OBJECTIVE: We sought to compare Japanese nulliparous labor progression with Friedman's classic 1955 curve and Zhang's 2002 curve. STUDY DESIGN: We developed a labor curve using retrospective record reviews of 2369 Japanese nulliparas, at term, spontaneous labor onset and singleton vertex deliveries of normal birth weight infants. RESULTS: The new ...

To determine whether timing or type of delivery affects the incidence of transient tachypnea of the newborn (TTN) in late preterm and term pregnancies. The cases of 85 newborns delivered at Fatih University Hospital and diagnosed with TTN between January 2006 and March 2009 were reviewed. For every newborn with ...

There are many options for natural and preventative therapies during pregnancy and childbirth, which may aid in minimizing the use of pharmaceuticals and invasive procedures. Patients may seek these out, and it is important for physicians to have some basic knowledge to guide their choices. Of all therapies, the most ...

OBJECTIVE: Our aim was to assess the effect of labor on the risk and course of transient tachypnea of the newborn (TTN) in term neonates from a contemporary, population-based cohort. METHODS: We analyzed perinatal characteristics of term singleton newborns (gestational age [GA] of > or =37 completed weeks) who were ...

Preventing preterm delivery remains one of the great challenges in modern medicine. Preterm birth rates continue to increase and accounted for 12.7 percent of all U.S. births in 2005. The etiology of preterm delivery is unclear, but is likely to be complex and influenced by genetics and environmental factors. Women ...

Elective induction of labor is at an all-time high in the United States despite known associated risks. It can lead to birth of an infant too early, a long labor, exposure to a high-alert medication with its potential side effects, unnecessary cesarean birth, and maternal and neonatal morbidity. There is ...

Despite recent improvements in child survival in sub-Saharan Africa, neonatal mortality rates remain largely unchanged. This study aimed to determine the frequency of delivery and newborn-care practices in southern Tanzania, where neonatal mortality is higher than the national average. All households in five districts of Southern Tanzania were approached to ...

OBJECTIVE: To identify maternal, pregnancy, delivery and infants characteristics related to neonatal asphyxia and associated with substandard care. DESIGN AND SETTING: A nation-wide case-control study in Sweden. POPULATION: Infants born between 1990 and 2005 with a gestational age > or = 33 weeks and a spontaneous or induced onset of ...

Intra-amniotic and systemic infection/inflammation have been causally linked to preterm parturition and fetal injury. An emerging theme is that adipose tissue can orchestrate a metabolic response to insults, but also an inflammatory response via the production of adipocytokines, and that these two phenomenons are interrelated. Adiponectin, an insulin-sensitising, anti-inflammatory adipocytokine, ...

OBJECTIVE: The aim of this study was to identify changes in protein expression in normal pregnancy compared with preterm labor by using 3 proteomic methods. STUDY DESIGN: Serum was collected from 25 nonpregnant (n = 5) and pregnant women at 24-40 weeks' gestation (n = 20) who had preterm labor ...

We evaluated acute neonatal morbidities in the delivery room associated with primary cesarean performed prior to labor and in the first or second stages of labor. A retrospective cohort study was conducted on subjects undergoing term, primary cesareans at the Women's Pavilion, Miller Children's Hospital in Long Beach, California from ...

A male Labrador Retriever neonate presented for evaluation 8 hours after birth because of the onset of generalized seizure activity. The neonate was one of 8 puppies delivered over a 19-hour period to a 4-year-old female Labrador Retriever at an assistance dog breeding colony. Uterine and fetal heart monitoring were ...

OBJECTIVE: We examined the obstetric outcomes of low-risk labors at the 'Japanese tatami' mat compared with Western-style delivery room. METHODS: A retrospective cohort study was performed on 201 deliveries at the 'Japanese tatami' delivery room and 360 deliveries at the standard Western-style delivery room. RESULTS: There were no measurable differences ...

The off-label use of Cytotec (misoprostol) to induce labor has increased over the past few decades. The increase in medical interventions in childbirth, many of which are not based on scientific evidence, and the rise in maternal and infant morbidity and in maternal and infant mortality cannot continue to go ...

AIM: To examine the maternal and neonatal characteristics related to labor outcome following induction for prelabor rupture of membranes (PROM) after 37 weeks' gestation. METHOD: All singleton pregnancies delivered following spontaneous or induced labor after 37 weeks in four years were analyzed. Patients with labor induction for PROM comprised the ...

OBJECTIVE: Premature labor is still the leading cause of infant mortality and morbidity worldwide. Multiple etiological factors including genetics and environment are held responsible for preterm birth. However, scientific data regarding the link between premature birth and genetics are limited. SUBJECTS AND METHODS: In this study, we included 50 women ...

For many women, the essential ingredients for a safe and satisfying birth include a sense of empowerment and success in coping with or transcending the experience, in addition to having solid, positive encouragement from a support companion. The massage practitioner can enhance these ingredients by adding knowledgeable, caring touch which ...

