|
| ||
|
|
||
Bishop Score (bishop + score)
Selected AbstractsCervical phosphorylated insulin-like growth factor binding prote,n-1 for the prediction of preterm delivery in symptomatic cases with intact membranesJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2009H. Mete Tanir Abstract Aim:, This prospective, observational study was an attempt to evaluate whether a positive cervical phosphorylated insulin-like growth factor binding prote,n-1 admission test in women with signs and symptoms of preterm labor (PTL) may be useful in the prediction of women who will deliver prematurely. Methods:, Pregnant women with confirmed gestational age between 24 and 37 weeks' gestation with <3 cm cervical dilatation and intact membranes were included in the study. Prior to digital examination, a sterile speculum examination was performed using a dacron swab rotated in the external cervical os for 15 s. The test was based on immunochromatographic qualitative analysis of cervical phosphorylated insulin-like growth factor binding prote,n-1. Test (+) and (,) cases were evaluated in terms of maternal demographic characteristics and neonatal outcomes. Results:, A total of 68 cases were enrolled in the study. There were no statistically significant differences between test (+) and (,) groups, in terms of maternal characteristics or adverse neonatal outcomes. However, cases with + test had high Bishop scores on admission (P = 0.01) and gestational age at delivery (P = 0.003). For deliveries within 7 days of admission, the strongest predictors were test positivity (RR:24,%95CI:2.8,204, P < 0.0001) and Bishop score (RR:1.3, %95CI: 1.0,1.6, P = 0.03). For deliveries <34 weeks' gestation, the test had a sensitivity, specificity, positive predictive values, negative predictive values, +likelihood ratios and ,likelihood ratios of 70%, 74%, 48%, 88, 2.8 and 0.39, respectively. Conclusion:, Among women with signs and symptoms of PTL, the high negative predictive value of this test to predict the PTL <34 weeks' gestation as well as within 7 days of delivery may be of value in the reassurance of patients, avoiding unnecessary medical interventions. [source] A comparison between the effect of oxytocin only and oxtocin plus propranolol on the labor (A double blind randomized trial)JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 3 2008Maryam Kashanian Abstract Objective:, The comparison between the effect of oxytocin alone or in combination with propranolol on labor. Methods:, A double blind randomized controlled trial was performed on 150 nulliparas with a gestational age of 39,41 weeks of pregnancy and a Bishop score of ,5. In the first group (oxytocin group = 75), oxytocin alone was used for induction of labor. In the second group (propranolol group = 75 cases), before the beginning of oxytocin, 2 mg propranolol was slowly injected intravenously then the oxytocin was initiated. Results:, The number of patients who delivered in the first day showed no difference between the two groups. The mean duration for obtaining good contractions was shorter in the propranolol group in both the first and second day of induction The mean interval between the beginning of induction until the beginning of active phase at the first day of induction was shorter in the propranolol group. The mean interval between the beginning of induction until delivery at the first day of induction was shorter in the propranolol group. The amount of necessary oxytocin for the first day of induction was less in the propranolol group. Conclusion:, Propranolol may shorten the induction duration and labor and reduce the amount of necessary oxytocin. [source] Comparative study of induction of labor in nulliparous women with premature rupture of membranes at term compared to those with intact membranes: Duration of labor and mode of deliveryJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2006Kyo Hoon Park Abstract Aim:, To evaluate the effect of premature rupture of membranes (PROM) at term on the duration of labor and mode of delivery in comparison with intact membranes in nulliparous women with an unfavorable cervix whose labor was induced. Methods:, This retrospective cohort study included all term nulliparous women with an unfavorable cervix requiring labor induction over a 2-year period. Prostaglandin E2 (dinoprostone) and oxytocin were used for labor induction. Criteria for enrolment included (i) singleton pregnancy; (ii) term nulliparous women; or (iii) Bishop score below 6. Statistics were analyzed with Student's t -test, ,2 -test, Fisher's exact test, and multiple logistic regression. Results:, Our study subjects were 82 women whose labor was induced for PROM and 219 women with intact membranes whose labor was induced for social or fetal reasons. The mean durations of active phase of labor were not significantly different between women with PROM and those with intact membranes. However, the women with PROM had a significantly longer mean duration of second stage and a higher rate of cesarean delivery for failure to progress than those with intact membranes. Multiple logistic regression demonstrated that only PROM and fetal macrosomia were significantly associated with an increased risk of cesarean delivery for failure to progress after other confounding variables were adjusted. Conclusions:, Labor induction for PROM at term in nulliparous women with an unfavorable cervix is associated with longer duration of the second stage and a higher risk of cesarean delivery for failure to progress in comparison to those with intact membranes. [source] Utility of