Objective: To test the validity of the statement "We are busy because it is getting close to the full moon" often heard on labor ward, by analysis of birth statistics in relation to lunar cycles.Method: Data for births from spontaneous onset labors for 12 lunar cycles from January 1 to ...

OBJECTIVE: Our purpose was to create a model for predicting amnionitis and rapid delivery in preterm labor patients by use of amniotic fluid interleukin-6 and clinical parameters. STUDY DESIGN: Amniotic fluid was cultured and analyzed, and a clinical score (incorporating gestational age, amniotic fluid Gram stain, glucose, leukocyte esterase, and ...

OBJECTIVE: Our purpose was to compare vaginally administered misoprostol (Cytotec) with intravenous oxytocin for labor induction in women with premature rupture of membranes beyond 36 weeks' gestation. STUDY DESIGN: Two hundred subjects with rupture of membranes without labor were randomly assigned to receive vaginally administered misoprostol or intravenous oxytocin. Twenty-five ...

OBJECTIVE: To evaluate whether the clinical response to prostaglandin-induced labor is modulated by nitric oxide (NO) activity. METHODS: Fifty-two cases of nulliparous women at term who delivered vaginally after prostaglandin E (PGE) induction of labor were enrolled. The induction was required mainly for amniotic fluid reduction or late-onset gestational hypertension. ...

Lambdoid synostosis results in skull deformities of varying degrees characterized by occipital flattening over the involved suture and other compensatory changes in skull shape. Such changes include contralateral occipital bossing, contralateral frontal flattening, ipsilateral frontal bossing, and ipsilateral anteroinferior displacement of the pinna (ear shearing). These deformities tend to worsen ...

OBJECTIVE: To use intrapartum sonography as a tool to investigate the development of the persistent occiput posterior position during labor, as well as to identify parameters correlating with the outcome of labor. METHODS: A prospective study of 408 women in labor after 37 weeks' gestation with a singleton fetus in ...

Patient-controlled analgesia (PCA) has been used at our institution for the past 5 years, as an alternative labor analgesic when epidural analgesia is contraindicated. This retrospective study evaluates the effects of maternal PCA fentanyl on infants of greater than 32 weeks gestational age. The neonatal charts (n=32) were reviewed for ...

BACKGROUND: We evaluated the accuracy of the Bishop score in predicting the likelihood of successful labor induction (entry into active phase) in nulliparous and multiparous women. METHODS: During an index year, all patients having induction of labor and a preinduction Bishop score were included in a standard protocol for cervical ...

The objective of this article is to review current literature pertaining to intra- and early postpartum sonography. All the manuscripts published in the English language regarding this topic were selected from a MEDLINE search from 1966 through August 1997. Additional sources were identified through cross-referencing. Currently, intra- and early postpartum ...

Our objective was to evaluate the efficacy and safety of labor induction in women with a breech presentation, and an unripe cervix. We conducted a retrospective, matched-paired study on patients with breech presentation and an unripe cervix (n = 23), who underwent induction of labor using extra-amniotic saline instillation. The ...

The conventional treatment for arrest of protracted active phase dilatation is amniotomy and oxitocin. This kind of labor dystocia is associated with an increased incidence in Cesarean delivery. We describe the use of cervical balloon after amniotomy for protracted active phase dilatation. We have used this approach in five parturients. ...

We evaluated the effect of maternal magnesium sulfate treatment on selected neonatal outcomes in < or =1000-g infants. In a 1-year (1992-1993) observational study, the National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units collected outcome data for 799 infants whose birth weights were < or ...

Despite widespread efforts to prevent preterm birth in the United States, greater than 10% of the more than 4 million births that occur each year are preterm. Up to 75% of morbidity and mortality in infants is linked to preterm labor and birth. Bed rest, which may have adverse physical ...

"Beginning in 1993, Israel began importing large numbers of foreign workers, replacing its traditional Palestinian labor force. This article presents a descriptive history and theoretical analysis of the migration, placing it in the context of Israel's reliance on noncitizen labor from the occupied territories. Dual labor market theory is particularly ...

