جستجوی مقالات مرتبط با کلیدواژه « prolonged pregnancy » در نشریات گروه « پزشکی »

Labor induction despite unfavorable cervix leads to a prolonged phase. Several methods are provided for preparing the cervix before induction of labor to improve the probability of success labor. This study aimed to compare the effect of double-balloon catheter and misoprostol for cervical ripening and labor induction in postterm pregnancy with unfavorable cervix in Shahid Beheshti hospital, Isfahan, Iran, during 2015-16.
In a clinical trial study, 110 postterm women were randomly divided into two groups of 55. For labor induction in the first group, 100 µg misoprostol tablets and in the second group, double-balloon catheter were placed in the posterior cul-de-sac. Progress of labor was measured using Bishop score and compared between the two groups.
Findings: During the intervention, Bishop score improved from 1.69 ± 1.05 to 8.62 ± 1.52 in misoprostol group and from 1.78 ± 0.98 to 7.93 ± 1.96 in double-balloon catheter group. Mean difference of Bishop score in the first and second groups was 6.92 ± 1.74 and 6.15 ± 1.87, respectively, and the difference between the two groups was statistically significant (P = 0.025).
Using double-balloon catheter is effective at least as misoprostol to induce labor in postterm pregnant women with unfavorable cervix. As misoprostol is associated with the risk of some side effects, using double-balloon catheter is more suitable for induction of labor.

Prolonged pregnancy occurs in approximately 10% of pregnancies which can also have consequences for the mother and fetus. Since there is no statistical evaluation of the outcome of prolonged pregnancy compared with term pregnancies in Sanandaj city, this study was performed with aim to evaluate the risk factors associated with prolong pregnancy and management of them.
This analytic-descriptive study was performed with evaluation of the files of all referring pregnant women and determining the prevalence of prolong pregnancy in Sanandaj Besat hospital during 2013-2014. Then, in this population, the variables of prolonged pregnancy compared to term pregnancy were collected. Finally, these two types of pregnancy were compared in terms of frequency of the number of pregnancy, the number of delivery, maternal BMI, reduction in amniotic fluid, use of misoprostol for cervical ripening, uterine atony, response to induction, mode of delivery, decelerations of fetal heart rate, Liquid Disposal, birth weight, 1 and 5 minute Apgar scores, and NICU admission. Data were analyzed by SPSS software (version 20) and Chi-square and T tests. P Prolonged pregnancy compared with term pregnancy was significantly different in terms of maternal and neonatal complications such as the number of pregnancy, the number of delivery, use of misoprostol for cervical ripening, uterine atony, response to induction, mode of delivery (vaginal or cesarean), decelerations of fetal heart rate, the response rate to induction, decelerations of fetal heart rate, birth weight, and 1 minute Apgar score (P 0.05).
Maternal and fetal risk factors were significantly higher in prolonged pregnancies than in term pregnancies. Therefore, it is essential to use guidelines for dealing with long-term pregnancies to maintain the health of mother and neonate.

Cervical ripening in labor is one of the most important objects in midwifery. Isosorbide dinitrate (ISDN) is one of the most important agents, which has been proposed for cervical ripening, but there are still controversies regarding its prescription. The present study aimed to assess the effects of vaginal and oral ISDN for preinduction cervical ripening.
In this non-blinded clinical trial, 99 nulliparous women with term or prolonged pregnancy were selected and were randomly divided into two groups by block randomization. The intervention groups included those received vaginal ISDN (n=50, 40 mg, daily) and oral ISDN (n=49, 20 mg, twice daily). Size of ripening was measured by bishop score before treatment and 24 hours after that.
24 hours after treatment, bishop score was significantly increased (P 0.05). Duration of induction to the second phase of delivery was compared in two groups. Although there was not any significant difference between the two groups in terms of shifting time from the active phase to delivery and duration of the second phase (P > 0.05), there was a meaningful difference between two groups in duration from induction to the active phase of delivery (P Prescribing vaginal ISDN for cervical ripening was more effective than oral medication, and it seems to be with minimum side effects.

Early prediction of prolonged pregnancy for prevention of fetal asphyxia is important. The present study aimed to examine transvaginal ultrasonographic measurement of the cervical length at week 37 as a predictor of prolonged pregnancy.

This study was a descriptive-correlated design of ultrasound examination at week 37 of gestation in 126 singleton pregnant women with cephalic presentation attending for prenatal care at the southern Tehran health antepartum clinics. The length of the cervix was measured using transvaginal ultrasound and clinical and demographic data questionnaire. Gestational age at the time of delivery was calculated. Prolonged pregnancy was defined as a pregnancy that extended beyond 41 weeks of gestation. T-test, χ2 test, Logistic Regression and receiver operating characteristic curve was used for statistical analysis using the SPSS ver. 16.0.

