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1.
Mercedes Valverde Pareja Alberto Puertas PrietoMaría Paz Carrillo Badillo Isabel Pérez HerrezueloFrancisco Montoya Ventoso 《Progresos de Obstetricia y Ginecología》2010
Objective
To evaluate the effectiveness of pulse oximetry and fetal electrocardiogram in the management of labor with fetal heart rate patterns associated with a risk of loss of fetal well-being.Subjects and methods
We performed an open, randomized, experimental trial with two groups: pulse oximetry was used in one group and the STAN® technique was used in the other. Each group included 40 women with single, term pregnancies in cephalic presentation and fetal heart rate patterns associated with a risk of loss of fetal well-being. The overall cesarean section rate, indications of risk of fetal distress, and neonatal acid-base balance were evaluated.Results
No significant differences were found in the rate of cesarean section (47.5 vs 40%; P = .33), indications of risk of fetal distress (32.5 vs 37.5%; P = .41), or neonatal outcomes.Conclusions
The use of pulse oximetry and STAN®21, as auxiliary methods to cardiotocographic recording, showed no superiority in reducing the cesarean section rate or improving neonatal outcomes. 相似文献2.
R. Crespo C. LaprestaS. Castán J.M. CampillosB. Rodríguez-Solanilla J.J. Tobajas 《Clínica e investigación en ginecología y obstetricia》2011,38(4):133
Objective
To evaluate the mode of delivery and maternal morbidity associated with pregnancies ending at 41 weeks.Material and methods
We designed a retrospective cohort study. The mode of delivery and maternal complications of 230 pregnancies ending at 41 weeks were compared with those in 234 pregnancies ending between 37 and 40 weeks at the Miguel Servet University Hospital in 2005.Results
Women delivering at 41 weeks had an increased risk of membrane sweep, unfavorable Bishop score at admission, induction and longer duration of labor. These increases were also seen in the rates of operative vaginal delivery (25.6 vs 17.6%, p < 0.001) and cesarean section (21.7 vs 8.5%, p < 0.001).Conclusions
The rates of maternal peripartum complications increase as pregnancy reaches 41 weeks. Accurate investigation of these rates is important to determine the gestational age at which the risk of continuing the pregnancy outweighs the risk of labor induction. 相似文献3.
Á. Luengo V. ZornozaA. Fernández-Corona C. González-García 《Clínica e investigación en ginecología y obstetricia》2012
Objective
To determine the obstetric results of labor induction in relation to body mass index (BMI) and gestational weight gain at the Leon Hospital between January and March, 2008.Material and method
We conducted a prospective cohort study of 127 labor inductions. The variables included were the medical reason for induction, the procedures employed for cervical ripening and induction, maternal age at the end of pregnancy, type of labor, parity, initial Bishop's score, BMI, weight, height, gestational weight gain, neonatal weight and Apgar test at 1 and 5 minutes.Results
Inductions were performed in 21.3% of births, while vaginal delivery was achieved in 81.1%. A total of 36.2% of the patients were overweight, 21.2% were obese and 4.7% were morbidly obese.Conclusions
A non-statistically significant association was observed between failure of vaginal delivery and BMI (P = .08) and body weight gain (P = .07). These two variables seem to increase the chances of failure of cervical ripening and induction of labor, increasing the percentage of cesarean sections. 相似文献4.
Ana Cardo Maza Ana M. Fuentes Rozalen Llanos Belmonte Andujar Marco Arones Collantes Juan Pablo García de la Torre Gaspar Gonzalez de Merlo 《Progresos de Obstetricia y Ginecología》2013
Objective
To present the case of a pregnant woman with a spontaneous umbilical cord hematoma and to provide a review of the literature.Subjects and methods
A primigravida, with no antecedents of interest and uneventful pregnancy, was admitted to our hospital in the latent phase of labor. Cardiotocography was unsatisfactory, and an urgent cesarean section was performed.Results
A 3050 g girl was born, with an Apgar score of 1/3, and was admitted to the intensive care unit. The neonate was discharged with a diagnosis of hypoxic-ischemic encephalopathy.Conclusions
Umbilical cord abnormalities should be suspected when the results of fetal monitoring are unsatisfactory. Histological analysis of the umbilical cord should be performed. 相似文献5.
