scholarly journals Influence of morning versus midnight initiation of induction of labour in late-term pregnancy on perinatal outcome and time of birth

2019 ◽  
pp. 1
Author(s):  
Katja Vince ◽  
Danijel Bursać ◽  
Ratko Matijević
Keyword(s):  
Retrospective Study ◽  
Epidural Analgesia ◽  
Prostaglandin E2 ◽  
Gestational Age ◽  
Perinatal Outcome ◽  
Working Hours ◽  
University Hospital ◽  
Term Pregnancy ◽  
Out Of Hours ◽  
Nulliparous Women

<p><strong>Objective. </strong>The aim of this study was to assess and compare morning vs. midnight initiation of induction of labor (IOL) on time of birth and perinatal outcome.</p><p><strong>Study Design. </strong>A retrospective study performed at University Hospital Merkur, Zagreb, Croatia; in period between 2006 to 2017. The participants were low-risk nulliparous women with gestational age over 41 weeks who had labor induced by a prostaglandin E2 analogue dinoprostone applied intracervically. Two groups were compared; the first one had IOL initiated in the morning and the second one at midnight.</p><p><strong>Results. </strong>A total of 206 pregnant women were included in the study. Women with IOL starting at midnight (n=103) gave birth more often during daytime (7am-6.59pm) compared to women with IOL starting in the morning (n=103) (p&lt;0.01). The midnight group also gave birth more often during regular hospital working hours (7.30am-3.30pm), but this result was not statistically significant (p=0.091). The rate of epidural analgesia was higher among women in the midnight group, while no other differences were observed in predefined perinatal outcome between the two groups.</p><strong>Conclusions. </strong>Initiation of IOL at midnight compared to morning results in giving birth more often during daytime. This presents a favourable option for reducing out of hours and night work.

Perinatal Outcome and its Prediction Using Longitudinal Feto-Maternal Doppler Follow-Up in Late Onset Small for Gestational Age Fetuses – A Prospective Cohort Study

2021 ◽  
Author(s):  
Silvia M. Lobmaier ◽  
Oliver Graupner ◽  
Javier U. Ortiz ◽  
Bernhard Haller ◽  
Christina Ried ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Prospective Cohort ◽  
Perinatal Outcome ◽  
Late Onset ◽  
Induction Of Labor ◽  
University Hospital ◽  
Operative Delivery ◽  
Longitudinal Measurements ◽  
Cesarean Delivery Rate

Abstract Purpose To describe the perinatal outcome of a prospective cohort of late-onset small-for-gestational-age (SGA) fetuses and to test adverse perinatal outcome (APO) prediction using Doppler measurements. Methods Singleton pregnancies from 32 weeks with suspicion of SGA (followed-up each 2 weeks) and randomly selected healthy controls at a university hospital were included. The whole SGA group was divided into the FGR subgroup or SGA percentile 3–10 subgroup. The following Doppler measurements were evaluated prospectively: umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, cerebro-placental ratio (CPR), and mean uterine artery (mUtA) PI. APO was defined as arterial cord blood pH ≤ 7.15 and/or 5-minute Apgar ≤ 7 and/or emergency operative delivery and/or admission to the neonatal unit. Induction of labor was indicated according to a stage-based protocol. Results A total of 149 SGA and 143 control fetuses were included. The number of operative deliveries was similar between both groups (control: 29 %, SGA: 28 %), especially the cesarean delivery rate after the onset of labor (11 % vs. 10 %). Most SGA cases ended up in induction of labor (61 % vs. 31 %, p < 0.001). The areas under the curve (AUC) for APO prediction were similar using the last UA PI, MCA PI, CPR, and mUtA PI and barely reached 0.60. The AUC was best for the FGR subgroup, using the minimal CPR or maximum mUtA PI z-score of all longitudinal measurements (AUC = 0.63). Conclusion SGA fetuses do not have a higher rate of operative delivery if managed according to a risk stratification protocol. Prediction of APO is best for SGA and FGR using the “worst” CPR or mUtA PI but it remains moderate.

scholarly journals Comparison of the labor curves with and without combined spinal-epidural analgesia in nulliparous women- a retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hitomi Ando ◽  
Shintaro Makino ◽  
Jun Takeda ◽  
Yojiro Maruyama ◽  
Shuko Nojiri ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Epidural Analgesia ◽  
Combined Spinal Epidural ◽  
Nulliparous Women ◽  
Spinal Epidural

Furcate insertion of the umbilical cord: pathological and clinical characteristics in 132 cases

2020 ◽  
Vol 48 (8) ◽  
pp. 819-824
Author(s):  
Philipp Kosian ◽  
Wolfgang Henrich ◽  
Michael Entezami ◽  
Alexander Weichert
Keyword(s):  
Retrospective Study ◽  
Umbilical Cord ◽  
Perinatal Outcome ◽  
Clinical Characteristics ◽  
Fetal Death ◽  
University Hospital ◽  
Intrauterine Fetal Death ◽  
Pathological Characteristics ◽  
Umbilical Vessel ◽  
Vessel Rupture

