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Background: Ensuring quality healthcare during pregnancy and childbirth is critical for improving health outcomes for both mothers and their babies. The postpartum period, or puerperium, begins after the expulsion of the placenta and lasts until the mother's body has nearly returned to its pre-pregnant state, typically six to eight weeks. This period is marked by significant physical, emotional, and psychological changes as mothers adjust to their new roles while recovering from childbirth. Factors such as delivery type, maternal age, baby gender, birth weight, and clinical parameters like blood pressure and fetal heart rate can significantly impact postpartum outcomes. Understanding these factors is crucial for developing targeted interventions to enhance maternal and neonatal health outcomes. This study aims to examine postpartum maternal well-being and associated factors among women at a tertiary care center in Agra, UP, to identify significant associations between clinical factors and selected demographic variables. Methods: A descriptive cross-sectional design was employed. Total 140 pregnant women selected through simple random sampling. Data were collected using a structured questionnaire and analyzed using SPSS software (version 23.0). Descriptive statistics, t-tests were utilized to summarize and analyze the data. Results: Among the 140 women, 46.4% were having their first child, 36.4% their second, 11.4% their third, and 5.7% had more than three children. A total of 67.9% had cesarean deliveries, while 32.1% had normal deliveries. The gender distribution of the babies was 45% male and 55% female. The mean age of mothers was 26.21 years, the mean baby weight was 2.6011 kg, and the average pregnancy period was 37.20 weeks. Significant associations were found between delivery type and pregnancy period (p = 0.091), baby gender and weight (p = 0.079), and infant life status with baby weight (p = 0.001), pregnancy period (p = 0.001), and fetal heart rate (p = 0.008). Conclusion: This study identifies significant factors influencing postpartum maternal wellbeing, suggesting the necessity for targeted and comprehensive postpartum care programs. The findings highlight the importance of monitoring and managing critical factors such as blood pressure, pregnancy duration, and fetal health to improve maternal and infant health outcomes. [ABSTRACT FROM AUTHOR]

Cesarean Section (C-Section) is an operation whereby a baby is brought to the world through a cut made on the abdomen and uterus. The factors that lead to C-Section includes premature rupture of the membranes, having an abnormal fetal heart rate, having previous C-Sections, or previous surgeries on the uterus, human immunodeficiency virus, having undergone cervical cerclage, or having sustained accidental injuries. If not predicted in the early stages, the mother and especially the baby faces many risks. Timely intervention and monitoring are made possible by early forcasting the mode of delivery. Although Deep Learning (DL) models aid in medical decision making, practitioners continue to have reservations about the accuracy and transparency in identifying important contributing factors. Our study presents an explainable DL system that utilizes a health indicators dataset comprising data gathered in India between 2019 and 2021 to forecast C-Section deliveries in the early stages. In order to solve class imbalance issues, the dataset is preprocessed utilizing encoding of categorical features, Proximity Weighted Synthetic oversampling, and a point biserial correlation coefficient approach to identify the highly correlated 65 features. A number of measures are used to assess the proposed Gated Highway Multi-layer-perceptron (GHiM) model, including accuracy, F1-score, recall, precision, MCC, loss, and execution time. With its accuracy of 0.866, F1-score of 0.863, and MCC of 0.732, the GHiM model outperformed models such as GRU, MLP, and HighwayNet by 2.5–3.5% Due to the complex structure of DL models, they are prone to over-fitting which is mitigated by training the GHiM using stratified 10-fold cross validation. Additionally, the most important characteristics in the categorization of C-Sections and normal births are determined by applying SHapley Additive exPlanation. This framework demonstrates that the GHiM model offers good accuracy and interpretability, and can enhance clinical decision support systems for C-Section delivery forecasting. [ABSTRACT FROM AUTHOR]

Copyright of Artuklu Health is the property of Mardin Artuklu University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This research aimed to determine the level of birth satisfaction in Turkiye and the affecting factors through a systematic review and meta-analysis. Methodology: In the study, 12 studies published between January 2017 and September 2022 and meeting the inclusion criteria were examined. The Mother Satisfaction Rating Scale in Normal Birth (MSRSNB) and the Maternal Satisfaction Rating Scale at Caesarean Delivery (MSRSCD) have been used to determine the satisfaction levels in the studies. The random effect model was used for variances between studies whereas Egger's and Begg's tests were used for publication bias. Cochran Q and I² values were calculated to test heterogeneity. Results: In Turkiye, the common estimation for the MSRSNB of women who had a normal delivery was 141.544 with a standard error of 5.128 (95% CI for I²=99.42 to 99.59). The common estimation for MSRSCD was 141.571 with a standard error of 5.422 (95% CI for I²=98.51 to 99.22). According to the random effect model, the difference in the scores between the cesarean section group and the normal delivery group was -0.137 (SE: 0.0619) among all patients. Conclusion: It was determined that the satisfaction levels of pregnant women living in Turkiye with cesarean section and normal delivery were not high. [ABSTRACT FROM AUTHOR]

Disorders in sensory processing can cause problems in intellectual, emotional, motor, and social development, manifesting as behavioral and learning difficulties. Researchers have identified many possible causes, such as genetic, environmental, and perinatal factors. Detecting and identifying disturbances in the development of sensory processing and initiating early therapy is crucial for growth and preventing the development of secondary problems. In spontaneous labor, the first contact between mother and child is timely, which is crucial for establishing mother-child coordination and the child's psychological development. However, in Cesarean section, the first contact time is delayed. Tactile processing plays a critical role in early physical and social development. This study aims to explore the impact of the mode of delivery on the occurrence of tactile sensitivity in preschool children through a retrospective cohort study and provide a scientific basis for primary prevention and early intervention of the disease. Our analysis of the Short Sensory Profile data revealed that tactile sensitivity exhibited the greatest deficit among the seven assessed areas, and children born by C-section showed a statistically significant higher tactile sensitivity compared to children born by normal vaginal delivery. This difference was greater than the observed differences in taste/smell sensitivity and visual sensitivity. The study concluded that tactile sensitivity is more common in infants delivered by Cesarean section than in infants born by normal vaginal delivery. Early diagnosis and possible therapy for improvement, especially in children born by Cesarean sections, is recommended. [ABSTRACT FROM AUTHOR]

