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Objective:To search, evaluate and summarize the best evidences related to induction of labor by oxytocin infusion in pregnant women with full-term pregnancy, and to provide reference for clinical practice in order to reduce the complications during labor, such as the proportion of instrument delivery, prolonged labor duration, uterine rupture, postpartum hemorrhage, etc. Standardize the management process of induction of labor with oxytocin, improve the satisfaction of pregnant women to participate in the decision of induction of labor, and improve the outcome of the newborn.Methods:Take the evidence-based nursing method, in view of the full-term pregnancy pregnant women oxytocin drip induced labor evidence-based labor management problems, nearly 10 years related literature retrieval from January 1st 2011 to April 9th, 2021, the Australian JBI evidence-based health care center of literature quality evaluation criteria and evidence classification system, all kinds of research evaluation and classification of retrieval.Results:Early detection to 340 articles, and eventually into 9 articles, including 1 clinical decision, 6 guides, 2 pieces of system evaluation. Totally 45 pieces evidences related to induction of labor by oxytocin infusion in pregnant women with full-term pregnancy were sumarized, including induced labor time, oxytocin side effects, induced labor before evaluation, induced labor of guardianship, infusion solution, such as health education, and other seven aspects.Conclusions:The present study summarized 45 pieces of best evidence on the management of labor induced by oxytocin infusion during term pregnancy, which provided some evidence-based basis for midwives, obstetric nurses and managers. Through the application of the best evidence, it is beneficial to improve the outcome of pregnant women in the neonatal perinatal period, standardize the process of inducing labor with oxytocin, and improve the quality of obstetric care.
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Objective:To study the insulin-like growth factors-1 (IGF-1) and lipid level of term small for gestational age (SGA) infants within 24 hours postnatally and to explore the correlation between IGF-1 and blood lipids.Methods:A prospective study was conducted on singleton term SGA and appropriate for gestational age infant (AGA) who were delivered and admitted to the neonatal ward of Guangdong Women and Children Hospital within 24 hours after birth from May 2020 to January 2021, and the infants were divided into SGA and AGA groups to compare the differences in IGF-1 and lipid levels within 24 hours after birth and to analyze the correlation between IGF-1 and lipids.Results:A total of 95 cases in the SGA group and 84 cases in the AGA group were included in the study. The proportion of infants with IGF-1 <25 ng/ml was significantly higher in SGA group (87.4%) than in the AGA group (52.4%). It was also found that the proportion of infants with IGF-1 <25 ng/ml in SGA was significantly higher than that in AGA within different gender composition groups, early-term and full-term births groups. The triglyceride (TG) level was higher in the SGA group than that in the AGA group, but the high-density lipoprotein cholesterol (HDL-C) level was lower than that in the AGA group ( P<0.05). IGF-1 level within 24 hours postnatally in SGA and AGA was positively correlated with HDL-C levels ( P<0.01) and negatively correlated with TG ( P<0.01), and HDL-C level was a predictor of IGF-1. Conclusions:Compared with term AGA, SGA term infants showed insufficient IGF-1 and HDL-C secretion and high TG within 24 hours after birth. Nutritional support for SGA should be given promptly after birth to avoid hypoglycemia and to stimulate IGF-1 secretion.
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Background: To compare the efficacy and safety of double‐balloon catheter with prostaglandin E2 (PGE2) in induction of labor.Methods: We searched electronic sources from Medline, Scopus, PubMed, Science Direct and Cochrane Library Database of Systematic Reviews. Only randomized controlled trials and observational studies comparing the PGE2 agents with double-balloon catheter for cervical ripening and labour induction in women with unfavorable cervix were included in the analysis. The main outcomes included vaginal delivery rate within 24 hours and cesarean delivery rates. We calculated relative risks and mean differences using fixed effects and random‐effects models.Results: Prostaglandin was more favourable for vaginal delivery within 24 hours compared to double balloon catheter, but was not statistically significant (RR 1.17: 95% CI 0.96-1.42 p =0.12). The induction to delivery time yielded a non-significant result that again favors prostaglandin (SMD 0.02 CI:0.18,0.22, p = 0.86). There was no significant difference in the cesarean delivery rates between the two groups (RR 1.02: 95% CI 0.92-1.14, p = 0.68). Uterine hyperstimulation and Neonatal Intensive Care Unit (NICU) admissions were significantly higher with prostaglandin. (RR 0.09: CI 0.04, 0.22 p<0.00001 and RR 0.75 CI: 0.62,0.90 p=003).Conclusions: There is no significant difference in the success of induction of labour between use of PGE2 and double balloon catheter. Uterine hyperstimulation and NICU admissions were significantly higher in Prostaglandin group.