The mean cervical length was 26.10 ±8.9. The rate of pregnancy that extended beyond 41 weeks of gestation in this study was 4.8%. The cervical length at week 37 was significantly longer in women who delivered at >41 weeks (n=6) than in those delivering at ≤41 weeks (n=120), (34.08 mm ±8.5 vs. 25.7 ±8.7 mm; P=0.02). The best cut-off value of cervical length at week 37 for the prediction of prolonged pregnancy was 25.5 mm, with a sensitivity of 100%, specificity of 50%, positive predictive value of 9%, and negative predictive value of 100%.

Cervical length at week 37 can predict the likelihood of prolonged pregnancy, but with low positive predictive value. This information can be utilized when counseling patients regarding the management of term pregnancies.

There is dearth of reports from Iran regarding the prevalence of postterm pregnancy and its complications. The present study was conducted to evaluate the prevalence, management and outcome of prolonged pregnancies. This cross-sectional study included data from the hospital records of all women referred to Shariati Hospital, Tehran, from 2001 to 2002 with pregnancies of more than 40 weeks in duration. Pregnancies ≥40-42 weeks were considered postdate and those more than 42 weeks postterm pregnancy. The data compiled from the hospital records were subjected to t, χ2 and Mann-Whitney U tests. Of the 1500 deliveries in this hospital, 98 patients were included in this study, 66.3% of whom were nullipara and 33.7% multipara. The prevalence of postterm pregnancy was estimated to be 3.3%. Cervix dilation of 2 cm or less on admission occurred in 65 women (73.3%). The mean Bishop score was 4.31. Of the 62 fetuses that underwent assessment tests, 54 (87.1%) were normal. The median time between the last test and induction of labor was 2.1 days, and 2.6 days for cesarean deliveries, which was not a significant difference (P=0.6). Cervical ripening with misoprostrol was performed in 36 cases (36.7%) and was successful in 18 cases. In this group, the median time for cervical ripening in multiparas was significantly less than nulliparas (4 vs. 7 hrs, P=0.004). Women not subjected to cervical ripening had a higher cesarean rate than those who did undergo cervical ripening (74.7% vs. 66.1%), although this difference was not significant (P=0.9). Vaginal and cesarean delivery rates showed no significant difference between cases that underwent induction with oxytocin and those subjected to cervical ripening with misoprostol (P=0.9). The mean Apgar score was 9.5, with all scores above 6. There were no cases of neonatal hypoglycemia, hypocalcemia, NICU admission or prenatal death. The mean nursery stay was 1.84 days with a range of 1-8 days. The prevalence of postterm pregnancies was 3.3% in this study, due in part to erroneous estimation of gestational age. Sonography exam in the first half of pregnancy can provide a better estimation of gestational age and thereby reduce the rate of postterm pregnancy. Cervical ripening and induction of labor shorten the duration of pregnancy; however, whether it has any beneficial effect on neonatal outcome remains controversial.

If pregnancy prolongs more than 42 weeks it is called prolonged pregnancy. It occurs in 10 percent of pregnancies. This problem increases the maternal morbidity and fetal morbidity and mortality. In order to avoid these complications and to manage prolonged pregnancies, different methods are used. The two current ways are the induction of labor at 41 weeks and the expecting management of pregnancy. The goal of this study was to compare the effectiveness of expecting management and induction in prolonged pregnancies. In this study 160 pregnant women with pregnancy age more than 41 weeks referring the Mobini Hospital in Sabzevar in the year 2005 were studied. After accurate determination of pregnancy age the patients were classified into two groups of elective induction and expecting management of pregnancy. The former group was admitted in hospital and the last were cared. Data was gathered through the questionnaire and analyzed by descriptive statistics. Results of this study showed that there was no difference in maternal and fetal complications such as meconium staining, fetal distress, and birth-time Apgar, weight and sex of neonates between the two groups. Incidence of cesarean section in elective induction was 57/5 % and in the expecting management of pregnancy was 22/5 % (p< 0/01). Also according to the results the mean time of hospitalization, differed in the two groups (2/17versus 1/17day, p < 0.05). According to the lack of maternal and fetal complications in expecting management of pregnancy, this method can be used for management of prolonged pregnancy instead of the elective induction in 41 weeks.

Unfavorable cervix is a major problem in termination of prolonged pregnancies. It is one cauese of increased cesarean section rate in these pregnancies. Prosta glandines are used for cevical ripening. In this randomized controlled trial, two groups with post term pregnancy and unfavorable cervix each included 50 patients underwent induction of labor with oxytocin. In the case group, prostaglandin suppository was used intravaginally 8 hours before induction. In this group Bishop score increased(0.75±0.69 vs 2.39±0.84)(P<0.005), and the time from beginning of induction to delivery was shorter than control group 574.8±280.1 vs 843.04±412.8 min)(P<0.005). C/S rate was the same intwo groups. The only side effect of PGE2 was nausea. It can be concluded that PGE2 vaginal suppoditory is useful for ripening of cervix and decreasing the duration of induction withoutserious side effects.