During pregnancy, high progesterone and relaxin levels produce physiological ligament relaxation on the pelvis. Therefore, moderate pubic symphysis and sacroiliac joints relaxing provide birth canal widening, thereby facilitating vaginal delivery. Sometimes, functional pain or pelvic instability may occur during pregnancy or puerperium, which is defined as symptomatic pelvic girdle relaxation. ...

This Practice Bulletin was developed by the ACOG Committee on Practice Bulletins— Obstetrics with the assistance of Suneet P. Chauhan, MD and George A. Macones, MD. The information is designed to aid practitioners in making decisions about appropriate obstetric and gynecologic care. These guidelines should not be construed as dictating an exclusive course of treatment or procedure. Variations i...

A wide range of clinical techniques and investigations is available to healthcare professionals to survey the condition of a fetus in the womb. These may be deployed from early pregnancy to birth. They range from the use of traditional equipment such as a Pinard's stethoscope, which allows direct auscultation of the fetal heartbeat, to ultrasound imaging of the fetus, which gives an ever-increa...

Recruitment of pregnant women in labour to clinical trials poses particular challenges. Interpretation of regulation lacks consistency or clarity and variation occurs as to the training required by clinicians to safely contribute to the conduct of intrapartum studies. The Royal College of Obstetricians and Gynaecologists Intrapartum Clinical Study Group initiated the development of a pragmatic,...

delivered safely. Perinatal death audits that evaluate both cause of death and potential for preventability are crucial to reduce preventable mortality. Finally, availability of sufficient staff and appropriate equipment to handle obstetric emergencies is crucial. Most important is the recognition that in order to reduce neonatal death and disability from intrapartum asphyxia, prevention and tr...