: The incidence of labor induction is steadily increasing worldwide. The main aim of this study was to evaluate the ultrasound parameters and their mutual correlation and to analyze the parameters' predictive capability in assessing the success of labor induction. The secondary goal was to assess patients' tolerability and acceptance of transvaginal ultrasound and digital gynecological examination. : This prospective observational follow-up study included 252 women selected for labor induction. The transvaginal ultrasound examination measured the posterior cervical angle, cervical length, the length and width funneling of the cervix, the distance between the head of the fetus and the external uterine os, and the position of the fetal occiput. After the ultrasound, a digital vaginal examination was performed (according to the Bishop score), and the women were asked to rate their perception of pain for each procedure. : The most common indication for labor induction was post-term pregnancy (57.59%), and the most common method of labor induction was oxytocin with amniotomy (70%). The results showed that a significant independent prediction of vaginal delivery could be provided based on the Bishop score and cervical length. Other investigated ultrasound parameters, the length and width of the funneling of the cervix ( < 0.001), the fetal head stage ( < 0.001), and the size of the posterior cervical angle ( < 0.05), showed statistical significance in relation to the success of labor induction. Patients reported lower discomfort and pain during transvaginal ultrasound examination (mean score 2, IQR 3) compared to digital examination (mean score 5, IQR 4), with < 0.001. : The results imply that the assessment of ultrasound parameters before induction of labor is necessary to predict the outcome and reduce the possibility of complications. In terms of tolerability and choice by the patients, the transvaginal ultrasound examination was better rated than the vaginal gynecological examination.
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http://dx.doi.org/10.3390/medicina60071127 | DOI Listing |
Reprod Sci
January 2025
Department of Pharmacology, University of Nevada, Reno School of Medicine, 1664 North Virginia St., Reno, NV, 89557, USA.
Matrix metallopeptidase 9 (MMP9) is a secreted zinc-dependent peptidase known for extracellular remodeling. MMP9 is elevated in tissues from women experiencing preterm labor, and previous research has shown that the addition of combined matrix metallopeptidases 2 and 9 (MMP2/9) enhances uterine contractions. We hypothesized that adding MMP9 alone would enhance myometrial contractions and that specific MMP9 inhibition would suppress uterine contractions.
View Article and Find Full Text PDFWien Med Wochenschr
January 2025
University Department of Gynecology and Obstetrics Clinical Hospital Merkur Zagreb, School of Medicine Catholic University of Croatia Zagreb, Collegium of the Surgical Medical Sciences Croatian Academy of Medical Sciences, Ilica 242, 10 000, Zagreb, Croatia.
Objective: The aims of this study were to determine the incidence of macrosomic births over a 5-year period and to examine the childbirth complications for both mother and newborn.
Patients And Methods: During the study period there were a total of 16,126 deliveries, of which 1905 were macrosomic fetuses (defined as those with a birthweight of 4000 g or more). Data on the course of pregnancy and childbirth were collected from existing maternal and peripartum medical records.
Clin J Pain
November 2024
Department of Anaesthesiology, Critical Care and Pain Medicine, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy.
Objectives: The rationale of adoption opioid sparing anesthesia (OSA) is to achieve perioperative analgesia with a minimal amount of opioid combined to non-opioid adjuvants during and after surgery, namely multimodal anesthesia. The OSA approach was originally developed to overcome the known complications of opioid-based anesthesia (OA) and the present scoping review (ScR) aims at providing the clinical evidence of safety and efficacy of OSA with respect to OA.
Methods: This ScR is mainly focused on studies presenting evidence on the safety and efficacy of OSA versus OA.
Neurology
February 2025
Department of Medicine (Austin Health), The University of Melbourne, Australia.
Background And Objectives: Aside from congenital malformations and impaired postnatal neurodevelopment, risks associated with antiseizure medication (ASM) use during pregnancy have been sparsely investigated, particularly outside of epilepsy. We aimed to assess these risks through a systematic literature review and meta-analysis, including ASM exposure for indication.
Methods: We searched MEDLINE, EMBASE, and Cochrane for studies including pregnant women on ASMs for any indication and untreated pregnant women, investigating obstetric complications and fetal/neonatal complications other than congenital malformations and impaired neurodevelopment.
Bioengineering (Basel)
November 2024
School of Mechanical and Electrical Engineering, Sanming University, Sanming 365004, China.
In experimental pain studies involving animals, subjective pain reports are not feasible. Current methods for detecting pain-related behaviors rely on human observation, which is time-consuming and labor-intensive, particularly for lengthy video recordings. Automating the quantification of these behaviors poses substantial challenges.
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