Sentences with phrase «of multiparous women»

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).

Not exact matches

: «1.1.1 Explain to both multiparous and nulliparous women who are at low risk of complications that giving birth is generally very safe for both the woman and her baby.

1.1.2 Explain to both multiparous and nulliparous women that they may choose any birth setting (home, freestanding midwifery unit, alongside midwifery unit or obstetric unit), and support them in their choice of setting wherever they choose to give birth: Advise low ‑ risk multiparous women that planning to give birth at home or in a midwifery ‑ led unit (freestanding or alongside) is particularly suitable for them because the rate of interventions is lower and the outcome for the baby is no different compared with an obstetric unit.

Our results support a policy of offering healthy nulliparous and multiparous women with low risk pregnancies a choice of birth setting.

For multiparous women there was no evidence of a difference in the primary outcome by planned place of birth.

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.

An additional analysis separating multiparous and primiparous women was undertaken as well as an analysis of stillbirth and early neonatal death.

The odds of cesarean section among women planning out - of - hospital birth were lower among multiparous women than among nulliparous women and among women with 12 years of education or less than among women with more than 12 years of education (Figure 1).

Overall, and for multiparous women, planned birth at home generated the greatest mean net benefit with a 100 % probability of being the optimal setting across all thresholds of cost effectiveness when perinatal outcomes were considered.

This decision uncertainty surrounding the most cost effective option was not found for place of birth in multiparous low risk women without complicating conditions, in whom planned home birth had a 100 % probability of being the most cost effective option across all thresholds of cost effectiveness (table 4).

With regards to maternal outcomes in nulliparous and multiparous women, planned birth at home generated the greatest mean net benefit with a 100 % probability of being the optimal setting across all thresholds of cost effectiveness.

This decision uncertainty surrounding the most cost effective option was not found for place of birth in multiparous low risk women, on whom planned home birth had a 100 % probability of being the most cost effective option across all cost effectiveness thresholds between # 0 and # 100000 (table 3).

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).

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).

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).

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).

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.

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).

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).

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).

Rates of cesarean section for multiparous women, when women with previous cesarean sections were excluded, were not different (p value cut - off for statistical significance after the Bonferroni correction 0.002).

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.

Power analysis, based on detecting a significant difference in the combined frequency of non-optimal factors during and after childbirth, led us to aim for a sample size of 1600 women, with approximately half being multiparous and preferably half choosing hospital birth.

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

Multiparous women were more likely to choose a hospital birth if they belonged to an ethnic minority; had a non-optimal body mass (Quetelet index outside the range 18.8 - 24.2; P < 0.05); had a history of obstetric complications, preterm birth, or instrumental delivery; or had received medication (including vitamins and iron) in pregnancy (table 2).

Of women in our study with prolonged second stage diagnosed, 20.5 % were delivered in less than 3 hours (for primiparous women) and in less than 2 hours (for multiparous women) from the time of complete dilatioOf women in our study with prolonged second stage diagnosed, 20.5 % were delivered in less than 3 hours (for primiparous women) and in less than 2 hours (for multiparous women) from the time of complete dilatioof complete dilation.