Ultrasound Evaluation of Caesarean Scar of Prelabour and Labour Caesarean Sections: A Cross Sectional Analytical Study

Caesarean section is dramatically increased throughout the world in recent years. Rupture of the uterus is a devastating complication in trial of labour following previous Caesarean section. Evidence suggests that the size of the uterine scar and the residual myometrial thickness (RMT) are associated directly with the risk of uterine rupture and risk of dehiscence in subsequent deliveries. Impact of the prelabour and labour Cesarean section on the RMT has not been studied in detail. Objectives: To compare RMT, Caesarean scar defects and to evaluate the elasticity of the Caesarean scar between women who underwent prelabour and labour Caesarean sections. Methods: This was a Cross sectional analytical study. Women who underwent Caesarean section in their first pregnancy were recruited. Sample was stratified to prelabour and labour Caesarean section groups. Transvaginal ultrasound scan was performed six months following the Caesarean section. Dimensions of the uterus, uterine scar defect, RMT and elastosonography of the uterine scar were assessed. Results: A total of 240 postpartum women were analyzed. Uterine niche was detectable in 194 subjects. Prelabour CS group had demonstrated 91.7% (n = 110) scar defects (uterine niche) out of 120 cases and the rate among labour CS group was 70% (n = 84). There was a significant difference in the presence of uterine niche among 2 groups as Prelabour group was found to have more scar defects (p mm (SD 1.2) and 4.99 mm (SD 1.3) respectively and there was no significant difference (t = 0.38, p = 0.71). There was no significant difference between the dimensions of the uterine CS defects of the studied groups. Prelabour CS group had significantly higher Target strain [0.28 vs. 0.24 (t = 2.12, p = 0.04)] and significantly less strain ratio [1.45 vs. 1.55 (t -2.42, p = 0.04)] than labour CS group indicating a better scar in prelabour group. Conclusion: There was no significant difference in RMT and uterine scar defects between prelabour and labour Caesarean section groups. But prelabour Caesarean section scars were less stiff than labour Caesarean section scars. Further studies are warranted to elaborate on the association.

Semi-nonparametric Evidence of Young Women’s Participation in the Congolese Labour Market

This article analyses the determinants of young women’s participation in the labour market. For this purpose, the Employment Policy Enhancement Survey (EAPE), conducted by the Laboratoire de Recherches et d’Etudes Economiques et Sociales (LARES) in collaboration with CERDI in 2018 was used as the database. The results of Gallant and Nychka’s (1987) semi-nonparametric procedure show that health status, household size, marital status, and educational attainment are explanatory factors of young women’s labour market participation in Congo.

Foley Balloon Catheter versus Oral Misoprostol for Induction of Labour after Prelabour Rupture of Membranes: A Retrospective Data Analysis

Objectives: The Foley balloon catheter (FC) is a viable method for cervical ripening, but concerns about infection risk restrict its use in cases of prolonged prelabour rupture of membranes (PROM). This study aims to evaluate the efficacy and safety of the FC compared to oral misoprostol for cervical ripening after PROM. Study Design: A retrospective data-analysis of 128 pregnant women was conducted. Of these, 49 underwent cervical ripening with an FC and 79 with oral misoprostol. We included all women with a vital singleton pregnancy at 37 - 42 weeks of gestation who underwent cervical ripening after ≥ 24 hours of PROM in specific time frames in two Dutchsecondary care and teaching hospitals. The primary outcome was the incidence of intrapartum infection, a composite of maternal and neonatal infection. In addition, we evaluated the mode of delivery, duration of priming and priming-to-delivery interval. Secondary endpoints included uterine hyperstimulation, umbilical cord prolapse, birth weight, Apgar scores, length of admission to the neonatal low dependency unit, admission to the (neonatal) Intensive Care Unit (ICU) and mortality. Statistical analyses included bivariate and multivariate techniques. Results: Cervical ripening with FC, compared with oral misoprostol, showed a higher incidence of intrapartum infection, respectively 32.7% (n = 16) vs. 12.7% (n = 10) (p = 0.006). However, after adjusting for epidural anaesthesia and pregestational BMI, the association was no longer significant. No difference was found in mode of delivery and total priming-to-delivery interval (median 21.3 hours vs. 22.0, p = 0.897). Furthermore, FC, compared with oral misoprostol, showed a longer duration of cervical ripening and hence a shorter duration of active labour (p 0.001). Apart from the 1-min Apgar score, secondary maternal and neonatal outcomes did not differ between the groups. Conclusion: In women who require cervical ripening after prolonged PROM at term, the FC and oral misoprostol are similar in terms of efficacy and safety. Advantages associated with the FC are its safe application in women with a history of caesarean section, although we did not study these women, and an implied shorter duration of active labour. Our study adds to the limited available data on the use of the FC after the rupture of membranes and a large randomized controlled trial is needed to strengthen our findings.

