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Dilatations, Cervical

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Most cited protocols related to «Dilatations, Cervical»

1
Labor Progression and Duration Analysis
We used data from the Consortium on Safe Labor, a multicenter retrospective observational study that abstracted detailed labor and delivery information from electronic medical records in 12 clinical centers (with 19 hospitals) across 9 American College of Obstetricians and Gynecologists (ACOG) U.S. districts from 2002 to 2008. 87% of births occurred in 2005 – 2007. Detailed description of the study was provided elsewhere.5 Briefly, participating institutions extracted detailed information on maternal demographic characteristics, medical history, reproductive and prenatal history, labor and delivery summary, postpartum and newborn information. Information from the neonatal intensive care unit (NICU) was linked to the newborn records. Data on labor progression (repeated, time-stamped cervical dilation, station and effacement) were extracted from the electronic labor database. To make our study population reflect the overall U.S. obstetric population and to minimize the impact of the various number of births from different institutions, we assigned a weight to each subject based on ACOG district, maternal race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic and others), parity (nulliparas vs. multiparas) and plurality (singleton vs. multiple gestation). We first calculated the probability of each delivery with these four factors according to the 2004 National Natality data. Then, based on the number of subjects each hospital contributed to the database, we assigned a weight to each subject .5 We applied the weight to the current analysis. This project was approved by the Institutional Review Boards of all participating institutions.
There were a total of 228,668 deliveries in the database. A total of 62,415 parturients were selected. Figure 1 depicts the sample selection process for the current analysis. Women were grouped by parity (0, 1, 2+). We used a repeated-measures analysis with 8th degree polynomial model to construct average labor curves by parity.6 In this analysis, the starting point was set at the first time when the dilation reached 10 cm (time = 0) and the time was calculated backwards (e.g., 60 minutes before the complete dilation, -60 minutes). After the labor curve models had been computed, the x-axis (time) was reverted to a positive value, i.e., instead of being -12 → 0 hours, it became 0 → 12 hours.
To estimate duration of labor, we used an interval-censored regression7 to estimate the distribution of times for progression from one integer centimeter of dilation to the next (called “traverse time”) with an assumption that the labor data are log-normally distributed.8 (link) The median and 95th percentiles were calculated. Because multiparous women tended to be admitted at a more advanced stage labor than nulliparous women, many multiparous women did not have information on cervical dilation prior to 4 cm. Therefore, the labor curve for multiparous women started at 5 cm rather than at 4 cm as for nulliparous women.
Finally, to address the clinical experience wherein a woman is first observed at a given dilation and then measured periodically, we calculated cumulative duration of labor from admission to any given dilation up to the first 10 cm in nulliparas. The same interval censored regression approach was used. We provide the estimates according to the dilation at admission (2.0 or 2.5 cm, 3.0 or 3.5 cm, 4.0 or 4.5 cm, 5.0 or 5.5 cm) because women admitted at different dilation levels may have different patterns of labor progression. We then plotted the 95th percentiles of the duration of labor from admission as a partogram. All statistical analyses were performed using SAS version 9.1 (PROC MIXED for the repeated-measures analysis and PROC LIFEREG for interval censored regression). Since the objective of this paper is to describe labor patterns and estimate duration of labor without comparing among various groups, no statistical tests were performed.
Zhang J., Landy H.J., Branch D.W., Burkman R., Haberman S., Gregory K.D., Hatjis C.G., Ramirez M.M., Bailit J.L., Gonzalez-Quintero V.H., Hibbard J.U., Hoffman M.K., Kominiarek M., Learman L.A., Van Veldhuisen P., Troendle J, & Reddy U.M. (2010). Contemporary Patterns of Spontaneous Labor With Normal Neonatal Outcomes. Obstetrics and gynecology, 116(6), 1281-1287.
