Correlation between umbilical arterial pH values and fetal vertebral artery Doppler waveforms at the beginning of the second stage of labor: a pilot prospective study

2018 ◽  
Vol 32 (18) ◽  
pp. 3068-3073 ◽  
Author(s):  
Danila Morano ◽  
Gennaro Scutiero ◽  
Piergiorgio Iannone ◽  
Giulia Nencini ◽  
Elena Mantovani ◽  
...  
Keyword(s):  
Prospective Study ◽  
Vertebral Artery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Ph Values ◽  
Arterial Ph ◽  
Umbilical Arterial Ph

scholarly journals Maternal and foetal outcome in second stage caesarean section: a prospective study

2021 ◽  
Vol 10 (4) ◽  
pp. 1644
Author(s):  
Shuchi Sharma ◽  
Poojan Dogra ◽  
Reena Sharma ◽  
Suraj Bhardwaj
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Cervical Dilatation ◽  
Bladder Injury ◽  
Fetal Head ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Adjacent Structures ◽  
A Prospective Study

Background: Caesarean section is the most commonly performed abdominal operation in women all over the world. Caesarean sections during the second stage labour accounts for approximately one fourth of all primary caesareans.  Caesarean section at full cervical dilatation is technically difficult and is associated with increased trauma to the lower uterine segment and adjacent structures, as well as increased haemorrhage and infection. Aims and objectives were to determine the indications, maternal and foetal morbidity associated with caesarean section in the second stage of labour.Methods: This prospective study included consecutive 50 cases of caesarean section deliveries conducted in second stage of labor for singleton live pregnancies at term. The data collected in the study was analyzed in terms of maternal demographics, indications of caesarean section, intra-operative and postoperative complications and neonatal outcomes.Results: In our series of 50 deliveries, arrest of descent of fetal head due to malposition was the most common indication of caesarean section accounting for 74% and average procedure time was 45-70 minutes. PPH (62%) was the most common complication. Bladder injury was found in 14% cases. Neonatal outcome variables like APGAR<3 at 5 minutes, respiratory distress and neonatal death were observed in 7, 26 and 2 deliveries respectively.Conclusions: Women undergoing cesarean section in second stage of labour are associated with increased maternal and fetal morbidity. They require special care and hence operation should ideally be performed and supervised by an experienced obstetrician. A proper judgement is required to take a decision for caesarean section at full cervical dilatation.

scholarly journals Effects of Local Anesthetic on the Time Between Analgesic Boluses and the Duration of Labor in Patient-Controlled Epidural Analgesia: Prospective Study of Two Ultra-Low Dose Regimens of Ropivacaine and Sufentanil

2015 ◽  
Vol 28 (1) ◽  
pp. 70 ◽  
Author(s):  
José Manuel Costa-Martins ◽  
Cláudia Camila Dias ◽  
Marco Pereira ◽  
Jorge Tavares
Keyword(s):  
Epidural Analgesia ◽  
Prospective Study ◽  
Local Anesthetic ◽  
Low Dose ◽  
Labor Pain ◽  
Neuraxial Blockade ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Group I ◽  
Group Ii

<p><strong>Background:</strong> Patient-controlled epidural analgesia with low concentrations of anesthetics is effective in reducing labor pain. The aim of this study was to assess and compare two ultra-low dose regimens of ropivacaine and sufentanil (0.1% ropivacaine plus 0.5 μg.ml-1 sufentanil vs. 0.06% ropivacaine plus 0.5 μg.ml-1 sufentanil) on the intervals between boluses and the duration of labor.<br /><strong>Material and Methods:</strong> In this non-randomized prospective study, conducted between January and July 2010, two groups of parturients received patient-controlled epidural analgesia: Group I (n = 58; 1 mg.ml-1 ropivacaine + 0.5 μg.ml-1 sufentanil) and Group II (n = 57; 0.6 mg.ml-1 ropivacaine + 0.5 μg.ml-1 sufentanil). Rescue doses of ropivacaine at the concentration of the assigned group without sufentanil were administered as necessary. Pain, local anesthetic requirements, neuraxial blockade characteristics, labor and neonatal outcomes, and maternal satisfaction were recorded.<br /><strong>Results:</strong> The ropivacaine dose was greater in Group I (9.5 [7.7-12.7] mg.h-1 vs. 6.1 [5.1-9.8 mg.h-1], p &lt; 0.001). A time increase between each bolus was observed in Group I (beta = 32.61 min, 95% CI [25.39; 39.82], p &lt; 0.001), whereas a time decrease was observed in Group II (beta = -1.40 min, 95% CI [-2.44; -0.36], p = 0.009). The duration of the second stage of labor in Group I was significantly longer<br />than that in Group II (78 min vs. 65 min, p &lt; 0.001).<br /><strong>Conclusions:</strong> Parturients receiving 0.06% ropivacaine exhibited less evidence of cumulative effects and exhibited faster second stage progression than those who received 0.1% ropivacaine.<br /><strong>Keywords:</strong> Analgesia, Obstetrical; Analgesia, Patient-Controlled; Labor Pain; Ropivacaine; Sufentanil.</p>

Safety of misoprostol vaginal insert for labor induction using standard vs. adjusted retrieval criteria: a comparative cohort study