Background and Aims During pregnancy, a woman's body undergoes many changes, which can be studied from physiological and psychological aspects. The purpose of this research is to compare functional disability and body image after normal and cesarean delivery. Methods The current research is of a comparative causal type. In this study, 114 non-athlete women who gave birth in Urmia City, Iran, were selected voluntarily and availably within one month after delivery. Of these, 58 had a normal delivery and 56 a cesarean delivery. Back functional disability was evaluated by the Oswestry disability index questionnaire, knee functional disability by the international knee documentation committee questionnaire, and body image by body image questionnaire in pregnant women. The data were analyzed using SPSS software, version 24. Results The independent t test showed a significant difference between the functional disability of the back and knees in the two groups with normal delivery and cesarean delivery. So, the cesarean section group had more disability in the low back and knee area compared to the normal delivery group (P=0.001). Also, the normal delivery group had a better body image compared to the cesarean group. Conclusion Normal delivery can be considered a safe delivery method to prevent the occurrence of functional disability in the back and knees and effectively reduce adverse symptoms related to body image after delivery. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study is to investigate the effectiveness of the cervical consistency index measured by ultrasonography in predicting the success of labor induction and to apply a more objective and painless method instead of the Bishop score. Methods: A total of 230 primiparous pregnant women were included in our study. Initial Bishop scores, cervical lengths, cervical consistency index measurements, and delivery type of the patients were recorded. Those who responded to induction and delivered vaginally and those who did not respond and gave birth by cesarean section were compared. p value <0.05 was considered statistically significant. Results: There was no significant cut-off value for CCI parameter (p=0.052) and CL parameter (p=0.890) in predicting successful labor induction in first pregnancies. A significant cut-off value was found for the Bishop parameter (p=0.007). A statistically significant negative and weak correlation was found between Bishop score and CL (r=- 0.328; p<0.001). There was no statistically significant relationship between other parameters (p>0.05). Conclusion: Measurement of cervical length and cervical consistency index with transvaginal ultrasound in first pregnancies did not find statistically significant results in predicting the success of labor induction. [ABSTRACT FROM AUTHOR]

Pregnancy and delivery are physiological conditions that are marked by abrupt alterations to hormones, immunological and molecular characters. The current study aimed to evaluate oxytocin (OT), prolactin (PRL), cortisol and insulin growth factor-2 (IGF-2) levels as physiological biomarkers; programmed cell death protein1 (PD-1), programmed cell death ligand-1 (PD-L1),interleukin-6 (IL-6) as immunological biomarkers, and single nucleotide polymorphisms (SNPs; rs53576 and rs2254298) of oxytocin receptor gene OXTR as molecular factors in samples of Iraqi women undergoing caesarean section (CS) and normal delivery (ND). Blood samples were collected from 96 pregnant women at term with ages ranging between 16-43 years. Regarding the physiological biomarkers, the study findings indicated that the change in OT, cortisol and IGF-2 between CS and ND groups was not significant, While the PRL level indicated a highly significant (P≤0.001) decrease in the CS group, especially in comparison with the ND group. Immunological biomarkers demonstrated a significant (P≤05) elevation for PD-1 as well as for PDL1 in the CS group as compared to the ND group. However, PD-1/PD-L1 ratio revealed a high significant (P≤0.001) rise in CS compared with ND. The IL-6 results revealed a significant (P≤0.001) reduction in the CS groups compared to the ND group. And regarding the SNP of OXTR (rs53576), the findings revealed no notable association in genotypes CC, TC and TT between both groups. In addition, the mutant C allele and the wild T allele revealed no significant association between CS and ND groups [OR=1.26 (0.68-2.3%)]. The SNP results of OXTR (rs2254298) showed a high positive association (P≤0.001) in genotypes GG, AG and AA between CS and ND groups. Also, the mutant G allele and the wild A allele revealed high significance (P≤0.001) between both groups [OR=5.3 (2.8-9.76%)]. [ABSTRACT FROM AUTHOR]

Background and Objective: Women’s satisfaction with the experience and process of childbirth is a decisive factor in the mental health of the family and society and also affects fertility intentions in that many women with bitter memories of a previous birth do not want to have children again. Accordingly, this study aimed to compare childbirth satisfaction based on the type of delivery performed at Fatemieh Hospital in Hamadan, Iran. Materials and Methods: This cross-sectional study was conducted on 242 pregnant women referred to Fatemieh Educational and Medical Center in Hamadan, Iran. Sampling was performed through available sampling among individuals who met the inclusion criteria. Written informed consent was obtained from the participants. Data collection tools were the demographic characteristics questionnaire and the McKay Childbirth Satisfaction Rating Scale, which were completed two hours after delivery until the mother was discharged from the hospital. Study data were collected according to the objectives of the study and analyzed using the SPSS statistical software (version 23). The significance level was set at 0.05. Results: The results of this study showed that there was no significant difference between the two groups in terms of demographic variables. Out of 120 deliveries with spinal analgesia, 93 (77.5%) were dissatisfied with the delivery, and 27 (22.5%) were satisfied. In the routine delivery group, out of 122 patients, 98 (80.3%) were dissatisfied with the delivery, and 24 (19.7%) were satisfied. There was no statistically significant difference between the two groups in terms of women’s satisfaction with childbirth (P=0.6). Conclusion: The findings show no statistically significant difference in women’s satisfaction with childbirth between the two methods of delivery, including spinal analgesia and routine delivery without analgesia.

Objective:To assess the effects of delivery types on growth patterns and mandibular asymmetry.Methods:One hundred six patients were divided into two groups as those who were born via normal delivery and via cesarean delivery. Skeletal growth patterns were measured on cephalograms using NemoCeph software (Nemotec, Madrid, Spain). The condylar, ramal and total asymmetry indexes were calculated on panoramic radiographs using the ImageJ software (ImageJ software, 1.37, National Institutes of Health, Bethesda, Maryland, USA). The mothers of the patients were also asked to respond to questions on their childbirth experiences and the infancy stages of their children.Results:There was no statistically significant difference between the groups in terms of their skeletal, dental and soft tissue parameters on their cephalometric images (p>0.05). While there was a significant difference in the asymmetry index scores of the normal delivery group based on their Co-Sg distance values, there was a significant difference in the index scores of the cesarean delivery group based on their Sg-Go distance values (p0.05). A significant correlation was observed between the gestational weeks of the patients at birth and their total asymmetry scores (p