Andrés Calvo Pérez Pedro J. Cabeza Vengoechea Carlos Campillo Artero Javier Agüera Ortiz 《Progresos de Obstetricia y Ginecología》2007
Objectives
To describe the quality management system applied by the Obstetrics and Gynecology Service of the Manacor Hospital, Majorca (Spain) to the process of cesarean section, and to assess the appropriateness of caesarean sections performed in this service between 2004 and 2005.Subjects and methods
Consensus was reached on evidence-based indications for emergency and elective cesarean sections and on their quality criteria. All clinical records were reviewed to assess the appropriateness of cesarean sections performed from 2004-2005 according to previously established standards.Results
In all two-monthly periods, appropriateness was achieved according to previously established standards (100% of elective interventions and > 90% of emergency cesarean sections), except in July-August, 2004 and May-June 2005 (appropriateness of elective cesarean sections = 92%), and in July-August 2004 (appropriateness of emergency interventions = 84%).Conclusions
To reduce unjustified variability in clinical practice, cesarean section indications must be standardized, based on scientific evidence, and regularly assessed. 相似文献6.
Objectives
To determine the influence of the women's exposure to maternal education on smoking and the use of obstetric emergency services.Method
A multicenter observational study was conducted on women whose childbirth was the first in four hospitals in Andalusia (Spain) in 2011. The data were collected through an interview and medical history. The analysis estimated odds ratios and both raw and adjusted averages.Results
A total of 520 women were studied. Participation in the maternal education program seemed to have no influence on the use of obstetric emergency services (ORa = 0.70, 95% CI = 0.47-1.04) or on changing smoking habits (ORa = 0.84, 95% CI = -0.43-1.68).Conclusions
Attendance at a maternal education program did not modify smoking. We found no conclusive evidence of the impact of maternal education on the use of emergency obstetric services. 相似文献7.
Gil Rodríguez-Caravaca Manuel Albi-González Laura Rubio-Cirilo Laura Frías-Aldeguer Patricia Hanna Crispín-Milart M. Concepción Villar del Campo 《Progresos de Obstetricia y Ginecología》2014
Objective
To evaluate compliance with a protocol for antibiotic prophylaxis in cesarean sections and its influence on the incidence of surgical wound infection.Patients and methods
A prospective cohort study was carried out to assess compliance with our antibiotic prophylaxis protocol. Percentages of compliance and the cumulative incidence of infection were calculated. The effect of compliance with the protocol for antibiotic prophylaxis on surgical wound infection was estimated with the relative risk.Results
We included 680 patients. Overall compliance with the protocol was 95.7%. The most frequent cause of lack of compliance was the time of administration (96.6%). The cumulative incidence of infection was 2.5% and there was no association between compliance with the protocol and the infection rate (RR = 4.5; 95% CI: 0.55-38.4; P>.05).Conclusions
Compliance with the protocol for antibiotic prophylaxis was high. The cumulative incidence of surgical wound infection was low and was unrelated to antibiotic prophylaxis. 相似文献8.
Resultados perinatales de un protocolo de atención para gestantes con riesgo de prematuridad extrema
A. Corrales Gutiérrez J.A. Suarez GonzalezM.R. Cabrera Delgado M.E. Benavides Casal 《Clínica e investigación en ginecología y obstetricia》2014
Introduction
Gestational age and birthweight are the most important variables that influence perinatal outcomes and future quality of life.Method
An intervention project was applied following a protocol for the perinatal care of women admitted to the Mariana Grajales Perinatal Care Unit in Santa Clara at risk of extremely preterm delivery (26 to 32 weeks).Objective
To evaluate perinatal results and neonatal survival in this high-risk group.Results
The causes of extreme prematurity were, in order of frequency, aggravated preeclampsia, premature rupture of membranes, spontaneous delivery, and gastorrhagia in the second half of pregnancy. The most common route of delivery was cesarean section. Birthweight was less than 1 500 g in 52% of the neonates, mainly due to preeclampsia and preterm delivery. Low Apgar scores of 4-6 were found in 12.3% of the neonates with 100% recovery at 5 minutes. Delivery occurred at less than 30 weeks in 30.1%. Pregnancy was prolonged by 8.6 days in preeclampsia, by 6 days in premature rupture of membranes and by 322 days in preterm delivery. The most frequent complications were hyaline membrane disease (15%) and sepsis (36.9%), which provoked one death.Conclusions
Survival in this group of high-risk neonates was high, decisively influencing the low infant mortality rate in this unit in 2009-2010. 相似文献9.
