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Induction Of Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Amniotomy—artificial rupture of the membranes—is another technique used in labor induction. There is insufficient evidence to assess the effectiveness of amniotomy alone [78]. No trials compared amniotomy alone with intracervical prostaglandins. If performed without cervical ripening or achieving a favorable cervix, amniotomy may be followed by long intervals before onset of labor. In induced patients, early amniotomy is associated with a shorter duration of labor and no increase in CD in a meta-analysis of four trials [79]. The rate of intrapartum fever is mixed in RCTs and warrants additional research [79].
HIV
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Jenani Jayakumaran, William R. Short
Delay amniotomy; however, it is not contraindicated and may be used to augment labor later in the active phase. Avoid invasive fetal monitoring, intrauterine pressure catheter (IUPC), fetal scalp electrode (FSE), fetal blood sampling (FBS), episiotomy, forceps, or vacuum delivery [44, 45].
Abnormal Labour
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Malik Goonewardene
Following amniotomy, the fetal head descends and directly presses on the cervix, and prostaglandins, which increase the sensitivity of oxytocin receptors, are released. Therefore, amniotomy is commonly used to augment labour in case of poor progress in the first stage. Amniotomy shortens the first stage of labour and slightly reduce the rate of caesarean deliveries in cases of an abnormal first stage of labour with no difference in adverse maternal or neonatal outcomes. However, amniotomy is associated with intrauterine infection and, in the presence of a high presenting part, cord prolapse.
Comparative evaluation of normal saline, 1/3-2/3, and ringer's lactate infusion on labour outcome, PH, bilirubin, and glucose level of the umbilical cord blood in nulliparous women with labour induction: a randomised clinical trial
Published in Journal of Obstetrics and Gynaecology, 2022
Ladan Haghighi, Fatemeh Jahanshahi, Mojgan Mokhtari, Zahra Rampisheh, Mina Momeni
In this double-blind trial, the subjects and the specialist who performed vaginal examinations were unaware of the allocation status of the three groups. After obtaining informed consent, the participants were randomly (with a random number table) divided into three groups, and a peripheral intravenous angiocatheter with an attached two-way stopcock was inserted. For labour induction, oxytocin was infused through one of the ducts at a 0.2 ml/min rate. This rate was increased by 0.2 ml every 15 minutes until induction of adequate uterine contractions (3-5 uterine contractions in 10 min with a duration of 40–60 seconds) or any indication of caesarean delivery. Through the other duct, for hydration, the first group received normal saline, the second 1/3-2/3, and the third Ringer's lactate fluid, each at a rate of 125 mL/h. All participants were examined every 4 hours during the latent phase and every two hours during the active phase by one specialist. With the beginning of the active phase (cervical dilation of ≥5 min the presence of adequate uterine contractions), amniotomy was performed, and patients received epidural analgesia for pain relief.
Second trimester uterine rupture and repair followed by morbidly adherent placenta: a case report
Published in Journal of Obstetrics and Gynaecology, 2021
Claire Pintault, Aurore Bleuzen, Franck Perrotin, Caroline Diguisto
In any case, such rupture early in pregnancy can be difficult to distinguish from other causes of acute abdominal pain (e.g. appendicitis or ovarian torsion), due to both its rarity and the lack of specificity of its clinical signs, mainly intense abdominal pain, vaginal bleeding and shock (Surico et al. 2016). Two different methods of management have been reported – either hysterectomy or uterine repair. Management should be decided based on the woman's background, her hemodynamic status, the integrity of the amniotic sac, and the continued development of the pregnancy. The occurrence of a stillbirth may change the choice of management. Different types of uterine repair have been reported: separate sutures, patch or fibrin glue (Sugawara et al. 2014; Surico et al. 2016). Surgeons must be aware of the risks of iatrogenic amniotomy while suturing (Hawkins et al. 2018).
Effects of the time of pregnant women’s admission to the labor ward on the labor process and interventions
Published in Health Care for Women International, 2021
Melek Balcik Colak, Hafize Ozturk Can
In another study, 49.8% of the pregnant women were administered oxytocin. Of the women who were administered oxytocin, 4.5% had cesarean sections (Bergqvist et al., 2012). The rate of oxytocin induction in the present study was similar to the rates in other studies. While the rate of amniotomy and anti-spasmolytic drug administration were higher in the active phase group, the rate of oxytocin application was higher in the latent phase group. Amniotomy is usually performed in the last part of the active phase. Contractions are thought to accelerate due to regular and strong pregnancy amniotomy and anti-spasmodic treatment. Because, it is not possible to assess the duration of the first stage of labor as the pregnant women come to hospital in the active phase, and thus it may be necessary to accelerate birth. It was also stated that amniotomy and oxytocin administration in the early period caused a moderate decrease in cesarean rates and shortened the duration of birth (Wei et al., 2013).