OBJECTIVE: To estimate the risk for preterm delivery and obstetric complications in women with prior cold-knife conization. METHODS: In a retrospective study, we compared 76 deliveries of 65 women with prior cold-knife conization with the remaining 29,711 singleton deliveries at our institution between 1992 and 2002. RESULTS: We found significant ...

This study evaluated the risk of brain damage in neonates delivered at < 34 weeks following a prolonged latency after preterm premature rupture of membranes (pPROM). The medical records of 77 singletons delivered at < 34 weeks with pPROM and 66 singletons delivered at < 34 weeks with preterm labor ...

PREFACE: Normal childbirth has become jeopardized by inexorably rising interventions around the world. In many countries and settings, cesarean surgery, labor induction, and epidural analgesia continue to increase beyond all precedent, and without convincing evidence that these actions result in improved outcomes (1,2). Use of electronic fetal monitoring is endemic, ...

OBJECTIVE: The object of this study was to determine the effects of maternal tocolysis with glycerol trinitrate (GTN) patches on the neurodevelopment of infants. STUDY DESIGN: This was a randomized, multicenter, controlled trial comparing the efficacy of GTN patches with standard beta2 agonist as tocolytic therapy. The previously reported outcomes ...

OBJECTIVE: To describe temporal trends of preterm birth subtypes, neonatal morbidity, and hospital neonatal mortality. METHODS: A database of 1.7 million births that occurred in 51 maternity hospitals in Latin America from 1985 to 2003 was studied. Subgroups of preterm births were classified according to the presence or absence of ...

Our objective was to determine maternal risk factors for developing intrapartum fever during term labor and to evaluate perinatal outcomes for infants exposed to mothers with fever. We performed a retrospective cohort study of 330 mothers and their infants and 330 controls in a single institution. Prolonged labor, nulliparity, maternal ...

OBJECTIVE: The purpose of this study was to evaluate the prevalence of labor dystocia and its association with interpregnancy interval. STUDY DESIGN: We linked the birth data for Michigan infants who were born from 1994 to 2002 with the hospital discharge data. The International Classification of Diseases (9th revision, clinical ...

CONTEXT: Clinically preferred maternal position during childbirth has varied between supine and nonsupine over time and from patient to patient. Preferred maternal birthing position is coming under increasing scrutiny. OBJECTIVE: To compare postpartum maternal and infant outcomes resulting from supine and nonsupine positions maintained during the second stage of labor. ...

The reported prevalence of posttraumatic stress disorder due to childbirth ranges from 1.5 to 6%. The purpose of this qualitative study is to conduct a narrative analysis of 11 mothers' birth trauma stories. The dramatistic pentad provided the overall structure for this narrative analysis. Using pentadic cartography, the author mapped ...

PROBLEM: To determine the associations between preterm delivery <37 weeks (PTD), cervical fluid interleukin-1beta (IL-1beta) concentration, and its +3953 single nucleotide polymorphism (SNP). METHOD OF STUDY: Cervical fluid, peripheral blood, and cord blood samples were obtained from a cohort of women 23-32 weeks gestation with preterm labor symptoms and intact ...

OBJECTIVE: The purpose of this study was to determine whether intravenous magnesium sulfate (MgSO4) followed by oral nifidepine tocolysis in women with preterm labor between 32 0/7 and 34 6/7 weeks' gestation reduces neonatal hospital stay. STUDY DESIGN: Fifty-four women between 32 0/7 and 34 6/7 weeks with preterm labor ...

Nationwide the American College of Obstetricians and Gynecologists noted in 1995 that the survival rate for newborns at 34 weeks is within 1% of those born at or beyond 37 weeks. Newborn major morbidity is slightly but significantly increased from 34(0) to 36(6) compared with 37 or greater weeks. These ...

BACKGROUND: Few studies have examined in depth the labor progression of multiparas to determine if there is any additional impact of being parous beyond the first birth. The objective of this study was to determine the effect of parity on labor progression in contemporary obstetric practice. METHODS: Our sample consisted ...

Fetal heart rate monitors, including the newer pulse-oximetry and STAN monitors, are designed to detect fetal distress that affects less than 1% of women in labor. Non-progressive labor is a much more common disorder than fetal distress, with approximately 50% of women in labor requiring oxytocin. Current technology assessing labor ...

OBJECTIVE: The objective of the study was to compare operative delivery rates for nonreassuring fetal status between 2 groups of laboring women: those having conventional cardiotocograph monitoring and those having cardiotocograph monitoring plus fetal pulse oximetry. STUDY DESIGN: The intrapartum fetal oximetry prospective, multicenter, randomized, controlled trial (the FOREMOST trial) ...

OBJECTIVE: The purpose of this study was to compare the cost-effectiveness of dilation and evacuation versus misoprostol induction of labor for second-trimester termination. STUDY DESIGN: Using decision analysis, we compared the cost-effectiveness of dilation and evacuation and misoprostol induction of labor for second-trimester termination. Complications for dilation and evacuation and ...

