In line with the study guidelines, a sample of amniotic fluid was collected by the midwife at delivery. The level of lactate in AF was used as a sign of the uterine selleck inhibitor metabolic status at delivery and the analysis was Inhibitors,Modulators,Libraries performed immediately by a research midwife, using a lactate measurement device. The test result was blinded to both the midwife and the labouring woman. A cut off value for a very high AFL level was set at 12 mmol L. This is in line with earlier publications where there was an increased frequency of complicated deliveries in the group with a high AFL value. Foetal scalp blood sampling was performed in the deliveries where a non reassuring pathological CTG trace was presented. The test was performed with the mother supine and her legs in stirrups.
The scalp blood was collected in preheparinized glass Inhibitors,Modulators,Libraries capillary tubes, and the lactate analysis was carried out at the bedside. After delivery and before the newborns first cry, arterial and venous cord blood samples were drawn from a segment of the cord and Inhibitors,Modulators,Libraries analysed within a few minutes for ph. All cord Inhibitors,Modulators,Libraries blood analyses were performed using an ABL 800 analyser available in the labour ward. Socio demographic and obstetric background data were collected from the antenatal and delivery records. Statistical analyses were performed using SPSS 20. 0 and the Statistica for Windows statistical package, version 10. 0. Mean and standard deviation were used as descriptive measures. The difference between the groups of low moderate or high W DEQ was tested by t test for parametric variables and chi square test for categorical variables.
The sum of the responses on the W DEQ questionnaire Inhibitors,Modulators,Libraries was calculated. Internal missing data were replaced by the group mean for the unanswered question, according to the guidelines for the survey. The scores from the questionnaire were then compared with the outcome of delivery. A logistic regression was performed to estimate the association between the primary outcome and the following independent variables labour dystocia, latent phase 13 h, full cervical dilation and non descent of the foetal head 3 h, AFL 12 mmol L, epidural anaesthesia, Apgar 7 at 1 min. Our model strategy was as follows first, unadjusted associations with each factor were studied in a univariate model. Second, the adjusted association with respect to the risk factors measured was studied in a multivariable model. Before performing the logistic regression, clinically relevant interaction models were constructed. No significant interactions were detected. Results In all, 446 healthy women were sellckchem included in this study of various factors that might affect womens experience of delivery. After all the women had completed the W DEQ B questionnaire, four of the questions remained unanswered.