Is Induction of Labor with Early Rupture of Membranes Associated with an Increased Rate of Clinical Chorioamnionitis?

Objective: The objective of this study was to determine if early rupture of membranes (ROM) in women undergoing induction of labor (IOL) at term is associated with an increased rate of clinical chorioamnionitis. Study Design: A retrospective cohort study was performed on women undergoing IOL. Early ROM was defined as ROM at a modified Bishop score less than 5, cervical dilation less than 4 cm, or cervical effacement less than 80%. The rate of clinical chorioamnionitis was compared between women with early and late ROM. Results: The rate of clinical chorioamnionitis was 8.6% (24/279). ROM at an effacement of less than 80% was associated with a rate of clinical chorioamnionitis of 15.4% (12/78) compared to 6.0% (12/201) at an effacement of equal to or greater than 80%, p = 0.017. The rate of cesarean delivery was higher for patients with early ROM by any definition: 32% compared to 17.5% by modified Bishop score (p = 0.031), 32.4% versus 18.2% by cervical dilation (p = 0.049), and 33.3% versus 14.9% by cervical effacement (p = 0.001). Conclusions: In patients undergoing IOL, early ROM may be associated with an increased rate of clinical chorioamnionitis when performed at a cervical effacement of less than 80% and an increased rate of cesarean delivery.

Analysis of the Effect of Midwives’ Psychological Care Intervention on the Progress of Labor and Cesarean Rate of Elderly Women in Labor

Objective:To analyze the effect of midwife psychological nursing intervention in the clinical care of elderly women in labor.Methods:According to the order of admission,74 elderly women were divided into the control group and the observation group.In addition to the routine perinatal nursing interventions,the observation group strengthened the implementation of midwives’psychological nursing interventions.The duration of labor,mode of delivery,psychological state,and stress response indexes of the two groups were analyzed and compared.Results:The observation group had a shorter duration of all labor stages and total duration of labor than the control group,a lower cesarean section rate than the control group,and a higher degree of improvement in anxiety,depression,and stress response indexes in the 3-day postpartum period as compared to the control group(P<0.05).Conclusion:The implementation of midwife psychological care intervention in perinatal care of elderly women can further shorten the duration of labor,reduce the cesarean section rate,and improve the psychological state and stress indicators,which is worth promoting.

An Early Pregnant Chinese Woman with Cerebral Venous Sinus Thrombosis Succeeding in Induction of Labor in the Second Trimester

Cerebral venous sinus thrombosis(CVST)is a rare condition in early pregnancy.A22-year-old Chinese woman at10weeks of pregnancy requested induced abortion and was diagnosed as CVST for a severe headache accompanying with nausea and vomiting.The patient was treated successfully with anticoagulation,followed by amniocentesis,and finally succeeded in induction of labor safely.The diagnosis,treatment and prognosis for this rare condition are discussed in this paper.

Maternal and perinatal outcomes of induction of labor at term in the university clinics of Kinshasa, DR Congo

