Routine vaginal examinations compared to other methods for assessing progress of labour to improve outcomes for women and babies at term

Moncrieff, Gill; Gyte, Gillian ML; Dahlen, Hannah; Thomson, Gill; Singata‐Madliki, Mandisa; Clegg, Andrew; Downe, Soo

doi:10.1002/14651858.cd010088.pub3

Cited by 16 publications

(22 citation statements)

References 88 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hu et al [ 25 ] demonstrated that fetal distress is associated with endogenous opioids, measuring concentrations of plasmatic endogenous opioid neuropeptides (EOP), such as beta-endorphin, endorphin A [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ], and leu-enkephalin, measured by radioimmunoassay. They detected that the modifications in EOP levels in umbilical artery may play an important role in fetal distress, in the pathophysiological changes [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prolonged Dystocic Labor in Neuraxial Analgesia and the Role of Enkephalin Neurotransmitters: An Experimental Study

Malvasi

Cicinelli

Baldini

et al. 2023

IJMS

View full text Add to dashboard Cite

The investigation studied the enkephalinergic neuro fibers (En) contained in the Lower Uterine Segment (LUS) during the prolonged dystocic labor (PDL) with Labor Neuraxial Analgesia (LNA). PDL is generally caused by fetal head malpositions in the Occiput Posterior Position (OPP), Persistent Occiput Posterior Position (POPP), in a transverse position (OTP), and asynclitism (A), and it is detected by Intrapartum Ultrasonography (IU). The En were detected in the LUS samples picked up during cesarean section (CS) of 38 patients undergoing urgent CS in PDL, compared to 37 patients submitted to elective CS. Results were statistically evaluated to understand the differences in En morphological analysis by scanning electron microscopy (SEM) and by fluorescence microscopy (FM). The LUS samples analysis showed an important reduction in En in LUS of CS for the PDL group, in comparison with the elective CS group. The LUS overdistension, by fetal head malpositions (OPP, OTP, A) and malrotations, lead to dystocia, modification of vascularization, and En reduction. The En reduction in PDL suggests that drugs used during the LNA, usually local anesthetics and opioids, cannot control the “dystocic pain”, that differs from normal labor pain. The IU administration in labor and the consequent diagnosis of dystocia suggest stopping the numerous and ineffective top-up drug administration during LNA, and to shift the labor to operative vaginal delivery or CS.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In the last thirty years, intrapartum ultrasonography (IU) proved to be a good diagnostic tool, associated with the vaginal digital examination, for fetal malpositions and malrotations detection in the birth canal [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Prolonged Dystocic Labor in Neuraxial Analgesia and the Role of Enkephalin Neurotransmitters: An Experimental Study

Malvasi

Cicinelli

Baldini

et al. 2023

IJMS

View full text Add to dashboard Cite

show abstract

“…In a study conducted by Uzel and Yanıkekrem to determine the preferences of women regarding evidence-based practices in the intrapartum period, it was determined that only 0.6% of women were allowed for oral intake during delivery [19]. Despite the recommendations of international organizations, it is reported that midwives frequently perform unregistered vaginal examinations [20]. In the study conducted by Stepherd and Cheyne to determine the causes and frequency of vaginal examination during delivery, it was determined that almost 70% of the healthcare team performed vaginal examinations at intervals of more than four hours [21].…”

Section: Discussionmentioning

confidence: 99%

Components of obstetric violence: A descriptive study on physical abuse, non-consented care and non-confidential care

