[A pregnant woman with a painful abdominal retraction].

A 35-year old woman, gravida 2, para 1, came to our hospital with abdominal pain and a retraction of her abdomen, which appeared during her spontaneous contractions at 40 weeks and 5 days of pregnancy. She had a medical history of caesarean section for Frank breech presentation. This clinical presentation was suggestive for uterine rupture, which was confirmed during caesarean section.

SIMPLE: implementation of recommendations from international evidence-based guidelines on caesarean sections in the Netherlands. Protocol for a controlled before and after study.

Background: Caesarean section (CS) rates are rising worldwide. In the Netherlands, the most significant rise is observed in healthy women with a singleton in vertex position between 37 and 42 weeks gestation, whereas it is doubtful whether an improved outcome for the mother or her child was obtained. It can be hypothesized that evidence-based guidelines on CS are not implemented sufficiently.

Indications and results of labour induction in nulliparous women: an interview among obstetricians, residents and clinical midwives.

Objective: To investigate which clinical factors are important in management decisions that clinicians make in the process of labour induction, and which clinical factors they estimate as predictive of labour outcome after induction.

Study Design: A written interview was conducted among obstetricians, residents and clinical midwives in five teaching hospitals in the south of the Netherlands. Sixteen fictive vignettes were constructed of pregnant nulliparous women who were candidates for induction of labour.

Bishop score and risk of cesarean delivery after induction of labor in nulliparous women.

Objective: To quantify the risk and risk factors for cesarean delivery associated with medical and elective induction of labor in nulliparous women.

Methods: A prospective cohort study was performed in nulliparous women at term with vertex singleton gestations who had labor induced at 2 obstetrical centers. Medical and elective indications and Bishop scores were recorded before labor induction.