Comparative study of induced and spontaneous labour in nulliparous women using modified WHO partograph

Background: Induced or spontaneous labour has implication on the eventual mode of delivery and neonatal outcome. The aim of study is to compare mean duration of labour andmaterno-foetal outcome of induced versus spontaneous labour among nulliparous women using modified WHO partograph.Methods: The study was conducted in nulliparous women coming at term in active phase of labour (with cervical dilatation at least 4 cm) either spontaneous or induced, both labouring women were monitored using modified WHO partograph. Outcomes measures include requirement of augmentation of labour with oxytocin, mean duration of labour, eventual mode of delivery and the materno foetal outcome.Results: A total 100 women were compared in each group. There was no difference in mean age group, BMI, gestational age. More women had spontaneous vaginal delivery among those with spontaneous labour (76% versus 58%) (p=0.033). The mean duration of second stage of labour was significantly more in induced labour (16.25 minutes) than in spontaneous labour (14.60 minutes) (p=0.0212). The mean Apgar scores were comparable in two groups. Induced labour is comparable to spontaneous labour regarding fetomaternal outcomes but with increased rate of caesarean deliveries.Conclusions: Study concluded from our study that in spontaneous group mean duration of labour was less than induced group and most of the patient delivered vaginally. In induced group rate of caesarean was higher and requirement of oxytocin for labour augmentation was also more than spontaneous group. Maternal complications were also found more in induced group than spontaneous group whereas neonatal outcome was similar in both the groups. We observed in our study that induced labour can be a safe procedure among nulliparous women if labour is partographically monitored by WHO modified partograph.

Outcome of breech deliveries in nulliparous women

Background: Compared to cephalic presentation with respect to fetal morbidity and mortality, breech delivery management was a high risk. Aim: To evaluate the outcome of breech deliveries in nulliparous women. Materials and methods: This was a retrospective study conducted from October 2012 till September 2015 .The study was conducted at Government hospital Nizabmabad and CKM hospital, Warangal. The selection criteria were gestational age ≥ 32 weeks which was validated by ultrasound examination performed before 20 weeks gestation when calculated from last menstrual period, a singleton with breech presentation and normal fetal heart beats in nulliparous women. Adequate pelvis, frank or complete breech, estimated weight of foetus lesser than 3500 grams, no other obstetric complication were the inclusion criteria. Results: During these 3 years survey, 12000 deliveries were done. Out of which, 3000 were nulliparous, and there were 400 cases of breech presentation, and there was an incidence of 3.33%. A total of 250 women met the inclusion criteria and had undergone delivery by VBD or by Caesarean section. There were 120 caesarean deliveries, of which 56 (46.66%) were elective and 64 (53.33%) were emergencies. The main indication for emergency CS was acute foetal distress accounting to 42 (65.63%) cases. The main indication for elective CS was foetal birth weight ≥3500 grams accounting to 25 (44.64%) cases. Out of 130, 15 (11.54%) neonates had poor APGAR score (<7) at the 5th minute of birth. In elective caesarean section, none had poor APGAR score at 5th minute. In emergency, caesarean section, 6 (9.38%) had a poor APGAR score at the 5th minute. Out of the 6 cases, the indication for the emergency caesarean section was acute foetal distress, 2 in 35 years old patients carrying foetus of 3300 grams and 3200 grams, others had cord prolapsed. In APGAR score between Allanki Suneetha Devi, Jalem Anuradha. Outcome of breech deliveries in nulliparous women. IAIM, 2017; 4(7): 33-38. Page 34 the group of elective and emergency caesarean section, there was a statistically significant difference in the mean 5th minute. Conclusion: It can be concluded from this study that in cases of inadequate pelvis, foetal weight ≥3500 grams or ≤1800 grams, footling breech presentation, post term pregnancies, vaginal breech delivery is unsafe.