et al. 2022

View full text Add to dashboard Cite

This study aimed at assessing the components of obstetric violence of women in receiving care during labor and postnatal period.Material and methods: This research was designed as a web-based descriptive study. The study was conducted with 556 women who had a vaginal delivery were within the first 6 weeks after delivery. The data of the research were collected between November-December 2021.Results: The mean age of women was 27.33±5.75, and the mean gestational week was 38.96±1.42. It was determined that while 95% of the women who underwent the intervention had a vaginal examination for less than 4 hours, 86.9% of them had no freedom of positioning at birth, and information was not provided to 41.2% of them before shaving, 22.2% of them before the amniotomy, 6.3% of them before oxytocin administration, 7.8% of them before episiotomy administration, 23.6% of them before fundal pressure, and 88.9% of them before vacuum support. It was found that 69.8% of the women did not have a companion during the delivery process, 67.1% of them were not involved in the decisions during the delivery process, and 93.9% of them asked for getting permission and providing information in the interventions during the delivery process. Additionally, the difference between the distributions of exposure to obstetric violence according to some sociodemographic and obstetric characteristics of the women was not statistically significant (p<0.05). Conclusion:According to the result of the study, it was determined that women were subjected to some types of obstetric violence during labor and the delivery process.

show abstract

“…Particularly, labor is usually monitored to ensure that there are no signs of abnormal progress that might be harmful to mother or baby. The method most commonly used is routine vaginal examination (undertaken at regular time intervals) in order to provide information on cervical dilatation and the position of the baby [17]. However, evidence suggests that the manual vaginal examination might lead to errors (up to 88% of cases) and has limitations in indicating labor progression [18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

The success of vaginal birth by use of trans-labial ultrasound plus vaginal examination and vaginal examination only in pregnant women with labor induction: a comparative study

Nouri-Khasheh-Heiran

Montazeri

Conversano

et al. 2023

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background Predicting the success of vaginal delivery is an important issue in preventing adverse maternal and neonatal outcomes. Thus, this study aimed to compare the success rate of vaginal birth by using trans-labial ultrasound and vaginal examination, and vaginal examination only in pregnant women with labor induction. Methods This was a comparative study including 392 eligible pregnant women with labor induction attending to a teaching hospital affiliated with Iran University of Medical Sciences from April to October 2018 in Tehran, Iran. Women were randomly assigned to two groups; the trans-labial ultrasound plus vaginal examination (group A), and the vaginal examination only (group B). Women were included in the study if they satisfied the following criteria: singleton pregnancy, 37 to 42 weeks of gestational age, fetal head presentation, a living fetus with no abnormalities, uncomplicated pregnancy, and no previous cesarean section or any uterine surgery. We used a partograph for both groups to assess the fetal head position and the fetal head station. In group 1, the Angle of Progression (AoP) and Rotation Angle (RA) were also assessed. Finally, the success and progression of vaginal delivery in two groups were compared by predicting the duration of delivery and mode of delivery. Results The findings showed that 8.68% of women in the trans-labial plus vaginal examination group delivered by cesarean section, while 6.13% in the vaginal examination only group delivered by cesarean section (P = 0.55). In women with cesarean section in positive fetal head stations, Angle of Progression (AoP) was significantly decreased ranging from 90 to 135 degrees compared to women who delivered vaginally (135–180 degrees; P < 0.001). In addition, the Rotation Angle (RA) was significantly decreased in women with cesarean section ranging from 0 to 30 degrees compared to women who delivered vaginally (60-90degrees; P < 0.001). Further analysis indicated that a higher risk of cesarean section was associated with vaginal examination only as compared to trans-labial ultrasound plus vaginal examination (HR: 8.65, P < 0.001). Conclusion Angle of Progression (AoP) and Rotation Angle (RA) indexes might be useful parameters to predict labor progression and successful vaginal delivery among women undergoing labor induction.

show abstract

Routine vaginal examinations compared to other methods for assessing progress of labour to improve outcomes for women and babies at term

Cited by 16 publications

References 88 publications

Prolonged Dystocic Labor in Neuraxial Analgesia and the Role of Enkephalin Neurotransmitters: An Experimental Study

Prolonged Dystocic Labor in Neuraxial Analgesia and the Role of Enkephalin Neurotransmitters: An Experimental Study

Components of obstetric violence: A descriptive study on physical abuse, non-consented care and non-confidential care

The success of vaginal birth by use of trans-labial ultrasound plus vaginal examination and vaginal examination only in pregnant women with labor induction: a comparative study

Contact Info

Product

Resources

About