misoprostol for labor induction in severe pre-eclampsia and eclampsiaJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2004Shamsun Nahar Abstract Objectives:, To determine the effectiveness and safety of misoprostol in severe pre-eclampsia and eclampsia patients with unripe cervix. Methods:, A prospective observational study was carried out in 135 severe pre-eclampsia and eclampsia patients who required termination of pregnancy at the Department of Obstetrics and Gynecology, Khulna Medical College Hospital, Khulna, Bangladesh during January 2002 to October 2003. Fifty micrograms of misoprostol was used every 4 h in cases of unripe cervix (Bishop score , 6) in severe pre-eclampsia and eclampsia patients. Maternal and perinatal outcome as well as any complications were recorded. Results:, In severe pre-eclampsia and eclampsia patients vaginal delivery occurred in 79.3 and 80.5% of cases, and cesarean section was performed in 20.6 and 19.4% of cases, respectively. The maximum required responsive dose was 50,150 µg. Oxytocin augmentation was required in 29.3 and 35% of cases, respectively. Induction to delivery time was median 8 h, interquartile ranges 4.2,8.2 h in the severe pre-eclampsia group, and median, 9 h,, interquartile, ranges, 6.8,12.5 h, in, the, eclampsia, group,, and, average, hospital, stay, was, 3.4 ± 1.8, and 3.7 ± 1.7 days, respectively. The only maternal complications were hyperstimulation which occurred in 6.8 and 5.1% of cases, respectively. Neonatal death occurred in five (11.3%) and eight cases (12.1%), respectively. Conclusion:, Intravaginal misoprostol is well tolerated and very effective for the induction of labor in severe pre-eclampsia and eclampsia patients with unripe cervix. [source] Original Article: Predicting the outcome of induction of labourAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2010Ralph NADER Objective:, To test whether prediction of delivery outcome is feasible in post-term nulliparous pregnant women, using a published model and a locally produced model combining clinical and ultrasound assessment. Methods:, This is a prospective pilot study of 53 nulliparous women seen in a postdates clinic between 40 weeks four days and 41 weeks three days of gestation. They underwent a routine assessment including transabdominal ultrasound to determine amniotic fluid index, a Bishop score, and translabial ultrasound to determine the station of the fetal head at rest and bladder neck descent at rest and on valsalva. Additional information such as body weight at booking and current weight, height and a family history of caesarean section was obtained. Delivery outcome and labour details were obtained from the local obstetric database. Two models for prediction of delivery outcome were tested. Results:, Forty-nine complete datasets were analysed. Fourteen women had a normal vaginal delivery, 17 instrumental deliveries and 18 caesarean sections. A published model predicted the induction outcome in 62%. A local model using maternal age, body mass index, family history of caesarean section, station of the fetal head and bladder neck descent predicted vaginal delivery in 70% in our study. Conclusion:, Prediction of delivery outcome is of limited feasibility in post-term nulliparous pregnant women. Our locally produced model was successful in predicting vaginal delivery in 70% of women. Prediction of delivery outcome may not be sufficiently powerful to allow modification of current obstetric practice. [source] Cervical phosphorylated insulin-like growth factor binding prote,n-1 for the prediction of preterm delivery in symptomatic cases with intact membranesJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2009H. Mete Tanir Abstract Aim:, This prospective, observational study was an attempt to evaluate whether a positive cervical phosphorylated insulin-like growth factor binding prote,n-1 admission test in women with signs and symptoms of preterm labor (PTL) may be useful in the prediction of women who will deliver prematurely. Methods:, Pregnant women with confirmed gestational age between 24 and 37 weeks' gestation with <3 cm cervical dilatation and intact membranes were included in the study. Prior to digital examination, a sterile speculum examination was performed using a dacron swab rotated in the external cervical os for 15 s. The test was based on immunochromatographic qualitative analysis of cervical phosphorylated insulin-like growth factor binding prote,n-1. Test (+) and (,) cases were evaluated in terms of maternal demographic characteristics and neonatal outcomes. Results:, A total of 68 cases were enrolled in the study. There were no statistically significant differences between test (+) and (,) groups, in terms of maternal characteristics or adverse neonatal outcomes. However, cases with + test had high Bishop scores on admission (P = 0.01) and gestational age at delivery (P = 0.003). For deliveries within 7 days of admission, the strongest predictors were test positivity (RR:24,%95CI:2.8,204, P < 0.0001) and Bishop score (RR:1.3, %95CI: 1.0,1.6, P = 0.03). For deliveries <34 weeks' gestation, the test had a sensitivity, specificity, positive predictive values, negative predictive values, +likelihood ratios and ,likelihood ratios of 70%, 74%, 48%, 88, 2.8 and 0.39, respectively. Conclusion:, Among women with signs and symptoms of PTL, the high negative predictive value of this test to predict the PTL <34 weeks' gestation as well as within 7 days of delivery may be of value in the reassurance of patients, avoiding unnecessary medical interventions. [source] | ||||||||||