Participation in Prenatal Education, Knowledge and Attitude related to Delivery, Postpartum Care, Newborn Care in Nulliparous Women

PURPOSE: This study was done to identify content of prenatal education and to examine differences in prenatal education, knowledge, and attitude of nulliparous South Korean women. METHODS: A cross-sectional survey design was used with 134 conveniently recruited nulliparous women. Data were collected through self-report questionnaires. RESULTS: Average number of institutional prenatal education programs was 5.96 at clinics, 4.31 at health care centers, and 0.49 at hospitals. Women participated in an average 5.78 out of the 35 prenatal education contents: 15 types of prenatal and delivery, 10 postpartum self-care, and 10 parenting. Score for knowledge was 7.57out of 10. Women who participated in prenatal education (n=72) reported significantly higher scores in knowledge (t=2.71, p=.008) than women who did not participate (n=62). The average score for attitude was 7.22 out of 10. Nulliparous women over 36 weeks of gestational age had significantly higher scores for attitude (t=2.38, p=.019) than women under 36 weeks. There were significant positive correlations between newborn care knowledge and postpartum care self-efficacy (r=.26, p=.026), and newborn care knowledge and parenting confidence (r=.25, p=.034). CONCLUSION: Results indicate that policy is needed to increase participation in prenatal education and to establish strategies for health care centers and hospitals to provide prenatal education.

Longitud de vagina, hiato genital y cuerpo perineal en mujeres nulíparas

Objetivo: Estimar la longitud promedio de vagina, del hiato genital y cuerpo perineal en mujeres nulíparas. Diseño: Estudio descriptivo transversal con muestreo por conveniencia. Institución: Departamento de Ginecología y Obstetricia, Hospital Nacional Cayetano Heredia, Lima, Perú. Participantes: Mujeres nulíparas. Métodos: En 85 mujeres nulíparas atendidas en el Hospital entre enero y marzo 2014, en edad fértil, que habían iniciado relaciones coitales vaginales y que requerían evaluación ginecológica, se realizó medición del peso y talla. En posición de litotomía, se midió con un hisopo milimetrado la longitud total de la vagina, hiato genital y el cuerpo perineal. Las mediciones fueron realizadas por un solo examinador. La participación fue completamente voluntaria y con firma de consentimiento informado. Principales medidas de resultados: Longitud total de la vagina, hiato genital y el cuerpo perineal. Resultados: La media de la longitud total de vagina fue 8,1 ± 1,4 cm (DE), del hiato genital 2,2 ± 0,5 cm (DE) y del cuerpo perineal 2,3 ± 0,5 cm (DE). Conclusiones: Las medidas estimadas no difieren con resultados de estudios internacionales. Se requiere estudiar una mayor muestra de pacientes de las diferentes regiones para tener un estimado más representativo de estas medidas en pacientes nulíparas del Perú.

Objectives: To determine vaginal, genital hiatus and perineal body length in nulliparous women. Design: Cross-sectional descriptive study with convenience sample. Setting: Department of Obstetrics and Gynecology, Hospital Nacional Cayetano Heredia, Lima, Peru. Participants: Nulliparous women. Methods: From January through March 2014 in 85 nulliparous women in childbearing age who had coital sex and required gynecological evaluation, weight and height were obtained and length of vagina, genital hiatus and perineal body were measured with a graph swab in lithotomy position. Measurements were obtained by one single examiner. Participation was voluntary with signed informed consent. Main outcome measures: Length of vagina, genital hiatus and perineal body. Results: Average length of patients vagina was 8.1 ± 1.4 cm (SD), genital hiatus 2.2 ± 0.5 cm (SD), and perineal body 2.3 ± 0.5 cm (SD). Conclusions: Measures obtained did not differ from international studies. A broad population study is suggested to better estimate these measures in nulliparous Peruvian women.

