Displaying all 7 publications

  1. Goh YP, Tan PC, Hong JGS, Sulaiman S, Omar SZ
    Int J Gynaecol Obstet, 2021 Dec;155(3):532-538.
    PMID: 33484158 DOI: 10.1002/ijgo.13613
    OBJECTIVE: To evaluate the combined effect of massage and warm compress to the perineum (MassComp) compared with standard "hands-off" in the second stage of labor.

    METHODS: A randomized trial was conducted in a University hospital in Malaysia. Nulliparous women at term who were about to start pushing were randomized to massage during pushing and warm compress to the perineum in between pushes or to standard "hands-off" care. Primary outcome was suturing for perineal injury (episiotomy or tear).

    RESULTS: A total of 156 participants were analyzed based on intention to treat. Perineal repair rates were 53/79 (67%) for MassComp versus 70/77 (91%) for control (relative risk [RR] 0.72, 95% confidence interval [CI] 0.61-0.98, number needed to treat for an additional beneficial outcome [NNTb ] 5, 95% CI 2.83-8.62, P second degree or higher) rates 34/79 (43%) versus 51/77 (66%) (RR 0.72, 95% CI 0.58-0.97, NNTb 5, 95% CI 2.61-12.56, P = 0.004), episiotomy rates 28/79 (37%) versus 40/77 (53%) (RR 0.72, 95% CI 0.52-0.98, NNTb 8, 95% CI 3.63-36.46, P = 0.043), intervention to delivery intervals 29.5 ± 13.6 versus 27.9 ± 13.8 minutes (P = 0.472) and spontaneous vaginal delivery rates 63/79 (79.7%) versus 56/77 (72.7%) (RR 1.11, 95% CI 0.92-1.34, P = 0.306) for MassComp versus control, respectively.

    CONCLUSION: Massage and warm compress during pushing decreased the perineal suturing, major perineal injury, and episiotomy rates and improved maternal satisfaction.

    CLINICAL TRIAL REGISTRATION: https://doi.org/10.1186/ISRCTN42773879.

    Matched MeSH terms: Labor Stage, Second
  2. Upawi SN, Ahmad MF, Abu MA, Ahmad S
    Midwifery, 2022 Feb;105:103238.
    PMID: 34968819 DOI: 10.1016/j.midw.2021.103238
    OBJECTIVE: to compare the effect of amniotomy with early vs delayed oxytocin infusion on successful vaginal delivery.

    DESIGN: randomised controlled trial of nulliparous women with spontaneous labour at term.

    SETTING: labour suite of a university teaching hospital in Kuala Lumpur, Malaysia.

    PARTICIPANTS: 240 women were included (120 randomised into two arms).

    INTERVENTIONS: the randomisation sequence was generated using a computer randomisation program in two blocks: oxytocin infused early following amniotomy; and oxytocin infused 2 h after amniotomy.

    MEASUREMENTS AND FINDINGS: labour duration, mode of delivery, oxytocin dosage used, uterine hyperstimulation, postpartum haemorrhage, Apgar score and admission to the neonatal intensive care unit were recorded. No differences in vaginal delivery rate (62.9% vs 70.9%; p = 0.248) and second-stage labour were found between the early and delayed oxytocin infusion groups (21.2 ± 18.3 min vs 25.5 ± 19.9 min; p = 0.220). The mean interval from amniotomy to vaginal delivery was significantly shorter for the early group (5.8 ± 1.7 h vs 7.0 ± 1.9 h; p = 0.001), and more women in the early group delivered during/before the planned review at 4 h after amniotomy (53.6% vs 10.6%; p<0.001). Maximum oxytocin usage was lower in the early group (5.6 ± 4.4 mL/hour vs 6.8 ± 5.3 mL/hour; p = 0.104).

    KEY CONCLUSIONS: early oxytocin augmentation following amniotomy could be employed in low-risk primigravida, given that it is associated with a shorter labour duration without jeopardising maternal or neonatal outcomes.

    IMPLICATIONS FOR PRACTICE: low-risk primigravida benefit from early oxytocin infusion following amniotomy, and this can be offered as an additional practice in labour room care.