10.
S. Ortega Marcilla B. Royo ArillaE.L. Tejero Cabrejas R. Savirón CornudellaB. Rodriguez Solanilla S. Castán MateoJ.M. Campillos Maza 《Clínica e investigación en ginecología y obstetricia》2014
Objective
To analyze the perinatal results in our hospital comparing vaginal delivery and cesarean section in breech presentation singleton pregnancies at term.Material and Methods
All live ante-partum singleton fetuses in breech presentation, at 37 to 41+6 weeks and days who delivered between July 2006 and August 2010 were included in the study. We compared perinatal results between cesarean section and vaginal delivery.Results
There were no differences in Apgar score at 5 minutes < 7, pH umbilical cord < 7, base deficits and lactate, neonatal intensive care unit admission or perinatal mortality.Conclusions
With appropriate maternal and fetal conditions and a qualified medical team, a breech vaginal delivery could be propose obtaining good perinatal outcomes. 相似文献11.
Laia Martí Malgosa Belén Cochs CosmeJordi Costa Pueyo Sandra Medina ArgemíÀgueda Rodríguez Vicente Yolanda Canet Estévez 《Progresos de Obstetricia y Ginecología》2011,54(6):300-305
Objective
To compare the mean induction-expulsion times in two regimens of vaginal misoprostol for second-trimester pregnancy termination.Material and methods
We performed a retrospective study of 281 pregnancies between January 2000 and December 2005 (regimen A: 800 μg /24 h) and between June 2007 and December 2008 (regimen B: 400 μg /4 h). Induction-expulsion time was taken as the main outcome.Results
The mean expulsion time was similar in both regimens (19.7 h for A and 17.7 h for B). No significant differences were found in the expulsion rate at 12, 24 and 48 h. The most commonly observed adverse effect was fever, which was more frequent in regimen B. No major adverse effects such as uterine rupture or severe hemorrhage were observed.Conclusions
No significant differences were found between regimens A and B in the mean fetal expulsion time, although fever was more common in regimen B. 相似文献12.
Antonio Jiménez Caraballo Ana Ferrari BellverMaría Ramírez Pineda Silvia de los Reyes PeñaJosé Luis Dueñas Díez 《Progresos de Obstetricia y Ginecología》2007
Objective
To study prospectively the succes rate of the sacrospinous vault suspension, using the vaginal approach associating an anterior colporrhaphy, in the cases of posthisterectomy vaginal vault prolapse.Material and methods
Between January 1999-July 2005, 41 patients without urinary incontinence and vaginal vault prolapse were treated with the Richter-Amreich’s procedure associated with anterior colporrhaphy by the same surgeon. We have used the the Miya hook in all interventions and 2 sutures of Polyglactin 00. Every patient was 393 followed up a month after the operation and anually till now. We considered success as the lack of prolapse a month after the intervention, and relapse when another prolapse happened in a year or more after surgery. Patients were include in a database and Epi-info 3.3TM was used to perform the statistical analysis.Results
There were vaginal vault prolapse at 1- month follow-up in 4 of the 41 (success rate of 91.2%). Another 3 patients presented minor cystocele (grade 1), and one had a grade 2 cystocele without descent of vaginal apex (9.8%). There is no worsening of these cases till now in the annual follow-ups. The most common postoperatory complication was anemia, that was present in 13 patients (31,7%). The length of complete surgery was 102 ± 35 minutes. There is a clear correlation between operating time and surgeon experience.Conclusions
This technique is an effective method, economic and safe to treat posthysterectomy prolapse of the apical vaginal compartment. 相似文献13.