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Objective@#To investigate the effect of different cervical ripening methods on induction of labor in term pregnancy.@*Methods@#160 cases of labor induction of full-term pregnancy primipara were selected as the research subjecs.According to the different methods of cervical ripening, they were divided into two groups.The observation group (n=80) underwent dinoprostone suppositories induced labor, the control group (n=80) received intravenous infusion of small dose of oxytocin.The cervical Bishop score, cervical ripening effect, induction of labor, mode of delivery, neonatal outcome were observed in the two groups.@*Results@#Before treatment, the Bishop scores of the two groups had no statistically significant difference (t=0.436, P>0.05). After treatment for 24h, the Bishop score of the observation group was (8.3±2.6)points, which was higher than (5.9±2.0)points of the control group (t=6.544, P<0.05). In the observation group, the total effective rate of cervical ripening was 95.0%, which was higher than 66.2% of the control group (Z=-5.716, P<0.05). The duration of labor in the observation group was (12.6±4.5)h, which was significantly shorter than (21.7±7.8)h in the control group (t=9.039, P<0.05). The total labor, postpartum hemorrhage volume had no statistically significant differences between the two groups (t=2.298, 1.102, all P>0.05). In the observation group, 66cases (82.5%) were vaginal delivery, 14cases(17.5%) were cesarean section, those were 49cases(61.2%) and 31cases(38.8%) in the control group.The delivery mode of the observation group was significantly better than that of the control group(χ2=8.935, P<0.05). There were no statistically significant difference between the two groups in neonatal birth weight and postnatal 1min and 5min Apgar scores (all P>0.05).@*Conclusion@#Parturient with dinoprostone suppositories full-term pregnancy abortion can improve the cervical Bishop score and cervical ripening effect, improve the quality of delivery, it is better than oxytocin, and worthy of clinical application.
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Objective To explore the clinical effects of single-cavity and COOK cervical ripening balloon in promoting full-term pregnancy cervical mature and inducing labour. Methods 126 puerpera who were expect-ant in the obstetrics department of our hospital were selected from January 2016 to June 2017,and all of the puer-pera were induced labor by cervical ripening balloon.In 61 of them,single-cavity balloon was used,and 65 cases were induced labor by COOK balloon. Determining the cervical ripening situation,the time needed for inducing efficient uterine contraction,the first stage of labor time,the total labor time,vaginal delivery rate,natural labor situation,postpartum hemorrhage,amniotic fluid turbidity,puerperal infection and newborn asphyxia of the two groups.Results the time needed for inducing efficient uterine contraction of the two groups were(16.39±2.68)h, (14.54 ± 3.30)h,and the two groups were statistically different(P<0.05).There were no statistically significant differences in other items of two groups(P>0.05).Conclusion single-cavity balloon and COOK balloon are sim-ilar in promoting full-term pregnancy cervical ripening.The difference is that the time needed for inducing efficient uterine contraction of the single-cavity balloon is longer than COOK balloon,but have no adverse effect to the puer-pera and the newborn.Both types of balloons are recommended to be used in promoting full-term pregnancy cervical ripening and inducing labor.
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Objective To establish a reference range for the normal value of thromboelastography (TEG) in pregnant females.Methods According to the results of pregnancy and physical examination,166 pregnant females and 64 healthy females without pregnancy were selected as the pregnant group and the non-pregnant control group,respectively.The TEG value and the traditional coagulation index were measured.The TEG parameters of the two groups were compared and analyzed,establishing a reference range for the parameters.We further analyzed the effect of full-term pregnancy on TEG results and the correlation between traditional coagulation index and TEG test results.Results The traditional coagulation index and TEG test results of the pregnant females andthe non-pregnant females were significantly different.According to the results,a new TEG reference range was established:R 3.9-7.5 min,K 1.0-2.4 min,α 57.6°-74.9°,MA 55.7-75.7 mm,LY30 0-0.56％,CI(-0.97)-3.6.Full-term pregnancy had no significant effect on TEG results.In addition to LY30,other parameters of TEG had some correlation with the traditional coagulation index.Conclusions The general TEG reference range does not apply to pregnant females and established TEG normal reference range for pregnant females can be applied for clinical use.
