Clinical Research Directory

The Ophthalmic Artery Doppler Evaluation Prior to Labor Induction and Adverse Intrapartum Fetal Outcomes

The ophthalmic artery Doppler has been recently proposed as a potential "soft marker" for placental insufficiency in retrospective and observational studies, with similar clinical significance with respect to Uterine Artery (UA) Doppler evaluation and it is currently being investigated as an adjunctive clinical instrument to predict pre-eclampsia (PE) occurrence. Placental insufficiency strictly correlates with intrapartum fetal adverse outcomes and a concomitant induction of labor, alone, may further increase the hypoxic stress on the fetus during labor. This can be reflected by cardiotocographic alterations during labor, ultimately leading to emergency cesarean deliveries or instrumental vaginal deliveries. Despite great advancements in understanding various maternal-fetal pathologies, the investigators are still not able to properly detect fetuses that are at higher risk for intrapartum compromise among those receiving an induction of labor. Therefore, the aim of this prospective study is to investigate any potential association between altered ophthalmic artery Doppler PSV ratio measured before labor induction in at-term, pregnant patients with intra-partum fetal compromise. Furthermore, the investigators aim to also measure an additional parameter that is the optic nerve sheath diameter (ONSD) - an indirect measure of intracranial pressure - before and after the second stage of labour, with the aim of studying its physiology during and after delivery.

Effect of a Vertical Birthing Chair on Labor

The goal of this randomized clinical trial is to evaluate whether the use of a vertical birthing chair during the active second stage of labor improves fetal head descent and rotation. The effects will be assessed objectively by intrapartum ultrasonography, and effects on labor progress and maternal and neonatal outcomes. The main questions it aims to answer are: * Does the use of a vertical birthing chair improve intrapartum ultrasonographic parameters of fetal head descent and rotation compared with the standard semi-recumbent position? * Does the use of a vertical birthing chair affect the duration of the second stage of labor, mode of delivery, perineal injury, postpartum blood loss, maternal childbirth experience, and neonatal outcomes? Researchers will compare women assigned to use a vertical birthing chair with women assigned to the standard semi-recumbent position to determine the effects of maternal position during the active second stage of labor. Participants will: * Be randomly assigned to either the vertical birthing chair group or the standard semi-recumbent position group during the active second stage of labor. * Undergo intrapartum ultrasonographic assessment of fetal head descent and rotation. * Be evaluated for the duration and mode of delivery, episiotomy and perineal trauma, postpartum blood loss, and neonatal outcomes. * Complete the Childbirth Experience Questionnaire (CEQ) to assess their childbirth experience.

Tranexamic Acid for the Prevention of Obstetrical Hemorrhage After Cesarean

A randomized placebo-controlled trial of 11,000 women to assess whether tranexamic acid as prophylaxis lowers the risk of postpartum hemorrhage in women undergoing a cesarean delivery.

Effect of Mechanical Massage Cushion on Labor Pain and Comfort

This study was conducted to examine the effect of mechanical massage applied with a mechanical massage cushion during labor on labor pain and comfort. This research is a randomized controlled experimental study. The universe of the study consisted of primiparous women who gave birth normally in a state hospital between November 2021 and February 2022, and the sample consisted of 70 pregnant women (35 pregnant women in the experimental group and 35 pregnant women in the control group) who met the selection criteria. Data were collected face-to-face with the Personal Information Form, Visual Analog Scale (VAS), Verbal Category Scale (VCS), and Childbirth Comfort Questionnaire (CCQ). Data were analyzed using the SPSS 22.0 package program.

Role of the WHO Labour Care Guide in Improving Maternal and Fetal Outcomes

The goal of this randomized controlled trial is to compare the effectiveness of WHO labour care guide (LCG) with the WHO modified partogragh in improving the maternal and fetal outcomes among primigravida and multigravida in active labour .the study evaluates whether use of the Labour care guide leads to improved labour monitoring ,timely clinical decision making and better maternal and neonatal outcomes .this study will answer either of the two questions that is * There is no difference in maternal and fetal outcomes between women monitored with Wo labour care guide (LCG) and those monitored with the Modified Partogragh * There is a difference in maternal and fetal outcomes between women monitored with the WHO Labour care guide (LCG) and those monitored the modified Partogragh .

Ropivacaine and Fentanyl for Labor Epidural Initiation

This study is being done to determine the most effective dose of medicine to use to initially provide effective pain relief within the first 30 minutes of receiving an epidural for pain labor during labor. The study team will also study any side effects related to the epidural medication and patients' satisfaction with the quality of pain relief after receiving the epidural.

Visual Biofeedback Through Transperineal Ultrasound During the Expulsive Phase of Labour to Improve Maternal Childbirth Satisfaction

Childbirth is generally regarded as a positive life-changing experience. Up to 44% of women may however experience this as a traumatic event, with 3% suffering from post-traumatic stress disorder after childbirth. The aetiology of a traumatic childbirth experience is a complex interplay between pre-birth, intra-partum and postnatal factors. Feelings of loss of control, lack of interaction with the obstetric caregiver and lack of emotional or practical support during labour are important contributing factors. This trial aims to investigate the effect of providing Visual Biofeedback (VB) through Trans-Perineal Ultrasound (TPU) during the active 2nd stage of labour on maternal childbirth satisfaction. The hypothesis is that the intervention will improve patient-caregiver communication and enhance parturient women's sense of control and empowerment, ultimately improving the birth experience.