This paper investigates whether neonate gender determines the mode of maternal delivery. The Pearson correlation technique and the t-statistic were applied to ascertain whether neonate gender is a determinant of the mode of maternal delivery. The neonate rate of delivery based on gender and mode of delivery was also investigated. The study relied on secondary data from a general hospital in Nigeria. The study consists of 6,491 live births from 2010 to 2017. The analysis showed that 74.9% accounted for normal births while 25.1% for surgical births. The gender analysis showed that 47.5% of males and 52.5% of females were normal births while 47.8% of males and 52.2% of females were delivered via surgical mode. The study showed that 47.6% of males and 52.4% of females were delivered for the period under review. The correlation value 𝑟̅ = 0.5 suggests that neonates irrespective of gender can be delivered via a normal or surgical procedure. The analysis based on the t-statistic failed to reject the null hypothesis implying that neonate gender does not determine the mode of maternal delivery but maternal lifestyle during pregnancy. [ABSTRACT FROM AUTHOR]

Copyright of Fenerbahce University Journal of Health Sciences (FBU-JOSH) / Fenerbahçe Üniversitesi Sağlık Bilimleri Dergisi is the property of Fenerbahce University Journal of Health Sciences (FBU-JOSH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Research was conducted employing the extended socio-ecological model (ESEM) to examine factors associated with cesarean sections (CSs) and vaginal deliveries (VDs) among the women in our study population. Using the ESEM to determine South-Punjab and Pakistani women's mode of delivery predictors. The cross-sectional study with a sample size of 908 patients was conducted through private and public obstetrics and gynecology departments in South Punjab, Pakistan, from 12 June 2022 to 29 May 2023. The Chi-square analysis compared baseline variables, delivery outcomes and delivery methods. Logistic regression analysis is used to determine predictive factors. The study revealed that 75.66% of women had CS, while 24.34% had VD. Education level, age, residential area and fetal presentation all had significant associations with mode of delivery. Logistic regression analysis suggested that gynecologist recommendation, belief in CS safety, abnormal fetal presentation, maternal anemia and meconium aspiration syndrome were all significant predictors of CS. The ESEM model concluded that age, fatigue and women's preference for CS due to its reliability for her and her fetus were predictive factors for mode of delivery choices among South-Punjab Pakistani women. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Academic Research in Nursing (JAREN) is the property of Hemsirelikte Egitim ve Arastirma Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of FACSalud is the property of Revista FACSalud and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: There are many established risk factors for postpartum depression (PPD). It is controversial whether the mode of delivery is associated with PPD. This prospective study assessed the prevalence of PPD among women who delivered normally versus cesarean section and the association between sociodemographic factors and clinical factors with PPD. Materials and Methods: This prospective cohort study was conducted in the Department of Obstetrics and Gynecology, JIPMER Hospital Puducherry, from July 2019 to June 2020. Women without high risk factors for PPD were included. The sample size was 121 in the normal delivery (ND) group and 121 in the cesarean section (CS) group. PPD screening was conducted within one week of delivery and again after six weeks of delivery using a validated Tamil or English version of the Edinburgh Postnatal Depression Scale (EPDS). A score of EPDS score ≥ 13 was considered positive for PPD. Univariate and multivariable analysis was done to find out the association. Results: The overall prevalence of PPD was 27.27%. The prevalence of PPD was higher in the CS (34.71%) than in the ND group (19.83%). PPD was found 2.1 times (OR-2.1, CI 1.2–3.8) in the CS group within one week and 2.5 times (RR-2.5, CI 1.5–3.9) at six weeks of delivery, respectively. Among the social factors, a history of domestic abuse or violence was found to be significantly associated with PPD by both univariate and multivariable analysis. Conclusion: PPD was twice higher among women in the CS than in the ND group. Domestic abuse or violence was very highly significantly associated with PPD. [ABSTRACT FROM AUTHOR]

Copyright of Bezmialem Science is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Documentation of fetal to neonatal heart rate (HR) transition is limited. The aim of the current study was to describe HR changes from one hour before to one hour after normal vaginal deliveries. We conducted a prospective observational cohort study in Tanzania from 1 October 2020 to 30 August 2021, including normal vaginal deliveries with normal neonatal outcomes. HR was continuously recorded from one hour before to one hour after delivery, using the Moyo fetal HR meter, NeoBeat newborn HR meter, and the Liveborn Application for data storage. The median, 25th, and 75th HR percentiles were constructed. Overall, 305 deliveries were included. Median (interquartile range; IQR) gestational age was 39 (38–40) weeks and birthweight was 3200 (3000–3500) grams. HR decreased slightly during the last 60 min before delivery from 136 (123,145) to 132 (112,143) beats/minute. After delivery, HR increased within one minute to 168 (143,183) beats/min, before decreasing to around 136 (127,149) beats/min at 60 min after delivery. The drop in HR in the last hour of delivery reflects strong contractions and pushing. The rapid increase in initial neonatal HR reflects an effort to establish spontaneous breathing. [ABSTRACT FROM AUTHOR]

Background: Childbirth is a unique experience ina woman’s life and always remains indelibly engraved in her memory. For this reason, it is necessary to ensure appropriate conditions to have a positive birth experience. Thus, guidelines and protocols have been developed by major international organizations that aim to promote normal labor and better care for the mother and fetus without unnecessary interventions. The aim of this study is to investigate whether the international guidelines and protocols are observed in Greek maternity hospitals. Methods: The study involved 124 male and female students from the three departments of Midwifery: University of West Attica, International Hellenic University and University Western Macedonia, which completed an equal number of self-report questionnaires with their socio-demographic data and were then asked to answer questions posed by instructions for normal childbirth. Results: It was observed that many of the guidelines are not followed, such as grooming and enema, prohibition of feeding and fluid intake, application of pressure on the bottom of the uterus, frequent vaginal examination, prohibition in the presence of sessions, continuous cardiotocographic follow-up in low-risk pregnancies, termination of delivery only in a supine gynecological position, routine perineotomy and immediate ligation of the umbilical cord. Conclusions: The purpose of the guidelines is to maintain the natural course of childbirth by avoiding a series of unnecessary acts that alter the naturalness and undermine the rights of women in childbirth.

