) of pregnancy, pre-existing conditions, and concomitant disease, include: previous (high risk) fetus infection of the mother with a high (HIV with a low maternal viral load is not necessarily an indication for caesarean section) , such as a first outbreak of very recently before the onset of labor (which can cause infection in the baby if born vaginally) previous classical (longitudinal) caesarean section previous uterine rupture prior problems with the healing of the (from previous childbirth or ) rare

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2012 Wikipedia

172. Childbirth

("primiparae"), and usually does not extend beyond 10 hours in subsequent labours ("multiparae"). The median duration of active first stage is 4 hours in first labours and 3 hours in second and subsequent labours. Dystocia of labor , also termed dysfunctional labor or failure to progress, is defined as difficult labor or abnormally slow progress of labor. The term is used to describe a lack of progressive cervical dilatation or lack of descent of the fetus. Friedman's Curve, developed in 1955, was for many (...) years used to determine labor dystocia. However, more recent medical research suggests that the Friedman curve may not be currently applicable. Second stage: fetal expulsion [ ] Stages in the birth of the baby's head. The expulsion stage begins when the cervix is fully dilated, and ends when the baby is born. As pressure on the cervix increases, women may have the sensation of pelvic pressure and an urge to begin pushing. At the beginning of the normal second stage, the head is fully engaged

2012 Wikipedia

173. Exercise Training in Pregnancy for Obese Mothers

Hospital Information provided by (Responsible Party): Norwegian University of Science and Technology Study Details Study Description Go to Brief Summary: Observational studies demonstrate that overweight in pregnancy is a risk factor for adverse pregnancy outcomes as fetal macrosomia, prolonged labor, low Apgar score, shoulder dystocia, nerve plexus injuries, increased proportion of instrumental deliveries and perineal ruptures. There is a 2.6 fold risk for gestational diabetes mellitus (fourfold (...) in morbidly obese women) and a recent study has shown that fetuses of obese mothers develop insulin resistance in uterus. Main aims of this study are to assess if regular exercise in pregnancy among obese women can prevent or influence weight gain; impaired cardiac function in mother and fetus/newborn; impaired vascular function in mother; insulin resistance/sensitivity; body composition in mother and offspring; lumbopelvic pain; urinary and/or fecal incontinence; prolonged labor Condition or disease

2010 Clinical Trials

174. Does Intramyometrial Oxytocin Improve Outcome in Elective Cesarean Delivery?

by University of Saskatchewan: Oxytocin Intramyometrial Additional relevant MeSH terms: Layout table for MeSH terms Hemorrhage Postpartum Hemorrhage Uterine Inertia Pathologic Processes Obstetric Labor Complications Pregnancy Complications Puerperal Disorders Uterine Hemorrhage Dystocia Oxytocin Oxytocics Reproductive Control Agents Physiological Effects of Drugs (...) prophylaxis to prevent need for additional uterotonics, including additional oxytocin; Determine if the addition of prophylactic intramyometrial oxytocin improves both the primary outcome (uterine tone) and secondary outcomes (estimated blood loss, preoperative to postoperative change in hematocrit, need for additional uterotonics, and need for blood pressure support); and Act as a dose finding study to determine if the intramyometrial dose is sufficient to augment uterine contraction. The working

2010 Clinical Trials

175. Is there any evidence that a woman should avoid conceiving soon after birth?

outcomes. Twenty-two studies met the inclusion criteria. Overall, long interpregnancy intervals, possibly longer than 5 years, are independently associated with an increased risk of preeclampsia. There is emerging evidence that women with long interpregnancy intervals are at increased risk for labor dystocia and that short intervals are associated with increased risks of uterine rupture in women attempting a vaginal birth after previous cesarean delivery and uteroplacental bleeding disorders (placental (...) associated with increased risk of adverse perinatal outcomes. These data suggest that spacing pregnancies appropriately could help prevent such adverse perinatal outcomes.” The full paper is freely available at . The 2007 systematic review explored the association between birth spacing and risk of adverse maternal outcomes(2). The abstract states “The study was a systematic review of observational studies that examined the relationship between interpregnancy or birth intervals and adverse maternal