Objective: This paper aims at assessing outcomes following induction of labor and characteristics likely to predict vaginal delivery. Study design: This is a descriptive retrospective cohort study including all women with singleton pregnancies who delivered at term in the university clinics of Kinshasa, DR Congo, from January 01, 2006 until December 31, 2010. Induction was initiated regardless of cervical status. Methods of induction included: oxytocin perfusion, vaginal Misoprostol, intracervical insertion of the Foley catheter and amniotomy. Results of induction were compared in terms of failure of labor, cesarean section, fetal distress, and neonatal distress. Logistic regression was used to seek for independent contributing factors for adverse outcomes. Results: During the period of the study 115 patients at term (3.2%) were concerned with induction of labor. Means for maternal age, gestational age and weight at confinement were 30.5 ± 5.7 years, 37.95 ± 1.54 weeks and 69.3 ± 15.1 kg, respectively. The mean parity and gravidity were 2.4 ± 1.9 and 2.9 ± 1.9, respectively. The mean Bishop score was 6.2 ± 1.5 at the first induction, with 66 women (57.3%) having less than 7. Indications for induction were: preeclampsia (52 = 54.1%), premature rupture of membranes (34 = 29.5%), post term (17 = 14.6%), gestational diabetes (5 = 4.3%), stillbirth (5 = 4.3%), polyhydramnios (3 = 2.6%) and cardiopathy (1 = 0.8%). Methods of induction at the first attempt included: oxytocin (86 = 74.7%), vaginal misoprostol (20 = 17.3%), transcervical Foley catheter balloon (14 = 12.1%), and amniotomy (1 = 0.8%). Failure to induce uterine contraction at the first attempt was noted in 9/115 (7.8%) women. Vaginal delivery occurred in 78 (66.9%) women, and cesarean section in 34 (29.6%). The majority of cesarean sections were performed at the primary induction, most of them (29/34 = 85.3%) in women with bad Bishop score. Failure of induction was more likely to occur in association with high maternal weight (OR 6.8;CI 1.2 - 39.7), and somewhat birth weight (OR 2.1 but CI containing 1). Risk for cesarean section was increased in association with induction of labor in cases of high maternal weight (OR 10.3, CI 16.0 - 67.0), and somewhat of high birth weight (OR 2.3, but CI containing 1). Fetal distress was associated only with maternal weight (OR 15.7, CI 1.3 - 187.8), and neonatal distress only with Bishop score (OR 10.9, CI 1.1 - 108.0). Conclusion Induction of labor in our setting in order to get vaginal delivery is affected of a high risk of adverse outcomes such as failure of induction, cesarean delivery, fetal and neonatal distress. This risk is significantly influenced by maternal weight, birth weight and Bishop score. Lack of worse outcomes between the first and the subsequent attempts to induce labor can be regarded as a reason to try induction even in the presence of unfavorable cervix.

Comparative study for success rate of vaginal birth after cesarean section following labor induction by two forms of vaginal dinosprostone: A pilot study

Background: Cesarean delivery has become the most common major surgical procedure in many parts of the world. Induction of labor in women with prior cesarean delivery is an alternative to mitigate the rising cesarean rates. Objectives: To compare the VBAC success rate between two vaginal forms of dinoprostone for labor induction in women with prior cesarean section. Material and Methods: A pilot study was conducted at a large Governmental Hospital, Dhahran, Saudi Arabia, including 200 women with prior cesarean section and planned for labor induction. Participants were randomly allocated into two groups. Group A (n = 100) received dinoprostone 1.5 mg vaginal tablet. Group B (n = 100) received 10 mg dinoprostone sustained release vaginal pessary. Primary outcome was vaginal delivery rate. Secondary outcomes included maternal and neonatal outcomes. Results: The dinoprostone vaginal tablet and dinoprostone vaginal pessary had a comparable vaginal delivery rate (67% and 64%, respectively;p = 0.78). The median patient satisfaction with the birth process was superior in the dinoprostone vaginal pessary group (p = 0.04). Maternal and neonatal outcomes were similar in both groups. Conclusion: Both forms of dinoprostone were effective methods for labor induction in women with prior cesarean section. However, the patient satisfaction with the birth process was in favor of the dinoprostone sustained release vaginal pessary.

The Epidemiology of Induction of Labor among Women Aged 15 - 49 Who Delivered at Shaafi Hospital in Hodon District, Mogadishu Somalia 2020

Background: Induction of labor is an artificial termination utilized to decrease both maternal and neonatal morbidity and mortality. The study was aimed to assess the epidemiology of induction of labor among women aged 15 - 49 who delivered at Shaafi Hospital in Hodon District, Mogadishu Somalia 2020. Methodology: A cross-sectional and retrospective hospital-based study was conducted among 30 women aged 15 - 49 who had undergone induction of labor who were delivered at Shaafi Hospital Mogadishu during the period of the study from May-July 2020. Data were collected by interview method using structured questionnaire. Data analyzed was performed using Statistical Package for Social Science version 20. Results: The study showed that the majority of respondents 12 (40%) had undergone induction once time previously, followed by 8 (27%) had undergone induction previously two times, while 6 (20%) had undergone previously three times, 4 (13%) more than four times. 21 (70%) were delivered Spontaneous Vagina delivery (SVD), 6 (20%) were Cesarean section (CS) and 3 (10%) instrumental vaginal delivery. A total of (60%) were delivered in public hospitals, followed by (23%) were delivered in private hospitals and 5 (17%) home delivery. In addition the reasons of induction of labor a total of 27 (90%) were post term, followed by 2 (7%) were Intrauterine fetal death (IUFD), while few proportion of 1 (3%) were Pregnancy induced hypertension (PIH). Finally, the study revealed that the socio-demographic and obstetrical determinants such as age and daily meal intake as well as antenatal care visit and reasons for induction of labor e.g. Post term (Post-mature), Intrauterine fetal death (IUFD) and Pregnancy induced hypertension (PIH) showed significant association with their the induced labor (P Conclusion and Recommendations: The study recommended that ministry of health especially maternal and reproductive health unit should ensure that every pregnant woman has access to skilled maternal counseling and improve quality of antenatal, develop a national guideline of induction labor and continue training health workers at health facilities and monitor its implementations across the country.

