Associations between fetal position at delivery and duration of active phase of labor: A historical cohort study.

Introduction: In clinical experience, occiput posterior (OP) position is associated with longer labor duration than occiput anterior (OA) position, but few studies have investigated the association between labor duration and fetal position. We aimed to compare duration of the active phase of labor in OP deliveries with OA deliveries in a contemporary population using survival methods. Secondary aims were to compare the frequencies of operative interventions, obstetric anal sphincter injuries (OASIS), postpartum hemorrhage, and newborn outcomes in OP with OA deliveries.

Prevention of obstetric anal sphincter injuries with perineal support and lateral episiotomy: A historical cohort study.

Introduction: There are many risk factors for obstetric anal sphincter injury (OASIS) and the interaction between these risk factors is complex and understudied. The many observational studies that have shown a reduction of OASIS rates after implementation of perineal support have short follow-up time. We aimed to study the effect of integration of active perineal support and lateral episiotomy on OASIS rates over a 15-year period and to study interactions between risk factors known before delivery.

Ultrasound examination of the pelvic floor during active labor: A longitudinal cohort study.

Introduction: There is limited evidence about changes in the pelvic floor during active labor. We aimed to investigate changes in hiatal dimensions during the active first stage of labor and associations with fetal descent and head position.

Material And Methods: We conducted a longitudinal, prospective cohort study at the National University Hospital of Iceland, from 2016 to 2018.

Association of oxytocin augmentation and duration of labour with postpartum haemorrhage: A cohort study of nulliparous women.

Objective: Both duration of labour and use of oxytocin for augmentation are known risk factors for postpartum haemorrhage but distinguishing between the significance of these factors is complex. In this study, we aimed to investigate the association between both labour duration and oxytocin augmentation, for postpartum haemorrhage.

Design: A cohort study based on a secondary analysis of a cluster-randomised trial.

Ultrasound in labor: clinical practice guideline and recommendation by the WAPM-World Association of Perinatal Medicine and the PMF-Perinatal Medicine Foundation.

This recommendation document follows the mission of the World Association of Perinatal Medicine in collaboration with the Perinatal Medicine Foundation. We aim to bring together groups and individuals throughout the world for standardization to implement the ultrasound evaluation in labor ward and improve the clinical management of labor. Ultrasound in labor can be performed using a transabdominal or a transperineal approach depending upon which parameters are being assessed.

Induction of labor in twin pregnancies - A retrospective cohort study.

Objective: To investigate outcomes in spontaneous and induced twin deliveries. Secondary aims were to study impact of delivery interval and breech presentation of the first twin.

Methods: This retrospective cohort study comprised 354 twin deliveries at a tertiary Norwegian hospital.

Perinatal and 2-year neurodevelopmental outcome in late preterm fetal compromise: the TRUFFLE 2 randomised trial protocol.

Introduction: Following the detection of fetal growth restriction, there is no consensus about the criteria that should trigger delivery in the late preterm period. The consequences of inappropriate early or late delivery are potentially important yet practice varies widely around the world, with abnormal findings from fetal heart rate monitoring invariably leading to delivery. Indices derived from fetal cerebral Doppler examination may guide such decisions although there are few studies in this area.

Put your weight behind it-Effect of body mass index on the active second stage of labour: A retrospective cohort study.

Objective: To explore the duration of the active phase of the second stage of labour in relation to maternal pre-pregnant body mass index (BMI).

Design: Retrospective cohort study.

Setting: Labour wards of three Norwegian university hospitals, 2012-2019.

Trisomy 21 - incidence, diagnostics and pregnancy terminations 1999-2018.

Background: We hypothesised that the examinations offered to pregnant women at fetal medicine centres differ from those offered to other pregnant women in Norway. We therefore wanted to investigate the incidence, prenatal diagnostics and pregnancy terminations in cases of trisomy 21. We also wanted to compare the figures from the National Center for Fetal Medicine, St Olav's Hospital, Trondheim University Hospital, with national figures for Norway.