Pedro José Cabeza Vengoechea Andrés Calvo Pérez Ana Pilar Betrán María del Mar Mas Morey María Mercedes Febles Borges Paula Ximena Alcácer Ana Ramallo Alcover Enrique Francisco Campos Villamiel Eva María Morán Antolín Sabine Rehkugler Francisco Javier Agüera Ortiz Olga Román Delgado Ana Román De la Peña 《Progresos de Obstetricia y Ginecología》2010
Objective
To identify groups of women with changes in cesarean rates in two different periods.Subjects and methods
Deliveries in the Manacor Hospital in 2000-2001 and 2005-2006, were analyzed through a retrospective review of clinical records and were grouped using Robsońs classification.Results
The cesarean rate increased from 14 to 18.6% with a statistically significant increase among women with a single cephalic pregnancy at term who underwent labor induction or elective cesarean section. These two groups were the major contributors to the cesarean rate at our hospital.Conclusion
A trend towards an increase in the rates of cesarean section was found during the study period. Robson's Classification allowed us to identify the groups of women contributing to this increase. 相似文献14.
15.
José García Adánez Marina Navarro LópezCarmen Fernandez Ferrera María Medina DíazNatalia Pagola Limón Oscar Vaquerizo RuizAna Escudero Gomis 《Progresos de Obstetricia y Ginecología》2013
Objective
To review the obstetric and neonatal outcomes of the application of an updated vaginal breech delivery protocol 10 years after this practice had been discontinued.Methods
Breech presentations were referred to a dedicated breech unit at 36 weeks where the external cephalic version was offered. If breech presentation persisted, the patients were selected to undergo attempted vaginal delivery if the following criteria were met: a) estimated fetal weight of 2.500-3.600 g; b) frank or complete breech presentation; c) absence of hyperextension of the fetal head; and d) a clinically adequate pelvis. Intrapartum criteria included: a) progression of labor of ≥ 1 cm/hour in the first hour; b) In the second stage, 90 minutes were allowed for adequate descent of the breech, and 1 hour of active pushing, and c) the availability of an on-call expert.Results
A total of 93 patients showed single live pregnancies in breech presentation after external cephalic version. Sixty-nine patients (73.4%) underwent elective prelabor cesarean delivery, and 24 (26.6%) progressed to attempted vaginal breech delivery, which was successful in 19 (20.1%). Cesarean indications for breech presentation were reduced from 5.7% in 2009 to 2.02% after the application of external cephalic version and vaginal breech delivery (P<.001). We observed no fetal deaths, no Apgar test at 5 minutes of less than 7, no umbilical artery pH of less than 7, and no fetal injuries.Conclusions
. When antepartum and intrapartum criteria are met, vaginal breech delivery is safe. The availability of an on-call expert allows vaginal breech delivery to be safely performed. The combination of external cephalic version and vaginal breech delivery decreases the cesarean rate for breech presentation. 相似文献16.
María Arántzazu García Rico Alfonso Javier Martínez Rodríguez Sara María Ulla Díez María Consuelo Martínez Real 《Progresos de Obstetricia y Ginecología》2010
Objective
To evaluate levels of maternal anxiety in third trimester pregnancies according to pregnancy risk, classified as low, medium and high-risk/very high-risk.Patients and methods
We performed an observational, analytical and cross-sectional study of anxiety levels in 174 pregnant women followed-up in our hospital. Levels of both state anxiety and trait anxiety were evaluated in the three groups of pregnant women.Results
Of the 174 participants in the study, 98 (56.3%) had low risk pregnancies, 40 showed medium risk (23%) and 36 (20.7%) had high risk or very high risk pregnancies. We obtained a mean of 32.8 points for state anxiety and of 27.3 points for trait anxiety. Mean anxiety levels scores were 44.1 points in the high/very high risk group, 33 points in the medium risk group, and 28.5 points in the low risk group, with statistically significant differences (P = .0001 for the high risk group and P = .038 for the medium risk pregnancies). A significant correlation was found between trait anxiety and state anxiety (P = .0001). Statistically significant differences were observed in anxiety related to the number of children (P = .0001).Conclusions
In pregnant women, anxiety levels were higher than average levels in the general population. Anxiety levels increased in accordance with greater risk in the pregnancy. The greater the number of children the mother already had the lower her anxiety level. 相似文献17.