The aim of this study was to provide a theoretical basis, using biomechanical properties, for the clinical application of human umbilical vein (HUV) as material for vascular grafting. This was a nonrandomized, non-controlled in vitro study. The experiment was conducted in the Laboratory of Medical Biomechanics, Yunyang Medical College. HUVs ...

OBJECTIVE: To estimate the potential savings, both in terms of costs and lengths of stay, of one-week increases in gestational age for premature infants. The purpose is to provide population-based data that can be used to assess the potential savings of interventions that delay premature delivery. DATA: Cohort data for ...

A full-term, healthy female newborn was delivered via cesarean section because the labor did not adequately progress. The mother, age 33 years and of Asian ancestry, had a significant medical and obstetrical history: chronic hepatitis B carrier without cirrhosis, cutaneous lupus erythematosus (positive anti-Ro and anti-La antibodies), and a positive ...

OBJECTIVE: To estimate the minimum effective intravenous dose of oxytocin required for adequate uterine contraction after cesarean delivery for labor arrest. METHODS: A randomized single-blinded study was undertaken in 30 parturients undergoing cesarean deliveries under epidural anesthesia for labor arrest despite intravenous oxytocin augmentation. Oxytocin was administered as a slow ...

This study examined the effect of eating during the latent phase of labor on the hospital-estimated labor duration and birth outcomes for the mother and baby. A prospective, comparative trial with concurrent controls compared labor duration and outcomes of 176 low-risk, nulliparous women who birthed at four hospitals in Sydney, ...

BACKGROUND: The purpose of this study was to investigate the delivery outcome in relation to oxytocin use in labor. METHODS: We studied 106,755 deliveries from 1995 to 2002 in the Perinatal Revision South, a population-based register comprising information from 10 hospitals in southern Sweden. RESULTS: Oxytocin use in labor increased ...

In this column, the author presents summaries of four research studies that further support the benefits of normal birth. The topics of the studies address cord clamping of term infants, the association of multiple cesareans and placental abnormalities, induction of labor at 41 weeks, and the World Health Organization's recently ...

AIMS: Our aim is to investigate, in 13 cases (delivering preterm) and 21 matched (for age, parity, and gestational age) controls (delivering at term), whether midtrimester amniotic fluid concentrations of elastase, secretory leukocyte proteinase inhibitor (SLPI), soluble intercellular adhesion molecule-1, and soluble vascular cell adhesion molecule predict asymptomatic intra-amniotic inflammation/infection ...

High-dosage, tocolytic magnesium sulfate (MgSO4) administered to pregnant women during preterm labor can be toxic, and sometimes lethal, for their newborns (Cochrane Database of Systematic Reviews (relative mortality risk 2.82, 95% confidence interval 1.2-6.6)). Based on the results of the Magnesium and Neurologic Endpoints Trial and the work of many ...

We used microsatellite data to estimate levels of inbreeding in four species of solitary gall thrips that are in the same clade as the six species with soldier castes. Three of the four species were highly inbred (Fis 0.54-0.68), and the other apparently mated randomly (Fis near zero). These estimates, ...

BACKGROUND: The objective was to investigate whether acupuncture could be a reasonable option for augmentation in labor after spontaneous rupture of membranes at term and to look for possible effects on the progress of labor. METHODS: In a randomized controlled trial 100 healthy parturients, with spontaneous rupture of membranes at ...

BACKGROUND: Beta(2)-adrenergic receptor (beta(2)AR) agonists are not consistently successful when administered as tocolytic therapy. The beta(2)AR displays genetic variability; an arginine-to-glycine substitution at codon 16 (Arg16Gly) has been shown to increase receptor desensitization in response to agonist exposure, whereas a substitution of glutamate for glutamine at codon 27 (Gln27Glu) decreases ...

OBJECTIVE: To determine the labor and puerperal impact of continuing oral magnesium supplementation until delivery. STUDY DESIGN: Single-center study with matched controls. In 40 pairs of healthy women with vaginally delivered singleton pregnancies, matched for maternal age, race and parity, maternal and neonatal outcome endpoints were compared in those receiving ...

While taking an enema to induce labor is a controversial issue worldwide, in Taiwan it remains a routine procedure in many hospitals in preparation for birth. Episiotomy is also a prevalent procedure performed during the birthing process. Some physicians believe that enemas help reduce the risk of feces contamination of ...

OBJECTIVE: To assess the value of plasma proMMP-9 levels in predicting the progress of threatened preterm labor to true preterm labor and delivery within 7 days of presentation, along with the ultrasonographic measurement of cervical length. STUDY DESIGN: The study included sixty two pregnant women presented in the 2nd Department ...

BACKGROUND: Elective preterm delivery of the fetus with gastroschisis may help to limit injury to the extruded fetal gut and thus promote faster recovery of neonatal gut function and earlier hospital discharge. This hypothesis has not previously been tested in a prospective randomized controlled trial. METHODS: Between May 1995 and ...

OBJECTIVES:To test the hypothesis that absolute nucleated red blood cells (ANRBC) counts are higher at birth in infants who were born after prolonged rupture of membranes (PROM, >24 hours).STUDY DESIGN:Retrospective study of 31 infants admitted to the neonatal intensive care unit who were born after PROM, and pair matched for ...

