Reverse Breech Extraction Versus Push Technique for Fetal Delivery When Fetal Head is Deeply Impacted...
Obstructed Labor at Second Stage of LaborManagement of impacted fetal head during second stage cesarean requires careful and gentle attention to various surgical steps for delivery of a fetus without adverse maternal and neonatal outcomes, mostly by an experienced surgeon as in such situations, the lower uterine segment may be over-distended and indistinguishable from the vagina. Therefore, the uterine incision may inadvertently be placed too low, or in the vagina. Also, it may be difficult for the operating surgeon to maneuver his hand below the deeply engaged fetal head, which may be further compounded by the presence of molding and edema on the fetal head (caput succedaneum). This prospective controlled study was conducted at labor ward of department of obstetrics and gynecology at Ain Shams University Maternity Hospital to compare between the two techniques. A total of 70 pregnant women were enrolled and divided into two equal groups.
The REDUCED Trial: REDucing the Utilization of CEsarean Sections for Dystocia
Cesarean SectionDystociaThis project is a clustered randomized controlled trial of a knowledge translation intervention of new ACOG guidelines for the diagnosis of poor progress in labor. The intent is to reduce the rate of cesarean section (CS) in first time mothers at term (>= 37 weeks), with a vertex presenting singleton fetus, without increasing maternal or neonatal morbidity. The guidelines were developed from data from the Consortium for Safe Labor. The unit of randomization will be sites in Alberta that deliver
Learning Skills in Shoulder Dystocia Delivery Using Simulator Models
Shoulder Dystocia - DeliveredBirth DisorderLearning skills on shoulder dystocia on doctor and midwife
The Norwegian World Health Organisation Labour Care Guide Trial (NORWEL)
Labor DystociaLabor Complication7 moreAppropriate and timely care during birth is critical to the survival and health of women and their babies. In 2020, the World Health Organization (WHO) presented the Labour Care Guide (LCG) as the new recommended tool for monitoring birth and assessing progression, replacing the WHO partograph. This evidence-based guide was designed to ensure improved quality and safety of care, and to avoid unnecessary interventions during birth. The LCG was developed to be used in all settings globally, but it has only been tested in health facilities in South America, Asia and Africa, while it has not been tested in high-income settings. Implementing a new guideline for monitoring birth is a comprehensive operation that will affect both the national economy, health systems, and individual patients; therefore, further research on the possible advantages is needed before national enrolment. Hence, the trial proposed in this application is crucial to form the required foundation of knowledge. The trial will be conducted in labour wards at ten hospitals, covering all health regions in Norway, and the established Norwegian Research Network for Clinical Studies in Obstetrics (NORBIRTH), with dedicated local principal investigators, will provide a robust research environment. This trial will test the effect of the LCG. Results from this trial will provide knowledge needed to determine a future implementation of the LCG in Norway.
Effects of Systematic Cervical Exam Training on Labor and Delivery Care
Delivery ProblemCervix; Pregnancy1 moreAll physicians, nurses, and nurse midwives working on Labor and Delivery will be required to complete cervical exam simulation training. Data before and after institution of the training will be compared to determine if the training leads to less cervical exams during labor and increases consistency between examiners
Safety and Effectiveness of the Yaari Extractor for Management of Shoulder Dystocia
Shoulder DystociaProspective, multi-center, single arm with historical control, to verify the safety and effectiveness of the Yaari Extractor used by board certified or board eligible U.S. OB/GYN physicians in the management of shoulder dystocia.
Labor Scale Versus WHO Partograph for Management of Labor (ScaLP)
DystociaThe current study aims at evaluating the impact of the implementation of the labor scale, in comparison to the standard WHO partograph, in the management of primiparous women, including CD rate, maternal and neonatal outcomes of labor.
Early Diagnosis and Intervention for Fetal Malposition in Active Labor and Its Impact on Mode of...
Cesarean Delivery Affecting FetusLabor Dystocia1 moreThe goal of this randomized trial is to test if changing a person's position in labor can increase the chances of delivering their baby vaginally. Specifically, it aims to answer the questions: In fetuses who are facing upwards (occiput posterior, OP) or sideways (occiput transverse, OT) during labor, does changing the patient's position during active labor to a side-lying posture with a peanut ball increase the chances of them having a successful, spontaneous vaginal delivery? Does changing the patient's position in active labor affect the position of the baby at the time of delivery? Do intentional position changes in labor impact patient-perceived autonomy during their labor and delivery experience? Participants will: Receive an ultrasound during labor to determine the position of their baby Be asked to adopt a specific position in labor (side-lying with peanut ball) if they are randomized to the study group Receive additional ultrasounds during labor to assess their baby's position Fill out a questionnaire about their labor experience following the delivery of their baby
The Labour Progression Study, a Cluster Randomised Trial on Labour Progression for First Time Mothers...
Caesarean SectionsAugmentation With Oxytocin1 moreThe purpose of this study is to evaluate if the rate of emergency caesarean section can be reduced if adhering to a dynamic labour progression curve compared to a static progression curve for first time mothers without jeopardising maternal and neonatal outcomes
Body Fat Index for Obstetric Risk Stratification
Gestational DiabetesPre-Eclampsia1 morePrimary Outcome:- GDM Diagnosis Secondary Outcomes:- Pre-eclampsia diagnosis. Cesarean section delivery due to labor dystocia defined as protracted or arrested progress of labor using labor partogram.