R. Crespo A. Alvir M. Lapresta M.P. Andrés J.M. Campillos S. Castán 《Clínica e investigación en ginecología y obstetricia》2012
Objective
To evaluate the pregnancy and perinatal outcomes of twin gestations in women aged 35 or older.Material and methods
We designed a retrospective cohort study. Maternal complications, mode of delivery and perinatal outcomes were compared in 229 women who delivered at age 35 or older and in 374 women who delivered at age less than 35 years. The computerized database and medical records of pregnant women attending the Miguel Servet University Hospital from January 2001 to December 2007 were retrospectively reviewed.Results
Older women had an increased risk of conceptions after assisted reproductive techniques (p > 0.001), dichorionic pregnancies (p > 0.001) and gestational diabetes (p = 0.007; 95% CI: 1.119-3.19). There was no significant association between older maternal age and an increased incidence of preterm labor, premature rupture of membranes, fetal growth restriction, cesarean delivery or perinatal mortality.Conclusion
Based on our data and previous studies, advanced maternal age in twin pregnancies does not seem to significantly increase obstetric complications or adverse perinatal results. 相似文献18.
María Sánchez Toledo Cristina Álvarez LleóCarmen García Garrido Gaspar González de Merlo 《Progresos de Obstetricia y Ginecología》2013
Objective
To establish the relationship between the degree of sperm DNA fragmentation and seminal parameters, male age and outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).Subjects and methods
The sample consisted of 43 couples undergoing IVF/ICSI. The mean age of men was 35.62 ± 4.87 years and that of women was 33.88 ± 3.95 years. We prospectively analyzed sperm DNA fragmentation from each patient by the Sperm Chromatin Structure Assay (SCSA) and correlated the findings with seminal parameters (volume, concentration, progressive motility and morphology), IVF/ICSI outcomes and male age. IVF/ICSI outcome was evaluated by measuring the fertilization rate, embryo quality and the pregnancy and miscarriage rates.Results
DNA fragmentation was negatively correlated with progressive motility (p = 0.000) of fresh and capacitated (p = 0.041) semen. Older patients had a significantly lower percentage of progressive motility in fresh seminal samples (p = 0.034) and worse sperm DNA quality (p = 0.043). There were no significant differences between the fragmentation rate and fertilization rate, embryo quality, and the pregnancy and miscarriage rates.Conclusions
DNA fragmentation is inversely correlated with progressive motility in fresh seminal samples. DNA fragmentation does not predict the IVF/ICSI outcome but screening for sperm DNA damage may provide useful information in the diagnosis of idiopathic male infertility. Seminal quality is affected by increasing male age. 相似文献19.
Objetive
: To know Spanish Obstetrics and Gynaecology Society (SEGO) members about cesarean section on request.Method
Three questions appeared on SEGO web: 1) If a normal primigravid with a term, cephalic presentation foetus ask you for a caesarean section, would you do it?; 2) If a normal primigravid with a term, breach presentation foetus ask you for a caesarean section, would you do it?; 3) If a woman on her normal third pregnancy with two previous vaginal and with a term, breach presentation foetus ask you for a caesarean section, would you do it? Questions were asked in May 2006 and answers were collected 19th October 2006. Data analysis was processed with web page statistic method.Results
Among the 5300 members of SEGO, 1222 contacted the web page (23%). To question n° 1, 57.8% answered no, 24.8% yes and 17.4% had no answer. To question n° 2, 6.1% answered no, 93.8% yes and there were no abstention. To n° 3 question, 16.7% said no, 74.5% said yes and 8.8% has no opinion.Results are commented, advantages and disadvantages of caesarean are discussed as well as sanitary consequences of such an indication. 相似文献20.
María Cerrillo Martínez Esteban González MirasolMaría Dolores Díaz Serrano Azucena Tello MuñozGaspar González de Merlo 《Progresos de Obstetricia y Ginecología》2007