The Effect of Maternal Obesity on Oxytocin Requirements to Achieve Vaginal Delivery

Adams, April; Coviello, Elizabeth; Drassinower, Daphnie

doi:10.1055/s-0039-1694982

Cited by 13 publications

(17 citation statements)

References 30 publications

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“…Therefore, compared with the former ones, the dose of OT medication was more strictly limited in this group [13] . This study also found that the history of childbirth, BMI, and labor analgesia were independent factors affecting the OT medication, which was consistent with the results of the study by Adams, MD et al [14][15] . The possible reason was that the obesity, labor analgesia, and other factors would have inhibited the contractile ability of the uterine smooth muscle, requiring the increase of the exogenous OT dose for the OT receptors in vivo to enhance the contractions.…”

Section: Discussionsupporting

confidence: 92%

The Intelligent Regulation Model of Oxytocin for Women Having Vaginal Birth After Cesarean Section

Zhang

Gao

et al. 2021

Preprint

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Objective: To build an intelligent regulation model of oxytocin (OT) for women having a vaginal birth after cesarean section (VBAC) and further explore the intelligent and precise regulation of the scheme of the OT medication at delivery. Methods: A cross-sectional study design was used by collecting the data of the VBAC parturitions who delivered in the Obstetrics Department of the First Affiliated Hospital of Wenzhou Medical University from January 2014 to May 2020 and used the OT during the labor process. The multiple linear regression was used to analyze the modeling variables from the electronic medical records and the variables such as fetal heart rate (FHR) and uterine contraction (UC) frequency extracted from the cardiotocography. The OT drip speed predictive model was established based on the XGBoost algorithm and was compared using the logistic regression model and traditional decision tree. The data set was divided into the training set and test set at the 8:2 ratio, and the predictive performance of the model was evaluated for the accuracy, precision, recall rate, and F1 score. Results: A total of 1005 records with oxytocin regulation were included from 124 parturitions involving the VBAC. The XGBoost model performed the best prediction. Through the five fold crossover operation, the accuracy was 0.82, precision was 0.84, the recall rate was 0.80, and the F1 value was 0.82. Among them, the contraction duration, uterine pressure, FHR, UC frequency, and interval time from the previous cesarean section were the variables with great contribution to the modeling.Conclusion: This study constructed an OT regulation model based on the XGBoost, which recognized that the real-time intelligent regulation of the prenatal OT, with fast response speed, high model accuracy, and strong extrapolation had positive significance to obstetric clinical nursing.

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Section: Discussionsupporting

confidence: 92%

The Intelligent Regulation Model of Oxytocin for Women Having Vaginal Birth After Cesarean Section

Zhang

Gao

et al. 2021

Preprint

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“…17,22 They were also more likely to require higher dose of oxytocin infusion rate and longer duration of oxytocin exposure to achieve vaginal delivery. 34,35 Our study could not find the specific reason for this, it may be due to the fact that all our cases were spontaneous labour with no cases with induced labour that will usually also need augmentation.…”

Section: Progress Of Labourmentioning

confidence: 77%

Obstetric Outcomes of Obese Primigravida with Spontaneous Onset of Labour at Term

Ridzuan¹,

Ismail²,

Aziz³

et al. 2022

imjm

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INTRODUCTION: Obesity has reached pandemic level with higher prevalence among women. Obese pregnant women have higher risk of comorbidities, maternal and fetal complications. This study aimed to determine the prevalence of vaginal delivery and pregnancy outcomes of obese primigravida presented with spontaneous labour at term. MATERIALS AND METHODS: This prospective cohort study was conducted in a tertiary hospital in Perak involving 250 obese primigravida (BMI ≥27.5kg/m2) and 250 non-obese primigravida. Data collected from August 2020 till January 2021 and analyzed using descriptive statistics, independent T-test and Mann-Whitney U test by SPSS version 23.0. RESULTS: Our study found that there were no significant differences in the proportion of vaginal delivery and caesarean delivery between obese and non-obese primigravida [72.0% vs. 78% (vaginal delivery) and 28% vs. 22% (caesarean delivery)] with spontaneous onset of labour at term. No difference in complications of labour such as PPH and OASIS (p=0.187), with high successful delivery without complications. Obese women presented with cervical dilatation of 4cm had longer delivery interval [5.82(2.97) vs. 4.75(2.71), p=0.013] but shorter delivery interval at 6cm [2.41(1.58) vs. 3.61(1.78), p=0.026] compared to non-obese. They also had higher caesarean rate indicated for abnormal labour progress [28(71.8) vs. 11(28.2), p=0.019] and higher comorbidities [149(72.3) vs. 57(27.7), p=<0.001]. There was no difference in the fetal outcome (p=0.311). CONCLUSION: After careful selection, obese women with spontaneous labour at term are safe for vaginal delivery as they have similar risk of labour augmentation, duration of active labour, caesarean delivery, PPH and OASIS despite higher comorbidities.