Cervical Ripening for Induction of Labor: A Randomized Comparison between Vaginal Misoprostol versus Foley’s Catheter Placement in a Nigeria Tertiary Hospital

Background: Cervical ripening is prerequisite of successful induction of labor. Vaginal misoprostol and Foley’s catheter placement have been widely used for this purpose but the data are not always sufficient. We attempted to determine which (misoprostol versus Foley’s catheter) is more effective/safer in Nigerian setting. Methods: A randomized controlled trial was performed at Federal Teaching Hospital Abakaliki, Nigeria, involving 135 term pregnant women requiring cervical ripening and labor induction. Participants were randomly allocated to misoprostol versus catheter group. The following were recorded/measured/analyzed: Bishop’s score, age, parity, body mass index, gestational age, labor duration, indication, oxytocin use, mode of delivery, and Apgar score. Chi square test and t test were used where appropriate. Results: At 24 hours, all of misoprostol group were either in labor, had ripe cervix, or had delivered, whereas 35.4% of catheter group had still unripe cervix (x2 = 29.856, P = 0.0001). Misoprostol group was less likely to require oxytocin infusion (x2 = 52.600, P = 0.0001) and less likely to require cesarean delivery (cesarean: misoprostol versus catheter: 11% versus 34% (x2 = 9.800, P = 0.001)). Total medical cost for misoprostol was less than that of catheter (x2 = 14.703, P = 0.0001). Conclusion: 50 μg vaginal misoprostol, compared with catheter placement, was more effective, cheaper, and safe as a procedure of cervical ripening before induction of labor.

Transvaginal Sonographic Assessment of the Cervix for Prediction of Successful Induction of Labor in Nulliparous Women

Background: Induction of labor is commonly performed in obstetric practice. Many methods have been suggested as good predictors of the outcome of labor induction, yet none of them is satisfactory enough. Our study aims to assess cervical length and uterocervical angle measured by transvaginal ultrasound as predictors of successful induction of labor. Methods: Prospective cohort study conducted in Ain Shams University Maternity hospital over 150 nulliparous women undergoing induction of labor, in the period between May 2018 and August 2019. Transvaginal sonographic measurement of cervical length and uterocervical angle was done before induction of labor by prostaglandins. The patients were followed up till delivery and the outcome was recorded. Results: The best cut-off value of cervical length for prediction of success of labor induction was 32.3 mm with 60% sensitivity and 56% specificity and the best cut-off value of uterocervical angle was 110.2 degrees with 87% sensitivity and 93% specificity. The cervical length showed a significant negative correlation while the uterocervical angle showed a significant positive correlation with the success of labor induction. Conclusion: Cervical length and uterocervical angle are good predictors of successful labor induction.

The Change in Pulse Rate and Behavioral Score by Using Video Assisted Induction of Pediatric Anesthesia

Purpose: Objective of this study was to determine whether video assisted anesthesia induction reduced pediatric patients’ stress. Methods: With approval from the local ethics committee and parental informed consent, 75 children undergoing minor surgery were investigated in this prospective observational study. Patients were divided into three groups: group 1 was aged two to three years old, group 2 was aged four to six years old and group 3 was aged from seven to ten years old. The following three characteristics were evaluated: 1) the pulse rate at four points (the ward, the entrance at the operating room, mask notification and the mask fit);2) the behavioral score in the operating room;3) the amount of pain killers after the operation. Results: In group 1 (N = 20), there was a significant difference between the control group and the video assisted group regarding the percentage change in pulse rate based on the children’s ward when the patients looked at the mask. In group 2 (N = 26), there was no significant difference regarding any points. In group 3 (N = 29), there was a significant difference between control and video assisted group regarding the percentage change in pulse rate based on the children’s ward for all points. Also, regarding to the behavioral score, there was a significant difference between the control group and the video assisted group of all ages. However, there was no significant difference regarding the use of NSAIDs in the postoperative period between the control and the video assisted group. Conclusion: These results show that the video assisted anesthesia induction is effective for pediatric patients.

