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The diagnosis and management of preterm labor with intact membranes
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Roberto Romero, Tinnakorn Chaiworapongsa, Francesca Gotsch, Lami Yeo, Ichchha Madan, Sonia S. Hassan
In terms of the management of a vaginal delivery, some evidence suggests that delivery with intact membranes may improve umbilical artery pH by reducing the effect of mechanical forces on the fetus and umbilical cord. There is little evidence that the performance of a “prophylactic” outlet forceps or “elective” episiotomy improves neonatal outcome. Vacuum extraction is considered to be contraindicated in preterm neonates.
Instrumental delivery
Published in Sheila Broderick, Ruth Cochrane, Trauma and Birth, 2020
Sheila Broderick, Ruth Cochrane
Vacuum extraction means a device (e.g. a Ventouse) is used to aid delivery of the baby’s head by the application of a suction cup to the scalp. Because the suction cup is placed on the head rather than around it, the Ventouse does not add to the size of the head that is coming through the maternal pelvis and so in theory the risk of damage to the mother should be the same as with a normal delivery. Vacuum extraction is not used for babies before 36 weeks gestation.
EMQ Answers
Published in Justin C. Konje, Complete Revision Guide for MRCOG Part 2, 2019
G Neville Barnes forcepsOperators should be aware that no indication for operative delivery is absolute and should be able to distinguish ‘standard’ from ‘specific’ indications. A vacuum extractor should not be used at gestations of less than 34+0 weeks. The safety of vacuum extraction between 34+0 and 36+0 weeks of gestation is uncertain and should therefore be used with caution. (Operative Vaginal Birth. The Royal College of Obstetricians and Gynaecologists Green-top guideline No. 26, January 2011)
Pattern of implementation of Emergency Obstetric Life-Saving Skills in public health facilities in Nsukka Local Government Area of Enugu State, Nigeria
Published in Journal of Obstetrics and Gynaecology, 2022
Scholastica N. Ugwu, Oluwafemi J. Adewusi
The proportion of health workers who always manually remove retained placenta is lower than the report by a past similar study (Oyetunde and Nkwonta 2015). While assisted vaginal delivery using a vacuum extractor was being performed by a few, the rate is higher than vacuum delivery rates reported in other parts of the country (Mairiga et al. 2005; Mutihir and Pam 2008; Yakasai et al. 2015). Similar to other studies, only few of the health workers manage eclampsia with magnesium sulphate (Ramadurg et al. 2016; Sotunsa et al. 2016) however, some other studies reported higher usage of magnesium sulphate (Ishaku et al. 2013; Sheikh et al. 2016). Although the healthcare workers were trained on how to use magnesium sulphate, possible reasons for its low use include fear of toxicity, familiarity and ready availability of pre-packaged forms of less effective drugs such as diazepam, misinformation regarding who can administer the drug, variable procurement in the facilities (Ekele 2009; Kirk and Chattopadhyay 2016).
Primary immune thrombocytopenia in adults: Belgian recommendations for diagnosis and treatment anno 2021 made by the Belgian Hematology Society
Published in Acta Clinica Belgica, 2022
A. Janssens, D. Selleslag, J. Depaus, Y. Beguin, C. Lambert
With respect to the neonates, platelet counts <20 x 109/L and <50 x 109/L are seen in, respectively, 1–5% and 10% and 5–15% will require therapy. Thrombocytopenia in neonates is due to transplacental passage of antiplatelet antibodies present in mothers with ITP. This can also occur with maternal ITP in remission with or without splenectomy. Neonatal intracranial hemorrhage is seen in <1% and is not associated with the mode of delivery. Therefore, the mode of delivery in pregnant ITP patients should be solely based on obstetrical considerations. However, invasive procedures during labor (scalp electrodes, vacuum extractor, forceps) should be avoided as they are associated with an increased hemorrhagic risk to the fetus. Cordocentesis and fetal scalp or percutaneous umbilical blood sampling should also be avoided. A cord platelet count is indicated after delivery and serial platelet counts should be obtained in the newborns at birth and in the first week postpartum as the onset of thrombocytopenia can be delayed. IgIV and platelet transfusions are indicated to manage bleeding or if platelet count <30 x 109/L in the neonates. Cerebral imaging is recommended in newborns with platelets <50 x 109/L to exclude an intracranial hemorrhage.
The impact of sexual intercourse during pregnancy on obstetric and neonatal outcomes: a cohort study in China
Published in Journal of Obstetrics and Gynaecology, 2019
The clinical data (age, body height, pre-gestational body weight, gravidity and parity, history of CS, and application of assisted reproduction), delivery modes, pregnancy complications, and the perinatal outcomes of mother and newborn were collected by retrospectively reviewing the participant and neonatal electronic medical records (created by DTHealth 6.9.4 ©2011 DTHealth). The medical records of infant examinations at the ages of 6 weeks and 6 months were used. All of the data were gathered in Excel tables by a trained nurse (Miss T. Li) and checked again by Dr. L. Li. These items are shown in Table 3. At PUMCH, we collected vaginal swabs at approximately 36 weeks of gestation or immediately after the natural rupture of membranes for all women. Hence, we had information about vaginal infections involving vulvovaginal candidiasis (VVC) or group B streptococci (GBS). Vacuum extraction was applied as needed for surgical delivery, and obstetric forceps were not employed at PUMCH. For puerperal conditions not found in the electronic medical records (wound infections and endometritis), Miss T. Li and Dr. L. Li verified the participant complaints throughout the patient and emergency room medical records.