Labour Force and Its Realization in Labour Relationships

The personal rights are the institute of civil law. They are the subject of legal regulation in Provisions § 11 and follows of Slovak Civil Code. Current legal regulation does not offer their definition, only enumeration. Therefore, this situation makes good area for discovering if there are the next personal rights which have characteristic nature of this institute. It is important to analyze in which private relationships the personal right has the conditions for its full realization. It is important to discover in which kind of private relationships exist the personal rights which is typical for these relationships. This paper deals with the value of human personality--labour force. In the first part, the paper analyzes the nature of labour force and tries to show that labour force is the next personal right, using the method of analysis, induction, deduction, and synthesis. In the second part of the paper, it is labour force analyzed through its realization in labour relationships. This part of the paper tries to show that labour force is personal right typical for labour relationships, using the methods of analysis, synthesis, and generalization. The third part of the paper tries to evoke the discussion if the labour force is right or value.

STUDY ON THE MIGRANT LABOUR FORCE OF CHINA IN RECENT YEARS──A Case Study of Nanhai City of Guangdong Province

This Paper, taking Nanhai City of Guangdong Province as an example, focuses on five interrelated aspects of the migrant labour force of China in recent year’s. Attention is initially paid to the background of the labour migration from inland towards coastal area. Then, the demographic characteristics of the migrant labour force are analysed before turning to the analysis on the rare for the migration. Fourthly, the impacts of the migrant workers on the socio-economic development of Nanhai City and the problems are examined. Finally, the prospects and some suggestions for the labour migration are put forward.

Labour analgesia effects on foetal heart rate. A mini-review

Foetal well-being during labour is of utmost importance. One of the ways to attempt to assess foetal well-being is by recording foetal heart rate (FHR). Loss of variability and deceleration patterns are known to be associated with foetal distress. Decelerations and foetal bradycardia have been described after any type of effective labour analgesia. This review addresses the questions if certain analgesic techniques and/or analgesics lead to clinically relevant FHR changes, what is their aetiology, and how we should manage these FHR changes.

Research on the Impact of Rural Labour Forces Transfer on the Urban-rural Income Based on Economics of Discrimination

On the basis of the analytical frame of discrimination, the thesis establishes a model of transfer of rural labour forces into city, and researches the impact of rural labour forces transfer on urban-rural income. The results show that the transfer of rural labour forces into city can increase urban-rural income and bridge the income gap between city and village to a certain extent. However, the capital stock of city in China is greatly more than that of the village, so the rural labour forces transfer cannot eliminate the urban-rural income gap completely. In order to elevate the rural income level in China and narrow urban-rural income gap, the government should paint a picture with two brushes at the same time: on one hand, the government should promote the transfer of rural labour forces into city, and change the status quo of dual urban-rural labour forces market structure; on the other hand, the government should increase the input in rural areas and promote the increase of rural capital stock so as to further increase rural residents' income in the process of labour forces transfer.

