Evidence-based labor management: first stage of labor (part 3)

Counseling in maternal–fetal medicine: SARS‐CoV‐2 infection in pregnancy

“…In women with no or few symptoms, management of labor should follow routine, evidence-based guidelines for both first and second stage of labor. [54][55] SMFM suggests that amniotomy may still be utilized for labor management as clinically indicated, given the reassuring (but limited) data on vertical transmission, since SARS-CoV-2 has rarely been detected in vaginal secretions or amniotic fluid. 37 Since few reports described fetal heart rate changes in women with SARS-CoV-2 infection, it is reasonable to consider women with SARS-CoV-2 infection as "high-risk pregnancies" and as such to be managed with continuous electronic fetal heart rate monitoring, as suggested by the American College of Obstetricians and Gynecologists (ACOG) and the National Institute for Health and Care Excellence (NICE).…”

“…In women with no or few COVID-19 symptoms, management of labor should follow routine, evidence-based guidelines for both the first and second stage of labor 56,57 . SMFM suggests that amniotomy may still be utilized for labor management if clinically indicated, given the reassuring (but limited) data on vertical transmission, since SARS-CoV-2 has rarely been detected in vaginal secretions or amniotic fluid 38 .…”

Novel device vs manual examinations for the measurement of cervical dilation in labor: a randomized controlled trial

“…Much of current evidence-based management in labor is based on assessment of cervical dilation. 8 Currently, accuracy and consistency in cervical dilation measurements remains a great, unsolved problem in obstetrics, and the device did not improve inter-examiner agreement in this randomized controlled trial. Given the importance of cervical dilation measurements in the management of labor, continued efforts to refine current product concepts or invent new products and methods for increasing inter-examiner agreement are imperative efforts.…”

Quality of perinatal care for women with high-risk pregnancies during the COVID-19 pandemic in Iran

“… 36 The average level of emotional support and physical care in the first stage of labor was associated with poor scores for allowing movement during labor and giving information to the client, possibly due to a lack of understanding of women's autonomy in terms of self-care. Evidence-based information supports mobility in the first stage of labor in women without regional anesthesia 37 ; however, factors such as staff attitude and midwives' discomfort with delivery positions other than the lithotomy position may prevent its implementation. 38 At this stage, heart rate control was at the desired level, possibly due to the ease of use and availability of Sonicaid monitors.…”