Document Detail


Head-to-body delivery interval using 'two-step' approach in vaginal deliveries: effect on umbilical artery pH.
MedLine Citation:
PMID:  21463228     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. To assess the duration of head-to-body interval using a 'two-step' approach to delivery that include waiting for the next contraction to deliver the shoulders; and its effect on umbilical artery pH and neonatal outcome. Study design. Prospective observational study on vaginal deliveries with singleton cephalic fetuses at term from June to December 2005. Clinical variables were evaluated in reference to umbilical artery pH and evidence of neonatal acidemia, defined as pH ≤ 7.10 or base excess (BE) ≤ -12 in a multivariate model. Results. Head-to-body interval was timed and recorded in 789 deliveries. The mean head-to-body interval was 88 ± 61 s. Although head-to-body interval was significantly correlated to umbilical artery pH (p = 0.02), the decline in umbilical artery pH in relation to the head-to-body interval was clinically not significant (0.0078 units for every additional minute of the interval). At the multivariate analysis, umbilical artery pH ≤ 7.10 and/or BE ≤ -12 were significantly related to abnormal fetal heart rate tracing during the second stage (p = 0.012) and operative vaginal delivery (p = 0.045), but not to head-to-body interval (p = 0.25). Shoulder dystocia occurred in three cases (0.38%). Conclusion. A 'two-step' approach to birth does not significantly increase the risk of neonatal acidemia.
Authors:
Anna Locatelli; Maddalena Incerti; Alessandro Ghidini; Anna Longoni; Giovanna Casarico; Simona Ferrini; Nicola Strobelt
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-5
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
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