    Matched MeSH terms: Labor Stage, Second
  3. Nordström L, Achanna S, Naka K, Arulkumaran S
    BJOG, 2001 Mar;108(3):263-8.
    PMID: 11281466
    To determine longitudinally fetal and maternal blood lactate concentrations during the second stage of labour.
    Matched MeSH terms: Labor Stage, Second/blood*
  4. Norzilawati MN, Shuhaila A, Zainul Rashid MR
    Singapore Med J, 2007 Jun;48(6):e174-6.
    PMID: 17538741
    A 21-year-old primigravida with previous history of pulmonary tuberculosis had a normal but assisted vaginal delivery after a prolonged second stage. Within 12 hours, she complained of dyspnoea and was found to have abnormal neck and anterior chest wall swelling. A diagnosis of subcutaneous emphysema was made and this was confirmed with the chest radiograph, which also revealed pneumomediastinum. She recovered well within four days with conservative treatment.
    Matched MeSH terms: Labor Stage, Second/physiology
  5. Siti Hayati Mohd Nahwari, Bahiyah Abdullah, Suzanna Daud, Norhana Mohd Kasim, Norhana Mohd Kasim
    This case series highlights the outcome of four pregnancies complicated with COVID-19, as
    the pandemic of coronavirus disease 2019 (COVID-19) poses a lot of uncertainties due to lack
    of scientific evidence in guiding the management of pregnancy with COVID-19. The women
    were between 25 and 31 years of age and of 35 - 39 weeks of gestation with no underlying
    medical problems. Three women were delivered via caesarean section and one woman was
    delivered via ventouse delivery due to poor progress during the second stage of labour. Two
    women were in stage 4 of the disease (having breathing difficulties and requiring oxygen
    support) at presentations. One of them was treated with hydroxychloroquine (HC) only while
    another one was treated with both HC and antiviral medications; none required assisted
    ventilation during their hospitalizations. There is no vertical transmission of COVID-19 disease
    observed in this case series.
    Matched MeSH terms: Labor Stage, Second
  6. Norziah Aman, Fatimah Sham, Rashidah Bahari, Aminuddin Ahmad, Normala Salim
    Introduction: Epidural analgesia is the most effective method for intra-partum pain relief and most widely applied during childbirth. Various adverse effects of epidural analgesia have been described such as lower rate of sponta- neous vaginal delivery, a higher rate of instrumental vaginal delivery and prolongation of labour, however it remains controversial. The aim of this study to determine the effect of epidural on maternal outcome. The objective of this study was to assess the effect of epidural analgesia on the mothers with epidural and non epidural parturient at Hospital Putrajaya. Methods: Retrospective cohort study was used to collect data through Total Hospital Informa- tion System (THIS) on all delivery cases in Hospital Putrajaya from 1st January to 31st December 2016. A total of 906 mothers was retrospectively investigated in a cohort of 8000 delivery; and was divided into two groups of 453 mothers with epidural analgesia and non-epidural analgesia. Data were analysed using inferential statistics. Results: The mean age in this study was 30.1±4.1 years old with body mass index (BMI) was 28.5±4.5. Univariate analysis demonstrated that epidural group have lower rate of instrumental delivery (34.4%) and caesarean section (30.5%). However, they required more oxytocin used for augmentation (66.4%). The mean duration of first stage of labour was prolong in epidural group (6.0±2.5 hours) compared with non-epidural group (4.3±1.7 hours) while the duration of second stage of labour was also prolong in epidural group (15±19 min) as compared with non-epidural (7±11 min). Conclusion: Epidural analgesia had better maternal outcomes in term of mode of delivery but had adverse effects on duration of labour and oxytocin used.

    Matched MeSH terms: Labor Stage, Second
  7. Kamisan Atan I, Lai SK, Langer S, Caudwell-Hall J, Dietz HP
    Int Urogynecol J, 2019 06;30(6):917-923.
    PMID: 30741317 DOI: 10.1007/s00192-019-03887-z
    INTRODUCTION AND HYPOTHESIS: Forceps delivery and length of second stage are risk factors of maternal birth trauma, i.e., levator ani muscle (LAM) avulsion and anal sphincter trauma. The cesarean section (CS) rate has recently become the key performance indicator because of its increase worldwide. Attempts to reduce CS rates seem to have led to an increase in forceps deliveries and longer second stages. This study aimed to determine the association between variations in obstetric practice (between hospitals) and maternal birth trauma.

    METHODS: This was a retrospective ancillary analysis involving 660 nulliparous women carrying an uncomplicated singleton term pregnancy in a prospective perinatal intervention trial at two Australian tertiary obstetric units. They had been seen antenatally and at 3-6 months postpartum for a standardized clinical assessment between 2007 and 2014. Primary outcome measures were sonographically diagnosed LAM and external anal sphincter (EAS) trauma.

    RESULTS: The incidence of LAM avulsion (11.5% vs. 21.3%, P = 0.01) and composite trauma, i.e., LAM avulsion ± EAS injury (29.2% vs. 39.7%, P = 0.03) were higher in one of the two hospitals, where the forceps delivery rate was also higher (10.9% vs. 2.6%, P second stage (OR 1.01, P = 0.02) and forceps delivery (OR 5.24, P 

    Matched MeSH terms: Labor Stage, Second
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