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Management of Labor and Delivery, An Issue of Obstetrics and Gynecology Clinics, E-Book

Management of Labor and Delivery, An Issue of Obstetrics and Gynecology Clinics, E-Book

Aaron B. Caughey

(2017)

Additional Information

Book Details

Abstract

Dr. Caughey has recruited top experts to address the current questions and thinking with regard to the management of labor and delivery. Authors have presented current clinical reviews on the following topics: Defining and managing normal and abnormal first stage of labor; Defining and managing normal and abnormal second stage of labor; Laborist models on labor and delivery; Quality Improvement on Labor and Delivery; Fetal Malposition; Is there a place for outpatient pre-induction cervical ripening; Management of twins on labor and delivery; Cervical ripening techniques: Which is the best; Augmentation of labor: What are the approaches; Elective induction of labor: What is the impact; VBAC trends: Which way is the pendulum swinging; and Update on fetal monitoring. Readers will come away with the current clinical trends and information they need to successfully manage labor and delivery.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Management of Labor and Delivery\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents v
Foreword: Addressing Common Management Dilemmas in Labor and Delivery v
Preface: Evidence-Based Management of Labor and Delivery: What Do We Still Need to Know? v
Evidence-Based Labor and Delivery Management: Can We Safely Reduce the Cesarean Rate? v
Defining and Managing Normal and Abnormal First Stage of Labor v
Defining and Managing Normal and Abnormal Second Stage of Labor v
Labor Induction Techniques: Which Is the Best? vi
Is There a Place for Outpatient Preinduction Cervical Ripening? vi
Augmentation of Labor: A Review of Oxytocin Augmentation and Active Management of Labor vi
Elective Induction of Labor: What is the Impact? vi
Update on Fetal Monitoring: Overview of Approaches and Management of Category II Tracings vii
The Evolution of the Laborist vii
Fetal Malpresentation and Malposition: Diagnosis and Management vii
Labor and Delivery of Twin Pregnancies vii
Vaginal Birth After Cesarean Trends: Which Way Is the Pendulum Swinging? viii
Quality Improvement and Patient Safety on Labor and Delivery viii
OBSTETRICS AND GYNECOLOGY CLINICS\r ix
FORTHCOMING ISSUES ix
March 2018 ix
June 2018 ix
September 2018 ix
RECENT ISSUES ix
September 2017 ix
June 2017 ix
March 2017 ix
Foreword: Addressing Common Management Dilemmas in Labor and Delivery\r xi
Preface:\rEvidence-Based Management of Labor and Delivery: What Do We Still Need to Know? xiii
REFERENCES xiv
Evidence-Based Labor and Delivery Management 523
Key points 523
INTRODUCTION 523
WHY IS THE CESAREAN RATE INCREASING? 524
HOW DOES CESAREAN DELIVERY AFFECT PREGNANCY OUTCOMES? 525
WHAT ARE THE POTENTIAL APPROACHES TO SAFELY REDUCING CESAREAN DELIVERIES? 526
VAGINAL BIRTH AFTER CESAREAN DELIVERY 526
LABOR MANAGEMENT 526
ABNORMAL FETAL HEART RATE TRACINGS 528
MALPOSITION 528
MALPRESENTATION 528
TWIN GESTATIONS 529
INDUCTION OF LABOR 529
OTHER MANAGEMENT ISSUES 529
SUMMARY 530
REFERENCES 530
Defining and Managing Normal and Abnormal First Stage of Labor 535
Key points 535
INTRODUCTION 535
HISTORIC VERSUS MODERN LABOR CURVE 536
SPONTANEOUS LABOR 537
INDUCED LABOR 538