Experiences of women with the support they received from their birth companions during labour and delivery in Malawi

A study was conducted to describe the experiences of primiparous women with the support they received from their birth companions during labour and delivery in Malawi. The study design was descriptive and utilized qualitative data collection and analysis method on a sample of 20 primiparous women. The women were recruited from the postnatal ward of Bwaila hospital and were interviewed regarding their experiences on the support they received from their birth companions during labour and delivery using an open ended interview guide. Data was manually analyzed using content analysis. Primiparous women described the support they received from their birth companions as useful and beneficial. Birth companions provided advice, physical, emotional and spiritual support to the women during their labour and delivery. In addition, the birth companions were viewed as guardians of the women during labour and delivery. Results however, show that some women were not properly assisted by their companions because both the mothers and companions lacked knowledge on birth companionship. The results further show that birth companions play important roles during the birth and delivery of primiparous women and thereby improving birth outcomes. Therefore, there is a need to train the companions regarding support to a woman during labour and delivery. Primiparous women also need to be trained during antenatal care education so that they properly understand the roles of a birth companion as opposed to those of the midwives.

Removal of laparoscopic cerclage stitches via laparotomy and rivanol-induced labour: A case report and literature review

BACKGROUND Laparoscopic cervical cerclage is performed for patients with abnormal cervical anatomy and/or transvaginal cervical cerclage failure.However,the method of removing the stitches to allow labour induction remains controversial.According to published literature,stitches are removed through laparoscopic or transvaginal methods.Herein,we report,for the first time,a case of a patient who had undergone laparoscopic cerclage,and then underwent removal of stitches by laparotomy and labour induction in the third trimester of pregnancy.CASE SUMMARY A patient who underwent laparoscopic cervical cerclage due to cervical insufficiency became pregnant naturally following the operation.At 31 wk of pregnancy,severe foetal malformations were found.To successfully induce labour,cerclage stitches were removed via laparotomy,and rivanol was injected directly into the uterus.Following successful induction of labour,the patient delivered a dead foetus.CONCLUSION This report provides a reliable scheme of removing cerclage stitches for patients who have undergone laparoscopic cerclage but experience severe foetal malformations.

Sonopelvimetry: An Innovative Method for Early Prediction of Obstructed Labour

Aim: To evaluate an innovative sonopelvimetry method for early prediction of obstructed labour. Methods: A prospective study was conducted in two centers.GPS-based sonopelvimetry, laborProTM?(Trig Medical Inc., Yoqneam Ilit, Israel) devise, was used prior to labour in nulliparous women at 39 - 42 weeks gestation remote from labor. Maternal pelvic parameters, including inter-iliac transverse diameter, obstetric conjugate and interspinous diameter were evaluated. Fetal parameters included head station, biparietal diameter and occipitofrontal diameter. Data on delivery and outcome were collected from the electronic files. Results: The innovative use of sonopelvimetry was applied to 154 consecutive women, none of the participants complained of discomfort or complications observed. The mean time of examination was 15 + 2 minutes. Mean time of examination to delivery interval was 4.8 days (range 0 - 16 days). Small interspinous diameter and high head station were the best predictors for obstructed labour. Analysis indicated 87% sensitivity and 61% specificity for birth weight fetal head station and ISD combined in predicting obstructed labour with an area under the curve of 0.77. Conclusions: Our results indicate that GPS-based?sonopelvimetry combined with fetal estimated weight is a valuable tool in the risk assessment of obstructed labour. Parameters obtained by sonopelvimetry combined with birth weight may be useful.

