Objectives:To derive a prediction model combining various clinical factors associated with increased risk of emergency cesarean section following induction of labor in women with unfavorable cervix. Methods:All women with singleton term pregnancies undergoing induction of labor and fulfilling inclusion criteria were included in this cross-sectional study after supplying consent. Women with a Bishop score of 6 or less were induced with dinoprostone gel. Multiple regression analysis was used to find the most significant independent predictive factors and these factors were used to develop the predictive model and calculator.Results: After multiple logistic regression, risk of emergency cesarean after induction of labor was significantly associated with the following variables: height (adjusted odds ratio [aOR] 0.955, P = 0.033), nulliparity (aOR 3.987, P < 0.001), closed cervix (aOR 2.030, P = 0.030), fetal station −3 above ischial spine (aOR 2.719, P = 0.043), firm or medium cervical consistency (aOR 2.028, P = 0.004), cervical length 3 cm or longer (aOR 3.090, P = 0.015), posterior cervix (aOR 2.112, P = 0.002). Conclusion:Use of a prediction model would help to reduce the number of emergency cesarean sections secondary to unsuccessful inductions and help in the reduction of maternal and perinatal morbidity.
BACKGROUND: The severe acute respiratory syndrome coronavirus (SARS-CoV-2) has become a public health concern worldwide. It is important for pregnant women to know about the mode of transmission, symptoms, and preventive measures against COVID-19. The aim of this study was to evaluate the awareness and outlook of pregnant women and practical measures taken by them against COVID-19. MATERIALS AND METHODS: This cross-sectional questionnaire-based study was conducted for 1 month (June 10, 2020– July 10, 2020) in the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India. A prevalidated questionnaire was given to 109 pregnant women to assess the knowledge, attitude, and practice acquired against COVID-19 infection. The Chi-square test or Fischer's exact test was used to compare categorical data. RESULTS: Among 109 participants, 103 (94.5%) had good knowledge, 4 (3.7%) had average knowledge and 2 (1.8%) had poor knowledge about COVID-19. Majority of them had a positive attitude for the protective measures taken for the prevention of disease. CONCLUSIONS: Since there is no valid treatment for COVID-19, prevention is the only key to curve this infection. In the present study, 94.5% pregnant women had overall good knowledge score about the mode of transmission, symptoms, and preventive measures against COVID-19.
Cervical dysgenesis is a rare cause of obstructive amenorrhoea. We are presenting a case of a 15-year-old girl presented with primary amenorrhoea diagnosed with cervical dysgenesis with left ectopic kidney and endometriosis. The patient underwent laparoscopy followed by exploratory laparotomy with total abdominal hysterectomy with left salpingectomy followed by neovaginal creation and right ureteric D-J stenting and vaginal mould insertion. Cervical agenesis treatment should aim at the re-establishment of patency of the outflow tract. A fistulous tract with stent placement has been done in some cases but eventually, hysterectomy is required in view of recurrent and severe pelvic infection is a common problem. Ovarian function can be preserved if a hysterectomy is performed timely.
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