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Abstracts: Guillain-Barré syndrome (GBS)-complicating pregnancy is rare with estimated incidence between 1.2 and 1.9cases per 100,000 people annually., and it is generally believed that it carries a high maternal and fetal risk. We reported a case of 25 year old3rdgrvida patient with relapse of predominantly motor GBS(affecting lower limb muscles) complicating pregnancy without history of antecedent infection. patient managed with IV corticosteroids and IVIG.Patient successfully delivered vaginaly with vaccume without any operative intervention with uneventful postpartum period.
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Objective To study the relationship between hearing loss and serum bilirubin of neonates with hypercholesterolemia .Methods The serum bilirubin level and auditory brainstem response thresholds of 70 hyper_cholesterolemia neonates of full term pregnancy and normal weight were tested ,and the correlations of serum biliru_bin ,and occurrence time of jaundice with hearing threshold were analyzed .ResuIts Among the 70 neonates ,there were 17 cases with normal ABR thresholds and 53 with abnormal ABR thresholds ,including 27 with middle and se_rious hearing loss .In the cases of serum bilirubin less than 342μmol/L ,the percentage of cases with middle and se_rious hearing loss and with occurrence time of jaundice less than 48 hours was higher than theses cases with occur_rence time of jaundice more than 48 hours (P<0 .05) .In the cases of serum bilirubin higher than 342μmol/L ,there was no obvious difference between the percentage of cases of middle and serious hearing loss with occurrence time of jaundice less than 48 hours and those with occurrence time of jaundice more than 48 hours .Among the 53 cases with abnormal hearing thresholds ,positive correlation was observed between serum bilirubin and ABR threshold (r=0 .041) ,whereas negative correlation was observed between occurrence time of jaundice and ABR threshold (r=-0 .291) .ConcIusion The higher probability of hearing loss for hypercholesterolemia neonates with earlier occur_rence of jaundice ,the more serious hearing loss with higher serum bilirubin .
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Objective To investigate clinical efficacy and safety of misoprostol for termination with full-term pregnancy.Methods The number who had terminations with full-term pregnancy in our hospital obstetrics from July 2013 to March 2014 were 78, divided them into the experimental and control groups.Experimental group used misoprostol for induction of labor, the control group used oxytocin for induction of labor.Indicators were observed and compared between two groups of pregnant women, induction of labor effect indicators: the success rate of induction of labor, postpartum hemorrhage in 2h, the time of labor and the time of fetal delivery, cesarean section rate; induction of labor safety indicators: maternal complications and side effects, the physiological condition of the newborns and Apgar score.Results Basic information was no significant different between the two groups of pregnant women.induction of labor of experimental group success rate was 97.44%, which was 82.05% in the control group, success rate in experimental group was higher than the control group, with statistically significant results (P0.05), the experimental group had one case of mild neonatal asphyxia, there are two cases in the control group and one case of mild asphyxia neonatal asphyxia.Conclusion Effect of misoprostol which is used to terminate the pregnancy term is significant, and has high security, has high clinical value.
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Objetivos: analizar la respuesta a una dosis intravaginal de misoprostol administrada ambulatoriamente en pacientes embarazadas a término y de bajo riesgo, con deseos de una inducción selectiva del trabajo de parto.Materiales y métodos: cohorte descriptiva realizada en 373 pacientes con embarazos de 38 o más semanas, de bajo riesgo y sin una indicación médica específica, con el deseo de la paciente de finalizar su embarazo quienes recibieron una dosis inicial de 50 mcg de misoprostol intravaginal en forma ambulatoria. Se tomaron los tiempos entre la colocación del misoprostol, la iniciación del trabajo de parto, la hora de hospitalización y del parto. El trabajo de parto fue monitorizado y se evaluó la actividad uterina para detectar polisistolia o hiperestimulación uterina y estado fetal. Se evaluó el tipo de parto, el recién nacido, la necesidad de traslado a la unidad de neonatología y complicaciones maternas. Resultados: se obtuvo respuesta exitosa con dosis única de misoprostol de 50 mcg en 308 pacientes (85,3%). La tasa total de éxito teniendo en cuenta todas las dosis de 50 mcg fue del 98,9%. El 88,3% presentó su parto dentro de las primeras 24 horas de haber sido inducidas. El 91,7% de los casos fueron partos vaginales (74,8% eutócicos y 16,9% instrumentados), y el porcentaje de cesárea fue del 8,3%. El 97,3% de los RN tuvieron un puntaje de Apgar de 7 o más al minuto, y el 100% de 8 o más a los 5 minutos. No hubo complicaciones maternas. Conclusiones: el uso ambulatorio del misoprostol surge como alternativa para la inducción del trabajo del parto por su efectividad y seguridad. Aunque este no es un estudio controlado, los resultados señalan un beneficio importante del misoprostol ambulatorio, que convendría confirmar con estudios aleatorizados.