Objectives: To describe how the frequency of cesarean section has evolved in Colombia since 1998, both in overall terms as well as discriminated according to the legal standing of the healthcare providers (IPSs) where delivery takes place, and to estimate the size of the association between the legal standing of the institutions and the performance of cesarean sections between 2015 and 2017. Material and methods: A cross-sectional cohort study that describes the frequency of cesarean deliveries between 1998 and 2020, plus an analytical component to estimate the association between the legal nature and the route of delivery between 2015 and 2017, based on the birth records of the Colombian National Statistics Administrative Department (DANE). Proportions of cesarean sections and their increase by institution type are presented. The prevalence ratio was used as an estimator of this association. Results: In 1998, the proportion of cesarean deliveries was 25.7 %; it increased to 46.4 % by 2015 and then dropped to 44.6 % by 2020. After 1998, the proportion of cesarean sections in public hospitals increased from 26.2 % to 42.9 % by 2014, while in private providers it increased from 45.0 % to 57.7 % by 2013. The prevalence ratio of cesarean sections in private versus public institutions was 1.57 (95 % CI: 1.56-1.57). Conclusions: After a long period of sustained growth, there is now a reduction in the proportion of cesarean sections in the country. In public health care institutions, these procedures increased in greater proportion during most of the study period, while in private healthcare providers they are carried out at a higher frequency in all subgroups of women. It will be necessary to evaluate in the future, using more robust methodologies, whether the decrease in the frequency of cesarean section is a real or secular trend. [ABSTRACT FROM AUTHOR]

Objective: To define for women at low obstetric risk methods of management that respect the rhythm and the spontaneous course of giving birth as well as each woman's preferences. Methods: These clinical practice guidelines were developed through professional consensus based on an analysis of the literature and of the French and international guidelines available on this topic. Results: Labor should be monitored with a partograph (professional consensus). Digital cervical examination should be offered every 4 h during the first stage of labor, hourly during the second. The choice between continuous (cardiotocography) or discontinuous (by cardiotocography or intermittent auscultation) monitoring should be left to the woman (professional consensus). In the active phase of the first stage of labor, dilation speed is considered abnormal if it is less than 1 cm/4 h between 5 and 7 cm or less than 1 cm/2 h after 7 cm. In those cases, an amniotomy is recommended if the membranes are intact, and the administration of oxytocin if the membranes are already broken and uterine contractions are judged insufficient (professional consensus). It is recommended that pushing not begin when full dilation has been reached; rather, the fetus should be allowed to descend (grade A). Umbilical cord clamping should be delayed beyond the first 30 s in newborns who do not require resuscitation (grade C). Conclusion: The establishment of these clinical practice guidelines should enable women at low obstetric risk to receive better care in conditions of optimal safety while supporting physiologic birth. [ABSTRACT FROM AUTHOR]

Objective: To evaluate pelvic floor muscle strength (PFMS) in nulliparous, parous and postmenopausal women using vaginal digital palpation and perineometer. Material and Methods: It was a cross-sectional study, conducted in department of Obstetrics and Gynecology, VMMC & Safdarjung hospital. A total of 300 women were recruited from Gynaecology and Family welfare outpatient departments and divided into 3 equal groups—nulliparous women, premenopausal parous women and postmenopausal women. PFMS was measured by modified Oxford Scale with vaginal digital palpation and by perineometer. Linear regression analysis was performed to evaluate and compare mean PFMS and identify its associated factors. Results: Median age was 21 years in nulliparous, 27 years in parous and 58 years in postmenopausal group. The average body mass index was 27.45, 28.01 and 34.63 kg/m2 in nulliparous, parous and postmenopausal group. The mean MOS by digital vaginal palpation was 4.66 in nulliparous, 3.9 in parous and 2.54 in postmenopausal women. The difference was statistically significant. The mean PFMS by perineometer was 40.04 cm H2O, 37.69 cm H2O and 34.93 cm H2O in nulliparous, parous and postmenopausal group, respectively. The difference was statistically significant (p < 0.001). Majority (50%) of nulliparous women had PFMs between 41 and 50 cm H2O and parous (81%) had PFMS between 21 and 30 cm H2O. There was a statistical significance between the groups. Conclusions: The PFMS of nulliparous women was significantly higher than multiparous women, and difference was statically significant (p < 0.001). Age had an important influence on pelvic floor muscle before menopause, but after menopause, it is years of menopause which has significant negative impact on PFMS and not age. [ABSTRACT FROM AUTHOR]

Abstract Background Multiple methods exist for the management of pain during normal labor. Epidural analgesia has been reported to be an effective method in that perspective. The current study was conducted to evaluate the efficacy of dexmedetomidine as an adjuvant to local anesthetics in epidural analgesia for pregnant females presented for normal delivery. Sixty pregnant females were included in this prospective randomized study, and they were divided into two equal groups: control group which received bupivacaine alone and dexmedetomidine group that received bupivacaine with dexmedetomidine. The primary outcome was the onset of analgesia, while the secondary outcomes included the duration of analgesia, hemodynamic changes, labor progress, neonatal outcomes, and maternal complications. Results Dexmedetomidine group was associated with earlier onset of analgesia (P ˂ 0.001), prolonged duration (P ˂ 0.001), and lower need for top-up doses (P ˂ 0.001) compared to control group. Also, sedation and maternal satisfaction were significantly better in the same group (P = 0.001, 0.025; respectively). Labor progress parameters and neonatal outcomes were comparable between the two groups. Dexmedetomidine group has lower heart rate and mean arterial blood pressure compared to the control group. Despite of dexmedetomidine group had higher incidence of hypotension and bradycardia, it was statistically insignificant when compared to control group. Conclusions Dexmedetomidine is a reliable and an effective adjuvant to the local anesthetics in epidural analgesia during normal delivery as it resulted in earlier onset and significant prolongation of the analgesic time with decrease in the top-up doses intake. Trial registration Pan African Clinical Trial Registry ( PACTR201710002664704 ). Register on 3 October 2017.

Introduction: Many changes occur in postpartum period in the body and soul of mothers that may lead to mothers' feeling fatigue. The use of reflexology has been well established as a branch of complementary medicine in the promotion of health care, especially in the field of maternal and neonatal health. Therefore, this study was performed with aim to investigate the effect of foot reflexology on postpartum fatigue in primiparous women. Methods: This clinical trial study was performed on 70 primiparous women referred to the healthcare centers in the south of Tehran in 2018. The subjects were divided into two groups of control and reflexology. The mothers of the control group received postpartum routine care and the reflexology group received massage for 3 consecutive days for 30 minutes (15 minutes per leg). Both groups completed the fatigue assessment-visual questionnaire before and after the intervention (immediately and one week after completion). Data were analyzed by SPSS statistical software (version 21) and parametric inferential statistical tests such as analysis of variance with repeated measures and non-parametric measures (Chi-square). Also, independent t-test was used to determine the significant difference between the mean of some social demographic characteristics with the treatment outcome. p < 0.05 was considered statistically significant. Results: Demographic characteristics and severity of fatigue before the intervention were the same in both reflexology and control groups. Immediately after the intervention (p

