1
|
Li H, Yang L, Peng J, Cheng W, Ma H, Wu S, Wen J, Zhao Y. Duration time of labor progression for pregnant women of vaginal birth after cesarean in Hubei, China. Ir J Med Sci 2024:10.1007/s11845-023-03600-6. [PMID: 38169049 DOI: 10.1007/s11845-023-03600-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE There have been limited reports on the duration of labor progression in pregnant women undergoing vaginal birth after cesarean (VBAC). This study aimed to investigate the duration of labor progression during VBAC in Hubei, China. METHODS A total of 359 pregnant women undergoing VBAC were enrolled as the VBAC group, meeting the following criteria: singleton pregnancy, gestational age ≥ 37 weeks, live birth, history of cesarean delivery, and a willingness to attempt a vaginal delivery. At the same time, 359 primiparas successfully undergoing vaginal delivery were randomly enrolled in the control group at a 1:1 ratio. Subsequently, the durations of the first, second, and third stages of labor were comparatively analyzed between the two groups. RESULTS The duration of the first, second, and total stages of labor in the VBAC group was significantly shorter than that in the control group (p < 0.05). There was no significant difference in the duration of the third stage of labor between the two groups (p > 0.05). The amount of blood loss, the rate of postpartum hemorrhage (PPH), and episiotomy were higher in the VBAC group than in the control group (p < 0.05). The rate of labor analgesia and intrapartum fever in the VBAC group was significantly lower than that in the control group (p < 0.05). CONCLUSION The duration of labor progression of the first, second, and total stages of VBAC is shorter than that in primiparous women in our observation in China.
Collapse
Affiliation(s)
- Hao Li
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China
| | - Lijun Yang
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China
| | - Jing Peng
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China
| | - Wenxing Cheng
- Department of Gynaecology and Obstetrics, Wuhan University of Science and Technology, No. 2, Huangjiahu West Road, Hongshan District, Wuhan, 430065, China
| | - Hongwen Ma
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China
| | - Shiyao Wu
- Department of Gynaecology and Obstetrics, Wuhan University of Science and Technology, No. 2, Huangjiahu West Road, Hongshan District, Wuhan, 430065, China
| | - Jiao Wen
- Department of Gynaecology and Obstetrics, Wuhan University of Science and Technology, No. 2, Huangjiahu West Road, Hongshan District, Wuhan, 430065, China
| | - Yun Zhao
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China.
| |
Collapse
|
2
|
Li Y, Zhang L, Huang L, Liang Y, Chen J, Bi S, Deng W, Lin L, Wang X, Ren L, Zeng S, Huang M, Huang B, Zhang Y, Xie S, Du L, Chen D. Association between the second-stage duration of labor and perinatal outcomes in women with a prior cesarean delivery. BMC Pregnancy Childbirth 2022; 22:543. [PMID: 35790947 PMCID: PMC9254554 DOI: 10.1186/s12884-022-04871-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background The cesarean delivery (CD) rate has been increasing globally. Trial of labor after cesarean delivery (TOLAC) has been used as a key method for the reduction of the CD rate. Little is known, however, about the association between the second-stage duration of TOLAC and adverse maternal and neonatal outcomes. This study evaluated the association between perinatal outcomes and the duration of second-stage labor in women undergoing TOLAC. Methods A 10-year retrospective cohort study was performed at the Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, between January 2010 and January 2020. Women undergoing TOLAC who reached the second stage of labor were included in this study. Duration of the second stage of labor was examined as a categorical variable (group I: <0.5 h, group II: 0.5–2 h and group III: ≥2 h) and as a continuous variable to evaluate the association with adverse perinatal outcomes by using multivariable regression models and a Cox proportional hazards regression model adjusting for potential confounders. Results Of the 1,174 women who met the inclusion criteria, the median (interquartile range) length of the second stage was 0.5 h (0.3–0.9 h). Among them, 1,143 (97.4%) delivered vaginally and 31 underwent an unplanned CD. As the second-stage duration increased, operative vaginal delivery (OVD), CD, and postpartum hemorrhage (PPH) rates increased. Women in group III had higher risks of OVD (aOR = 11.34; 95% CI [5.06–25.41]), CD (aOR = 4.22; 95% CI [1.32–13.43]), and PPH (aOR = 2.43; 95% CI [1.31–4.50]) compared with group I. Correspondingly, blood loss and the oxytocin used to treat PPH increased significantly, while the postpartum hemoglobin reduced significantly in group III compared with group I. The incidence of uterine rupture, uterine atony, cervical laceration, red blood cell transfusion, and intensive care unit admission were similar in all three groups. Neonatal outcomes were not affected by the second-stage duration. Conclusions Women undergoing TOLAC with second-stage duration of ≥2 h have higher odds of OVD, unplanned intrapartum CD, and PPH. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04871-0.