A Comparative Study on the Effects of Vaginal Misoprostol and Vaginal Misoprostol Plus Estradiol on Labor Induction

Background:Cervical ripening is an important factor in predicting successful labor induction.In an unfavorable cervix,ripening should be done before induction.In this study,the effect of misoprostol and that of misoprostol plus estradiol on cervical ripening were compared.Methods:This randomized,double-blinded study included a total of 190 pregnant women who were identified for pregnancy termination due to maternal or fetal cause at 37 weeks with Bishop score of less than 4.The patients were assessed between April 2015 to April 2016 in two university hospitals at northeast Iran(Omol-Banin Hospital and Emam Reza Hospital,Mashhad).The patients who met the inclusion criteria were randomly assigned to two groups:the intervention group(Group A),who received 25 micrograms of vaginal misoprostol plus 50 micrograms of estradiol,and the control group(Group B),who received 25 micrograms of vaginal misoprostol only.Misoprostol was administered at 4-hour intervals until cervical ripening(Bishop score≥8)or upon initiation of active phase in both the groups.The maximum dosage of misoprostol was three doses,whereas estradiol was administered only once.Results:In this study,the main causes of pregnancy termination were ROM and post-term.There was no significant statistical difference in the Bishop score between the two groups(P=0.13).In addition,no significant difference was observed in the duration of time for cervical ripening(Bishop≥8)between the two groups(P=0.7).The duration between drug administration to the initiation of active phase and also from active phase to delivery showed no significant differences between the two groups(P=0.49 and 0.24,respectively).There was also no significant difference in the delivery route(operative vaginal delivery or Cesarean section)(P=0.2 and P=0.91,respectively).Conclusion:From this study,the use of misoprostol plus estradiol did not improve cervical ripening or decrease the induction time.Further studies are recommended to investigate complementary results.

The Efficacy and Safety of Dinoprostone Vaginal Insert for Labor Induction Following Optimization of Standard Operating Procedure: A Retrospective Study in China

Background:The study aimed to assess the efficacy and safety of dinoprostone vaginal insert in labor induction following optimization of standard operating procedure(SOP)and to discover independent predictors of vaginal delivery.Methods:This study comprised 551 pregnant women who required cervical ripening with dinoprostone before induction of labor.Using univariate and multivariate analyses,independent predictors of vaginal delivery were identified.Results:443 of the 551 women(80.4%)gave birth vaginally.Vaginal delivery was predicted by maternal age(24-30 vs.<24,P<0.001;30-35 vs.<24,P=0.03),gestational age(P=0.005),birth weight(P<0.001),parity(P=0.001),pre-pregnancy BMI(P<0.001),premature rupture of membranes(P=0.001),meconium-stained amniotic fluid(P<0.001),fundal height(P<0.001)and the Bishop score(P<0.001).None of the women exhibited severe postpartum hemorrhage.Conclusions:The maternal age,gestational age,birth weight,parity,body mass index,premature membrane rupture,amniotic fluid contamination,fundal height,and the Bishop score were independent predictors of vaginal delivery.These may guide the clinical use of dinoprostone for induction of labor.

Optimization of the Callus Induction System of Chenopodium quinoa Willd

Callus induction effects of nine varieties of Chenopodium quinoa Willd. were compared by taking stem segments and cotyledons of C. quinoa as the ex- plants. At the same time, callus JnductJon of stem segments was optimized, as well as the callus proliferation system. Research results showed that the optimal explant for callus induction was stem segment. The average callus induction rate of nine varieties reached 90% in culture medium MS ＋ 0.5 mg/L 2, 4-D. In the callus opti- mization test, treatment VI （MS ＋ 0.5 mg/L 2, 4-D ＋ 0.5 mg/L KT ＋ 0.5 mg/L NAA） and treatment II （MS ＋ 0.5 mg/L 2, 4-D） had close induction rate, but the callus morphology was greatly different. The latter had loose, glossy and yellowish white calluses. Therefore, culture medium MS ＋ 0.5 mg/L 2, 4-D was the optimal for callus induction. And using 2, 4-D together with KT and NAA could significantly increase the proliferation rate of calluses.