The Asymmetric Response of Older Male Labour Force Participation Rates to Pension Reform and Labour Market Variables

Increasing the labour force participation rates of older workers is a fundamental component of most OECD （Organization for Economic Cooperation and Development） countries＇ response to the fiscal pressures associated with ageing populations. Both pension reform and employment policies are key elements to achieving such increases in participation and reversing the early retirement trends of recent decades. Econometric modeling results from a panel of 12 OECD countries indicate that labour market variables have a greater influence than social security pension value or the standard age of retirement on the labour force participation rates of males aged 55-64 years. Further results from modeling the potential asymmetric response of participation rates to unemployment rates indicate that a decrease in unemployment rates has a greater impact upon increasing the labour force participation rates of older workers compared to the effect of an increase on unemployment rates has on discouraging participation. We found mixed results for the asymmetric response of participation to an increase or decrease in pension value. Findings thus emphasize the importance of labour market oriented policies to reduce unemployment rates in the developed economies in coming years to address ageing population concerns.

The Changing Labour Relations during the Period of Economic Reform:A Case Study of Chinese Township and Village Enterprises in Yangtze River Delta

The economic reform launched in the People's Republic of China(China) led to a rapid growth in non-state sectors.Various forms of corporate governances and ownerships emerged during the last two decades,especially the Township and Village Enterprises owned by local residents.This article is conducted on the changing labour relations in Chinese Township and Village Enterprises(TVEs) despite their increasing contributions to China's transition from planned economy to market economy,and studies the labour market and the Labour Law to understand the unique labour mobility and to test the relationship between Human Resource Management(HRM) practice and the performance among TVEs.

Epidural abscess after multiple lumbar punctures for labour epidural catheter placement

Epidural catheterization is routinely used by anaesthesiologists to provide labour and post-operative analgesia. In most cases, catheter placement is without serious side effects and uneventful. However, epidural abscess is a rare complication that may result in severe morbidity. We present a case of epidural abscess after labour epidural catheter placement in a healthy 36-year-old female who presented on post-partum d 10 with complaints of fever and back pain. She was treated with intravenous antibiotics and fully recovered.

SOME ASPECTS OF EXPORT LABOUR SERVICE IN CHINA

This paper focuses on the evolution and characteristics of the export labour service in China since the modern time especially since the reform of economic system in 1978.Historically the contract workers,central to the goal of making a living,were the main body of the international migration.And Guangdong and Fujian provinces were the main origin places of the migration but the destination of the migrants varied.Both pull and push forces for driving the migration were identified.Then analysis is turned to the characteristics of export labour service of China since the reform of economic system in 1978.1)The export laobur has increased rapidly despite a small quantity.2)The export labour service is planned and organized.3)The export workers are considered temporary migrants.4)The dominant ways of export labour service are project contracts and pure labour export.And 5)the destinations of export labour are scattered over the world.Thirdly,the impact of the export labour service on the origin places and the emerging problems and contradictions were examined. In China,export labour service has alleviated the employment contradiction and gradually become one of sources of gaining foreign currency on the one hand,and China,through the service,has learnt the advanced technology and management experiences of other countries.However,some problems in the service such as small number,unsatisfactory quality of the export labour,and the weak link betweenthe service and employment are emerging,which need to be solved.Finally,the prospects for China as a large country of export labour was discussed.

THEORIES AND PRACTICE OF TERRITORIAL DIVISION OF LABOUR AND LOCATIONAL SUPERIORITIES

There exists an inherent relationship between territorial division of labour and locational superiorities,of which becomes a basic point followed in the process of regional development and urban planning.The historical evolution of territorial division theories is reviewed first.The authors fully appraise the contributions of A.Smith et al.and comment on some of their shortcomings.An integrated system on locational superiorities is then put forward which contains four pairs of regional or urban superiorities.Finally,the relation of external elements and inherent mechanism in areal differentiation is probed.

Labour force participation of married women in China and Congo

The goal of this investigation was to find the major determinants of married women participation in the urban area labour force in Zhejiang (China) and Brazzaville (Congo). The methodology used in this study is correct and the resulting con- clusion is that the participation of married women basically depends on her personal and family characteristics. Age, education, presence of additional adult in the family are important factors in Brazzaville and Zhejiang. However, the number of children significantly affects only Brazzaville urban married women.

