Prediction of delivery mode by ultrasound-assessed fetal position in nulliparous women with prolonged first stage of labor

2015 ◽  
Vol 46 (5) ◽  
pp. 606-610 ◽  
Author(s):  
T. M. Eggebø ◽  
W. A. Hassan ◽  
K. Å. Salvesen ◽  
E. A. Torkildsen ◽  
T. B. Østborg ◽  
...  
Keyword(s):  
Delivery Mode ◽  
Nulliparous Women ◽  
Fetal Position ◽  
First Stage Of Labor

scholarly journals OP07.02: Prediction of delivery mode using angle of progression, before onset of labour in nulliparous women at term

2014 ◽  
Vol 44 (S1) ◽  
pp. 77-77 ◽  
Author(s):  
H. Jin ◽  
G. Cho ◽  
H. Hong ◽  
H. Seol ◽  
K. Ahn ◽  
...  
Keyword(s):  
Delivery Mode ◽  
Nulliparous Women ◽  
Angle Of Progression

scholarly journals Impact factors on cervical dilation rates in the first stage of labor

2018 ◽  
Vol 46 (1) ◽  
pp. 59-66 ◽  
Author(s):  
Jana Juhasova ◽  
Martina Kreft ◽  
Roland Zimmermann ◽  
Nina Kimmich
Keyword(s):  
University Hospital ◽  
Impact Factors ◽  
Cervical Dilation ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
Prolonged Labor ◽  
The Individual ◽  
Vertex Presentation ◽  
The University ◽  
First Stage Of Labor

AbstractAims:To assess cervical dilation rates of nulliparous and multiparous women in the active first stage of labor and to evaluate significant impact factors.Methods:In a retrospective cohort study between January 2007 and July 2014 at the University Hospital of Zurich in Switzerland, we analyzed 8378 women with singleton pregnancies in vertex presentation with a vaginal delivery at 34+0 to 42+5 gestational weeks. Median cervical dilation rates were calculated and different impact factors evaluated.Results:Cervical dilation rates increase during labor progress with faster rates in multiparous compared with nulliparous women (P<0.001). Dilation rates exceed 1 cm/h at a dilatation of 6–7 cm, but are very individual. Accelerating impact factors are multiparity, a greater amount of cervical dilation and fetal occipitoanterior position, whereas the use of epidural anesthesia, a higher fetal weight and head circumference decelerate dilation (P<0.001).Conclusion:Cervical dilation is a hyperbolic increasing process, with faster dilation rates in multiparous compared to nulliparous women and a reversal point of labor around 6–7 cm, respectively. Besides, cervical dilation is highly individual and affected by several impact factors. The diagnosis of labor arrest or prolonged labor should therefore be based on such rates and on the individual evaluation of every woman.

scholarly journals Influence of Body Mass Index on Gestation and Delivery in Nulliparous Women: A Cohort Study

2019 ◽  
Vol 16 (11) ◽  
pp. 2015 ◽  
Author(s):  
Noemí Rodríguez-Mesa ◽  
Paula Robles-Benayas ◽  
Yolanda Rodríguez-López ◽  
Eva María Pérez-Fernández ◽  
Ana Isabel Cobo-Cuenca
Keyword(s):  
Cesarean Section ◽  
Maternal Age ◽  
Obese Women ◽  
Nulliparous Women ◽  
Newborn Weight ◽  
Pregnancy And Delivery ◽  
Student’S T ◽  
Type Of Delivery ◽  
Fetal Position ◽  
Student’S T Test

Aims: To assess the influence of obesity on pregnancy and delivery in pregnant nulliparous women. Methods: A cohort, longitudinal, retrospective study was conducted in Spain with 710 women, of which 109 were obese (BMI > 30) and 601 were normoweight (BMI < 25). Consecutive nonrandom sampling. Variables: maternal age, BMI, gestational age, fetal position, start of labor, dilation and expulsion times, type of delivery and newborn weight and height. Results: The dilation time in obese women (309.81 ± 150.42 min) was longer than that in normoweight women (281.18 ± 136.90 min) (p = 0.05, Student’s t-test). A higher fetal weight was more likely to lead to longer dilation time (OR = 0.43, 95% CI 0.010–0.075, p < 0.001) and expulsion time (OR = 0.027, 95% CI 0.015–0.039, p < 0.001). A higher maternal age was more likely to lead to a longer expulsion time (OR = 2.054, 95% CI 1.17–2.99, p < 0.001). Obese women were more likely to have gestational diabetes [relative risk (RR) = 3.612, 95% CI 2.102–6.207, p < 0.001], preeclampsia (RR = 5.514, 95% CI 1.128–26.96, p = 0.05), induced birth (RR = 1.26, 95% CI 1.06–1.50, p = 0.017) and cesarean section (RR = 2.16, 95% CI 1.11–4.20, p = 0.022) than normoweight women. Conclusion: Obesity is associated with increased complications during pregnancy, an increased incidence of a cesarean section and induced birth but it has no significant effect on the delivery time.