Publication 2010
Dilatations, Cervical Disease Progression Epistropheus Ethics Committees, Research Ethnicity Gynecologist Hispanics Infant, Newborn Mothers Nulliparity Obstetric Delivery Obstetrician Obstetric Labor Pathological Dilatation Reproduction Woman
2
Perinatal Outcomes in Migrant Women
We recruited women delivering in three secondary and tertiary care maternity hospitals of Berlin/Germany ((1) the Virchow Campus site of the Charité University Hospital, (2) the Vivantes Klinikum am Urban, and (3) the Vivantes Klinikum Neukölln) in a 12-month period 2011/12 (n = 8157). Minors (n = 105, 1.3%), tourists not resident in Germany (n = 24, 0.3%), women terminating a pregnancy, and women with miscarriages and stillbirths (fetal death in utero ascertained at hospital admission and before onset of labor, n = 106, 1.3%) were excluded. It was not possible to contact 363 women despite multiple attempts. Of the remaining 7559 women 381 declined to participate. We conducted face-to-face interviews and linked them with highly standardized obstetric process and outcome data from hospital databases. Linkage of available interview data with obstetric process and outcome data failed in 72 cases. Six women did not consent to the linkage of data sources. In total, 7100 women participated (response rate of 89.6%). This corresponded to 7334 birth data records because of twin and triplet births.
For the analysis presented here, we considered only nulliparous women with vertex pregnancies and singleton birth, 37th week of gestation onwards. Women with elective cesarean delivery were excluded as they are not informative for our study question. We further restricted the sample to women with own migration experience (1st generation immigrants). Migrant women are a heterogeneous group. Health differences in this group might be larger than between migrant and non-migrant women. For this reason we selected women originating from Turkey and Lebanon (the two largest and only immigrant groups that allow separate analysis) and to women without a migration history (non-immigrant women). Also, 63 women without data on cervical dilatation were removed from analyses (see Fig. 1).

Flowchart of case recruitment, Berlin Perinatal study, 2011/12

In the original study, interviews were conducted with each subject at two time points: on admission to the delivery room (T1) and on the second or third day postpartum in the maternity wards (T2). Questionnaires were available in German, Turkish, Kurdish, Arabic, and other languages. Translators were involved in case of language barriers. Nearly all women with migration background (193 of 205) were able to communicate with the obstetrician in German. For this analysis, only T1 data was used. Formally, the analyses reported here are secondary analyses as the original study question related to pregnancy outcomes such as frequeny of cesarean deliveries [20 (link)].
Breckenkamp J., Läcke E.M., Henrich W., Borde T., Brenne S., David M, & Razum O. (2019). Advanced cervical dilatation as a predictor for low emergency cesarean delivery: a comparison between migrant and non-migrant Primiparae – secondary analysis in Berlin, Germany. BMC Pregnancy and Childbirth, 19, 1.
Publication 2019
Cesarean Section Childbirth Dilatations, Cervical Face Fetal Death Genetic Heterogeneity Immigrants Migrants Miscarriage Nonmigrants Obstetrician Pregnancy Triplets Twins Uterus Woman
3
Identifying Risk Factors for Obstetric Outcomes
Covariates comprised known medical risk factors for the outcome. BMI (at admission) was coded as dummy variable: < 25 kg/m2, 25 - < 30 kg/m2, and ≥ 30 kg/m2. Medical treatment with an oxytocic agent was included as dichotomous variable. Age of pregnant women (continuous) and migration status (non-immigrant women, Turkish migrant women, Lebanese migrant women) were also included as covariates. Furthermore, we adjusted for confounding by socioeconomic factors by the best available proxy, educational attainment, measured by the highest graduation level. The variable was categorized into low (no education/primary school), medium (secondary education), and high attainment (technical collage/vocational school, a-level vocational diploma). Additionally, documented values of cervical dilatation (ranged from 0 cm to 10 cm) were used as continuous variable in the multivariate analysis.
Breckenkamp J., Läcke E.M., Henrich W., Borde T., Brenne S., David M, & Razum O. (2019). Advanced cervical dilatation as a predictor for low emergency cesarean delivery: a comparison between migrant and non-migrant Primiparae – secondary analysis in Berlin, Germany. BMC Pregnancy and Childbirth, 19, 1.