AIMS: To identify risk factors for a short interval to birth in women with preterm labor, and to construct a statistical model to predict birth within seven days from the diagnosis of preterm labor at 22-35 weeks of gestation. METHODS: Vaginal flora was obtained from 126 singleton pregnant women hospitalized ...

OBJECTIVE: The objective of the study was to estimate practice patterns regarding bed rest in women with preterm premature rupture of membranes (PPROM) and arrested preterm labor. STUDY DESIGN: This was a mail-based survey of all Society for Maternal-Fetal Medicine members in the United States asking whether they would recommend ...

OBJECTIVE: Increased availability of oxytocin and misoprostol is needed to reduce the risk of postpartum hemorrhage. This review compiles rates and risks of adverse maternal and perinatal outcomes associated with use of these medications for labor induction and augmentation in low-income countries. Recommendations are proposed based on the findings. METHODS: ...

The aims of the present study were to compare the levels of mRNA and protein expression of matrix metalloproteinase (MMP)-1, -3, -8 and -9 in human cervical tissue in preterm and term labor as well as not in labor and to determine if corticotropin-releasing hormone (CRH) has an effect on ...

OBJECTIVE: To determine phase III study design using the phase II data for a proprietary controlled-release misoprostol vaginal insert for cervical ripening and labor induction. METHODS: The reported experiences in 2 phase II trials involving induction of labor in 168 women are discussed. RESULTS: Combining data from 2 phase II ...

Vaginal delivery is a natural process that usually does not require significant medical intervention. Management guided by current knowledge of the relevant screening tests and normal labor process can greatly increase the probability of an uncomplicated delivery and postpartum course. All women should be screened for group B streptococcus; women ...

OBJECTIVE: The anti-inflammatory limb of the immune response is crucial for dampening inflammation. Spontaneous parturition at term and preterm labor (PTL) are mediated by inflammation in the cervix, membranes, and myometrium. This study focuses on the changes in the amniotic fluid concentrations of the anti-inflammatory cytokine interleukin (IL)- 10. The ...

OBJECTIVE: Heat shock protein (HSP) 70, a conserved member of the stress protein family, is produced in almost all cell types in response to a wide range of stressful stimuli, and its production has a survival value. Evidence suggests that extracellular HSP70 is involved in the activation of the innate ...

OBJECTIVE: To estimate maternal-fetal medicine specialists' practice patterns and perceived risks and benefits to tocolysis. METHODS: We performed a mail-based survey of all Society for Maternal-Fetal Medicine (SMFM) members in the United States. Subjects were asked whether they would recommend tocolysis and what would be their first-line tocolytic in five ...

OBJECTIVE: To assess the outcome of induced deliveries with IUGR. STUDY DESIGN: We reviewed the computerized files of parturients who underwent inducted labor because of IUGR (<5th percentile). Outcome assessment included mode of delivery, indication for CS, NICU admissions and 5 min Apgar score. We compared these parameters to a ...

Sacrococcygeal teratomas (SCTs) are the most common germinal cell neoplasms of the fetus and neonate. They originate during embryonic development when the primitive streak fails to differentiate among mesodermal, ectodermal, and endodermal tissues in the embryonic disc. This article discusses the fetal pathophysiology of SCTs and the impact of the ...

We report on three pregnant women with ritodrine-induced neutropenia who were successfully treated with granulocyte-colony stimulating factor (G-CSF). The neutropenia occurred after continuous intravenous infusion of ritodrine for preterm labor. Ritodrine was discontinued and G-CSF was administered. Neutrophil counts returned to normal an average of 4.3 days after the administration. ...

OBJECTIVE: The purpose of this study was to determine the frequency and clinical significance of intraamniotic inflammation in patients with acute cervical insufficiency. STUDY DESIGN: Amniocentesis was performed in 52 patients with acute cervical insufficiency (cervical dilation, > or =1.5 cm) and intact membranes and without regular uterine contractions (gestational ...

This study examined the effects of a yoga program during pregnancy, on maternal comfort, labor pain, and birth outcomes. A randomized trial was conducted using 74-primigravid Thai women who were equally divided into two groups (experimental and control). The yoga program involved six, 1-h sessions at prescribed weeks of gestation. ...

BACKGROUND: The Valsalva pushing technique is used routinely in the second stage of labor in many countries, and it is accepted as standard obstetric management in Turkey. The purpose of this study was to determine the effects of pushing techniques on mother and fetus in birth in this setting. METHODS: ...

OBJECTIVE: To evaluate the management policy of delivery in a suspected macrosomic fetus and to describe the outcome of this policy. STUDY DESIGN: For this prospective observational study we followed the management by reviewing the medical records of 145 women and their infants. The study population included women at term ...