Predicting the Mode of Delivery by Angle of Progression (AOP) before the Onset of Labor by Transperineal Ultrasound in Nulliparous Women

2020 ◽  
Vol 16 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Priyanka Shankerappa Minajagi ◽  
Sujatha Bagepalli Srinivas ◽  
Shripad Hebbar
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Antenatal Clinic ◽  
Transperineal Ultrasound ◽  
Multivariable Logistic Regression Analysis ◽  
Fetal Head ◽  
Labor Dystocia ◽  
Nulliparous Women ◽  
Fetal Position ◽  
Angle Of Progression

Background: Prediction of the mode of delivery is crucial for better labour outcome. Recent studies suggest that the angle of progression (AOP), measured using transperineal ultrasound, can substantially aid the assessment of fetal head descent during labor, thereby predicting the mode of delivery. Objective: To assess the ability of the AOP measured by transperineal ultrasound to predict the mode of delivery in nulliparous women before the onset of labor. Methods: A prospective observational study was conducted at our hospital, of nulliparous women who had presented to the antenatal clinic at ≥ 38 weeks of gestation but not in labor. AOP was measured using transperineal ultrasonography and compared among the women having Caesarean section (CS) due to labor dystocia and vaginal delivery (VD). Various other confounding factors which increase the risk of caesarean section were analyzed. Results: Among total 120 nulliparous women, the mean AOP was narrower in patients undergoing CS (n = 28) compared to those with VD (n = 92) (91.6 ± 6.1° vs. 100.7 ± 6.9°; P < 0.01). Multivariable logistic regression analysis revealed that narrow AOP values (OR 3.66; P < 0.001; 95% CI 1.7- 14.5) and occiput-posterior fetal position (OR 1.63; P = 0.04; 95% CI 1.0-7.5) were the independent risk factors for CS. An AOP ≥ 96° (calculated from the ROC curve) was associated with VD in 95% (76/80) of women and an AOP < 96° was observed among 60% (24/40) of women who underwent CS. Conclusion: Narrow AOP (< 96°) and occiput-posterior fetal position are at higher risk for CS due to labor dystocia. AOP measured at the antenatal period could accurately predict the mode of delivery, thereby modifying labor outcome.

scholarly journals Effect of second child intent on delivery mode after Chinese two child policy implementation: a cross sectional and prospective observational study of nulliparous women in Chongqing

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018823 ◽  
Author(s):  
Jianlin Zhao ◽  
Nan Shan ◽  
Xiaochang Yang ◽  
Qin Li ◽  
Yinyin Xia ◽  
...  
Keyword(s):  
Observational Study ◽  
Caesarean Delivery ◽  
Prospective Observational Study ◽  
Delivery Mode ◽  
Second Trimester ◽  
Cross Sectional ◽  
Second Child ◽  
Nulliparous Women ◽  
Child Policy ◽  
Tertiary Teaching

ObjectivesTo assess the influence of second child intent on the delivery preferences and final delivery modes of nulliparous women, particularly caesarean delivery on maternal request (CDMR), after implementation of China’s two child policy.DesignCross sectional and prospective observational study.SettingA tertiary teaching hospital in Chongqing, China.Participants1000 low risk nulliparous women were initially involved, and were divided into two groups based on their intent on having a second child. 814 women who completed all interviews were analysed.Main outcome measuresPreferred mode of delivery in second trimester and at admission; final delivery mode, CDMR.Results814 women who completed all interviews were analysed, in whom 51.2% intended to have a second child. The preference for caesarean delivery (CD) at the second trimester between the intent and no intent group was 6.2% versus 17.9% (adjusted RR 0.35, 95% CI 0.20 to 0.63) and increased to 24.2% versus 37.3% (adjusted RR 0.65, 95% CI 0.45 to 0.94) at admission, respectively. The overall CD rates between the two groups were 41.0% versus 50.4% (adjusted RR 0.84, 95% CI 0.60 to 1.18), and the CDMR rates were 16.7% versus 29.0% (adjusted RR 0.56, 95% CI 0.37 to 0.86), respectively.ConclusionsWomen who intend to have a second child are less likely to request a CD, and high rates of CD and CDMR in nulliparous women may have decreased after implementation of China’s two child policy.