SPECIAL POPULATIONS 539
OBESITY 539
PRETERM LABOR 540
TRIAL OF LABOR AFTER CESAREAN 540
FETAL DESCENT 541
DEFINITIONS OF LABOR ARREST 541
FIRST-STAGE LABOR ARREST 541
FAILED INDUCTION OF LABOR 542
MANAGEMENT OF ABNORMAL LABOR 542
OXYTOCIN 542
INTERNAL TOCODYNAMOMETRY 543
AMNIOTOMY 543
SUMMARY 543
REFERENCES 544
Defining and Managing Normal and Abnormal Second Stage of Labor 547
Key points 547
INTRODUCTION 547
DEFINING NORMAL AND ABNORMAL LENGTH OF SECOND STAGE 548
FACTORS INFLUENCING LENGTH OF SECOND STAGE 548
Maternal and Obstetric Characteristics 548
Impact of Epidural Analgesia: Maternal Effect 549
Impact of Epidural Analgesia: Length of Labor 549
Impact of Epidural Analgesia: Operative Interventions 550
MANAGEMENT OF SECOND STAGE OF LABOR 550
Epidural Analgesia: Delayed Versus Immediate Pushing 550
Epidural Analgesia: Discontinuation Late in Labor 551
Epidural Analgesia and Fetal Occiput Malposition 552
MANAGEMENT OF PROLONGED SECOND STAGE OF LABOR 552
Length of Active Pushing During Second Stage and Associated Outcomes 552
Timing of Operative Intervention and Associated Perinatal Outcomes 553
PERINATAL OUTCOMES ASSOCIATED WITH LENGTH OF SECOND STAGE 553
Length of Second Stage and Associated Maternal Outcomes 554
Length of Second Stage and Associated Neonatal Outcome: Nulliparous Women 554
Length of Active Pushing and Associated Neonatal Outcome 559
Length of Second Stage and Associated Neonatal Outcome: Multiparous Women 559
SUMMARY 560
REFERENCES 560
Labor Induction Techniques 567
Key points 567
INTRODUCTION 567
ASSESSING THE CERVIX 568
Bishop Score 568
Transvaginal Ultrasound Imaging 569
Fetal Fibronectin 569
Summary: Cervical Assessment 570
CERVICAL RIPENING WITH PHARMACOLOGIC METHODS 570
Prostaglandins 570
Prostaglandin E1 570
Administration of prostaglandin E1 570
Comparisons of misoprostol use by route of delivery 571
Future prospects for misoprostol 571
Prostaglandin E2 571
Prepidil 571
Cervidil 571
Comparison of efficacy of preparations of prostaglandin E2 571
Side effects of prostaglandins 572
Contraindications of prostaglandins 572
Oxytocin 572
CERVICAL RIPENING WITH MECHANICAL METHODS 572
Membrane Stripping 573
Balloon Catheter 573
Procedure 573
Risk of infection 573
Future prospects for the Foley balloon catheter 573
COMPARISON OF METHODS FOR CERVICAL RIPENING 573
Single-agent Methods for Cervical Ripening 574
Combination Methods for Cervical Ripening 574
Summary: Comparison of Cervical Ripening Methods 577
INDUCTION TECHNIQUES FOR THE FAVORABLE CERVIX 577
Mechanical Methods for Induction in the Favorable Cervix: Amniotomy 577
Timing of amniotomy 577
Addition of oxytocin to amniotomy 577
Summary: amniotomy 578
Pharmacologic Methods in the Favorable Cervix: Oxytocin 578
Oxytocin protocols 579
SUMMARY 579
REFERENCES 579
Is There a Place for Outpatient Preinduction Cervical Ripening? 583
Key points 583
INTRODUCTION 583
METHODS 584
Foley Bulb 584
Outpatient data 584
Risks and safety profile 584
Prostaglandin Gel and Insert 585
Background 585
Outpatient data 585
Risk and safety profile 586
Cytotec 586
Background 586
Outpatient data 587
Risk and safety 587
Nitric Oxide 588
Background 588
Outpatient data 588
Risk and safety profile 588
SUMMARY 588
REFERENCES 589
Augmentation of Labor 593
Key points 593
INTRODUCTION 593
BACKGROUND 594
LITERATURE REVIEW 596
SUMMARY 598
REFERENCES 599
Elective Induction of Labor 601
Key points 601