2009 TRIP Answers

176. Oxytocin Regimen to Prevent Atony and Postpartum Hemorrhage During Vaginal Delivery: 3-arm RCT

Obstetric Labor Complications Pregnancy Complications Puerperal Disorders Uterine Hemorrhage Dystocia Oxytocin Oxytocics Reproductive Control Agents Physiological Effects of Drugs (...) Oxytocin Regimen to Prevent Atony and Postpartum Hemorrhage During Vaginal Delivery: 3-arm RCT Oxytocin Regimen to Prevent Atony and Postpartum Hemorrhage During Vaginal Delivery: 3-arm RCT - 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

2008 Clinical Trials

177. Up-Down Oxytocin Infusion

Inertia Dystocia Obstetric Labor Complications Pregnancy Complications Oxytocin Oxytocics Reproductive Control Agents Physiological Effects of Drugs (...) (ED90) of infusions of oxytocin for the prevention of uterine atony / postpartum hemorrhage and the need for additional uterotonics, in low risk parturients presenting for an elective CD. The primary outcome measure is the response of effective uterine contraction as either satisfactory or unsatisfactory as determined by the obstetrician blinded to the oxytocin infusion dose. Secondary outcomes will include need for additional uterotonics, calculated intra-operative blood loss and presence

2008 Clinical Trials

178. Active Management Of Risk In Pregnancy At Term to Reduce Rate of Cesarean Deliveries

, Apgar scores and admissions to the NICU. Condition or disease Intervention/treatment Phase Pregnancy Procedure: induction of labor Not Applicable Detailed Description: The study will include patients who have their prenatal care at the Paley clinic in AEMC, where the residents provide the prenatal care with supervision of OBGYN attending physicians, or at other affiliated clinics that are staffed by care givers from our OBGYN department. Patients at our obstetric clinics are scheduled for weekly (...) to 37 weeks (using the digichart system, the medical records and questioners) and the upper limit of the optimal time of delivery will be calculated for each patient, according to the method used by the UPenn group, with the time always being at least 38 weeks and no more then 41 weeks. Patients from the AMOR-IPAT group will be scheduled for induction of labor on the morning of the day of the calculated upper limit (plus or minus 2 days). To try and eliminate biases, a uniform method of induction

2008 Clinical Trials

179. Extensive cervical prolapse during labor: a case report. (PubMed)

prolapse was reduced by topical application of concentrated magnesium sulfate.In active labor, a prolapsed cervix that is enlarged and edematous can be managed with a topical concentrated magnesium solution to prevent cervical dystocia and lacerations. (...) Extensive cervical prolapse during labor: a case report. An extensive, irreducible cervical prolapse during pregnancy is a rare condition and can lead to various complications, including severe cervical edema and dystocia in labor. Treatment options are very limited.A 33-year-old woman with spina bifida and a history of multiple intraabdominal operations and extensive intraperitoneal adhesions was admitted in labor at 36(6/7) weeks' gestation with an irreducible cervical prolapse. The cervical

2008 Journal of Reproductive Medicine

180. Labour - Active Management and Induction

Thanks for your feedback. if you would like to report a specific issue with this page, please visit our . Thank you, we just sent a survey email to confirm your preferences. Further reading and references ; World Health Organization, 2018 ; Management of Spontaneous Vaginal Delivery. Am Fam Physician. 2015 Aug 192(3):202-8. ; Dystocia in nulliparous women. Am Fam Physician. 2007 Jun 175(11):1671-8. ; Prevention of prolonged labour. Br Med J. 1969 May 242(5655):477-80. ; Early amniotomy and early (...) for the woman [ ] . Liberal use of epidural anaesthesia. Regular rounds by the obstetrician. Early cord clamping and controlled cord traction with uterotonic [ ] . Antenatal education classes. Regular audit of labour ward process and outcomes. 'Active management' was not designed to lower caesarean section rates, but may have decreased the number of sections performed for dystocia - failure to progress [ ] . This effect was most significant in Dublin, where it was first used, but this success has not been

2008 Mentor

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