The effect of Zhang's guideline vs the WHO partograph on childbirth experience measured by the Childbirth Experience Questionnaire in the Labor Progression Study (LaPS): A cluster randomized trial.

Introduction: Childbirth experience is an increasingly recognized and important measure of quality of obstetric care. Previous research has shown that it can be affected by intrapartum care and how labor is followed. A partograph is recommended to follow labor progression by recording cervical dilation over time.

Descent of the presenting part assessed with ultrasound.

Fetal head descent can be expressed as fetal station and engagement. Station is traditionally based on clinical vaginal examination of the distal part of the fetal skull and related to the level of the ischial spines. Engagement is based on a transabdominal examination of the proximal part of the fetal head above the pelvic inlet.

Fetal head descent assessed by transabdominal ultrasound: a prospective observational study.

Background: Determining fetal head descent, expressed as fetal head station and engagement is an essential part of monitoring progression in labor. Assessing fetal head station is based on the distal part of the fetal skull, whereas assessing engagement is based on the proximal part. Prerequisites for assisted vaginal birth are that the fetal head should be engaged and its lowermost part at or below the level of the ischial spines.

Intrapartum ultrasound in women with prolonged first stage of labor.

The first stage of labor is from the start of active labor until the cervix is fully dilatated. To assess labor progress during this stage, a clinical examination has traditionally been done. The cervical dilatation, fetal head position, and fetal head station are evaluated.

There are 4, not 7, cardinal movements in labor.

The mechanics of labor describe the forces required for fetal descent, and the movements that the fetus must perform to overcome the resistance met by the maternal bony pelvis and soft tissue. The fetus negotiates the birth canal and rotational movements are necessary for descent. Anglo-American literature lists 7 cardinal movements, namely engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion.

Can ultrasound on admission in active labor predict labor duration and a spontaneous delivery?

Background: Identifying predictive factors for a normal outcome at admission in the labor ward would be of value for planning labor care, timing interventions, and preventing labor dystocia. Clinical assessments of fetal head station and position at the start of labor have some predictive value, but the value of ultrasound methods for this purpose has not been investigated. Studies using transperineal ultrasound before labor onset show possibilities of using these methods to predict outcomes.

Induction of labor in breech presentations - a retrospective cohort study.

Introduction: There is limited evidence on the safety and outcome of induction of breech labor. In this study, we aimed to compare the outcomes of spontaneous and induced breech deliveries and to describe variations in induction rates.

Material And Methods: This was a retrospective cohort study comprising 1054 singleton live fetuses in breech presentation at Trondheim University Hospital from 2012 to 2019.

When does fetal head rotation occur in spontaneous labor at term: results of an ultrasound-based longitudinal study in nulliparous women.

Background: Improved information about the evolution of fetal head rotation during labor is required. Ultrasound methods have the potential to provide reliable new knowledge about fetal head position.

Objective: The aim of the study was to describe fetal head rotation in women in spontaneous labor at term using ultrasound longitudinally throughout the active phase.

Fetal descent in nulliparous women assessed by ultrasound: a longitudinal study.

Background: Ultrasound measurements offer objective and reproducible methods to measure the fetal head station. Before these methods can be applied to assess labor progression, the fetal head descent needs to be evaluated longitudinally in well-defined populations and compared with the existing data derived from clinical examinations.

Objective: This study aimed to use ultrasound measurements to describe the fetal head descent longitudinally as labor progressed through the active phase in nulliparous women with spontaneous onset of labor.

Automatic measurement of head-perineum distance during intrapartum ultrasound: description of the technique and preliminary results.

Objectives: To evaluate the accuracy and reliability of a new ultrasound technique for the automatic assessment of the head-perineum distance (HPD) during childbirth.

Methods: HPD was measured on a total of 40 acquisition sessions in 30 laboring women both automatically by an innovative algorithm and manually by trained sonographers, assumed as gold standard.

Results: A significant correlation was found between manual and automatic measurements (Intra-CC = 0.