Publication 2019
Dilatations, Cervical Immigrants Migrants Oxytocics Pregnant Women Woman
4
Preterm Delivery Prevention with Magnesium
This trial was conducted at 20 participating Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network sites across the United States. Women were eligible if they were carrying singletons or twins at 24 through 31 weeks of gestation and were at high risk for spontaneous delivery because of rupture of the membranes occurring at 22 through 31 weeks of gestation or because of advanced preterm labor with dilatation of 4 to 8 cm and intact membranes. They were also eligible if an indicated preterm delivery was anticipated within 2 to 24 hours (e.g., because of fetal growth restriction). Women were not eligible if delivery was anticipated within less than 2 hours or if cervical dilatation exceeded 8 cm; in such cases, the intervention was assumed to have little chance of achieving an effect.10 (link) Additional exclusion criteria included rupture of the membranes before 22 weeks, unwillingness of the obstetrician to intervene for the benefit of the fetus, major fetal anomalies or death, maternal hypertension or preeclampsia, maternal contraindications to magnesium sulfate (e.g., severe pulmonary disorders), and receipt of intravenous magnesium sulfate within the previous 12 hours. The use of tocolytic drugs after randomization was proscribed.
The duration of gestation was determined at entry to the trial according to a previously described algorithm11 (link) that uses the date of the last menstrual period (if reliable) and the results of the earliest available ultrasound examination. The study was approved by the institutional review boards of each clinical site and the data coordinating center. All participants gave written informed consent before enrollment.
Rouse D.J., Hirtz D.G., Thom E., Varner M.W., Spong C.Y., Mercer B.M., Iams J.D., Wapner R.J., Sorokin Y., Alexander J.M., Harper M., Thorp JM J.r., Ramin S.M., Malone F.D., Carpenter M., Miodovnik M., Moawad A., O'Sullivan M.J., Peaceman A.M., Hankins G.D., Langer O., Caritis S.N, & Roberts J.M. (2008). A Randomized, Controlled Trial of Magnesium Sulfate for the Prevention of Cerebral Palsy. The New England journal of medicine, 359(9), 895-905.
Publication 2008
Dilatation Dilatations, Cervical Ethics Committees, Research Fetal Anomalies Fetal Growth Retardation Fetus High Blood Pressures Lung Diseases Menstruation Mothers Obstetric Delivery Obstetrician Pharmaceutical Preparations Pre-Eclampsia Pregnancy Premature Birth Premature Obstetric Labor Rupture, Spontaneous Sulfate, Magnesium Tissue, Membrane Tocolytic Agents Twins Ultrasonography Woman
5
Observing Childbirth Practices in LMICs
Twelve health facilities (maternity hospitals and maternity units within general hospitals [eg, district or regional hospitals]; three per country, all in urban areas) were purposively selected (appendix p 2). Health facilities were included in the study if they were not included in the formative phase, were a secondary-level facility or higher, had at least 200 births per month, had a well defined community catchment area, and allowed non-clinicians to perform observations. Data collection took place in Nigeria from Sept 19, 2016, to Feb 26, 2017, in Ghana from Aug 1, 2017, to Jan 18, 2018, in Guinea from July 1 to Oct 30, 2017, and in Myanmar from Jun 26 to Sept 5, 2017.
The labour observations were continuous, one-to-one observations of women by study researchers from admission, throughout labour and childbirth, until 2 h post partum. Labour observations were not done in Myanmar. The community-based survey was done with women up to 8 weeks post partum.
Women were eligible for the labour observation if they were admitted for childbirth in early established or active labour (<6 cm cervical dilation), were aged at least 15 years, were willing and able to participate, and provided informed consent. Women were not eligible if they were admitted for reasons other than childbirth, immediately transferred or taken directly to theatre, a first-degree relation to a facility employee (mother, sister, cousin), or distressed or otherwise unable to reasonably consent. Pregnant women who were not admitted were eligible to participate if they returned and were admitted for childbirth.
Women were eligible for the survey if they were admitted for childbirth, were aged at least 15 years, were willing and able to participate, resided in the catchment area, and provided consent. Women were not eligible if they were admitted for reasons other than childbirth, were a first-degree relation to a facility employee, were distressed or otherwise unable to reasonably provide consent, resided outside the catchment area, or were unable to provide sufficient contact information.