Partus induction is an important integrative component of reproduction management in the swine industry. In this context, the question is to what extent the application of uterotonic substances may influence the vitality of piglets. The blood pH value is used as a laboratory objective diagnostic parameter of neonatal acidosis. This ...

BACKGROUND: To analyze the clinical and sonographic variables that affect the success of labor induction. METHODS: Bishop score, cervical length, and parity were studied in 196 pregnant women in the prediction of successful vaginal delivery within 24 hr of induction. Logistic regression and segmentation analysis were performed. RESULTS: Cervical length ...

Intra-amniotic inflammation (IAI) may cause preterm birth with poor neonatal out-come. To identify novel biomarkers for IAI, we analyzed amniotic and cervical fluid samples from 27 patients with signs of threatening preterm birth with or without IAI by surface-enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS). Seventeen proteins were significantly ...

AIM: Term pregnancy complicated by premature rupture of membranes (PROM) is thought to be associated in part with subclinical infection, and places mothers and neonates at an increased risk for several complications. Therefore, perinatal care would be greatly helped if a reliable clinical measure were available for predicting the incidence ...

Companies and leaders don't succeed or fail in a vacuum. When it comes to longterm success, the ability to understand and adapt to changing business conditions is at least as important as any particular personality trait or competency. A clear picture of how powerful the zeitgeist can be emerges from ...

BACKGROUND: The purpose of this study was to assess the efficacy, side effects and cost of misoprostol regimens in various obstetrical situations frequently occurring in developing countries. STUDY DESIGN: One hundred and four parturient women with indications for labor induction received different regimens of misoprostol in the range of 50-800 ...

There is dispute in the United States about what should be the first line of tocolytics for preterm labor. In Europe, the initial choice to prevent preterm birth is a calcium channel antagonist (CCA). Randomized studies have noted that CCAs are as efficacious as other tocolytics and a meta-analysis concluded ...

Premature labor and subsequent premature delivery is the major cause of perinatal death in the world. Numerous risk factors identify patients at jeopardy for preterm labor, but with poor sensitivity. Several biologic and biochemical markers have been recently studied that may allow early identification of patients at risk of preterm ...

Preterm labor (PTL) is common in multiple gestations. Management of patients includes attempts at prevention of PTL, acute tocolysis when PTL is diagnosed, and long-term maintenance tocolysis. Clinical therapeutics should be aggressively directed at minimizing the background uterine contractions to reduce the incidence of PTL and to provide a greater ...

OBJECTIVE: The purpose of this study was to assess whether the duration of labor has any effect on the occurrence of cerebral white-matter damage in very preterm infants who are delivered in the presence of intrauterine infection. STUDY DESIGN: From a cohort of infants who were born spontaneously at <32 ...

Magnesium sulfate has become the first-line tocolytic for short-term use to arrest idiopathic preterm labor. The reasons for its acceptance include familiarity of the drug, ease of use, and the virtual absence of serious maternal side effects. Sufficient data exist showing its efficacy if used in higher doses. Attention to ...

Over the past 20 years, the number and rate of multiple births have dramatically increased in the United States. The rise in multiple births is mainly attributable to the increased use of ovulation-inducing drugs and the newly developed assisted reproductive technologies such as in vitro fertilization. Multifetal gestation is associated ...

OBJECTIVE: To compare the efficacy and safety of arithmetic and geometric increases in oxytocin infusion dosage during induction of labor. METHODS: A total of 120 pregnant women requiring induction of labor at term were randomly assigned to receive oxytocin at dosages increasing arithmetically or geometrically. Maternal demographics, labor delivery data, ...

BACKGROUND: To determine whether the measurement of beta-human chorionic gonadotropin (beta-HCG) level in the vaginal washing fluid could be useful for the diagnosis of premature rupture of membranes. METHODS: Totally, 120 pregnant women were enrolled in this study. Subjects were divided into four groups [group I, no preterm labor and ...

BACKGROUND: The pharmacokinetics of a novel slow-release (SR) misoprostol was studied and compared to conventional misoprostol. METHODS: Thirty-one women, pregnant between 8 and 12 weeks, requesting surgical abortion were randomly allocated to receive orally 400 microg conventional misoprostol, 400 microg SR misoprostol or 800 microg SR misoprostol. Venous blood samples ...

OBJECTIVE: Study the effectiveness of tocolysis for preterm labor with advanced cervical dilatation ( > or = 3 cm) to achieve sufficient latency for the effect of steroids to occur, and delivery of more mature neonates. STUDY DESIGN: We studied 249 singleton pregnancies, 23-36 weeks gestation in preterm labor, stratified ...

Deposits of hemosiderin are found frequently in the interstitium of the lungs of infants who die suddenly and have been a suggested marker for hypoxia during previous episodes of apnea. We studied the epidemiology of pulmonary interstitial hemosiderin (PIH) in 94 infants with a diagnosis of the sudden infant death ...