AbstractObjective: Our objective was to evaluate the impact of a standardized induction protocol on reducing maternal and neonatal morbidity in women undergoing an induction with an unfavorable cer...
#1Dana Vitner(Rappaport Faculty of Medicine)H-Index: 5
#2Inna Bleicher(Rappaport Faculty of Medicine)H-Index: 2
Last. Ron Gonen(Rappaport Faculty of Medicine)H-Index: 22
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AbstractObjective: We aimed to compare maternal morbidity and mortality of cesarean sections (CS) in the second versus first stage of labor.Study design: Retrospective study of all CS at a single, university-affiliated medical center, between January 2010 and December 2014. Eligibility was limited to term, singleton pregnancies with cephalic presentation. Maternal outcomes of second-stage CS were compared to those of first-stage CS. The primary outcome was defined as estimated blood loss >1000 m...
Last. George A. Macones(WashU: Washington University in St. Louis)H-Index: 18
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Abstract Background The perinatal and maternal consequences of induction of labor at 39 weeks among low-risk nulliparous women are uncertain. Methods In this multicenter trial, we randomly assigned low-risk nulliparous women who were at 38 weeks 0 days to 38 weeks 6 days of gestation to labor induction at 39 weeks 0 days to 39 weeks 4 days or to expectant management. The primary outcome was a composite of perinatal death or severe neonatal complications; the principal secondary outcome was cesar...
#1Annessa Kernberg(OHSU: Oregon Health & Science University)H-Index: 4
#2Aaron B. Caughey(OHSU: Oregon Health & Science University)H-Index: 91
: Labor augmentation can be used to hasten labor, shorten the time to delivery, and perhaps reduce the risk of cesarean delivery. Particularly in women with longer labors or less frequent contractions, oxytocin augmentation seems to have positive impacts on these outcomes. Despite this, the evidence for augmentation alone on the risk of cesarean delivery is unclear, with varying evidence. More recently, oxytocin protocols have been recommended to standardize care and ensure patient safety.
AbstractObjective: To examine the outcomes of vaginal birth after cesarean (VBAC) in women, in spontaneous labor, delivering after 37 weeks’ gestation at an institution where trial of labor after a previous cesarean delivery (TOLAC) is encouraged and management of labor is standardized.Methods: This retrospective cohort study included 3071 women with one previous cesarean only and no vaginal delivery who underwent a trial of labor from 2001 to 2011. Women were managed using the standardized “act...
OBJECTIVE:To evaluate the effectiveness of four commonly used induction methods.METHODS:This randomized trial compared four induction methods: misoprostol alone, Foley alone, misoprostol–cervical Foley concurrently, and Foley–oxytocin concurrently. Women undergoing labor induction with full-term (37
Last. Brian M. Mercer(Case Western Reserve University)H-Index: 99
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The rise in maternal morbidity and mortality has resulted in national and international attention at optimally organizing systems and teams for pregnancy care. Given that maternal morbidity and mortality can occur unpredictably in any obstetric setting, specialists in general obstetrics and gynecology along with other primary maternal care providers should be integrally involved in efforts to improve the safety of obstetric care delivery. Quality improvement initiatives remain vital to meeting t...
Background: Cesarean delivery is the most common inpatient surgery in the United States, where 1.3 million cesarean sections occur annually, and rates vary widely by hospital. Identifying sources of variation in cesarean use is crucial to improving the consistency and quality of obstetric care. We used hospital discharge records to examine the extent to which variability in the likelihood of cesarean section across US hospitals was attributable to individual women’s clinical diagnoses. Methods a...
#1Methodius G. Tuuli(WashU: Washington University in St. Louis)H-Index: 33
#2Lucy Liu(WashU: Washington University in St. Louis)H-Index: 6
Last. Alison G. Cahill(WashU: Washington University in St. Louis)H-Index: 33
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Objective The objective of the study was to compare maternal and neonatal infectious morbidity following cesareans performed in the second and first stages of labor. Study Design We conducted a retropective cohort study of all consecutive, singleton, term, cesarean deliveries in laboring women in a single institution from 2005 to 2012. Second-stage cesareans were defined as those performed at complete cervical dilation (10 cm), and first-stage cesareans were those performed before 10 cm cervical...
AbstractIn this observational study, we investigated the maternal and perinatal complications of caesarean delivery performed in the second stage compared with the first stage of labour at a tertiary hospital in Istanbul. This study was performed from June 2008 to July 2011. Primary maternal outcomes measured included intraoperative surgical complications, surgery duration, need for blood transfusion, endometritis, requirement for hysterectomy, unintended extension and length of hospital stay. N...
#1Rebecca F. Hamm(UPenn: University of Pennsylvania)H-Index: 4
#2Rinad S. Beidas(UPenn: University of Pennsylvania)H-Index: 41
Last. Lisa D. Levine(UPenn: University of Pennsylvania)H-Index: 15
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Standardized labor induction protocols utilizing evidence-based active management practices are associated with improved obstetric outcomes. However, these protocols are complex and include multipl...