All women provided written consent. Institutional permission for recruitment and observation was obtained from each site; consent was not sought from providers. This study was approved by the WHO Ethical Review Committee, WHO Review Panel on Research Projects, and in-country ethics committees. The country-specific ethical review committees that reviewed and approved this project were Le Comité National d'Ethique pour la Recherche en Santé (Guinea); Federal Capital Territory Health Research Ethics Committee (Nigeria); Research Ethical Review Committee, Oyo State (Nigeria); State Health Research Ethics Committee of Ondo State (Nigeria); Ethical Review Committee of the Ghana Health Service (Ghana); Ethical and Protocol Review Committee of the College of Health Sciences, University of Ghana (Ghana); and Ethics Review Committee, Department of Medical Research (Myanmar).
Bohren M.A., Mehrtash H., Fawole B., Maung T.M., Balde M.D., Maya E., Thwin S.S., Aderoba A.K., Vogel J.P., Irinyenikan T.A., Adeyanju A.O., Mon N.O., Adu-Bonsaffoh K., Landoulsi S., Guure C., Adanu R., Diallo B.A., Gülmezoglu A.M., Soumah A.M., Sall A.O, & Tunçalp Ö. (2019). How women are treated during facility-based childbirth in four countries: a cross-sectional study with labour observations and community-based surveys. Lancet (London, England), 394(10210), 1750-1763.
Publication 2019
Childbirth Dilatations, Cervical Ethics Committees Ethics Committees, Research Mothers Pregnant Women Woman Workers

Most recents protocols related to «Dilatations, Cervical»

1
Obstetrics Ward Admissions and Workflow
The study was conducted in June and July of 2019 in the Department of Obstetrics & Gynecology, Lok Nayak Hospital, Maulana Azad Medical College, New Delhi, India, which is one of the largest medical institutes in the country. It hosts over 1500 childbirths per month. Around eight to ten women are in labour at any point of time, with two to three doctors posted in each shift, round the clock. The obstetrics ward has forty beds, while the labour room has fifteen beds. Women are triaged at the time of admission. Women in early labour (upto 4 cm of cervical dilatation) are admitted to the wards, and those in an advanced stage of labour are admitted directly to the labour room.
Sarwal T., Sarwal Y., Tyagi S, & Sarwal R. (2023). Healthcare providers perceptions regarding the presence of Birth Companion during childbirth at a tertiary care hospital in India. BMC Pregnancy and Childbirth, 23, 159.
Publication 2023
Childbirth Dilatations, Cervical Physicians Woman
2
Intrapartum Caesarean Delivery Factors
The base cohort included the participants who met the inclusion criteria during the study period, and the cohort will be followed up until their placentas are delivered. The case group will be the women who receive intrapartum caesarean delivery finally, while the control group will be those who vaginally deliver their live babies. Intrapartum caesarean delivery is defined as a final caesarean section for women who planned vaginally deliver and had entered the latent phase of labour process. The signs of entering the latent phase are regular and gradually increased uterus contractions that occur at 5–6 min intervals and last for at least 30 s, accompanied by the cervical canal efface, the dilatation of the cervix and the decreasing fetal presentation.24 Each cohort case will be matched with two controls on age (within 2 years), gestational week (within 2 weeks) and same parity. The technical protocol of this study is shown in figure 1.
Huang C., Luo B., Wang G., Chen P, & Ren J. (2023). Development and validation of a prediction model for intrapartum cesarean delivery based on the artificial neural networks approach: a protocol for a prospective nested case–control study. BMJ Open, 13(2), e066753.
Publication 2023
Cervix Uteri Cesarean Section Dilatations, Cervical Infant Placenta Pregnancy Uterine Contraction Woman
3
Postpartum Hemorrhage and Obstetric Complications
Primary postpartum hemorrhage: Postpartum blood loss was visually estimated by the midwives and nurse, during which they made a quantitative estimate of the amount of blood lost. In direct blood collection, all blood lost during the postpartum period (except for the placenta and membranes) is contained in a disposable plastic collector bag, which is attached to a plastic sheet and placed under the woman's buttocks. When the bleeding stops, the bag could be gravimetrically weighed, allowing for a direct measurement (28 (link), 29 (link)).
