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Abnormal Uterine Contractions
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
Secondary inertia is a condition when after achieving the active phase of labour with good uterine contractions, the uterine contractions start reducing in intensity, frequency, and duration. It is more often seen in a primigravida. This is a protective mechanism against obstructed labour and ruptured uterus. Cephalo-pelvic disproportion, contracted pelvis, malpresentation and position, big baby, dehydration, maternal anxiety, and fear can cause this condition. A caesarean section might be necessary to deliver such a woman. Contracted pelvis and disproportion pelvis should be ruled out before considering augmenting with oxytocin. Otherwise, there can be disastrous consequences like obstructed labour, ruptured uterus, and arrest in the second stage.
Abnormal Labour
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Malik Goonewardene
The presenting part may be too large (e.g. macrosomia due to maternal diabetes mellitus or post dates or hydrocephalus), or more commonly, the relative diameters of the presenting part may be increased due to a malposition of the vertex, its attitude, or asynclitism, or a malpresentation. Figure 8.3 shows the relevant diameters of the fetal head. The disparity in the relationship between the fetal head and the maternal pelvis is referred to as cephalopelvic disproportion (CPD), a diagnosis that should be made only during labour.
DRCOG MCQs for Circuit B Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Causes of prolonged labour include:Cephalopelvic disproportion.Android pelvis.Brow presentation.Persistent occipitoposterior position.Uterine inertia.
Effect of regional vs general anesthesia on vital functions after cesarean section: a single center experience
Published in Hypertension in Pregnancy, 2022
Danka Mostic Stanisic, Nevena Kalezic, Nina Rajovic, Tatjana Ilic Mostic, Jelena Cumic, Tamara Stanisavljevic, Aleksandra Beleslin, Jelena Stulic, Ivana Rudic, Nevena Divac, Natasa Milic, Radan Stojanovic
This was prospective cohort study conducted at Clinic for Gynecology and Obstetrics, Clinical Center “Dragisa Misovic – Dedinje,” Belgrade, Serbia. Inclusion criteria were patients at term pregnancy (37–42 weeks of gestation), with ASA II score (American Society of Anesthesiologist’s score – a subjective assessment of a patient’s overall health ranging from I to V), who would deliver by cesarean section. Indications for elective or urgent c-section were set up by obstetricians. Indications for elective c-section were based on following pregnant woman’s condition: pelvis measurements, pelvis abnormality, placenta previa and previous c-section due to cephalopelvic disproportion, and fetus biophysical profile (BPP) registered by ultrasound as value 6. Indications for urgent c-section were abruptio placentae, prolapsus funiculus umbilicalis and fetal asphyxia, or inadequate progress of labor. Patients were excluded if they had complicated pregnancy, were transferred to the intensive care unit or were diagnosed with chorioamnionitis (the latter because their pain scores may have been affected by a concurrent infection in addition to post-surgical pain) and absence of written consent.
Effect of vaginal pH on efficacy of dinoprostone gel for labour induction: a cross-sectional study
Published in Journal of Obstetrics and Gynaecology, 2022
G. K. Poomalar, N. Fathima Shantini, Rini Ezhil
This was a cross-sectional study carried out in Department of Obstetrics and Gynaecology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India, carried out from November 2015 to August 2017. Sample size was calculated based on the prevalence of induction rate of 20%. To achieve 95% confidence level with 5% margin of error, the minimum required sample size calculated was 150 using epi info software. Pregnant women with singleton pregnancy with foetus in vertex presentation >37 weeks of gestation with unfavourable Bishop’s score ≤5, planned for induction were included in the study. We have complied with Declaration of Helsinki ethical conduct of research involving human subjects in our study. Women with following conditions such as cephalopelvic disproportion, ruptured membranes, suspected chorioamnionitis, abnormal vaginal discharge, parity >4, previous LSCS or h/o uterine surgery, severe IUGR, severe pre-eclampsia, abruptio placenta and abnormal NST were excluded from the study. Cephalopelvic disproportion was assessed by Munro Kerr mullers method at the time of induction and those diagnosed with borderline CPD or severe CPD were excluded from the study.
Echogenic particles in the amniotic fluid of term low-risk pregnant women: does it have a clinical significance?
Published in Journal of Obstetrics and Gynaecology, 2021
Gul Nihal Buyuk, Z. Asli Oskovi-Kaplan, Serkan Kahyaoglu, Yaprak Engin-Ustun
The demographic characteristics, obstetric and neonatal outcomes of the patients are listed in Table 1. The pregnant patients in the two groups were similar in terms of age, parity, BMI, foetal birth weight, and gestational age. Particulate amniotic fluid was more commonly seen in smoking mothers (p = .005). The rate of pregnant women with lower Apgar scores (<7) both in 1st and 5th minutes were higher in pregnant patients with particulate amnion group (p = .006, p = .031 respectively). However, the need for admissions to the neonatal intensive care unit (NICU) did not differ between groups. The rate of spontaneous rupture of membranes was significantly higher in the control group (p = .035). Significantly more male foetuses were born in the particulate amniotic fluid group than the control group (p = .043). The primary caesarean rate was 18.4% in the particulate amniotic fluid group and 14.2% in the control group and this difference had a statistical significance (p: .037). The C-section indications were foetal distress (81.9%, n = 68), cephalopelvic disproportion (8.4%, n = 7) and failure to progress in labour (9.6%, n = 8). The rate of the instrumental deliveries was similar in both study and control groups. There were no foetal losses in both study and control groups.