Objectives: Analyzing response to an outpatient intravaginal dose of misoprostol administered to low-risk, full-term pregnant patients desiring selective induction of labor. Materials and methods: Descriptive cohort study of 373 low-risk pregnant patients (38 or more weeks), lacking medical indication for such procedure but desiring to terminate their pregnancy who received an initial 50 mcg dose of intravaginal misoprostol as outpatients. The time taken between placing the misoprostol, initiation of labor, hospitalization time and actual labor were recorded. Labor was monitored and uterine activity evaluated for detecting polysistolia or uterine hyper-stimulation and fetal state. The type of birth, the newborn, the need for transfer to a neonatal unit and maternal complications were also evaluated. Results: A successful response was obtained in 308 patients (85.3%) with a single 50 mcg dose of misoprostol; success rate was 98.9% considering all 50 mcg doses. 88.3% of the patients gave birth within the first 24 hours of having been induced. Vaginal birth accounted for 91.7% of the cases (74.8% eutocic and 16.9% instrumented), the rest being cesarean (8.3%). 97.3% of the newborn had an APGAR score of 7 or more at one minute and 100% scored 8 or more at 5 minutes. There were no maternal complications. Conclusions: Using out-patient misoprostol has emerged as an alternative for inducing labor due to its effectiveness and safety. Even though this was not a controlled study, the results highlighted misoprostol's important out-patient benefit which should be confirmed by randomized studies.
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Adult , Female , Pregnancy , Misoprostol , PregnancyABSTRACT
Objective To investigate the effect of microminiature water halloon combined with misoprostol per rectum for delivery of full-term pregnancy. Methods 305 full-term pregnant women with planned delivery were divided into three groups at random.The observation group (n=99) was given microminiature water balloon combined with misoprostol per rectum.The first control group (n=96) was only given misoprostol per rectum. The second control group (n=110) was given 0.5% oxytocin in a continuous infusion.Their results were taken a com-parative study,including the cervical ripening,dilivery process,delivery ways and the condition of the newbom. Results The observation group was better than other groups for cervical ripening(P<0.00).Tune from induction to the onset of regular contraction activity of the uterus in the observation group was significantly shorter than other groups (P<0.00).The rates of cesarean section and the total stage of lahor between the observation and the first control group were not statistically significant(P>0.05),but they were significantly different from the second con-trol group.There were no significant differences among the groups in neonatal asphyxia and amount of postpartum blood loss. Conclusions The efficiency of microminiature water balloon combined with misoprostol per rectum for delivery of full-tarm pregnancy was better than other groups.It has a short delivery process and shows no side effects on both mother and fetus,which is worthy of popularizing in obstetrics.
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The aim of this study was to determine the roles of ET-1 and NO on uterine blood flow in pregnancy. Uterine arteries were isolated from 17 nonpregnant and 12 pregnant women. Nonpregnant group included patients with median age of 48.6+/-2.3 years who underwent hysterectomy, because of myoma. Pregnant group included patients with median age of 31.3+/-1.4 years undergoing cesarean delivery. ET-1 and ET-2 induced concentration-dependent contraction in isolated nonpregnant and pregnant uterine arteries. The contractile response and maximal contraction were increased in pregnant uterine arteries. In nonpregnant uterine arteries, there was no contraction in response to ET-3, whereas pregnancy induced concentration-dependent contraction by ET-3. Tissue nitrite/nitrate level and immunohistochemical staining of eNOS and iNOS were increased in pregnant uterine arteries, compared with nonpregnant uterine arteries. In addition, the expressions of eNOS and iNOS mRNA were significantly increased in pregnancy. Moreover, contractions by ET isopeptides, including ET-1, were enhanced, and immunohistochemical staining of ET-1 and ET-1 mRNA expression was increased in pregnant uterine arteries. These results suggest that NO production by increased NOS activity, especially eNOS activity, is related to placental and uterine blood flow. Furthermore, ET-1 appears to play a pathophysiological role in pregnant complications such as hypertension.