Labor Induction. Failed labor induction : toward an objective diagnosis. To evaluate maternal and perinatal outcomes in women undergoing labor induction with an unfavorable cervix according to duration of oxytocin administration in the latent phase of labor after ruptured membranes. Economic implications of labor induction.
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Labor Induction. Failed labor induction : toward an objective diagnosis. To evaluate maternal and perinatal outcomes in women undergoing labor induction with an unfavorable cervix according to duration of oxytocin administration in the latent phase of labor after ruptured membranes.
Economic implications of labor induction. To assess health service costs associated with labor induction according to different clinical situations in a tertiary-level hospital. In a prospective study, individual patient cost data were assessed for women admitted for induction of labor at a tertiary hospital in Spain between November 1, , and August 31, The costs of labor induction were estimated according to maternal and neonatal outcomes, method of delivery, cervical condition at admission, and obstetric indication.
Direct costs including professional fees, epidural, maternal stay, consumables, and drugs were calculated. Overall, women were included in the final cost analysis. Following the induction of labor , a number of patient- and treatment-related factors influence costs associated with delivery.
Published by Elsevier Ireland Ltd. All rights reserved. Timing of induction of labor. Determining the optimal timing for induction of labor is critical in minimizing the risks to maternal and fetal health. While data are available to guide us in some clinical situations, such as hypertension and diabetes, many gaps in knowledge still exist in others, including cholestasis of pregnancy, fetal anomalies, and placental abruption.
This review of the currently available literature assesses the risks and benefits of preterm and early term induction in a wide variety of maternal and fetal conditions. Aim: This study designed to compare titrated misoprostol regarding its safety and efficacy with dinoprostone for induction of labor.
Statistical analysis done using Student's t-test for quantitative data and Rev Bras Women who attempted VBAC with labour induction with dinoprostone were compared with women undergoing spontaneous labour. Logistic regression analyses were performed to asses Factors predicting labor induction success: a critical analysis.
Because of the risk of failed induction of labor , a variety of maternal and fetal factors as well as screening tests have been suggested to predict labor induction success. Certain characteristics of the woman including parity, age, weight, height and body mass index , and of the fetus including birth weight and gestational age are associated with the success of labor induction ; with parous, young women who are taller and lower weight having a higher rate of induction success.
Fetuses with a lower birth weight or increased gestational age are also associated with increased induction success. The condition of the cervix at the start of induction is an important predictor, with the modified Bishop score being a widely used scoring system. The most important element of the Bishop score is dilatation. Other predictors, including transvaginal ultrasound TVUS and biochemical markers [including fetal fibronectin fFN ] have been suggested. Further research is needed to evaluate these potential predictors and insulin-like growth factor binding protein-1 IGFBP-1 , another potential biochemical marker.
Induction of labor in a contemporary obstetric cohort. We sought to describe details of labor induction , including precursors and methods, and associated vaginal delivery rates. This was a retrospective cohort study of , electronic medical records from 19 hospitals across the United States, through Induction occurred in For all precursors, cesarean delivery was more common in nulliparas in the latent compared to active phase of labor.
Regardless of method, vaginal delivery rates were higher with a ripe vs unripe cervix, particularly for multiparas Induction of labor was a common obstetric intervention. Selecting appropriate candidates and waiting longer for labor to progress into the active phase would make an impact on decreasing the national cesarean delivery rate. Published by Mosby, Inc. Elective induction of labor has been linked to increased rates of prematurity and rising rates of cesarean birth.
The purpose of this investigation was to evaluate current trends in induction of labor scholarship focusing on evidence-based factors that influence the practice of elective induction.
A key word search was conducted to identify studies on the practice of elective induction of labor. Analysis of the findings included clustering and identification of recurrent themes among the articles with 3 categories being identified. A total of 49 articles met inclusion criteria: 7 patient, 6 maternity care provider, and 4 organization factors emerged.
Only 4 of the articles identified were evidence based. Currently, there is limited data-based information focused on factors that influence elective induction of labor. To evaluate the efficacy of acupuncture, and sweeping of the fetal membranes, as methods for induction of labor Objective We assessed experience and preferences among term women undergoing induction of labor with oral misoprostol or Foley catheter. We adapted a validated questionnaire about expectancy and experience of labor and asked women whether they would prefer the same method again in a future pregnancy.
Results The questionnaire was completed Oral misoprostol versus dinoprostone vaginal tablets for labor induction. Directory of Open Access Journals Sweden. Full Text Available Background: Induction of labour is common in obstetric practice.
We conducted this study to find the appropriate and safe drug for labour induction and to compare the safety and efficacy of oral misoprostol and vaginal dinoprostone for labour induction. Methods: In a provisional, prospective and cross-sectional study, one hundred and fifty five singleton cephalic presentation full term pregnancies with medical or obstetric indication for labour induction were allocated in two groups.