Length of the First Stage of Labor and Associated Perinatal Outcomes in Nulliparous Women

2012 ◽  
Vol 32 (1) ◽  
pp. 21
Author(s):  
Y.W. Cheng ◽  
B.L. Shaffer ◽  
A.S. Bryant ◽  
A.B. Caughey
Keyword(s):  
Perinatal Outcomes ◽  
Nulliparous Women ◽  
First Stage Of Labor

scholarly journals The Correlation of the Level of Anxiety of Nulliparous Women to the Length of the First Stage of Spontaneous Labor at Private Maternity Clinics in the Working Area of Delitua Puskesmas, Deli Serdang District in 2013

2017 ◽  
Vol 4 (1) ◽  
pp. 57-60
Author(s):  
Namora Lumongga Lubis ◽  
Megawati Sinambela
Keyword(s):  
Univariate Analysis ◽  
Sampling Technique ◽  
Bivariate Analysis ◽  
Health Providers ◽  
Chi Square ◽  
Nulliparous Women ◽  
Maternity Clinics ◽  
Childbearing Women ◽  
Severe Anxiety ◽  
First Stage Of Labor

Abnormal length of the first stage of labor in nulliparous women (first pregnancy) can be related to severe anxiety during labor. Based on the preliminary survey in several private maternity clinics at the working area of Delta Puskesmas, Deli Serdang District, it was found that there was a prolonged first stage of labor (27.65%) in nulliparous women. The purpose of this study was to analyze the influence of anxiety level to the length of the first stage of labor. The type of this study was an analytic survey with explanatory research type. The samples comprised 40 childbearing women in private maternity clinics of Kasih Ibu, Kurnia, Tanjung, Wanda, and Mayana which were located in the working area of Delitua Puskesmas, Deli Serdang District, using accidental sampling technique. The data were gathered by using questionnaires and analyzed in the univariate analysis by using frequency distribution form, and bivariate analysis using Chi-Square test. The result of this study showed that the level of anxiety (p = 0.001) significantly related the length of the first stage of labor in which mothers who had severe anxiety. It is recommended that health providers should provide standardized services to childbearing women, especially to nulliparous women, so that their level of anxiety can be decreased facing the first stage of the labor process. It is also recommended that the husbands should support their wifes by positive behaviors so they will not think about negative things on their babies and on themselves.

scholarly journals Simple models to predict vaginal delivery and spontaneous fetal occiput rotation based on intrapartum ultrasound and maternal characteristics

2021 ◽  
Author(s):  
Cheng Chen ◽  
Xiaoxing Zhang ◽  
Xiaohan Guo ◽  
Hangkai Bao ◽  
Peiying Luo ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Prediction Models ◽  
Characteristic Curve ◽  
Delivery Mode ◽  
Maternal Height ◽  
Fetal Head ◽  
Maternal Characteristics ◽  
Nulliparous Women ◽  
Latent Phase ◽  
Simple Models

Objective: To develop the prediction models for identifying fetal occiput rotation and vaginal delivery based on intrapartum sonographic findings. Design: Prospective observational study. Setting: Hangzhou, China. Population: Nulliparous women with a singleton cephalic presentation at term. Methods: Serial intrapartum ultrasonography were performed in the latent phase (T1) and every three hours after that (T2, T3 and T4). The managing clinicians performed paired digital vaginal examinations to assess labor progress. Main Outcome Measures: Delivery mode and successful internal fetal head rotation to the occiput anterior (OA) position. Results: 614 women were included, of whom 524 underwent vaginal delivery, and 90 required cesarean section. The percentage of women with fetuses in non-occiput anterior position at the latent phase was 53.9% (331 cases), as 257 women underwent spontaneous rotation to OA position before delivery, 74 were with persistent occiput posterior or transverse position. We developed a model on the basis of the maternal height and middle angel to predict the spontaneous fetal occiput rotation, with the area under the receiver operating characteristic curve (AUC) was 0.667 (95%CI 0.583-0.751). Moreover, a prediction model based on the maternal height and angle of progression to evaluate whether women underwent vaginal delivery was also developed, of which the AUC was 0.738(95% CI: 0.763-0.793). Both models showed satisfactory calibration. Conclusion: Simple models based on maternal characteristics and intrapartum ultrasound findings might provide useful information for predicting vaginal delivery and internal fetal occiput rotation.

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