Parity

Background: This case-control study aimed to assess the prevalence of symptoms and risk of obstructive sleep apnea (OSA) among Saudi pregnant women.
Methods: The study included consecutive Saudi pregnant women attending the antenatal service between July 2015 and December 2016. Pregnant women were compared with an age-matched group of non-pregnant women. OSA symptoms and risk were assessed using a validated Arabic version of the Berlin questionnaire (BQ).
Results: The study included 742 pregnant women and 742 age-matched non-pregnant women. At the time of the survey, 8.2% were in the first trimester; 33.4% in the second trimester; and 58.4%in third trimester. Snoring was reported by 14% of pregnant women and 5% reported breathing pauses during sleep. Based on the BQ stratification for risk of OSA, 19.3% of pregnant women and 16.6% of the control group were at high risk for OSA. A comparison between the high OSA-risk and low OSA-risk pregnant women revealed that the pregnant women in high risk group were older (30.9±5.9 years vs. 29±5.4 years, p=0.001), had a higher body mass index (BMI) (34.3±5.2 kg/m2 vs. 28.7±5.8 kg/m2, p<0.001), and higher parity (1.9±2 vs. 1.5±1.7, p=0.020). A multivariate logistic regression analysis revealed the following independent variables, BMI (OR 1.173 [95% CI 1.129 - 1.219], p<0.001), PIH (OR 7.85 [95% CI 1.691 - 36.447], p=0.013) and presence of RLS (OR 2.209 [95% CI 1.332 - 3.279], p<0.001).
Conclusions: OSA symptoms and risk were relatively common among Saudi pregnant women. Increasing the awareness among physicians about this association is essential to improve early detection of the disorder.

To quantify practice changes associated with implementing a clinical practice guideline for the second stage of labor in term nulliparous women with epidural anesthesia and to describe the lessons learned about knowledge translation. The main clinical practice guideline recommendation was waiting up to 2 hours before pushing after full dilatation. Pre- and post-evaluation of clinical outcomes and knowledge translation strategies associated with implementing the second stage of labor clinical practice guideline at two birthing units within a large teaching hospital. The implementation of the clinical practice guideline resulted in a significant increase in median waiting time before pushing of 33 minutes at Site 1. This change was also reflected in the twofold increase in the proportion of women waiting longer than 120 minutes before pushing at this site. There was no change in waiting time at Site 2. The duration of the second stage did not change significantly at either site. The m...