Hemodynamic instability: It defined as any instability in the blood which changes (the pulse rate, the respiratory rate, the temperature, the blood pressure, the status of the skin and mucous membranes), which can lead to inadequate arterial blood flow to organs (3 ).
Prolonged labor: It is a failure of labor to progress and can be determined by the labor stage and whether the cervix has thinned and opened appropriately during labor (30 ).
Onset of labor: a series of continuous, progressive contractions of the uterus, additionally characterized by a bloody show and rupture of the amniotic sac (a bag of water), which is self-reported by the parturient or by a clinician report (30 ).
Prolonged latent phase of first stage: It had been defined as a nullipara who has not entered the active phase 20 h after the onset of the latent phase and a multipara who has not entered the active phase 14 h after the onset of the latent phase (30 ).
Prolonged in active first stage labor: A dilatation of cervix <1–2 cm/h after a women reaches the active phase (≥6 cm) is considered a delay in progress of labor (30 ).
Prolonged second stage of labor: this stage covers more than 2.5 h duration for nulliparous and 1 h in multiparous (30 ).
Obstructed labor is defined as labor with little or no progress despite strong uterine contractions confirmed through vaginal and abdominal examination (30 ).
Retained placenta: A placenta that was actively controlled during the third stage of labor and has not undergone placental expulsion within 30 min of the baby's birth (31 (link)).
Uterine atony is defined as a soft and weak uterus after delivery, and it happens when the uterine muscles don't contract enough to clamp the placental blood vessels shut after childbirth (30 , 31 (link)).
Zenebe G.A., Zenebe W.A., Ewunie T.M, & Dires S. (2023). Primary postpartum hemorrhage and associated factors among delivering women in Gedeo Zone, Southern Ethiopia. Frontiers in Medicine, 10, 1096501.
Publication 2023
Abdomen Amnion Arteries Birth BLOOD Blood Circulation Blood Pressure Blood Vessel Buttocks Cervix Uteri Debility Dilatations, Cervical Hemodynamics Immediate Postpartum Hemorrhage Midwife Mucous Membrane Myometrium Nulliparity Nurses Obstetric Delivery Obstetric Labor Placenta Placenta, Retained Postpartum Hemorrhage Pulse Rate Respiratory Rate Skin Tissue, Membrane Uterine Contraction Uterine Inertia Uterus Vagina Woman
4
Preterm Delivery Predictors in Abnormal Discharge
Pregnant women who presented with abnormal vaginal discharge, preterm pre-labour rupture of membrane (PPROM) or preterm labour, gestational age from 22 weeks to 34 weeks, singleton pregnancy, and those who consented to the study were recruited. Abnormal vaginal discharge was defined as a change in colour (such as grey, green or yellow, or blood-stained), copious amount, or odour, associated with itchiness or soreness. Preterm labour was defined as having regular contractions of at least 2 in 10 min with cervical effacement and cervical os dilatation. Pregnant women with the following criteria were excluded: obstetric complications that can be confounding factors for preterm delivery such as pre-existing medical disorders e.g., diabetes, hypertension, cardiac and renal disease, and all complicated pregnancies (antepartum hemorrhage, fetal anomaly, multiple gestation, intrauterine growth restriction, or polyhydramnios. Oligohydramnios caused by IUGR or fetal anomalies were excluded. However, oligohydramnios following PPROM during enrolment was not our exclusion criteria). Women who had cervical incompetence, uterine or cervical anomaly, fetal death, and history of recent douching, or sexual intercourse pre-testing, as well as recent use of systemic or vaginal antimicrobial therapy either as suppository drugs or spray within the preceding 72 h were excluded from the study.
Ng B.K., Chuah J.N., Cheah F.C., Mohamed Ismail N.A., Tan G.C., Wong K.K, & Lim P.S. (2023). Maternal and fetal outcomes of pregnant women with bacterial vaginosis. Frontiers in Surgery, 10, 1084867.