Introduction: Pregnancy brings about many changes in mothers' body which continue even after the baby is born. After a vaginal delivery, taking good care of the mother is an essential part of postpartum care and to maintain overall fitness. Objective: The purpose of this research was to evaluate the effect of a physiotherapeutic intervention to improve the maternity fitness of Indian women. Methodology: It was a three-group RCT (randomized controlled trial). The target population consisted of women in ante and postnatal stage, 50 participants (58 were included in the end) in each group, randomly selected from Obstetrics and Gynecology OPD of a tertiary care hospital in North India. The study was carried out in the department of PRM (Physiotherapy). A total of 174 participants was included in the study and was divided into three groups, two intervention groups, and one control group. The target population consisted of women in ante and postnatal stage, randomly selected from ANC (Antenatal clinic) and PNC (Post-natal clinic). The study was conducted over a period of 4 years (2014–2018). They were advised to do exercise, postural correction, regular walking, and electrotherapy modalities and six follow-ups throughout their pregnancy. Outcome measures like (Visual Analogue Scale = VAS): Low and upper back pain relief (n = 158), Leg cramps (n = 41), Coccyx pain (n = 36), Sacro-iliac joint pain (n = 26) was considered. Results: The impact of the intervention package on both ante-natal and post-natal women with fitness-related health problems showed significant improvement. Conclusion: Pain, leg cramp and heaviness in the lower limb, coccyx pain, etc., during pregnancy are common complaints that start early in pregnancy and may persist throughout life if treatment does not start early in the pregnancy.

Background: Childbirth is a unique experience ina woman's life and always remains indelibly engraved in her memory. For this reason, it is necessary to ensure appropriate conditions to have a positive birth experience. Thus, guidelines and protocols have been developed by major international organizations that aim to promote normal labor and better care for the mother and fetus without unnecessary interventions. The aim of this study is to investigate whether the international guidelines and protocols are observed in Greek maternity hospitals. Methods: The study involved 124 male and female students from the three departments of Midwifery: University of West Attica, International Hellenic University and University Western Macedonia, which completed an equal number of self-report questionnaires with their socio-demographic data and were then asked to answer questions posed by instructions for normal childbirth. Results: It was observed that many of the guidelines are not followed, such as grooming and enema, prohibition of feeding and fluid intake, application of pressure on the bottom of the uterus, frequent vaginal examination, prohibition in the presence of sessions, continuous cardiotocographic follow-up in low-risk pregnancies, termination of delivery only in a supine gynecological position, routine perineotomy and immediate ligation of the umbilical cord. Conclusions: The purpose of the guidelines is to maintain the natural course of childbirth by avoiding a series of unnecessary acts that alter the naturalness and undermine the rights of women in childbirth. [ABSTRACT FROM AUTHOR]

Unnecessary caesarean delivery continues to be an increasingly important problem in the world. Thanks to the information and training provided with the right resources, it is possible to reduce the caesarean rates and increase the normal birth rates with the right choices. This study aimed to learn the opinions of female employees in Eskişehir family health centers about normal and caesarean births, to determine important points and develop suggestions for these methods. The population of the study was 170 working women. Factor analysis, 16 items normal birth, and caesarean delivery scale were gathered under one factor, and this single factor explained 36.775% of the total variance. Results showed that when item-total correlation values of normal birth and caesarean section were examined, it was found that item-total correlation values of 16 items in the scale were between 0.407 and 0.759. When item scores were examined, it was determined that there was consistency between the items. This research has shown that the majority of female workers prefer to giving births by caesarean section, while there is no clinical indication and they are suggested to normal delivery. As a result of the established DFA model, the fit indexes of the model were found to be among the perfect fit values (x2/df=65.26/25≤3).

Documentation of fetal to neonatal heart rate (HR) transition is limited. The aim of the current study was to describe HR changes from one hour before to one hour after normal vaginal deliveries. We conducted a prospective observational cohort study in Tanzania from 1 October 2020 to 30 August 2021, including normal vaginal deliveries with normal neonatal outcomes. HR was continuously recorded from one hour before to one hour after delivery, using the Moyo fetal HR meter, NeoBeat newborn HR meter, and the Liveborn Application for data storage. The median, 25th, and 75th HR percentiles were constructed. Overall, 305 deliveries were included. Median (interquartile range; IQR) gestational age was 39 (38–40) weeks and birthweight was 3200 (3000–3500) grams. HR decreased slightly during the last 60 min before delivery from 136 (123,145) to 132 (112,143) beats/minute. After delivery, HR increased within one minute to 168 (143,183) beats/min, before decreasing to around 136 (127,149) beats/min at 60 min after delivery. The drop in HR in the last hour of delivery reflects strong contractions and pushing. The rapid increase in initial neonatal HR reflects an effort to establish spontaneous breathing.

Background: Multiple methods exist for the management of pain during normal labor. Epidural analgesia has been reported to be an effective method in that perspective. The current study was conducted to evaluate the efficacy of dexmedetomidine as an adjuvant to local anesthetics in epidural analgesia for pregnant females presented for normal delivery. Sixty pregnant females were included in this prospective randomized study, and they were divided into two equal groups: control group which received bupivacaine alone and dexmedetomidine group that received bupivacaine with dexmedetomidine. The primary outcome was the onset of analgesia, while the secondary outcomes included the duration of analgesia, hemodynamic changes, labor progress, neonatal outcomes, and maternal complications. Results: Dexmedetomidine group was associated with earlier onset of analgesia (P ˂ 0.001), prolonged duration (P ˂ 0.001), and lower need for top-up doses (P ˂ 0.001) compared to control group. Also, sedation and maternal satisfaction were significantly better in the same group (P = 0.001, 0.025; respectively). Labor progress parameters and neonatal outcomes were comparable between the two groups. Dexmedetomidine group has lower heart rate and mean arterial blood pressure compared to the control group. Despite of dexmedetomidine group had higher incidence of hypotension and bradycardia, it was statistically insignificant when compared to control group. Conclusions: Dexmedetomidine is a reliable and an effective adjuvant to the local anesthetics in epidural analgesia during normal delivery as it resulted in earlier onset and significant prolongation of the analgesic time with decrease in the top-up doses intake. Trial registration: Pan African Clinical Trial Registry (PACTR201710002664704). Register on 3 October 2017. [ABSTRACT FROM AUTHOR]

