Newborn Apgar Score and Prediction of Maternal Death

Associations of maternal exposure to fine particulate matter constituents during pregnancy with Apgar score and duration of labor: A retrospective study in Guangzhou, China, 2012-2017

BACKGROUND

Limited evidence is available for demonstrating effects of prenatal PM_2.5 and its components exposure on Apgar score and duration of labor.

OBJECTIVE

We sought to investigate the associations between PM_2.5 constituents, Apgar score and duration of labor, and evaluated the potential mediating role of duration of labor.

METHODS

This study included 5396 participants. The V4·CH.02 was applied to assessing exposure to PM_2.5 constituents. The associations between PM_2.5 constituents Apgar score and duration of labor were examined by multivariate linear regression. Mediation analysis was conducted to estimate the potential mediation effect of duration of labor.

RESULTS

Trimester-specific exposure to soil dust was significantly associated with 1-min Apgar score (1st trimester: OR: 1.03, 95% CI:0.97, 1.10; 2nd trimester: OR: 1.07, 95% CI: 1.01, 1.14; 3rd trimester: OR: 1.07, 95% CI: 1.01, 1.13), duration of first stage of labor (1st trimester: β: 0.32, 95% CI: 0.07, 0.58; 2nd trimester: β: 0.27, 95% CI: 0.04, 0.51; 3rd trimester: β: 0.37, 95% CI: 0.13, 0.61) and duration of second stage of labor (1st trimester: β: 0.04, 95% CI: -0.00, 0.09; 2nd trimester: β: 0.05, 95% CI: 0.01, 0.10; 3rd trimester: β: 0.05, 95% CI: 0.00, 0.09). The duration of labor mediated the relationship between soil dust and 1-min Apgar score.

CONCLUSION

This study demonstrated that prenatal exposure to soil dust was significantly associated with the risk of abnormal 1-min Apgar score and extended stage of labor.

Is Uterine Myomectomy a Real Contraindication to Vaginal Delivery? Results from a Prospective Study

OBJECTIVES

The main goal of our research was to explore correlations between a history of uterine myomectomy and maternal-fetal outcomes, throughout a comparison between vaginal deliveries in patients with or without a history of uterine myoma excision.

MATERIALS AND METHODS

A prospective study was carried out at two tertiary care hospitals between January 2019 and January 2020. Women were assigned into two groups according to the history of laparoscopic or laparotomic myomectomy (Group 1) or without myomectomy (Group 2).

RESULTS

80 women successfully delivered after myomectomy. Pregnancies with previous laparoscopic or laparotomic myomectomy were associated with a minor rate of spontaneous labor onset (RR 1.17; 95% CI 1.04 - 1.31) and with an increased rate of emergency cesarean section (RR 1.22; 95% CI 1.09 - 1.36). Moreover, myomectomy group had a significant number of indications to emergency cesarean section correlated to suspected uterine rupture (RR 1.19; 95% CI 1.02-1.39). There were no uterine ruptures or neonatal deaths recorded. First stage of labor was longer in the myomectomy group (316 vs 204 mins, p = 0.01). No differences in the rates of the prolonged first and second stage of labor, postpartum hemorrhage and vaginal laceration, and no neonatal adverse outcomes were found between groups.

CONCLUSIONS

Pregnancies after myomectomy might be associated with an elevated rate of emergency cesarean section only due to a higher percentage of suspected uterine rupture, without a real hazard of adverse obstetric or neonatal outcomes.

SLK Triple Therapy Improves Maternal and Fetal Status and Promotes Postpartum Pelvic Floor Function in Chinese Primiparous Women

Background

During pregnancy, appropriate physical activity plays critical roles in maternal and fetal health. This study investigated the effects of Sophrology childbirth-Kegel-Lamaze respiratory training (SLK triple therapy) on maternal and newborn health, pelvic floor function, and quality of life.

Material/Methods

Single-pregnant primiparous women involved in this study were divided into the control group (n=120) and the SLK triple therapy group (n=120). SLK triple therapy was taught to and practiced by the women in the SLK triple therapy group. Data on delivery mode (natural delivery or cesarean section), postpartum complications (postpartum urinary incontinence, postpartum hemorrhage), and birth process were recorded. Apgar scores and body weight of newborns were evaluated. Pelvic floor function, postpartum emotion, and sexual functions were assessed.

Results

Women in the SLK triple therapy group had significantly better natural delivery rate compared to the control group (p<0.05). SLK triple therapy significantly decreased the postpartum urinary incontinence rate and reduced the postpartum hemorrhage rate compared to the control group (p<0.05). Birth process and postpartum hemorrhage volume in the SLK triple therapy group were also significantly lower compared to the control group (p<0.05). Apgar scores were significantly lower and body weights were significantly higher in the SLK triple therapy group compared to the control group (p<0.05). SLK triple therapy significantly improved pelvic floor function compared to the control group (p<0.05). SLK triple therapy significantly decreased SDS scores and enhanced FSFI scores compared to the control group (p<0.05).

Conclusions

SLK triple therapy improved maternal and fetal health by improving pregnancy outcomes, promoting postpartum pelvic floor function, reducing the incidence of depression, and enhancing sexual function. Therefore, SLK triple therapy has great utility in treating primiparous women.