The aim of the current study is to assess the effect of antenatal education on pregnant women's knowledge, attitude, and preferences of delivery mode.

开始日期2024-09-01

申办/合作机构

Mansoura University

NCT06550232 / Not yet recruiting临床4期IIT

The Effect of IV PAPAVERINE 80 mg Prior to Propess on Bishop Score and Pain, Double Blinded Randomized Placebo Controlled Trial

We aim to evaluate the effect of administering papaverine prior to PGE2 (propess) insertion on changes in Bishop-scores and on the induction-to-delivery interval.

开始日期2024-08-11

申办/合作机构

Western Galilee Hospital

NCT06453811 / Not yet recruitingN/AIIT

The Effect of a Self-Efficacy Theory-Based Spouse Participation Childbirth Preparation Program on Fear of Childbirth, Self-Efficacy, Mode of Delivery and Birth Outcomes: A Randomized Controlled Trial

The research is designed as a pre-test, post-test, parallel-group, randomized controlled study to examine the effect of a spouse-participated childbirth preparation program based on self-efficacy theory on fear of childbirth, self-efficacy, mode of delivery and outcomes. Participants will be allocated to experimental and control groups through block randomization. Participants in the experimental group will be enrolled in a three-session spouse-participated childbirth preparation program based on self-efficacy theory once a week, in addition to receiving routine care at the hospital. Participants in the control group will not receive any intervention, only routine care provided at the hospital.

开始日期2024-07-01

申办/合作机构-

100 项与阴道分娩过程相关的临床结果

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100 项与阴道分娩过程相关的转化医学

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0 项与阴道分娩过程相关的专利（医药）

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项与阴道分娩过程相关的文献（医药）

2024-02-01·International Urogynecology Journal

Family medicine physician identification of obstetric lacerations: a US national survey

Article

作者: Sheeder, Jeanelle K ; Niblock, Franklin C ; Simon, Natalie T ; Hoss, Molly L ; Hurt, K Joseph ; Rabaza, Cristina A

INTRODUCTION AND HYPOTHESISWe evaluated family medicine obstetric providers' identification and categorization of vaginal delivery lacerations in the USA. We hypothesized that there would be inaccuracy in family medicine physicians' identification of vaginal delivery injuries, similar to our previous studies of midwives and obstetricians (OBs).METHODSWe included clinically active physicians who attended deliveries within 2 years and evaluated their identification and categorization of delivery lacerations using descriptive text and visual images. We asked about their education on this topic and how they document lacerations in the labor and delivery record.RESULTSWe analyzed 250 completed responses (70% of opened surveys). Fifty-five percent of respondents characterized their obstetric laceration training as "good" or "excellent" and half previously had education on obstetric lacerations. The median accuracy overall for the classification and identification of perineal lacerations was 78% (IQR 56-91%). Respondents frequently mischaracterized nonperineal lacerations. Few respondents (36%) reported using the third-degree injury subclassification system. In adjusted analysis, the highest scoring respondents were board certified in family medicine, with fewer years in practice, and a higher obstetric volume.CONCLUSIONSObstetric laceration diagnoses may be inaccurate, which could influence perinatal quality and patient outcomes. We found gaps in knowledge similar to previous reports on midwives and obstetricians in the USA. These data suggest a need for increased education and training on obstetric injuries, perhaps especially for physicians with less obstetric activity. Improved categorization and identification of vaginal delivery trauma can impact management and improve women's postpartum care and long-term pelvic floor outcomes.

2023-10-13·Medwave

Síndrome de disfunción orgánica múltiple progresiva en embarazo adolescente: reporte de caso clínico.

Article

作者: Lizama Deluchi, Carolina ; Silva Elgueta, María Teresa ; Twele Montecinos, Loreto ; Rodrigues Boock, Jennifer ; Strickler, Alexis

IntroductionAdolescent pregnancy is a physiological process, but it can evolve with premature delivery, severe obstetric or clinical pathologies, mortality, or sequelae for mother and child. We aim to report the progressive multiple organ dysfunction syndrome secondary to pyelonephritis and sepsis during prepartum, delivery, and puerperium of adolescent pregnancy and its sequelae.Case reportA 14-year-old adolescent with a pregnancy of 27 weeks of gestation controlled from 8 to 25 weeks. She was urgently admitted to the high-risk obstetric unit due to signs of preterm labor, pyelonephritis, and acute renal injury. Treatment was started with intravenous cefazolin and betamethasone for lung maturation, oral nifedipine, and magnesium sulfate to prevent preterm labor and fetal neuronal protection, evolving with sustained hypotension and septic shock. At 13 hours after admission, she was transferred to the intensive care unit, where she evolved with persistent and progressive multiple organ failure for 28 days, progressively affecting the cardiovascular, hematologic, respiratory, and gastrointestinal systems. She was treated with vasoactive drugs, antibiotics, invasive mechanical ventilation, ultrafiltration, hemodialysis, pleural drainage, and cholecystectomy. Twenty-four hours after admission to intensive care, preterm vaginal delivery occurred. She developed chronic kidney disease stage KDIGO 5 (Kidney Disease Improving Global Outcomes V) and is awaiting renal transplantation. On the other hand, the preterm newborn presented severe neonatal asphyxia, bronchopulmonary dysplasia, and hypoxic-ischemic encephalopathy.ConclusionComplicated adolescent pregnancy is a health emergency. Avoiding delays in the diagnosis and treatment of pyelonephritis, septic shock and the progressive multiple organ dysfunction syndrome can prevent mortality and permanent sequelae, both maternal and neonatal.

2022-06-01·International Urogynecology Journal3区 · 医学

Obstetric anal sphincter injuries and other delivery trauma: a US national survey of obstetrician–gynecologists

3区 · 医学

Article

作者: Bunn, Jason G ; Sheeder, Jeanelle ; Connell, Kathleen A ; Estin, Miriam ; Diko, Sindi ; Schulkin, Jay ; Hurt, K Joseph

INTRODUCTION AND HYPOTHESISObstetric lacerations complicate the majority of deliveries. The application of standardized guidelines for assessing delivery trauma has not been assessed thoroughly in the United States. We recently identified gaps in US midwives' clinical assessment of delivery trauma. We conducted a cross-sectional national survey of practicing obstetricians in the USA to characterize their classification of obstetric lacerations. We hypothesized that attending obstetricians' identification and diagnosis of delivery trauma would be similar to our findings for midwives with frequent inaccuracy.METHODSWe recruited clinically active obstetricians through the Pregnancy-Related Care Research Network. We asked participants to classify (from written definitions) and diagnose (from standard illustrations) common forms of vaginal delivery trauma using the widely employed perineal laceration degree system. We performed bivariate analysis of high- and low-scoring respondents and logistic regression to model characteristics associated with higher diagnostic accuracy.RESULTSOf the 162 respondents who started the survey, 76% (123) were included for analysis (22% of solicited emails). Overall, we found wide variation in response accuracy with as few as 62% of respondents correctly classifying certain types of lacerations. Only 49 out of 123 (40%) use the Sultan third-degree subclassification system and 67 out of 123 (52%) continue to use the midline/median approach for episiotomies. Providers reporting fewer deliveries per month and fewer publicly insured patients earned higher scores.CONCLUSIONSObstetricians in a nationally representative US perinatal provider network inconsistently identify perineal and nonperineal lacerations. We found important clinical knowledge gaps, suggesting that vaginal delivery diagnoses in obstetric quality studies and pelvic floor research might be inaccurate.