Breast milk is a rich fluid. The benefits of it already are worldwide known because there are a lot of studies that show it. But there are some factors that affect the process or the choice of feeding with breast milk like as mother and fetal conditions. This study aims to describe the association between mood of delivery and breastfeeding and especially the initiation of the breastfeeding How the breast's condition affects the breastfeeding. This is a point (cross-sectional) study, which was implemented for a period of 5 months during the years 2018-2019. The survey included 200 women with a distribution by race, educational level, age, number of pregnancies, mode of delivery, number of abortions, etc. The study used a questionnaire with structured and semi-structured questions through which information was obtained on a number of general elements and mainly those related to the way the birth process and the impact on breastfeeding. The results show that the age group with the greatest involvement in this study is 19-29 years old with 51.5% followed by the age group 30-39 years old with 47% and only 1.5% are in the age group over 39 years’ old. Mothers with higher educational level (49.7 %) followed by mothers with 8 years of schooling (29.1%) and mothers with high school (19.9%). 50% of mothers delivery by normal delivery and 49 % of them by cesarean- section. There is a statistically significant relationship between the delivery mode and breastfeeding, χ2 = 4.348, P <0.05 (P = .037); between the delivery mode and the time of starting breastfeeding, χ2 = 6.943, P <0.05 (P= .031). [ABSTRACT FROM AUTHOR]

Introduction: Pregnancy brings about many changes in mothers' body which continue even after the baby is born. After a vaginal delivery, taking good care of the mother is an essential part of postpartum care and to maintain overall fitness. Objective: The purpose of this research was to evaluate the effect of a physiotherapeutic intervention to improve the maternity fitness of Indian women. Methodology: It was a three-group RCT (randomized controlled trial). The target population consisted of women in ante and postnatal stage, 50 participants (58 were included in the end) in each group, randomly selected from Obstetrics and Gynecology OPD of a tertiary care hospital in North India. The study was carried out in the department of PRM (Physiotherapy). A total of 174 participants was included in the study and was divided into three groups, two intervention groups, and one control group. The target population consisted of women in ante and postnatal stage, randomly selected from ANC (Antenatal clinic) and PNC (Post-natal clinic). The study was conducted over a period of 4 years (2014–2018). They were advised to do exercise, postural correction, regular walking, and electrotherapy modalities and six follow-ups throughout their pregnancy. Outcome measures like (Visual Analogue Scale = VAS): Low and upper back pain relief (n = 158), Leg cramps (n = 41), Coccyx pain (n = 36), Sacro-iliac joint pain (n = 26) was considered. Results: The impact of the intervention package on both ante-natal and post-natal women with fitness-related health problems showed significant improvement. Conclusion: Pain, leg cramp and heaviness in the lower limb, coccyx pain, etc., during pregnancy are common complaints that start early in pregnancy and may persist throughout life if treatment does not start early in the pregnancy. [ABSTRACT FROM AUTHOR]

Background: Human choices and decisions are highly affected by some psychological and personality traits. These psychological characteristics may also be related to the choice of delivery type. Therefore, the present study aimed to investigate the relationship between personality dimensions and choice of delivery type (cesarean section or normal) in pregnant women referred to Abolfazl hospital in Minab county, Iran, in 2018. Materials and Methods: This is a cross-sectional descriptive study. The statistical population consisted of all pregnant women referred to Abolfazl medical center in 2008 in Minab, 118 of whom were selected by convenience sampling. The NEO Five-Factor Inventory (NEO-FFI) was used to collect the data. Results: There was a significant difference in the choice of delivery type (normal and cesarean section) in pregnant women with extraversion and conscientiousness personality traits (P value

Aim:Being able to relieve pain that occurs during delivery provides physical and emotional involvement of the mother in the birth and could reduce maternal and fetal undesirable effects. We planned this questionnaire study to evaluate the painless delivery approaches of physicians working in the fields of gynecological diseases and obstetrics.Methods:A survey was made consisting of 10 questions about the painless delivery approaches with the gynecologists and obstetricians in Turkey. Ninety-eight physicians’ answers were evaluated.Results:It was observed that the painless birth in the clinics was not widespread, the low painless delivery options offered rate was low and the informing was inadequate in clinics throughout Turkey. In addition, it was concluded that physicians did not have a common idea to the effect on the action of delivery.Conclusion:The role of gynecologists and obstetricians, as well as anesthesiologists, is great in spreading painless delivery practice. We also wanted to emphasize that informing the patient during pregnancy by the gynecologic diseases and obstetricians may reduce the rate of cesarean delivery due to the patient’s request.

Background/Aim: Physical activity during pregnancy assumes an important role in the health of both the pregnant and newborn. Our study aims to evaluate the effects of Pilates workouts on labor and newborn outcomes. Methods: This retrospective case control study was conducted with the nulliparous pregnant women admitted to our obstetrics clinic. We evaluated the effects of a Pilates workout program for 70-80 minutes per day, once a week for eight weeks, on the labor and newborn outcomes. We defined the labor outcomes as the type of delivery and the gestational age at delivery and the newborn outcomes as one-minute (APGAR-1) and five-minute Apgar scores (APGAR-5). Results: The incidences of episiotomy, vacuum-assisted vaginal delivery, and cesarean section (CS) were significantly lower in pregnant women who participated in Pilates workouts (P<0.001). Pilates workouts increased the chance of normal vaginal delivery. The gestational age at delivery was significantly lower, and the APGAR-1 and APGAR-5 scores were significantly higher among those in the Pilates group (P<0.001). Conclusion: A supervised Pilates workout is an effective and achievable exercise method decreasing cesarean delivery and assisted vaginal delivery. It also has no negative effects on newborns, supported by the higher APGAR scores of babies whose mothers were in the Pilates group. [ABSTRACT FROM AUTHOR]

Background and objectives: During the postpartum period, mothers may experience physical and emotional changes. Postpartum Depression (PPD) may affect 10-15% of all women after delivery. In some studies, the type of delivery has been considered as a risk factor for postpartum depression. The present study was designed to investigate and compare the frequency of postpartum depression in women with normal and cesarean delivery. Methods: This descriptive-analytic study was conducted on 300 women referring to the Sayad Shirazi Hospital. First the Women who had Beck depression inventory score>12 were excluded and then the participants were divided into two equal groups of normal (150) and cesarean (150) delivery. Two weeks after delivery, Beck depression inventory was filled out and data analysis was performed by SPSS software V.16 using, chi-square and Mann-Whitney test. Results: Results showed that 13% of all participants 12.7% of the cases in normal and 13.3% in cesarean groups had postpartum depression. The severity of depression was higher in women with cesarean delivery compared to normal delivery and this difference was significant (mean rank 172.29 vs. 128.71, p

