Vacuum extraction is successful in 95% of cases with an occiput posterior position: the results of a prospective, multi-center study.

Background: Occiput-posterior (OP) position is associated with labor arrest, need of operative delivery and failed instrumental vaginal delivery with resulting adverse peripartum outcomes. Vacuum extraction (VE) is the most commonly performed type of instrumental delivery worldwide. This study aimed to investigate the outcome of VE in fetuses with sonographically confirmed OP position prior to the procedure.

Rational approach to fetal heart rate monitoring and management during the second stage of labor.

Second stage of labor is considered to be associated with an increased risk of intrapartum fetal hypoxic injury. This is due to a combination of several risk factors such as -the increased frequency, strength and duration of uterine contractions due to higher number and affinity of myometrial oxytocin receptors; -the Ferguson's reflex which leads to a reflex release of endogenous oxytocin in response of the distension of the cervix by descending fetal head in late stages of labor; maternal expulsive efforts with the Valsalva manoeuvre that may reduce maternal oxygenation, as well as reduce the venous return and maternal cardiac output due to increased intrathoracic pressure, winch may lead to reduced placental oxygenation; - and increased fetal intracranial pressure due to head compression leading to a potential decrease in fetal cerebral oxygenation. In addition, the umbilical cord often forms one or more loops around the fetal neck, which may get tightened as the head descends leading to an acute and intermittent cessation of fetal oxygenation.

Efficacy of intrapartum bundles and interventions in reducing vaginal delivery-related perineal trauma: a systematic review.

Objective: The aim of this systematic review is to summarize the current evidence on preventive interventions and bundles, including combinations of multiple techniques, aimed at reducing vaginal delivery-related perineal injury.

Methods: A systematic research of literature was independently conducted on different databases (PubMed, MEDLINE, EMBASE) by the authors, using a combination of the identified keywords and index terms as per current PRISMA guidelines. The research was restricted to papers published in English starting by 2000.

Ultrasound evaluation of the size of the umbilical cord vessels and Wharton's jelly and correlation with intrapartum CTG findings.

Objective: To compare the sonographic measurement of the umbilical cord between women with or without repetitive decelerations during the first stage of labor.

Study Design: Prospective study including a non-consecutive cohort of women at term gestation carrying a normal sized fetus at term in cephalic presentation. The cross-sectional area of the umbilical cord, of its vessels and the amount of the Wharton's jelly were assessed at 2D ultrasound upon labor admission.

Ectopic atrial beats may cause a ZigZag pattern at intrapartum recording of the fetal heart rate using fetal scalp electrode.

Novel Insights Continuous intrapartum fetal heart rate assessment by fetal scalp electrode may record arrythmias like recurrent atrial ectopic beats and depict an increased fetal heart rate variability mimicking a ZigZag pattern. Introduction Fetal scalp electrode (FSE) is considered the gold standard for the intrapartum monitoring of the fetal heart rate (FHR) being associated with the lowest rate of signal loss and artifacts including the recording of the maternal heart rate. FSE acquires a fetal electrocardiogram and evaluates the time intervals between successive R waves.