AbstractObjectivesFurcate cord insertion is a rare abnormality affecting approximately 0.1% of all pregnancies. Macroscopically, the umbilical vessels separate before reaching the placenta, lose their Wharton’s jelly, and insert at the placenta centrally, eccentrically, or marginally. The aim of this retrospective study was to determine the prevalence of furcate cord insertion more accurately, the pathological characteristics, and clinical outcomes.MethodsWe conducted a retrospective study of 132 cases of furcate insertion of the umbilical cord using the pathological database of the Charité University Hospital Berlin, Germany, between 1993 and 2016. This included 99 cases, including one termination of pregnancy within our institution and 33 cases from external hospitals. An analysis of the pathological features of the 132 cases and the perinatal outcome of the 98 cases within our institution were performed.ResultsFurcate cord insertion occurred in 0.16% pregnancies. Of the 132 cases, seven cases of intrauterine fetal deaths were observed. Three of those could be linked to the furcate cord insertion. In two of those cases, single umbilical vessel rupture was identified as the cause of fetal death.ConclusionsIn most cases of furcate cord insertion, the outcome is good; however, intrauterine fetal death occurs in approximately 1.02% of cases.

scholarly journals Burnout Syndrome during Residency Training in Jordan: Prevalence, Risk Factors, and Implications

2021 ◽  
Vol 18 (4) ◽  
pp. 1557
Author(s):  
Abdullah Nimer ◽  
Suzan Naser ◽  
Nesrin Sultan ◽  
Rawand Said Alasad ◽  
Alexander Rabadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Working Hours ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Burnout Syndrome ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Factors Associated ◽  
Resident Physicians ◽  
Healthcare Professions

Burnout syndrome is common among healthcare professions, including resident physicians. We aimed to assess the prevalence of burnout among resident physicians in Jordan, and a secondary aim was to evaluate the risk factors associated with the development of burnout syndrome in those residents, including gender, working hours, psychological distress, training sector, and specialty. In this cross-sectional study, 481 residents were recruited utilizing multistage stratified sampling to represent the four major health sectors in Jordan. Data were collected using an online questionnaire, where the Copenhagen Burnout Inventory (CBI) was used to assess the prevalence of burnout. The prevalence, group differences, and predictors of burnout were statistically analyzed using STATA 15. Overall, 373 (77.5%) residents were found to have burnout. Factors associated with higher levels of burnout were psychological stress (β = 2.34, CI = [1.88–2.81]), longer working hours (β = 4.07, CI = [0.52–7.62], for 51–75 h a week, β = 7.27, CI = [2.86–11.69], for 76–100 h a week and β = 7.27, CI = [0.06–14.49], for >100 h a week), and obstetrics/gynecology residents (β = 9.66, CI = [3.59–15.73]). Conversely, medical sub-specialty residents, as well as private and university hospital residents, had lower burnout levels. We concluded that decreasing the workload on residents, offering psychological counseling, and promoting a safety culture for residents might help in mitigating burnout consequences.

scholarly journals Can the timing of hospitalization influence the outcomes of childbirth?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Kundisova ◽  
N Nante ◽  
S Bardelli ◽  
C Lorenzini ◽  
L Alaimo
Keyword(s):  
Gestational Age ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Lower Probability ◽  
Cross Sectional ◽  
Medical Interventions ◽  
Physiological Processes ◽  
Early Arrival ◽  
High Possibility ◽  
Initiation Of Breastfeeding

Abstract Background The timing of hospitalization of pregnant females could influence the outcomes of both mother and the baby. The aim of this study was to analyze impact of coming to hospital too early on outcomes of childbirth. Methods A cross-sectional study was conducted in the birth center of Siena University hospital (Italy), all women that gave birth between 2017 and 2019 were included. Examined variables were: age, parity, gestational age: GA(weeks), Bishop score at admission: BS (0-13; &gt;9 high possibility of spontaneous delivery), time to delivery:TTD (min), labor duration:LD (min), n°of interventions (induction, amniorhexis, augmentation):NI, type of birth (vaginal/caesarean section: CS/operational birth: OB), laceration, episiotomy, hematic loss: HL (ml), skin to skin:StS and initiation of breastfeeding: BR (yes/no). The females that came too early were identified if TTD &gt;75° percentile. Analysis was performed with Stata 12. Results A total of 758 females were analyzed (32.0±5.2years), 55.5% multiparous, average GA was 39.6±1weeks, average BS was 7.2±2.5; 63% had BS &lt;9. Average TTD was 376.7±318.5min; 23% came too early (TTD 865.6±244), more likely primiparous (OR 3.9) and those with higher GA (OR 1.2). A negative correlation between BS and TTD was observed (Rho=-0.6), females with BS &lt;9 had higher probability to have prolonged TTD (OR10.8). Ninety-three% had vaginal birth, 6%CS, 1%OB Average LD was 169.1±145 min, average NI was 0.64±0.93, 78% had lacerations, 7.2% episiotomy. Average HL was 299.3±282.7ml. Females with prolonged TTD had higher NI (1.2 ±1 vs 0.4±0.6), higher probability of CS (OR 3), OB (OR4.5) and episiotomy (OR3.6), lower probability of StS and BR (OR 0.9), prolonged LD (299±184 vs. 120±102) and major HL (347.2±301.8 vs 284.9±275.4). Conclusions Our study showed an association between too early arrival to hospital and adverse maternal and fetal outcomes in terms of higher use of medical interventions that can interfere with physiological processes. Key messages The risk of arriving too early in hospital for labor was higher in primiparous and in those with higher gestational age. The too early arrival in hospital for labor was associated within increased use of medical interventions, interfering with physiological processes.

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