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“…This could be due to; maternal obesity is related with a lower bishop score, women with lower bishop scores are at greater risk for failed induction [ 41 ]. In addition, to achieve vaginal delivery, obese women require more concentration, higher doses, and longer duration of exposure of uterotonics medication, using similar protocol and guidelines on labor induction for all women with different BMI to end up with higher failure rate among obese women [ 44 , 45 ]. The current study has been shown that uterine contractility impairment is higher among morbid obesity women; uterine contractility dysfunction might lead to failed induction [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

“…Women whose newborn birth weight ≥ 4000 g were 2 times more likely to have failed induction as compared with women whose newborn birth weight was 2500–3900 g. This study is supported by the previous studies [ 16 , 39 ]. This might happened due to the mean birth weight of neonates were higher among women who had greater BMI [ 44 ], larger BMI leads to lower bishop scores, and failed induction of labor [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Predicting factors of failed induction of labor in three hospitals of Southwest Ethiopia: a cross-sectional study

Genetu

Shewangizaw

Lambyo³

2021

BMC Pregnancy Childbirth

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Introduction Failed induction of labor affects maternal and neonatal outcomes as well as the cost of healthcare, especially in low-resource setting regions in which the prevalence of failed induction is higher despite the incidence of labor induction is low. This study aimed to assess the prevalence of failed induction of labor in southwest Ethiopia. Method A hospital-based cross-sectional study was conducted among 441 induced women from March 1 to August 30, 2018. A systematic random sampling technique was used to select study participants. Data were collected using a pretested and structured questionnaire. Bivariable and multivariable logistic regression models were done and fitted to identify predictors of failed induction. An adjusted odds ratio with 95% confidence interval (CI) was calculated to determine the level of significance. Result Premature rupture of membrane was the most common cause of labor induction and the commonly used method of labor induction were oxytocin infusion. Cesarean section was done for 28.1% of induced women. Failed induction of labor was found to be 21%. Primiparous [AOR = 2.35 (1.35–4.09)], analgesia/anesthesia [AOR = 4.37 (1.31–14.59)], poor Bishop Score [AOR = 2.37 (1.16–4.84)], Birth weight ≥ 4 k grams [AOR = 2.12 (1.05–4.28)] and body mass index [AOR = 5.71 (3.26–10.01)] were found to be significantly associated with failed induction of labor. Conclusion The prevalence of failed induction of labour was found to be high. Preparation of the cervix before induction in primi-parity women is suggested to improve the success of induction. To achieve the normal weight of women and newborns, proper nutritional interventions should be given for women of reproductive age. It is better to use analgesia/anesthesia for labor induction when it becomes mandatory and there are no other optional methods of no- pharmacologic pain management.

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The Effect of Maternal Obesity on Oxytocin Requirements to Achieve Vaginal Delivery

Cited by 13 publications

References 30 publications

The Intelligent Regulation Model of Oxytocin for Women Having Vaginal Birth After Cesarean Section

The Intelligent Regulation Model of Oxytocin for Women Having Vaginal Birth After Cesarean Section

Obstetric Outcomes of Obese Primigravida with Spontaneous Onset of Labour at Term

Predicting factors of failed induction of labor in three hospitals of Southwest Ethiopia: a cross-sectional study

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