Collapse
Affiliation(s)
- Yulian Li
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Lizi Zhang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Lijun Huang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Yingyu Liang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Jingsi Chen
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Shilei Bi
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Weinan Deng
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Lin Lin
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Xiaoyi Wang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Luwen Ren
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Shanshan Zeng
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Minshan Huang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Baoying Huang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Yijian Zhang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Sushan Xie
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Lili Du
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China. .,The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, 510150, China.
| | - Dunjin Chen
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Engineering and Technology Research Center of Maternal-Fetal Medicine, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China. .,The Third Affiliated Hospital of Guangzhou Medical University, The Medical Center for Critical Pregnant Women in Guangzhou, 63 Duobao Road, Liwan District, Guangzhou, 510150, China.
| |
Collapse
|
3
|
Chuai Y, Jiang W, Xu X, Wang A, Yao Y, Chen L. Maternal oxygen exposure may not change umbilical cord venous partial pressure of oxygen: non-random, paired venous and arterial samples from a randomised controlled trial. BMC Pregnancy Childbirth 2020; 20:510. [PMID: 32887557 PMCID: PMC7650259 DOI: 10.1186/s12884-020-03212-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/26/2020] [Indexed: 02/02/2023] Open
Abstract
Background Despite the widespread use of oxygen (O2) in intrauterine resuscitation, the obstetric scientists’ understanding of O2 therapy is full of contradictions. We tested the hypothesis that higher maternal arterial partial pressure of oxygen (PO2) is associated with higher umbilical cord venous PO2 (UvPO2). Methods This is a planned secondary analysis of a randomised controlled trial (RCT), 443 normal women were 1:1 randomly allocated to receive 2 L/min O2 or room air from the onset of second stage to delivery. We reported that maternal 2 L/min O2 exposure cannot affect the umbilical cord arterial pH or the fetal heart rate (FHR) pattern. In 217 non-random samples, we found 2 L/min O2 exposure increased the maternal arterial PO2 to the median 150 mmHg (hemoglobin would be saturated). The primary outcome for this analysis was UvPO2 in these non-random samples. Results There were no significant differences between the O2 group (N = 107) and the control group (N = 110) in the UvPO2 (median 30.2, interquartile 25.4–35.2 versus median 28.3, interquartile 23.4–35.3, mmHg, P = 0.379). There were also no significant differences between room air and different percentiles of O2 exposure duration (< 25th, ≧ 25th < 50th, ≧ 50th < 75th, ≧ 75th percentile) in the UvPO2. Conclusions Maternal O2 exposure at super-physiological levels (median arterial blood PO2 150 mmHg) in normal labor may not change the UvPO2. Clinical trial registration ClinicalTrials.govNCT02221440, first posted in 20 August 2014.
Collapse
Affiliation(s)
- Yunhai Chuai
- Chinese PLA General Hospital, Medical School of Chinese PLA, Fuxing Road No. 28, Beijing, 100853, China.,Department of Obstetrics and Gynaecology, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wen Jiang
- Department of Obstetrics and Gynaecology, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiaobin Xu
- Department of Anaesthesia, Chaoyang Chinese Traditional and Western Medicine Emergency Medical Center, Beijing, China
| | - Aiming Wang
- Department of Obstetrics and Gynaecology, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yuanqing Yao
- Chinese PLA General Hospital, Medical School of Chinese PLA, Fuxing Road No. 28, Beijing, 100853, China. .,Department of Obstetrics and Gynaecology, First Medical Center, Chinese PLA General Hospital, Beijing, China.
| | - Lei Chen
- Chinese PLA General Hospital, Medical School of Chinese PLA, Fuxing Road No. 28, Beijing, 100853, China. .,Department of Obstetrics and Gynaecology, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China.
| |
Collapse
|
4
|
Hayata E, Nakata M, Takano M, Umemura N, Nagasaki S, Oji A, Maemura T, Katagiri Y, Morita M. Safety of uterine fundal pressure maneuver during second stage of labor in a tertiary perinatal medical center: A retrospective observational study. Taiwan J Obstet Gynecol 2019; 58:375-379. [PMID: 31122528 DOI: 10.1016/j.tjog.2018.10.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2018] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the conformity of the indications and implementation status of uterine fundal pressure maneuver (UPFM) and to examine its safety according to the Japan Society of Obstetrics and Gynecology (JSOG) guidelines. MATERIALS AND METHODS We selected all the patients (n = 265) who were treated with UFPM between January 2015 and March 2017. We first evaluated the conformity of the indications and implementation status of UFPM concerning the guidelines for obstetrical practice in Japan, 2017. Second, we retrospectively examined maternal and fetal adverse events (AEs) to determine the safety of UFPM. RESULTS In total, 265 patients underwent UFPM; of all the UFPM-assisted deliveries, 189 patients (72%) were evaluated for conformity. Of these 189 patients, 181 (95.7%) were confirmed to be compliant. Laceration of the birth canal was the most frequently occurring maternal AE, followed by cervical laceration. No cases of uterine rupture, severe AEs leading to an extended hospital stay, and maternal deaths were observed. Although fetal AEs requiring admission to neonatal intensive care unit (NICU) were recorded for 33 patients (12.5%), all newborns developed normally without sequela. CONCLUSION The findings of this study may support the validity of the 2017 guidelines. Because it is difficult to find evidence of the safety of use of UFPM, it is essential to accumulate experiences and results learned in clinical practice to build a consensus in the future using the current 2017 guidelines as a standard as done in the current study.
Collapse
Affiliation(s)
- Eijiro Hayata
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan
| | - Masahiko Nakata
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan.
| | - Mayumi Takano
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan
| | - Nahomi Umemura
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan
| | - Sumito Nagasaki
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan
| | - Ayako Oji
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan
| | - Toshimitsu Maemura
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan
| | - Yukiko Katagiri
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan
| | - Mineto Morita
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan
| |
Collapse
|