BACKGROUND One of the strategies for a good outcome and pain free childbearing is to design the delivery room. OBJECTIVES The aim of this study was to evaluate the effects of snoezelen room on childbearing outcome such as pain intensity, duration of labor, and perinea status in nulliparous women. PATIENTS AND METHODS This study was a randomized controlled clinical trial consists of 100 chil...

BACKGROUND Anesthesia today has strived to decrease labor pain in a tolerable and controllable fashion. Intrathecal midazolam has been introduced as an adjunct to analgesics. The study was planned to assess the efficacy, safety and duration of analgesia produced by intrathecal midazolam adjunct to sufentanil in decreasing labor pain. METHODS In a randomized clinical trial 80 parturient includ...

OBJECTIVE The purpose of this study was to identify an appropriate population and a balanced set of maternal and neonatal measures to drive a hospital network obstetric quality improvement program. STUDY DESIGN Sutter Health, a large Northern California health care system with>40,000 births annually, served as the site for this project. We chose to focus on the standardized nulliparous patien...

OBJECTIVE To increase access to early second-trimester surgical abortion by determining noninferiority of same-day synthetic osmotic dilators compared with overnight Laminaria for cervical preparation before early second-trimester dilation and evacuation. METHODS We enrolled women between 14 and 18 weeks of gestation and randomized them to same-day synthetic osmotic dilators or overnight Lami...

OBJECTIVE To compare labor outcomes in women accompanied by an additional support person (doula group) with outcomes in women who did not have this additional support person (control group). DESIGN Randomized controlled trial. SETTING A women's ambulatory care center at a tertiary perinatal care hospital in New Jersey. PATIENTS/PARTICIPANTS Six hundred nulliparous women carrying a singlet...

OBJECTIVE To investigate if occiput posterior delivery is the consequence of persistence of an initial occiput posterior position or malrotation from an initial occiput anterior or transverse position. METHODS This was a cross-sectional study involving transabdominal sonography to determine fetal occipital position in 918 singleton pregnancies with cephalic presentation in active labor at 37-...

The objective of this descriptive study was to characterize the transfers of mothers from the Sapopemba Birth Center to reference hospitals in São Paulo, from September 1998 to July 2008. The studied population was 229 cases of mother transfers. Data were obtained from medical records and record books of the transferred women. Descriptive analysis was performed. The transfer rate was 5.8% (5.5%...

You are a busy family physician with a practice that includes obstetrics and teaching medical students. Cervical examinations are a routine part of your on-call duties. You have medical trainees with you, and they have often struggled with the cervical examination. One night on call, your trainee admits a patient in active labour and reports the cervical dilation to be 7 cm. However, she is unc...

Background: Dysfunctional labour is the commonest abnormality of first stage labour. It complicates 50% nulliparous deliveries and associated with increased perinatal morbidity mortality. occurs when progress in active phase abnormally slow (<1 cm/hr). largely due to ineffective uterine contractions or cervical dilatation. Augmentation oxytocin standard management dysfunctional as it enhance...

Endometerial biopsy is often performed as outpatient procedure. Difficulty may be encountered in entering cervical os especially in nulliparous women. This may cause, complications, excessive pain and may even hinder performance of the procedure. The same problem may occur during hysteroscopy, dilatation & curettage, chromopertubation, IUCD insertion or fractional curettage. If cervical priming...