In the second group vaginal tablets of dinoprostone 3mg then 1. Primary outcome measures were: induction success, induction -delivery interval and number of used doses. Secondary outcome measures included: maternal side effects, caesarean section rate, mode of delivery and neonatal outcome.
Data was collected from patient case notes and analyzed using software SPSS version Induction of labor succeeded in It was observed that there were no significant differences between the two groups in final outcomes nor in obstetrical complications.
There was no significance in differences between misoprostol and dinoprostone groups in induction -delivery interval Conclusions: This study demonstrated that oral. Identification of first-stage labor arrest by electromyography in term nulliparous women after induction of labor. Worldwide induction and cesarean delivery rates have increased rapidly, with consequences for subsequent pregnancies.
The majority of intrapartum cesarean deliveries are performed for failure to progress, typically in nulliparous women at term.
Current uterine registration techniques fail to identify inefficient contractions leading to first-stage labor arrest. An alternative technique, uterine electromyography has been shown to identify inefficient contractions leading to first-stage arrest of labor in nulliparous women with spontaneous onset of labor at term.
The objective of this study was to determine whether this finding can be reproduced in induction of labor. Uterine activity was measured in nulliparous women with singleton term pregnancies and a fetus in cephalic position during induced labor. Electrical activity of the myometrium during contractions was characterized by its power density spectrum.
No significant differences were found in contraction characteristics between women with induced labor delivering vaginally with or without oxytocin and women with arrested labor with subsequent cesarean delivery. Uterine electromyography shows no correlation with progression of labor in induced labor , which is in contrast to spontaneous labor.
To identify potential risk factors for cesarean delivery following labor induction in multiparous women at term. We conducted a retrospective case-control study. Cases were parous women in whom the induction of labor had resulted in a cesarean delivery. For each case, we used the. Full Text Available Objective. For each case, we used the data of two successful inductions as controls.
Successful induction was defined as a vaginal delivery after the induction of labor. The study was limited to term singleton pregnancies with a child in cephalic position. These 80 cases were compared to the data of parous women with a successful induction of labor.
In the multivariate analysis history of preterm delivery odds ratio OR 5. In multiparous women, the risk of cesarean delivery following labor induction increases with previous preterm delivery, short maternal height, and limited dilatation at the start of induction. Labor induction and cesarean delivery: A prospective cohort study of first births in Pennsylvania, USA. Mode of delivery at first childbirth largely determines mode of delivery at subsequent births, so it is particularly important to understand risk factors for cesarean delivery at first childbirth.
In this study, we investigated risk factors for cesarean delivery among nulliparous women, with focus on the association between labor induction and cesarean delivery. A prospective cohort study of nulliparous women with singleton pregnancies who attempted vaginal delivery at hospitals in Pennsylvania, , was conducted. We used nested logistic regression models and multiple mediational analyses to investigate the role of three groups of variables in explaining the association between labor induction and unplanned cesarean delivery-the confounders of maternal characteristics and indications for induction , and the mediating intrapartum factors-including cervical dilatation, labor augmentation, epidural analgesia, dysfunctional labor , dystocia, fetal intolerance of labor , and maternal request of cesarean during labor.
More than a third of the women were induced Induced women were more likely to deliver by cesarean The intrapartum factors significantly mediated the association between labor induction and cesarean delivery explaining The indications for labor induction only explained 6.
Increased risk of cesarean delivery after labor induction among nulliparous women is attributable mainly to lower cervical dilatation at hospital admission and higher rates of labor complications. In premature rupture of membranes PROM , the risk of chorioamnionitis increases with increasing duration of membrane rupture. Decreasing the time from PROM to delivery is associated with lower rates of maternal infection. The American College of Obstetricians and Gynecologists suggests that all women with PROM who do not have a contraindication to vaginal delivery have their labor induced instead of being managed expectantly.
Although the use of oxytocin for labor induction has been demonstrated to decrease the time to delivery compared with expectant management, no studies have evaluated the effectiveness of cervical ripening with a Foley bulb to additionally decrease the time to delivery. To determine whether simultaneous use of an intracervical Foley bulb and oxytocin decreases time from induction start to delivery in nulliparous patients with PROM compared with the use of oxytocin alone.
Our primary outcome was time from induction to delivery.
Phylogeographic implications for release of critically endangered manatee calves rescued in Northeast Brazil. The Antillean manatee Trichechus manatus manatus , a subspecies of the West Indian manatee, is a large-bodied marine mammal found in fresh, brackish, and marine habitats throughout the Caribbean Islands and Central and South America. Antillean manatees in Brazil are classified as critically endangered, with a census size of approximately individuals. The population in the Northeast region of Brazil is suspected to have approximately manatees and is threatened by habitat alteration and incidental entanglement in fishing gear. A high incidence of dependent calf strandings have been identified near areas of altered critical manatee habitat. The majority of the calves are neonates, discovered alive, with no potential mothers nearby.
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