Assessment of labor using a new type partogram compared to the classical Fisher partogram.

OBJECTIVE: To assess the quality of a new type partogram used to monitor labor. METHODS: We compared efficacy using two types of partograms. The first was the classical WHO partogram (group A) and the second a new type in which we estimated and reported the sub of cervical dilatation and the position of the descending head (group B). RESULTS: It was noted that there was a statistically significant decrease of the duration between the initiation of active phase of labor and the delivery time (dt1+dt2+dt3) (p<0.001, A: mean: 318.4±10.4 min, B: 246.56±8.28 min). Also observed was early initiation in the acceleration stage of the active phase in the first phase of labor (dt1) (p<0.001, A: 108.73±5.29 min, B: 69.96±4.99 min), shorter duration of the acceleration stage of the active phase in the first phase of labor (dt2) (p<0.001, A: 136.93±4.79 min, B: 91.89±4.04 min) and early initiation in the second phase of labor in women who were studied with the new partogram (B). CONCLUSION: The new partogram is more helpful in the recognition of the initiation of the acceleration stage during the active phase of labor and in the timely use of appropriate actions in order to achieve a safer delivery.

A short narrative review of the feasibility of adopting mild ovarian stimulation for IVF as the current standard of care.

INTRODUCTION: Mild ovarian stimulation has been conceived, proposed and implemented in clinical practice as a safer and cheaper alternative to conventional strategies of controlled ovarian hyperstimulation in preparation for in vitro fertilization (IVF). Our aim was to summarize the key evidence on this topic and explore its possible role as the standard treatment option for women undergoing IVF. MATERIALS AND METHODS: A short narrative review of the existing literature, with emphasis on mild ovarian stimulation clinical and cost effectiveness, as well as treatment limitations. RESULTS: Numerous studies highlight mild ovarian stimulation's favorable characteristics with respect to oocyte/embryo quality, reduced patient risk, and ease of intervention. There is, however, a need for high-quality laboratory environment. Limitations regarding poor responders, older women, or those seeking ovarian stimulation for non-infertility indications should also be considered. Finally, outcomes on the cumulative success rates and the cost effectiveness of mild ovarian stimulation remain inconclusive. CONCLUSION: Mild ovarian stimulation protocols for IVF should currently be implemented only in carefully selected populations. Further research is needed to clarify the remaining controversies in this IVF approach.