Effect of SDS/THF on thermodynamic and kinetic properties of formation of hydrate from a mixture of gases(CH_4+C_2H_6+C_3H_8) for storing gas as hydrate

In this work, the effect of sodium dodecyl sulfate(SDS) and combined effect of sodium dodecyl sulfate(SDS) and tetrahydrofuran(THF) on thermodynamic and kinetic properties of CH4+C2H6+C3H8hydrate formation have been studied. Four different concentrations of sodium dodecyl sulfate(100 ppm, 500 ppm,1000 ppm and 1500 ppm) have been used to see its effect on phase equilibrium condition and formation kinetics. Though sodium dodecyl sulfate(SDS) does not vary the pressure–temperature condition of hydrate formation, it has a prominent favorable effect on induction time, gas consumption, storage capacity and formation rate. The addition of 3%(mol) tetrahydrofuran(THF) to water + SDS system results in large shifts in phase equilibrium boundary to lower pressure and higher temperature. It has been noticed that the addition of tetrahydrofuran further enhances the formation rate. So the mixture of sodium dodecyl sulfate(SDS) and tetrahydrofuran(THF) can be effectively used as promoter for storing natural gas as hydrate.

Causes of the exchange rate with the U.S. trade deficit

With debate that the U.S. trade deficit is due to overestimate exchange rate of RMB, the paper pointed out that exchange rate is not the main factor for the formation of balance of payments on trade. U.S. trade deficit is largely due to the current international monetary system, international division of labor and the trade structure determined by it, low savings rates and other factors.

Effectiveness of Dinoprostone and Cook's Balloon for Labor Induction in Primipara Women at Term

Labor induction is commonly used for achieving successful vaginal delivery.This study aimed to compare the effectiveness of dinoprostone and Cook's balloon as labor-inducing agents in primipara women at term.A retrospective cohort study among primipara women was conducted in Hubei Maternity and Child Health Hospital.Basic clinical characteristics were collected.The main outcomes were vaginal delivery rate,cesarean section rate and forceps delivery rate.Obstetric and perinatal outcomes were also compared.Univariate and multivariate analyses were further performed to evaluate the predictors for vaginal delivery within 24 h.A total of 845 eligible primipara women undergoing labor induction were recruited.Of them,141 women were induced with dinoprostone(dinoprostone group,DG),and 704 with Cook's balloon(Cook's balloon group,CG).Groups were homogeneous except more women with premature rupture of membranes in DG,with gestational hypertension in CG(P<0.05).The vaginal delivery rate within 12 h was 1.98%and 16.52%in CG and DG respectively(P=0.0001).Besides,the vaginal delivery rate within 24 h was 37.62%and 52.26%in CG and DG respectively(P=0.0079).DG showed the lower rate of oxytocin augmentation,artificial rupture of membrane and postpartum hemorrhage and the shorter interval from insertion to active labor than CG(P<0.05).Multivariate regression analysis revealed that abortion history,oxytocin augmentation,artificial rupture of membrane,and obstric analgesia were independent predictors for vaginal delivery within 24 h.In conclusion,dinoprostone was more effective than Cook's balloon to induce labor and achieve vaginal birth in the sample of primipara women at term.

Effect of Photoperiod Treatments on Dormancy Induction and Changes in Correlated Respiratory Rate of Nectarine Peach Bud

The responses of dormancy induction to illumination and the characteristics of respiratory rate were studied with the nectarine peach bud in this article. The trial was conducted with nectarine （Prunus persica var. nectariana cv. Shuguang） and involved three treatments： a short day treatment （8 h）, a long day treatment （16 h）, and the normal condition as the control. The dormancy status was determined with the growth of shoot and the sprouting ability, and the respiratory rate was mensurated with oxygen electrode. Short day treatment could induce the growth stopping of peach shoots ahead, promote the development of dormancy, and induce buds into dormancy with 21 d previous to control. Long day treatment postponed the growth stopping and the induction and development of dormancy. The respiratory rate decreased according to the development of dormancy induction. The minimum respiratory rate appeared about 7 days after the start of dormancy induction. Bud respiratory rate increased during this period and then declined and remained at low level during dormancy period. Long day reduced buds respiratory rate slightly. Short day could induce dormancy obviously, and long day postponed dormancy induction. The changes of respiratory rate were correlated with the development of dormancy induction, and the bud respiratory rate was also affected by photoperiod.