INTRODUCTION 601
CURRENT TRENDS IN ELECTIVE INDUCTION 602
IMPACT ON CESAREAN DELIVERY 602
IMPACT ON STILLBIRTH 605
IMPACT ON NEONATAL AND MATERNAL MORBIDITY 605
IMPACT ON PATIENT EXPERIENCE AND COST 608
SUMMARY 611
REFERENCES 611
Update on Fetal Monitoring 615
Key points 615
INTRODUCTION 615
IS ELECTRONIC FETAL MONITORING PREDICTIVE OF NEONATAL OUTCOMES? 616
ELECTRONIC FETAL MONITORING PATTERNS AND CLASSIFICATION 616
MANAGEMENT OF CATEGORY II FETAL HEART TRACINGS 617
Adjunct Tests of Fetal Well-Being 617
In Utero Resuscitation 619
INTRAPARTUM FACTORS TO CONSIDER 620
Neuraxial Anesthesia 620
Magnesium 620
Intrauterine Growth Restriction 620
Meconium 621
SUMMARY 621
REFERENCES 621
The Evolution of the Laborist 625
Key points 625
INTRODUCTION 625
MODELS OF CARE 626
QUALITY OF CARE 627
FINANCIAL IMPACT 627
SUMMARY 628
REFERENCES 628
Fetal Malpresentation and Malposition 631
Key points 631
INTRODUCTION 631
FETAL MALPRESENTATION 632
Breech Presentation 632
Transverse and Oblique Lie 634
Face and Brow Presentation 634
Compound Presentation 634
FETAL MALPOSITION 635
Prevalence 635
Maternal and Neonatal Outcomes 636
Diagnosis 636
Management 637
SUMMARY 638
REFERENCES 638
Labor and Delivery of Twin Pregnancies 645
Key points 645
INTRODUCTION 645
BACKGROUND 645
Mode of Delivery and Success Rates of Twin Vaginal Delivery 645
Mode of Delivery: Safety of Vaginal Twin Delivery 646
Mode of Delivery: Conclusion 647
PROTOCOL FOR DELIVERY OF TWINS 647
Patient Selection 647
Third-Trimester Counseling 648
Timing of Delivery 648
Induction of Labor 648
Regional Anesthesia 648
Management of Labor 649
Delivery: Active Management of the Second Stage 649
Twin B: cephalic and engaged 650
Twin B: breech or transverse 650
Twin B: Unengaged 650
TWIN DELIVERY: COMPLICATIONS AND MANAGEMENT 651
Uterine Atony 651
Difficult Extraction 651
Unengaged Vertex of Twin B 651
Complications of Active Management During the Second Stage 651
Uterine hypertonicity 651
Malpresentation 651
Failed breech extraction 652
Cord prolapse/hand presentation/funic presentation 652
Nuchal arm 652
Head entrapment 652
SUMMARY 652
REFERENCES 653
Vaginal Birth After Cesarean Trends 655
Key points 655
INTRODUCTION 655
The Rise and Fall of Trial of Labor After Cesarean 656
The Impact of Litigation Concerns 656
MODE OF DELIVERY OUTCOMES 657
Maternal Outcomes 657
Maternal mortality 657
Uterine rupture 657
Uterine rupture: impact of induction of labor 658
Other maternal morbidity 658
Impact on future pregnancies 659
Neonatal and Infant Outcomes 659
Perinatal mortality 659
Neonatal morbidity 660
PREDICTION OF SUCCESSFUL TRIAL OF LABOR 661
PREDICTION OF UTERINE RUPTURE 661
TRIAL OF LABOR AFTER CESAREAN IN SPECIAL POPULATIONS 662
History of 2 Previous Cesarean Deliveries 662
Multifetal Gestation 662
Malpresentation and External Cephalic Version 663
SUMMARY 663
REFERENCES 663
Quality Improvement and Patient Safety on Labor and Delivery 667
Key points 667
INTRODUCTION 667
COMMUNICATION 668
Standardized Terminology 668
Structured Systems to Enhance Communication 669
MULTIDISCIPLINARY TEAM TRAINING 669
SIMULATION 670
STANDARDIZATION OF CLINICAL PRACTICE 670
Checklists 671
Clinical Guideline: Obstetric Hemorrhage 671
Clinical Guideline: Management of Hypertension 673
Clinical Guideline: Prevention of Thromboembolism 673
Quality Improvement Initiative: The Maternal Early Warning System 674
SUMMARY 676
REFERENCES 677