Publication 2023
Coitus Diabetes Mellitus Dilatation Dilatations, Cervical External Os of the Cervix Fetal Anomalies Fetal Death Fetal Growth Retardation Fetal Membranes, Premature Rupture Gestational Age Heart Hemorrhage High Blood Pressures Kidney Diseases Microbicides Neck Odors Oligohydramnios Pessaries Pharmaceutical Preparations Pharmacotherapy Polyhydramnios Pregnancy Pregnancy Complications Pregnant Women Premature Birth Premature Obstetric Labor Suppositories Therapeutics Uterine Cervical Incompetence Uterus Vagina Vaginal Suppository Woman
5
Misoprostol for Induction of Labor
The Angusta® protocol consisted of the oral administration of 25 µg of misoprostol every 2 h. The dose not to be exceeded in 24 h was 200 µg, or eight tablets. The entire procedure took 14 h. All of the tablets were delivered with a glass of water by a midwife. Tablet administration was recorded on a handwritten sheet. Pain was scored on a numerical scale at tablet administration. Cardiotocography (CTG) was performed for at least 30 min before and 60 min after first the administration of misoprostol. In the absence of an anomaly, repetitive CTG was not systematic. CTG was performed only in the event of painful uterine contractions suggesting labor, loss of amniotic fluid, or bleeding.
There was an additive effect of misoprostol and oxytocin. This required a wash-out interval of 4 h between the last intake of Angusta® and the introduction of oxytocin.
We recorded each patient’s age, gestity, parity, body mass index (BMI), initial Bishop score, and gestational age of IOL.
The beginning of labor required cervical dilation greater than 3 cm, and active labor was diagnosed as a cervical dilation greater than 6 cm. We reported the time between taking the first tablet and the start of labor, and between taking the first tablet and the active phase of labor, in hours.
Pambet M., Delabaere A., Figuier C., Lambert C., Comptour A., Rouzaire M, & Gallot D. (2023). Factors of Non-Compliance with a Protocol for Oral Administration of Misoprostol (Angusta®) 25 Micrograms to Induce Labor: An Observational Study. Journal of Clinical Medicine, 12(4), 1521.
Publication 2023
Administration, Oral Amniotic Fluid Cardiotocography Dilatations, Cervical Gestational Age Index, Body Mass Midwife Misoprostol Obstetric Labor Oxytocin Pain Patients Tablet Uterine Contraction

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The Pipelle aspirator is a medical device used for the collection of endometrial tissue samples. It is a single-use, flexible plastic tube with a piston mechanism that is inserted into the uterus to gently suction and extract a small amount of the uterine lining for diagnostic purposes.
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More about "Dilatations, Cervical"

Dilatations, Cervical refer to the process of widening or expanding the opening of the cervix, the lower part of the uterus.
This procedure is commonly performed during various medical examinations, procedures, and treatments, such as cervical dilation and curettage (D&C), intrauterine device (IUD) insertion, and hysteroscopy.
The cervical dilation process can be facilitated using a variety of techniques and tools, including: - Mechanical dilators: These are specialized instruments, such as the Hegar dilator or the Pipelle aspirator, that are manually inserted into the cervix to gradually expand the opening. - Osmotic dilators: These are materials, like laminaria tents or Cytotec (misoprostol), that absorb moisture and swell, causing the cervix to dilate. - Pharmacological agents: Medications like Ropivacaine can be used to numb the cervix and facilitate dilation.
Proper cervical dilation is crucial for various medical procedures, as it allows for safe and effective access to the uterine cavity.
Researchers and healthcare professionals often investigate different dilation techniques, including comparing the effectiveness, safety, and patient comfort of various methods.
PubCompare.ai, an AI-driven platform, can help streamline the research process on cervical dilatations.
The tool allows users to discover protocols from literature, preprints, and patents, and leverage AI-powered comparisons to identify the best approaches for their needs.
This can be particularly useful for studies involving cervical dilation, where researchers may need to compare different techniques, tools, or medications.
In addition to cervical dilation, PubCompare.ai can also assist with research on related topics, such as the use of SAS 9.4, SPSS version 14.0 or 19.0, RNAlater solution, and Paraformaldehyde in various medical and scientific applications.
By providing a seamless and reproducible research process, this innovative tool can help researchers make more informed decisions and optimize their studies on cervical dilatations and related areas.