Abstract Background Worldwide rising cesarean section (CS) births is an issue of concern. In India, with increase in institutional deliveries there has also been an increase in cesarean section births. Aim of the study is to quantify the prevalence of cesarean section births in public and private health facility, and also to determine the factors associated with cesarean section births. Methods We analyzed data from district level household survey data 4 (DLHS-4) combined individual level dataset for 19 states/UTs of India comprising 24,398 deliveries resulting in 22,111 live births for year 2011. The percentages and Chi-square has been computed for the select variables viz. Socio demographic, maternal, antenatal care and delivery related based on type of births (CS Vs normal births). The multiple logistic regression model has been used to identify the potential risk factors associated with CS births. Results Of 22,111 live birth analyzed 49.2% were delivered at public sector, 31.9% at private sector and 18.9% were home deliveries. Prevalence of CS births were 13.7% (95% CI; 13.0- 14.3%) and 37.9% (95% CI; 36.7- 39.0%) in the public and private sectors, respectively. Higher odds of CS births were observed with- delivery at private health facility (OR 3.79; 95% C.I 3.06-4.72), urban residence (OR 1.15; 95% C.I 1.00- 1.35), first delivery after 35 years of maternal age (OR 5.5; 95% C.I 1.85- 16.4), hypertension in pregnancy (OR 1.32; 95% C.I 1.06- 1.65) and breach presentation (OR 2.37; 95% C.I. 1.63- 3.43). Conclusions Our findings shows that CS births are nearly three times more in private as compared to public sector health facilities.The higher rates of CS births, especially in private sector, not only increase the cost of care but may pose unnecessary risks to women (when there is no indications for CS). The government of India need to take measures to strengthen existing public health facilities as well as ensure that cesarean sections are performed based upon medical indications in both public and private sector health facilities.

This study used functional magnetic resonance imaging to explore the neural networks of pain during labor and its relief. It was hypothesized that epidural analgesia would affect the neural activities and the underlying network connectivity. Analysis using dynamic causal modelling and functional connectivity was performed to investigate the spatial activity and network connection of labor pain with and without epidural analgesia. This Institutional Review Board approved study acquired Magnetic Resonance Imaging from 15 healthy women of spontaneous normal delivery (with/without epidural analgesia = 7/8, aged 29.6 ± 2.3 and 29.3 ± 4.8 years old respectively) using a 1.5 Tesla scanner. Numerical rating score of pain was evaluated by a research nurse in the beginning of the first stage of labor and approximately 30 min after imaging examination. Six regions of interested from the activated clusters and literature were selected for dynamic causal modelling, which included primary and secondary somatosensory cortex, middle frontal gyrus, anterior cingulate cortex, insula and lentiform. Functional connectivity was calculated from selected sensory and affective regions. All analyses were performed by using software of statistical parametric mapping version 8 and CONN functional connectivity toolbox. The result showed that the experience of labor pain can lead to activations within a distributed brain network. The pain relief from epidural analgesia can be accompanied with altered functional connectivity, which was most evident in the cingulo-frontal system. The present study, therefore, provides an overview of a pain-related neural network that occur during labor and upon epidural analgesia. [ABSTRACT FROM AUTHOR]

Objectives: to describe the profile on childbirth care at a reference maternity hospital in the State of Piauí based on the 2018 World Health Organization Recommendations. Methods: retrospective cross-sectional quantitative study, descriptive documentary, population census, containing vaginal deliveries performed in 2017. The data was entered in Microsoft Excel for simple statistical analysis. Results: the percentages registered at the Centro Obstétrico Superior (Superior Obstetric Center) and Centro de Parto Normal (Normal Delivery Center) were, respectively, 85.5% and 98% with the presence of a companion, 34.2% and 94% used the partogram, 63.8% and 98% took non-pharmacological methods for pain relief, 74.8% and 98.7% received fluids during labor. Amniotomy at 15.2% and 17.2%, oxytocin was administered at 26.5% and 14.6% in the 1st and 2nd periods, non-lithotomic position at 39.7% and 93.4%, episiotomy 9.9% and 6.6%. After birth, 85.5% and 96% of newborns had skin-to-skin contact and, in 65.5% and 94% there were maternal breastfeeding promotion. Conclusions: this study comprehended the indicators on childbirth care service, which are, in general, better than the national and the northeast region ones. The importance of registering indicators to evaluate care is emphasized. [ABSTRACT FROM AUTHOR]

Objective This study aimed to determine the level of knowledge, attitude, and awareness about the vaginal and cesarean deliveries of female students attending 4th grade of Suleyman Demirel University Faculty of Medicine. Material and Methods In order to determine the knowledge and awareness level of the information about the normal delivery and cesarean delivery, a survey was developed by us in accordance with the literature. The survey includes the personal information form and the questions exploring knowledge and attitudes about the normal delivery and cesarean delivery. Results: 59 students who completed the gynecology and obstetrics internship (Group 1), with a mean age of 22,03 ± 2,84 and 23 students who non-completed the internship (Group 2), with a mean age of 22,44 ± 1,04 were included the study. In group 1, the rate of want to have a normal delivery in the future was 62.3% (n=38) (in the other group was 72.7%). When the students' thoughts were evaluated in terms of the most reliable delivery mode; In the group 1, this was vaginal delivery because o answer "less complicated" (83.3%; n=50), whereas in the group 2, all participants (100%; n=21) preferred vaginal delivery option (with thinking that it is healthier). The highest cause of fear in both groups was delivery pains. Conclusion The level of knowledge, attitude, and awareness was found to be very low generally. According to the study, it is understood that there is a need for additional training programs during the internship. [ABSTRACT FROM AUTHOR]

Objectives: Low back pain in postnatal women is a major issue. So, lumbar curvature is a key feature to maintain core strength for which it has to be assessed. The individual variations in spinal curvature and lordotic pattern signifies the bio mechanics of the spine and it responds according to the load/activities. So this search is taken up among postnatal women. Women should also have awareness about the posture maintenance after the delivery. Postnatal women should work for the correction of the spinal curvatures. So, early assessment is necessary. Also secondary factors like the type of shoes women wear, Occupation and Lifestyle can influence the spinal curvatures which can be dealt with easier with the outcome of the research. Methodology: In this correlational study, 100 women with age group of 25 to 35 years who have undergone cesarean section delivery and normal delivery, 50 each, were enrolled. Their lumbar lordosis was measured by the flexicurve. Results were obtained and compared. Result: The average mean value of lumbar lordosis in the women with cesarean section delivery was 45.12 degrees and in women with normal delivery was 39.80 degrees. Conclusion: On comparing summary score of lumbar lordosis in women with normal delivery and cesarean section delivery, there is difference of about 5.32 degrees in the score. The t test shows value of 37.296 in normal delivery and 42.969 in cesarean section. Thus concluding that incidence of lumbar lordosis in women with cesarean section is more than in the women with normal delivery. [ABSTRACT FROM AUTHOR]