Non-Fistulous Complications of Prolonged Obstructed Labour among Obstetric Fistula Patients in Southern Nigeria

Background: Long-term complications of prolonged obstructed labour are multisystemic, obstetric fistula about the most devastating. Efforts at controlling obstetric fistula pay little attention to the non-fistulous injuries which reduce the quality of life of the affected women even after a successful fistula repair. The objectives of this study were to determine the burden of the non-fistulous complications among fistula patients, identify these injuries and the factors associated with them. Methods: This cross-sectional study was conducted at the National Obstetric Fistula Centre, Abakaliki, South-East Nigeria from July to December 2016. The hospital has performed over 2600 free fistula repairs. This study was approved by the Research and Ethics Committee of the hospital. The study population comprised of women who developed obstetric fistula following prolonged obstructed labour. Direct questioning, examination findings, operation findings and laboratory results, using a pre-tested, semi-structured and interviewer-administered proforma were used to collect data. Informed consent was obtained from the subjects. Data were analyzed using the Statistical Package for Social Sciences [SPSS] version 21. Frequency and proportions were used to describe categorical variables while means and standard deviation were used to describe continuous variables. Association between categorical variables and direct obstructed labour injuries was tested using chi-square test and predictors of obstructed labour injuries were determined using logistic regression. A P-value 0.05 was considered statistically significant. Results: One hundred and sixty one (161) women participated in the study. The mean age of the women was 33.4 years while the mean parity was 3.2. Non-fistulous complications of prolonged obstructed labour were found in 96.9% (156) of the women. These included cervical retraction (42.2%), obstetric nerve palsy (30.4%), vaginal scarring (29.8%), partial urethral loss (16.1%), anal sphincter injury (3.1%), cervical stenosis (5.0%) and urethral stenosis (3.7%). Others were ammoniacal dermatitis (29.2%), secondary amenorrhoea (21.7%), secondary infertility (9.3%), dyspareunia (6.8%), hypomenorrhea (1.2%) and bladder stone (3.7%). Majority (79.4%) of the women with cervical retraction had caesarean section (CS) as against 20.6% who had vaginal delivery. This was statistically significant (P 0.001). A higher proportion of participants with amenorrhea were delivered via CS (44.3%) compared to those who had vaginal delivery (21.2%). This was also statistically significant (P = 0.012). Neurologic injury was associated with primiparity although this was not statistically significant (P = 0.171). Conclusion: Almost all fistula patients also have non-fistulous complications of prolonged obstructed labour. Efforts to manage the fistula should equally address these complications. We advocate comprehensive care for identification and management of these injuries to improve the quality of life and overall well-being of these women. To reduce complications like cervical retraction, there should be an emphasis on safer caesarean section for women with prolonged obstructed labour.

Characteristics of Child Labour and Their Health Problems: Findings from Rural Community of India

Background: Child labour is a big problem. Studies have indicated several problems of child labour. However, few studies have indicated the characteristics of child labour rural India. Objectives: This study has explored characteristics of child labour and their families in the rural community of eastern India and also identified their health problems. Methods: A cross-sectional study was designed to explore their characteristics in purposively selected areas in rural Howrah, India. Frequency table and bar-diagrams were used. Results: The study identified 72% boys and 28% girls as child labour. Majority of the children (67.9%) were labour because they wanted to help their parents. In 8.9% cases, they were forced to work by their parents. In 5.4% cases, they were orphans. Majority of the children were not satisfied (78.6%) with their job place and job status. Conclusions: Child labourers are not satisfied with their job. Their money is used in family. Parents are illiterate. Lack of effective education system and availability of functional schools are both causes and consequences of child labour. Due to illiteracy, working conditions for these children get worse as they are not even aware of the occupational benefits.

