View clinical trials related to Obstetric Labor.
Filter by:Prospective observational cohort study on the learning curve for the sonographic assessment of labor progress (fetal head position and station) amongst obstetric caregivers. Study participants: convenience sample of 20 obstetric caregivers working in the department of obstetrics and gynecology at the University Hospital of Leuven - recruited over a 12-month period. Format of the training program: 1. Observational phase: the goal is to measure the accuracy of the clinical assessment of fetal head position and station throughout the different stages of labor by caregivers working within the department. 2. Self-study: reading of the 2018 practice guidelines on intra-partum ultrasound by ISUOG and watching the corresponding teaching video. 3. Supervised implementation phase: one-to-one teaching by experienced sonographers, who initially demonstrate, later interactively supervise the quality of the scans acquired by the obstetric caregiver. 4. Proficiency testing: from this point onwards, the trainee independently performs ultrasound scans in labor to asses fetal head position and station. The scans will be repeated by the expert sonographer, the results will be compared (qualitatively and quantitatively) and immediate feedback provided if indicated. Every observation will have a binary outcome (success or failure of trainee acquisition) according to predefined quality assessment criteria. Observations will be continued until proficiency is reached (saturation of the learning curve).
In a prospective cohort of patients in the second phase of labor, the investigators measured the head-perineum distance and correlate it to the mode of delivery (spontaneous delivery - instrumental delivery - ceasarean section).
Purpose: To compare the efficacy and safety of low-dose protocol of vaginal misoprostol and vaginal dinoprostone insert for induction of labor in women with post-term pregnancies. Methods: The investigators designed a prospective, randomized, open-labeled, blinded for the end-point evaluators trial including women of at least 41 weeks of gestational age with uncomplicated singleton pregnancies and Bishop score lower than 6. Participants were randomized into dinoprostone or misoprostol groups in a 1:1 ratio. Baseline maternal data and perinatal outcomes were recorded for statistical analysis. Successful vaginal delivery within 24 hours was the primary outcome variable.
The CIC-IT 1403 laboratory of the University Hospital of Lille has developed a technological solution for acquiring and synchronizing abdominal ECG, acoustic and Doppler signals. The purpose of this clinical trial is to build a database of signals issued from this device to develop signal processing algorithms to allow optimization of the fetal heart rate calculation. This study will be carried out in the maternity ward of the Jeanne de Flandre Hospital in the maternal-fetal pathology department Doppler, ECG and acoustic sensors will be placed on the mother's abdomen to capture the heart rate of the fetus and mother as well as uterine contractions. For each of the participants, we will make two 15-minute recordings: one with conventional ECG electrodes and one with ECG textile electrodes. This procedure will not affect the usual care of the patient
This study aims to examine the effect of intrapartum treatment of diabetic women with combined glucose and constant insulin infusion compared to glucose alone on the incidence of neonatal hypoglycemia. Pregnant women with diabetes in pregnancy will be randomly divided during labor to 2 groups: group 1, will receive intravenous glucose with constant insulin infusion; group 2 will receive intravenous glucose alone. The primary outcome is the incidence of neonatal hypoglycemia.
Digital vaginal examination is the most common method for assessing progress of labor and delivery. Considering it is the most common intervention women receive during course of labor, evidence for psychological effects of digital vaginal examination on women is surprisingly sparse. Reducing the number of vaginal examination during labor has been proposed by many authors as benefit of more vaginal examination is unclear. However this is unlikely to happen until more research on the topic demonstrates clear detrimental effects of vaginal examination. Our study is aimed at investigating association of vaginal examination with psychological distress of women during labor. Anxiety during labor is associated with longer labor duration, increased perception of pain, problems with newborn attachment, and increased rates of postpartum depression and post-traumatic stress disorder. In this study, women were assigned to either digital vaginal examination or transperineal ultrasound assessment groups were compared to each other in a randomised controlled setting.
Mobilization, ambulation, during obstetrical work attitudes are naturally adopted by women since ancient times in many countries. The advent of the epidural in the 60s revolutionized the management of pain during childbirth. The consideration of such advance is to keep the laboring parturients lying down. Indeed at this time the use of high doses of local anesthetics charge of an engine block against formally allocate all up. In a matchless analgesic efficacy during childbirth, epidurals also offers the possibility of a secure obstetrical gesture because without general anesthesia, inhalation great purveyor in these women with full stomach. These advantages explain the considerable growth in the number of epidurals performed in obstetric work in France over the last thirty years. However, this analgesia technique will soon be implicated in the alterations of obstetric mechanics, its effects depend primarily on the nature and concentration of the products used. Evolution is then marked by a considerable reduction of concentrations of local anesthetics used with the addition of opioids, allowing to achieve an isolated analgesia without impairing motor skills, it involves the lower limbs or muscles pelvis, allowing the woman to mobilize. Ambulatory epidural and made its appearance in the early 90. Responding to women in labor demand wishing to receive effective labor analgesia without being confined to bed, she then puts to the test the dogmas and practices on how to provide analgesia that is both effective and safe. It is now well codified and used daily in some maternity hospitals. The mobilization of women during labor is a subject that motivates obstetric teams Caen University Hospital for many years. Motherhood has thus given the means for monitoring and ambulatory epidural analgesia protocol suitable for this technique. The introduction of this daily care protocol opens new possibilities of care delivery hoped more physiological and less iatrogenic. A critical evaluation of the changes possibly recorded on obstetric mechanics inherent question, motivating, for which the answers are now few and discordant in the literature. The investigators therefore propose a randomized study evaluating single-center relative to obstetrical work typically occurring in a bed, the mobilizations of repercussions out of bed, in terms of obstetrical mechanics and comfort of the parturient. Those will be objectified by a significant change in the working hours. This study included 560 patients is scheduled to last 2 years. Positive effects could also have repercussions in terms of public health and even of health economics.
Primary aim of this study is to analyse contemporary labor patterns by measuring rate of dilatation and head descent via transperineal ultrasonography. Labor curves will be generated using data regarding rate of dilatation, head-descent obtained via transperineal ultrasonography. Factors which are known to effect duration of labor will be taken into account.
The hypothesis tested is that the physical changes associated with cervical ripening result in a detectable decrease in rigidity. The main objective of this study is therefore to determine whether the measured elastographic rigidity of cervical tissues in addition to cervix size can be used to predict delivery within the next 48 hours (creation of a prognostic score).
The purpose of this research is to test a new instrument, called a fetal STAN monitor, that may be used during labor to monitor the electrical activity of the baby's heart. This new instrument is designed to help the doctor determine how well the baby is doing during labor. It will be used along with the existing electronic fetal monitor used to measure the baby's heart rate and the mother's contractions during birth. The specific purpose of this research study is to see if this new instrument (fetal STAN monitor) will have an impact on newborn health.