Purpose of the Study The purpose of the study that is still in continuation is the use of the Odon device during complicated vaginal deliveries such as prolonged stage two labor. With current trials underway in China, India, South Africa, and Argentina and the hypothesis of safety and success is currently being tested. The current trials underway are being examined to determine if the Odon device is as safe and effective as compared to current forms of tools used for complicated labors including forceps and vacuum extraction. The study is also currently testing to prove cost effectiveness and uses for rural areas in which maternal mortality rates as well as neonatal mortality rates are increasingly high due to complicated labor and limited resources. With this study making its advancements in modern Obstetrics the researchers and data hope to prove success by adding the Odon device to the list of Obstetric tools available for use.
Literature Review A review of the literature by the authors found extensive data to support the Odon device as being the more cost effective and reasonable choice for complicated labor. When comparing current options available today like the use of forceps and the vacuum extractor all approved assisted instrument for complicated labor the authors found that the vacuum extractor is less likely to achieve vaginal delivery than forceps but is associated with lower caesarean deliveries and less perineal and fetal injuries. With further testing and
Vacuum assisted deliveries are a method to help facilitate a vaginal birth even if the mother is becoming to exhausted to push or if the baby has reached a difficult position during labor and is prevented from progressing. While the vacuum may be helpful for the labor it runs the risk of causing a subgaleal hemorrhage (SHG) in newborns this condition is a result of the connection between the sinuses of the scalp and the veins of the brain have been ruptured which causes bleeding and swelling of the head and can lead to severe hypovolemia and death (Davis, 2001). SGH occurrences after vacuum delivery are in the range of 26 to 45 per 1000 vaginal deliveries (Modanlou, 2010). In order to treat and correct SGH nurses are
Compared to the general adult population the maternal airway management can be more challenging as changes during pregnancy can increase the difficulty of intubation (Brien and Conlon, 2013). Its makes hard to insert laryngoscope when the patient have a large breast, the chance of bleeding and swelling increases due to oedema and vascularity of the upper respiratory tract, and the patient desaturate quicker as there is increase in oxygen requirements and there is reduced in functional residual capacity (Mushambi et al, 2015). As a result of all the changes during pregnancy, if the problems encountered during the intubation of Mrs D were to happen to an obstetric patient, it is important to provide optimal surgical condition for to progress rapidly while aiming for a good neonatal outcome (Local theatre policy, 2015b). In obstetric patients, much of the issue is about the urgency with which the foetus must be delivered and the surgical operation must be done as quickly as possible - therefore making decisions in the event of certain clinical situations occurring will require a much quicker decision making process because there is an immediate threat to the life of the woman or foetus (Mushambi et al, 2015). This is why emergency obstetric anaesthesia is such a potentially hazardous
In order to obtain an in depth knowledge of the subject of perineal massage in the intrapartum period, an extensive amount of literature needed to be investigated, this was done by accessing the University electronic database, which accessed a vast amount of sources. A search was performed using CINAHL (Cumilative Index to Nursing and Allied Health Literature). CINAHL searches a variety of health journals from around the world. By searching using key words a significant amount of literature was sourced. In order to narrow down the results the search was repeated but key words were combined, this was to access results that were more specific to the subject area. Though this database was useful and provided a vast amount of literature, few of the articles were actually research based, therefore those ones were excluded.
Randomization was used to generate what patient went to which group. The way the patients were chosen eliminated bias because “Randomization was performed according to a computer-generated list by means of sequentially numbered, opaque, sealed envelopes which revealed the allocation of the subject to either induction or expectant management”(Nielsen et al. p. 60). This secure randomization added a great strength to the study. The sample size seemed fairly large, 226 patients were split into 116 for elective induction and 110 to expectant management, although the power analysis was disclosed in this study and determined that 600 patients were required. Only 226 patients were used and because it would take 4 years to reach the required amount of patients, the study was discontinued. This was both a strength and weakness because disclosing this information made the study more honest but the quota needed to reach the best answers was not attained. The study for the 226 patients was pretty standard with the 80% power and alpha at 0.05. T-test and chi square tests were used to compare the proportions between the groups of people. The women were chosen based on the inclusion criteria of being 39 weeks gestation or older, maternal age of more than 17, fetal cephalic presentation, singleton gestation, a candidate for vaginal delivery, and a Bishop score of 5 or greater in nulliparous women and 4 or greater for multiparous women. This inclusion criterion was a concern because both nulliparous women and multiparous women were being tested together. This was a weakness because the labor patterns of a nulliparous woman compared to a multiparous woman are very variable and sure to distort study data. It was also disclosed how gestational age was achieved which included the crown rump test measured in 6-12
The author is a nurse in a level two trauma facility in a community of approximately fifty thousand people in Oregon. The community is a college-town surrounded by a large agricultural area. There is a minimal ethnic diversity within the community. The diversity present occurs mainly from internationally students and faculty from the college. There is a growing population of women who desire low interventional births in the community. The author has worked on the labor and delivery unit of the hospital for the last 14 years. The hospital is the only one in the area to offer trial of labor services to women who have previously undergone a cesarean section. The unit on average experiences around 1000 deliveries annually.