Meta-analysis of the relationship between the breast cancer and abortions among nulliparous women / 局解手术学杂志

Objective To evaluate the relationship between the risk of breast cancer and abortions among nulliparous women. Methods Searched the data of Cochrane Library and PubMed before June 2014 to identify potentially studies which involved the relationship between the risk of breast cancer and abortions among nulliparous women. Data was extracted by two independent authors from each study. STATA software was used for statistical analysis. Calculated the pooled RR and 95% CI as the assessment of the link between abortions and breast cancer in fixed effects models. Results 13 studies were included. The study showed the RR and 95%CI of the relationship between the risk of breast cancer and abortions was 0. 98[0. 89,1. 08],P>0. 05 in nulliparous women, and the number of abortions was not associated with the risk of breast cancer. The RR and 95%CI of the relationship between the risk of breast cancer and induced abortions or spontaneous abor-tions were 0. 96[0. 88,1. 04],1. 01[0. 88,1. 14], respectively. Conclusion There is no correlation between breast cancer and abortions a-mong the nulliparous women, and the risk of breast cancer would not increas as the number of abortions increase.

Anatomical Evaluation of Shofukukyuketsu by 3D Image Analysis / 日本東洋医学雑誌

Lower abdominal cramps, or <I>shofukukyuketsu</I> in Japanese, are thought to be one indication to use tokakujokito for the abdominal symptom of <I>oketsu</I>. To clarify the condition, anatomical analysis was performed using 3 D imaging.There were 20 women and11men entered in this study who consulted our hospital for lower abdominal pain or a sense of discomfort. Width and the thickness of the rectus muscle of the abdomen were analyzed. Moreover, gas images and feces in the intestinal tract under the abdominal wall were also observed. In addition, the presence of rectus abdominal muscle separation, or <I>shofukufujin</I> in Japanese, was evaluated. In the women, where lower abdominal cramps were a complaint, young age (53.1 ± 18.3 vs. 30.4 ± 9.8, p < 0.05), low parity (1.5 ± 1.0 vs. 0.25 ± 0.5, p < 0.05), and thickness of the abdominal rectus muscle (8.14 ± 2.5 mm vs. 12.4 ± 1.6 mm, p < 0.05) were confirmed. Also in several cases of lower abdominal cramps, feces were seen at the sigmoid colon. A significant difference was seen in the male group. Cases with lower abdominal cramps suggest involvement of local muscle spasms at the bottom of abdominal rectus muscle, which may contribute to the seemed symptom of abdominal formation. On the other hand, a mechanism different from that in women was considered in the men. This suggests that it is necessary to consider gender differences when making a Kampo diagnosis.

Anatomical Evaluation of Shofukukyuketsu by 3D Image Analysis / 日本東洋医学雑誌

Lower abdominal cramps, or <i>shofukukyuketsu</i> in Japanese, are thought to be one indication to use tokakujokito for the abdominal symptom of <i>oketsu</i>. To clarify the condition, anatomical analysis was performed using 3 D imaging. There were 20 women and11men entered in this study who consulted our hospital for lower abdominal pain or a sense of discomfort. Width and the thickness of the rectus muscle of the abdomen were analyzed. Moreover, gas images and feces in the intestinal tract under the abdominal wall were also observed. In addition, the presence of rectus abdominal muscle separation, or <i>shofukufujin</i> in Japanese, was evaluated. In the women, where lower abdominal cramps were a complaint, young age (53.1 ± 18.3 vs. 30.4 ± 9.8, p < 0.05), low parity (1.5 ± 1.0 vs. 0.25 ± 0.5, p < 0.05), and thickness of the abdominal rectus muscle (8.14 ± 2.5 mm vs. 12.4 ± 1.6 mm, p < 0.05) were confirmed. Also in several cases of lower abdominal cramps, feces were seen at the sigmoid colon. A significant difference was seen in the male group. Cases with lower abdominal cramps suggest involvement of local muscle spasms at the bottom of abdominal rectus muscle, which may contribute to the seemed symptom of abdominal formation. On the other hand, a mechanism different from that in women was considered in the men. This suggests that it is necessary to consider gender differences when making a Kampo diagnosis.