There are several physical and social factors that are associated to the maternal health and may be considered influential towards the C-Section across the world. Several studies have been conducted in different regions of the world, mostly targeting the pregnant women in specific region. The dynamicity of pregnancy and differences among women with respect to region and social life enforces the researchers to widen the sphere of research at regional level to comprehensively explore the significant risk factors associated to mother and expected child. In this paper, the region of interest is the native city of authors lacking medical facilities and proper pregnant women healthcare infrastructure. As compared to advanced countries, no such study is ever conducted in this region that involves cause analysis of factors resulting in enhanced cases of C-sections and assisting physicians via providing decision support systems based on knowledge induced from machine learning approaches. The aim of this paper is twofold. The first objective is to collect data regionally, in order to conduct local study, first of its kind in this region, and acquire results that are helpful for public health offices in decision making. Second, it is desired to produce different birth classification models and study their applicability on birth data collected previously. The best approach on the basis of correct classification may later be used to produce decision support systems to assist physicians to gain knowledge from the hidden patterns in data. The success of such study is crucial as it will open the doors of interdisciplinary research in two distinct fields of the region.

Introduction: Innumerable factors are considered in the decision-making when choosing the type of childbirth. When it is a first-time woman, there are not previous experiences, so other factors can influence her in the selection of how to give birth. Objective: to identify the preference of the first-time pregnant woman in terms of the type of childbirth, to know the factors that influence her decision-making in that selection and her expectations in relation to childbirth through the chosen type of birth-delivery. Method: A descriptive study with a quantitative approach carried out with 35 first-timers in prenatal care in public health units in a municipality in the south of Minas Gerais, Brazil. Data collection was conducted in August and September 2015 and a semi-structured interview was used. Results: the selection of the vaginal delivery, the presence of positive expectations in relation to the chosen way of birth-giving and the lack of influence of third parties on the decision-making process prevailed. Conclusions: The decision of the women in selecting the way of birth- delivery is turning in a preference, but a simply a professional indication, which highlights the importance of health education in prenatal consultation. [ABSTRACT FROM AUTHOR]

Vitamin B12 plays a dynamic role in one carbon metabolism, which is essential for the general healthy pregnancy and predominantly for fetal growth. Another parameter is maternal glucose during pregnancy. For the transport of the glucose across the placenta, insulin resistance is change for the normal development of the fetus. This study included 30 pregnant women enrolled at Al-Karkh Materuity hospital in January to May 2019. The pregnant women with 23rd to 25th gestational week were included in the present study. Fasting blood was collected form cases (either showed vitamin B12 deficiency or high serum glucose) and healthy participants after obtaining informed consent. The parameters like child birth weight, type of delivery and duration of pregnancy was recorded. The vitamin B12 content was significantly lower (222.43±48.41pg/ml) in the B12 deficient group as compared to healthy control (492.71±52.81 pg/ml). It was observed that the women with B12 deficiency lead to the premature delivery. The fetus birth weight is negatively correlated with the presence of vitamin B12 deficiency. Compared to the healthy control, women with high serum glucose showed significant (p≤0.0001) increased in the fetus weight, which may be one of the reason for C-section delivery. About 87.32% GDM women undergone C-section delivery, while only 12.68% normal delivery occurs. Most of the normal child delivery was found in the B12 deficient women and maximum normal child delivery rate was in the healthy control. The fetus birth weight is positively correlated with the presence of increased serum glucose leves of the mother. It was positively correlated with the pregnancy complications such as premature birth, increased in fetus weight etc. For anaemic condition in the mother, vitamin B12 deficiency can be one of the key factor and it should be monitored before planning of pregnancy. [ABSTRACT FROM AUTHOR]

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A prolonged second stage of vaginal delivery increases the risk of shoulder dystocia, unnecessary episiotomies and cesarean sections. However, no standardized method has been proposed to tackle this issue. The effects of pelvic floor myofascial manipulation intervention during the second stage of labor in primiparas and its prognostic value in neonatal postpartum outcomes remain unknown. In the present study, a total of 60 primiparas who were expecting a vaginal delivery in the Second Affiliated Hospital of Hainan Medical College (Haikou, China) between October 2021 and January 2022 were selected. These women were randomly assigned to a control group (standard intrapartum care) or an experimental group (pelvic floor myofascial manipulation for 15-20 min during the second stage of labor along with standard intrapartum care) using a random number table, with 28 patients in each group. There was no significant difference in age, gestational time or body mass index between the two groups before delivery, indicating that the baseline data were comparable. The second stage of labor duration, forced breath-holding time and postpartum hemorrhage volume in the experimental group were significantly lower than those in the control group. The pain visual analog scale scores, fatigue scores and neonatal Apgar scores in the experimental group were also significantly lower than those in the control group. The rate of episiotomy in the experimental group was lower than that in the control group, but the difference was not statistically significant. In conclusion, pelvic floor myofascial manipulation intervention during the second stage of labor for primiparas with vaginal delivery can reduce the duration of the second stage of labor, the amount of bleeding during labor and the pain during labor. Meanwhile, it has the potential to improve neonatal outcomes. [ABSTRACT FROM AUTHOR]

Objective: To determine the prenatal psychologic (anxiety and depression) and perinatal obstetric (pregnancy and labor complications) predictors of postpartum depression (PPD) in late-term pregnancies. Materials and methods: A total of 149 women with late-term gestation who were hospitalized for antenatal fetal surveillance were included. All participants were asked to complete Hospital Anxiety and Depression Scale immediately after hospitalization and Edinburgh Postnatal Depression Scale in the postpartum period. Demographic, psychologic, and obstetric variables were tested as predictors of PPD by regression analysis. Results: High scores for prenatal anxiety, depression, and PPD were detected in 17.4%, 12.8%, and 23.5% of the participants, respectively. The mode of delivery was not associated with PPD for late-term pregnancies. Women having urgent cesarean, planned cesarean, and vaginal delivery had similar rates of PPD (28.1%, 23.8%, and 21.9%, respectively). In the multivariant analysis, prenatal depression [odds ratio (OR), 9.85; 95% confidence interval (CI), 2.72–35.65], prenatal anxiety (OR, 4.95; 95% CI, 1.59–15.39) and suspicion of fetal distress (OR, 4.44; 95% CI, 1.13–13.64) were found to be independent predictors of PPD. Conclusion: For late-term pregnancies, women with prenatal anxiety or depression and had cesarean delivery due to the suspicion of fetal distress were at risk for PPD.