Maternal and Fetal Outcomes Following Labour at Term in Singleton Pregnancies with Meconium-Stained Amniotic Fluid: A Prospective Cohort Study

Background: Meconium stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Literature on the subject is still poorly documented in the African setting. Objective: The aim of this study was to determine the maternal and fetal outcomes in case of meconium stained amniotic fluid observed during term labour. Materials and Methods: We conducted a prospective cohort study enrolling all consenting pregnant women with term singleton fetus in cephalic presentation admitted for labour with ruptured fetal membranes in the maternity units of the Yaoundé Central Hospital (YCH) and the Yaoundé Gynaeco-Obstetric and Pediatric Hospital (YGOPH) of Cameroon between December 2014 and April 2015. The exposed grouped was considered as participants having MSAF, while the non-exposed group comprised those with clear amniotic fluid (CAF). The two groups were monitored during labor using the WHO partograph, and then followed up till 72 hours after delivery. Variables studied included the colour and texture of amniotic fluid as well as maternal and fetal complications. Data was analyzed using Epi-info version 3.5.4. The chi-square and Fischer’s exact tests were appropriately used to compare the two groups. A p-value less than 5% was considered statistically significant. Results: 2376 vaginal deliveries were recorded during the study period among which MSAF was observed in 265 cases, hence a prevalence rate of MSAF of 11.15%. Among these cases of MSAF, 52.1% was thick meconium and 47.9% was light meconium. Maternal morbidity was high in the group with MSAF;these included: Higher proportions of caesarean delivery (RR = 2.35 p -4) and prolonged labor (RR = 3 p -4). In this same group, the incidences of chorioamnionitis and puerperal sepsis were low (0.94% and 0.70% respectively), although there was a three-fold higher risk that was not statistically significant (RR = 3, P = 0.31). Fetal and neonatal outcomes were poorer in the MSAF group compared to the CAF group. The complications included fetal heart rate abnormalities, low Apgar score at the 5th minute, need for neonatal resuscitation, neonatal asphyxia and neonatal infection which were significantly higher in the MSAF group (all p < 0.05). Meconium aspiration syndrome (MAS) was found in 2.34% of MSAF cases. Perinatal mortality was 2.34% and all cases of death occurred in the thick MSAF group. Conclusion: MSAF observed during labour is associated with increased perinatal morbidity and mortality. Its detection during labor should strongly indicate very rigorous intra partum and postpartum monitoring. This will ensure optimal management and reduction in the risks of complications.

Factors Associated with Compliance with Infection Control Guidelines in the Management of Labour by Healthcare Workers at Mulago Hospital, Uganda

Globally, infections acquired during childbirth contribute to one tenth of the maternal deaths annually [1] [2]. Factors predisposing to high risks of puerperal infections include non-compliance with Standard Precautions of Infection Control (SPIC), unhygienic births by unskilled birth attendants, multiple vaginal examinations, prolonged labour and premature rapture of membranes [1]. The main purpose of this study was to determine factors associated with compliance to standard precautions of infection control the management of labour by healthcare workers in Mulago Hospital to generate information, which may be used in infection control and prevention practices. A cross-sectional study utilizing a quantitative approach was conducted among 115 healthcare workers. Consecutive sampling was done to include respondents in the study. Data were collected by direct observation and researcher administered questionnaires. Data were coded and entered into the computer using SPSS version 20 with programmed quality control checks. Descriptive data analyses, frequencies, cross tabulations and logistic regression analysis were the major statistical methods used. 103 healthcare workers were involved in the study, where 74% were females. Overall compliance was at 52%, although it varied across domains. The majority of the healthcare workers (95.1%) did not comply with hand hygiene. Being a male was associated with low compliance scores a cross most domains. One of the hospital factors which was significantly associated with compliance to hand hygiene was having had an in-service training with p = 0.008 and p = 0.012 at multivariate analysis. Overall compliance to standard precautions of infection control was low compared to the Centre for Disease Control (CDC) recommendation. The findings in this study provide insight into individual and hospital related factors associated with compliance with standard precautions of infection control in the management of labour. There is an urgent need to put up interventions to improve on compliance with SPIC in management of labour among all healthcare workers.