Sentences with phrase «multiparous women»

For multiparous women with low risk pregnancies, the perinatal outcome of planned home birth was significantly better than that of planned hospital birth, whether or not background was controlled for.

For primiparous women, it was assumed that the scars represented previous myomectomies, but the higher rate among multiparous women suggests that some primary cesarean deliveries actually may have been repeat cesarean deliveries that were recorded incorrectly.

Among women who had a primary cesarean delivery for failure to progress, 42.6 % of primiparous women and 33.5 % of multiparous women never progressed beyond 5 cm of dilation before delivery (Table 3).

In multiparous women there were more differences between planned hospital births and planned home births: rates of referral during labour, inadequate progress, perineal laceration, episiotomy, medication in third stage of labour, placental retention, postpartum haemorrhage, and blood transfusion (table 1).

A prospective study of the progress of labor in 220 nulliparous women and 99 multiparous women who spontaneously entered labor evaluated the benefit of prolonging oxytocin augmentation for an additional 4 hours (for a total of 8 hours) in patients who were dilated at least 3 cm and had unsatisfactory progress (either protraction or arrest) after an initial 4 - hour augmentation period (21).

Researchers have found that after a 3 - hour or more second stage of labor, only one in four nulliparous women (27) and one in three multiparous women give birth spontaneously, whereas up to 30 — 50 % may require operative delivery to give birth vaginally in the current second stage of labor threshold environment (30).

A population - based study of 58,113 multiparous women yielded similar results when the duration of the second stage was greater than 2 hours (31).

Using this tool we compared the outcomes of planned home births with those of planned hospital births for primiparous and multiparous women after controlling for the confounding effects of social, medical, and obstetric background.

In our cohort, 42.6 % of primiparous women and 33.5 % of multiparous women underwent a primary cesarean delivery for failure to progress when the cervix was dilated less than 6 cm.

Results: Thirty - one percent (n = 190/604) of nulliparous and 18 % (n = 143/782) of multiparous women reported high fear levels.

For example, the recent Eunice Kennedy Shriver National Institute of Child Health and Human Development document suggested allowing one additional hour in the setting of an epidural, thus, at least 3 hours in multiparous women and 4 hours in nulliparous women be used to diagnose second - stage arrest, although that document did not clarify between pushing time or total second stage (33).

Multiparous women (someone who has had more than one child) will often see it earlier.

Transfers were four times as common among primiparous women (25.1 %) as among multiparous women (6.3 %), but urgent transfers were only twice as common among primparous women (5.1 %) as among multiparous women (2.6 %).

However, higher rates of a composite outcome of perinatal morbidity and mortality were seen for nulliparous women having homebirths (adjusted odds ratio 1.75; 95 % CI, 1.07 — 2.86), with no differences for multiparous women.

No difference in long - term outcomes for planned home versus planned hospital births for multiparous women.

The duration of the second stage of labor and its relationship to neonatal outcomes has been less extensively studied in multiparous women.

In this study, the 95th percentile rate of active phase dilation was substantially slower than the standard rate derived from Friedman's work, varying from 0.5 cm / h to 0.7 cm / h for nulliparous women and from 0.5 cm / h to 1.3 cm / h for multiparous women (the ranges reflect that at more advanced dilation, labor proceeded more quickly)(Table 2).

Given the available literature, before diagnosing arrest of labor in the second stage and if the maternal and fetal conditions permit, at least 2 hours of pushing in multiparous women and at least 3 hours of pushing in nulliparous women should be allowed (Table 3).

A prolonged latent phase (eg, greater than 20 hours in nulliparous women and greater than 14 hours in multiparous women) should not be an indication for cesarean delivery.

For women who had not progressed despite 4 hours of oxytocin (and in whom oxytocin was continued at the judgment of the health care provider), the vaginal delivery rates were 88 % in multiparous women and 56 % in nulliparous women.

The vaginal delivery rate for women who had not progressed despite 2 hours of oxytocin augmentation was 91 % for multiparous women and 74 % for nulliparous women.

On the basis of the 95th percentile threshold, historically, the latent phase has been defined as prolonged when it exceeds 20 hours in nulliparous women and 14 hours in multiparous women (18).

In one retrospective study of 5,158 multiparous women, when the duration of the second stage of labor exceeded 3 hours, the risk of a 5 - minute Apgar score of less than 7, admission to the neonatal intensive care unit, and a composite of neonatal morbidity were all significantly increased (30).

For example, a case — control study demonstrated that women with a prior cesarean delivery and no prior vaginal delivery had labor patterns similar to nulliparous women, whereas women with a prior cesarean as well as a prior vaginal delivery had labor patterns similar to multiparous women (125).

The median value of the perinatal background index (our cutoff between favourable and unfavourable) was 29 points for primiparous women and 28 points for multiparous women.

Primiparous women and multiparous women were considered separately because of well known differences in outcome.

However, the multiparous women in our study were at low risk and their history would not have prompted referral to an obstetrician.

Non-optimal characteristics in perinatal outcome index among planned home and planned hospital births in primiparous and multiparous women

Primiparous women (t = 1.99, P < 0.05) and multiparous women (t = 5.56, P < 0.001) with a planned home birth scored better on the perinatal outcome index than those with planned hospital birth.

In multiparous women, the perinatal outcome index controlled for background was significantly better with planned home birth than with planned hospital birth (table 3).