A new method for improving the inductively coupled data transmission rate of mooring buoy based on carrier signal frequency selection

In the inductively coupled data transmission system of the mooring buoy, the carrier signal frequency of the transmission channel is limited due to the inherent characteristics of the system, resulting in limited channel bandwidth. The limited channel bandwidth limits the increase in inductively coupled data transmission rate.In order to improve the inductively coupled data transmission rate of mooring buoy as much as possible without damaging the data transmission performance, a new method was proposed in this paper. The method is proposed to improve the data transmission rate by selecting the appropriate carrier signal frequencies based on the principle of maximizing the amplitude value of amplitude-frequency characteristic curve of the system. Research has been done according to this method as follows. Firstly, according to the inductively coupled transmission mooring buoy structure, the inductively coupled data transmission circuit model was established. The binary frequency shift keying(2FSK) digital signal modulation mode was selected. Through theoretical analysis, the relation between the carrier signal frequency and the data transmission performance, the relation between the carrier signal frequency and the 2FSK signal bandwidth were obtained. Secondly, the performance and the bandwidth of the signal transmission were studied for the inherent characteristics of the actual inductively coupled data transmission system. The amplitude-frequency characteristic of the system was analyzed by experiments. By selecting the appropriate carrier signal frequency parameters, an excellent data transmission performance was guaranteed and a large 2FSK signal bandwidth was obtained. Finally, an inductively coupled data transmission rate optimization experiment and a bit error rate analysis experiment were designed and carried out. The results show that the high-speed and reliable data transmission of the system was realized and the rate can reach 100 kbps.

The Principle of Mathematical Induction Applied to the Generalized Model for the Economic Design of X-Control Charts

Rahim and Banerjee [1] developed a general model for the optimal design of x-control charts. The model minimizes the expected cost per unit time. The heart of the model is a theorem that derives the expected total cost and the expected cycle length. In this paper an alternative simple proof for the theorem is provided based on mathematical induction.

Automatic &Safe Oxytocin Induction of Labor

Aims: To prevent fetal damage by excess oxytocin administration of manually controlled infusion, by automatic and safe increasing infusion setting with monitoring uterine contraction and fetal heart rate. Methods: Starting infusion level was 2 milliU/ml, as oxytocin sensitivity of a pregnant uterus is unknown, to avoid hyper contraction and fetal bradycardia caused by unexpected excess oxytocin sensitivity. The infusion automatically increased with automatic monitoring of uterine contraction curve, then the increasing stopped when contraction reached to normal labor level, where the infusion level maintained, which continued until delivery, if there is no trouble. However, the infusion continued until expiring all fluid in case of insensitive uterus, where the induction was performed in another day. The infusion stopped automatically when contraction was too strong, or fetal heart rate is abnormal. Thus, oxytocin sensitive case is protected from excess contraction and fetal asphyxia. Results: Normal vaginal delivery was achieved in 28/33 cases (85%), which was more than manually controlled infusion. No case was abnormal in successful oxytocin infusion. Conclusion: The automated technique will be applied to oxytocin labor induction.

Numerical and Experimental Investigation on the In-Flight Melting Behaviour of Granulated Powders in Induction Thermal Plasmas

An innovative in-flight glass melting technology with thermal plasmas was developed for the purpose of energy conservation and environment protection. In this study, modelling and experiments of argon-oxygen induction thermal plasmas were conducted to investigate the melting behaviour of granulated soda-lime glass powders injected into the plasma. A two-dimensional local thermodynamic equilibrium （LTE） model was performed to simulate the heat and momentum transfer between plasma and particle. Results showed that the particle temperature was strongly affected by the flow rate of carrier gas and the particle size of raw material. A higher flow rate of carrier gas led to lower particle temperature and less energy transferred to particles which resulted in lower vitrification. The incomplete melting of large particles was attributed to the lower central temperature of the particle caused by a larger heat capacity. The numerical analysis explained well the experimental results, which can provide valuable practical guidelines for the process control in the melting process for the glass industry.