The intent of this paper is to examine effective solutions for reducing cesarean deliveries. Cesarean deliveries involve more risk to both the mother and baby than vaginal births do. Cesarean deliveries have a higher potential of complications than vaginal births. Cesarean deliveries cost more, require longer hospital stays, and require more resources—both human and systemic—than vaginal births.
Over the years birthing methods have changed a great deal. When technology wasn’t so advanced there was only one method of giving birth, vaginally non-medicated. However, in today’s society there are now more than one method of giving birth. In fact, there are three methods: Non-medicated vaginal delivery, medicated vaginal delivery and cesarean delivery, also known as c-section. In the cesarean delivery there is not much to prepare for before the operation, except maybe the procedure of the operation. A few things that will be discussed are: the process of cesarean delivery, reasons for this birthing method and a few reasons for why this birthing method is used. Also a question that many women have is whether or not they can vaginally
“Today, many if not most obstetricians do not attend births: they perform fetal extractions through the vagina or through an abdominal cut.” Faith Gibson (p.37)
The authors have done a thorough literature review and presented their findings by starting out with some important statistics about typical supportive care during the birth process, and elaborating on the last 50 years of research done on the types of pushing efforts and how they related to the outcomes of the births. It reflects on the role of midwives as being supportive of spontaneous pushing by the mother and the positive outcomes for those women and children. They did report on a recent meta-analysis which supported the use of spontaneous pushing and only recommended directed pushing in certain hazardous situations. The authors’ review of the current literature affirms their claim that there have been no studies done to analyze the role
The nurse must be mindful of each intervention initiated and the possible benefits of the intervention against its potential harmful effects for both mother and fetus. Not providing basic comfort measures for the mother can cause serious physical and emotional problems and could lead to possible fatigue and feelings of failure from the mother. The priority of this nursing intervention is to provide the mother and fetus with the least discomfort as possible and
Hands on or hands off the perineum: a survey of care of the perineum in labour (HOOPS) (Trochez, Waterfield and Freeman, 2011).
Vaginal birth after caesarean (VBAC) is the name used for identifying the method of giving birth vaginally after previously delivering at least one baby through a caesarean section (CS). A trial of labour (TOL) is the term used to describe the process of attempting a VBAC. An elected repeat caesarean (ERC) is the other option for women who have had a caesarean in the past. The rates of women choosing to deliver by means of an ERC has been increasing in many countries, this is typically due to the common assumption that there are too many risks for the baby and mother (Knight, Gurol-Urganci, Van Der Meulen, Mahmood, Richmond, Dougall, & Cromwell, 2013). The success rate of VBAC lies in the range of 56 - 80%, a reasonably high success rate, however, the repeat caesarean birth rate has increased to 83% in Australia (Knight et al., 2013). It is essential to inform women of the contraindications, success criteria, risks, benefits, information on uterine rupture and the role of the midwife in relation to considering attempting a VBAC (Hayman, 2014). This information forms the basis of an antenatal class (Appendix 1) that provides the necessary information to women who are considering attempting a VBAC and can therefore enable them to make their own decision regarding the mode of birth.
Childbirth can be described as one of the most rewarding and also painful experiences in a woman’s life. Most women choose some type of method to ease pain, however, there has been a lot of controversy over with pain management method is the most effective. According to the CDC (Center for Disease Control), In 2013, there were 3,932,181 births recorded in the United States, 32.7% of those births were surgical procedures. In 2012, 1.36% of recorded births occurred out-of-hospital, meaning these births took place mostly in homes or birthing centers. Without the option of medicine that a hospital provides, how were these women able to manage their pain during labor and delivery. There are many different methods for easing pain during childbirth, some methods involve the use of medicine and surgery, and others include natural techniques, such as hypnosis, Lamaze, and many others. It is a personal preference of the parents over which method is right for the needs of the mother and child. This can be an overwhelming decision for new parents to make because they have to take into consideration the safety of the mother and child, pain management for the mother and desire for medical involvement.
monitor fetal heartbeat. In the first stage of labor , the neck of the uterus,
A first time pregnant woman in labor who has limited medical knowledge about episiotomy may become frighten when all of a sudden as she is actively pushing, the provider tells her stop because the passageway to let the baby out is narrow, therefore he/she is going to perform a procedure which involves an incision made to the vagina that will assist the birthing process, therefore allowing the baby to be delivered easily and preventing further complications. This might be really frightening to the patient due to her limited knowledge and prior misconceptions about the procedure.