2020 ◽  
Vol 48 (5) ◽  
pp. 488-494
Author(s):  
Aleke Brandstetter ◽  
Moritz Döbert ◽  
Peter Schwaerzler ◽  
Timm Fabian Döbert ◽  
Hendrik Hasselbeck ◽  
...  
Keyword(s):  
Cohort Study ◽  
Neonatal Outcome ◽  
Labor Induction ◽  
Ph Values ◽  
Academic Center ◽  
Arterial Ph ◽  
Comparative Cohort Study ◽  
The Mean ◽  
Safety Assessments ◽  
Umbilical Arterial Ph

AbstractObjectiveTo compare the safety of misoprostol vaginal insert (MVI) for labor induction using standard and adjusted criteria.MethodsThis was a single-center, comparative cohort study of 138 pregnant women ≥37/0 weeks undergoing labor induction with MVI using standard (69 women; administration for up to 24 h; MVI-24) or adjusted (69 women; administration for up to 10 h; MVI-10) criteria in a tertiary academic center in Germany. The main maternal safety outcomes were the rate of tachysystole and rate of tachysystole requiring tocolysis. Neonatal safety assessments included Apgar score at 5 min and postpartum arterial fetal pH.ResultsUterine tachysystole occurred in more women in the MVI-24 group compared with the MVI-10 group [47.8% vs. 25.5%; P = 0.001; relative risk (RR) 2.36 (95% confidence interval [CI]: 1.39–4.00)] and as did uterine tachysystole requiring tocolysis [MVI-24: 26.1% vs. MVI-10: 11.6%; P = 0.049; RR 2.25 (95% CI: 1.05–4.83)]. The mean 5-min Apgar scores were 9.64 for the MVI-24 group and 9.87 for the MVI-10 (P = 0.016). Low postpartum umbilical arterial pH values occurred more often in the MVI-24 compared with the MVI-10 group (pH 7.10–7.19: 26.1% vs. 20.3% and pH <7.10: 4.4% vs. 0.0%, respectively).ConclusionAdjusted retrieval criteria for MVI of up to 10 h exposure instead of the standard 24 h reduced uterine tachysystole and improved the neonatal outcome.

Particulate matter (PM10) exposure, birth and fetal-placental weight and umbilical arterial pH: results from a prospective study

2017 ◽  
Vol 31 (5) ◽  
pp. 651-655 ◽  
Author(s):  
Niccolò Giovannini ◽  
Lianne Schwartz ◽  
Sonia Cipriani ◽  
Fabio Parazzini ◽  
Ilaria Baini ◽  
...  
Keyword(s):  
Particulate Matter ◽  
Prospective Study ◽  
Placental Weight ◽  
Arterial Ph ◽  
Umbilical Arterial Ph ◽  
A Prospective Study ◽  
Pm10 Exposure

scholarly journals Influence of Different Methods of Intrapartum Analgesia on the Progress of Labour and on Perinatal Outcome

2019 ◽  
Vol 79 (04) ◽  
pp. 389-395
Author(s):  
Javier Ortiz ◽  
Thomas Hammerl ◽  
Maria Wasmaier ◽  
Valerie Wienerroither ◽  
Bernhard Haller ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Short Term ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Arterial Ph ◽  
Intravenous Analgesia ◽  
Analgesic Technique ◽  
Umbilical Arterial Ph

Abstract Background Various methods of intrapartum analgesia are available these days. Pethidine, meptazinol and epidural analgesia are among the most commonly used techniques. A relatively new one is patient-controlled intravenous analgesia with remifentanil, although the experiences published so far in Germany are limited. Our goal was to study the influence of these analgesic techniques (opioids vs. patient-controlled intravenous analgesia with remifentanil vs. epidural analgesia) on the second stage of labour and on perinatal outcome. Material and Methods We conducted a retrospective study with 254 parturients. The women were divided into 4 groups based on the analgesic technique and matched for parity, maternal age and gestational age (opioids n = 64, patient-controlled intravenous analgesia with remifentanil n = 60, epidural analgesia n = 64, controls without the medicinal products mentioned n = 66). Maternal, fetal and neonatal data were analysed. Results The expulsive stage was prolonged among both primiparas and multiparas with patient-controlled intravenous analgesia with remifentanil (79 [74] vs. 44 [55] min, p = 0.016, and 28 [68] vs. 10 [11] min, p < 0.001, respectively) and epidural analgesia (90 [92] vs. 44 [55] min, p = 0.004, and 22.5 [73] vs. 10 [11] min, p = 0.003, respectively) compared with the controls. The length of the pushing stage was similar among primiparas in all groups but prolonged compared with the controls in multiparas with patient-controlled intravenous analgesia with remifentanil (15 [17] vs. 5 [7] min, p = 0.001) and epidural analgesia (10 [15] vs. 5 [7] min, p = 0.006). The Apgar, umbilical arterial pH and base excess values were similar between the groups, as were the rates of acidosis and neonatal intensive care unit admission. Conclusion Parturients with patient-controlled intravenous analgesia with remifentanil and epidural analgesia showed a prolonged expulsive stage compared with the opioid group and controls. The short-term neonatal outcome was not influenced by the three methods examined.

Second stage of labor in the age of epidural anesthesia

1998 ◽  
Vol 5 (1) ◽  
pp. 171A-171A
Author(s):  
E XENAKIS ◽  
J PIPER ◽  
M MCFARLAND ◽  
C SUITER ◽  
O LANGER
Keyword(s):  
Epidural Anesthesia ◽  
Second Stage Of Labor ◽  
Second Stage
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