We describe the complicated course of a rare pregnant woman with symptomatic Huntington disease (HD) and discuss multidisciplinary care issues that may be encountered. A 31-year-old gravida 2, para 1 with advanced HD was admitted at 30 weeks gestation for preterm labor. Her course was complicated by progressive cognitive and ...

OBJECTIVES: To determine the relationship between the translabial cervical length and the latency period or peripartum maternal infection in women with preterm premature rupture of membranes (PPROM). METHODS: Fifty-five women with a singleton gestation and PPROM between 24 and 34 weeks who had a translabial ultrasound performed within 24 hours ...

Unplanned, adverse events during labor or delivery may generate a negative response for the mother during the early postpartum period, resulting in disruption of usual functioning and mood. Alterations in maternal mood can lead to a more debilitating condition known as Postpartum Depression. Postpartum Depression negatively affects the quality of ...

A young mother shares the stories of her two sons' births. Her first birth experience was complicated by muscle spasms and changes in her baby's heart rate during labor and, later, by medical problems with her baby in the days after birth. The mother's strength and commitment shine through at ...

OBJECTIVE: The receptor for advanced glycation end products, RAGE, plays an important role in the pathogenesis of several diseases. sRAGE, soluble receptor for advanced glycation end products, is an inhibitor of the pathological effect mediated via RAGE. The aim of this study was to assess the usefulness of measuring sRAGE ...

Spontaneous rupture of membranes (ROM) is a normal component of labor and delivery. Premature ROM (PROM) refers to rupture of the fetal membranes prior to the onset of labor irrespective of gestational age. Once the membranes rupture, delivery is recommended when the risk of ascending infection outweighs the risk of ...

Interfering with the normal physiological process of labor and birth in the absence of medical necessity increases the risk of complications for mother and baby. Six evidence-based care practices promote physiological birth: avoiding medically unnecessary induction of labor, allowing freedom of movement for the laboring woman, providing continuous labor support, ...

AIMS: To determine whether sonographic measurement of cervical length predicts intra-amniotic infection and impending preterm delivery (within 7 days of amniocentesis) in women with preterm labor and intact membranes, and to compare the predictability with that of amniotic fluid (AF) white blood cell (WBC) count. METHODS: Transvaginal ultrasonographic assessment of ...

OBJECTIVE: In the past, oligohydramnios occurring early during the secondary trimester was the reason to terminate the pregnancy because of poor prognosis. Even though amnioinfusion has been reported for improving the prognosis of the infant, it is still not frequently used because of unfavorable results. We present our experience with ...

Obstructed labor is a common complication of human childbirth. In parts of the world where access to emergency obstetric services is limited, obstructed labor is a major cause of maternal mortality. Women who survive the ordeal of prolonged obstructed labor often end up suffering from an obstetric vesicovaginal fistula or ...

Water intoxication, a form of acute hyponatremia, has been described in various clinical situations. Although hyponatremia is a common metabolic disorder in hospitalized patients, it is generally not well known as a hazard in the labor and delivery room. However, several factors predispose laboring women to develop hyponatremia. Moreover, because ...

Progesterone plays a critical role in the maintenance of pregnancy and has been effectively used to prevent recurrences of preterm labor. We investigated the role of genetic variation in the progesterone receptor (PGR) gene in modulating risks for preterm labor by examining both maternal and fetal effects. Cases were infants ...

OBJECTIVE: The purpose of this work was to investigate whether xanthochromia in newborns is related to maternal labor before delivery. METHODS: We reviewed the medical charts of all of the infants < or = 30 days of age who had a lumbar puncture performed in a single pediatric emergency department ...

OBJECTIVES: This study was undertaken to analyze trends in intrapartum fetal death and rates of perinatal autopsy over a 25-year period in Dublin, Ireland. STUDY DESIGN: A retrospective multicenter analysis of 508,342 nonanomalous infants 500 g or more, delivering in 3 tertiary-referral university institutions between 1979-2003. RESULTS: There has been ...

AIM: The effectiveness of the management of preterm birth remains an important health care issue, especially when considering that more than two thirds of singleton neonatal death occurs in preterm labor. The purpose of this study was to compare oral celecoxib with intravenous magnesium sulfate as tocolytic. METHODS: This was ...

BACKGROUND: Primary non-gestational uterine cervical choriocarcinoma is very unusual and although it has been hypothesized that it can arise by metaplastic transformation of cervical epithelium, solid evidence has been lacking. CASE: Primary non-gestational uterine cervical choriocarcinoma was diagnosed in a 47-year-old, woman undergoing tubal resection 17 years previously. A histologically- ...

The objective of this article is to review the role of matrix metalloproteinases (MMPs) in fetomaternal/neonatal complications of preterm birth. The function of MMPs as proteolytic enzymes involved in tissue remodeling/destruction is reviewed in preterm labor, preeclampsia, premature rupture of membranes, intrauterine growth restriction, chronic lung disease, necrotizing enterocolitis, intraventricular ...