OBJECTIVE: To test a simple method of intrapartum amnioinfusion to replace amniotic fluid during labor in cases of prolonged labor and severe variable fetal heart rate decelerations or thick meconium. STUDY DESIGN: We conducted a prospective study of intrapartum amnioinfusion in sixteen consecutive patients. A simple transcervically placed Foley bladder ...

BACKGROUND: To study the relationship between different types of acidemia in umbilical artery blood at birth, fetal heart rate (FHR) patterns during labor, and infant long-term outcome. METHODS: Case-control study of 48 infants with pure high base deficit (base deficit (BD) > or = 12 mmol/L and pCO2 < 8.0 ...

"Getty, Rittersporn and Zemskov recently claimed that no more than 2 million people could have perished from collectivization, famine, execution, terror, and forced labor in the USSR during the 1930s. Prior demographic confirmation of this estimate was provided by Anderson and Silver who contended that killings were unlikely to exceed ...

OBJECTIVES: Despite controversy regarding the efficacy of home uterine activity monitoring (HUAM), it is currently licensed for detection of preterm labor in women with previous preterm deliveries. In practice, however, it is being more widely utilized in an effort to prevent preterm delivery. This study seeks to determine which group ...

The suggestions offered in this article represent an effort to reduce the incidence of cesarean delivery for dystocia while maintaining a safe course to vaginal birth. Avoiding difficult labor induction in which a compelling indication is lacking, providing prompt and effective oxytocin therapy of arrested first stage labor, and liberalizing ...

OBJECTIVES: The goal of this study was to determine whether a relationship exists between heat-humidity indexes and rates of preterm labor and preterm delivery. METHODS: Preterm labor and delivery rates were compared during the 2 summer and 2 winter weeks with the highest and lowest heat-humidity indexes for each season. ...

Antenatal administration of steroids (betamethasone 12 mg i.m. twice q 24 hr) enhances fetal lung maturation and reduces neonatal morbidity in preterm prelabor rupture of membranes (PROM). However, the risks of repeated administration of steroids 7 days after the initial course are unknown. We evaluated the prevalence of histologic evidence ...

To test the hypothesis that women receiving intrapartum amnioinfusion have more rapid labors than do controls. Prospective clinical trials of amnioinfusion published in major American obstetric and gynecologic journals between 1985 and 1995, identified through a literature search using MEDLINE and manual index review, were examined. METHOD OF STUDY SELECTION: ...

OBJECTIVE: To determine the relation between the initial neonatal nucleated erythrocyte (nRBC) count and acute infection or ischemia in cases delivered before 32 weeks' gestation. METHODS: A set of 465 nonanomalous singleton live births delivered at 22-32 weeks' gestational age (GA) contained 386 cases with a complete blood count obtained ...

OBJECTIVE: To compare the tocolytic action and the side effects of nicardipine to those of salbutamol in patients presenting premature labor in order to propose nicardipine as a promising alternative to salbutamol in the treatment of premature labor. STUDY DESIGN: Ninety patients admitted to the Saint-Antoine Hospital (Paris, France) for ...

Preliminary conclusions from our research include the possibility that each of the HPA products evaluated, even though correlated (e.g., ACTH and beta E), may be linked to unique and specific outcomes. Maternal stress during the 28-30 weeks of gestation is associated with birth outcome. Increased levels of psychosocial stress were ...

OBJECTIVE: To determine whether sweeping or stripping membranes at 38-40 weeks' gestation leads to spontaneous labor within 7 days. METHODS: One hundred fifty antenatal low-risk patients at 38-40 weeks' gestation were assigned randomly to sweeping or control (ie, Bishop score only) groups and stratified based on the ability to pass ...

Preterm delivery due to preterm labor and pPROM is responsible for most infant morbidity and mortality in the United States. The patient who presents with suspicious symptoms should undergo a thorough evaluation to confirm the diagnosis of either entity and identify a treatable cause. Determination of gestational age, fetal well-being, ...

OBJECTIVE: Although several studies have documented an increase in maternal temperature associated with use of epidural analgesia during labor, none have investigated the impact of epidural use on the rate of intrapartum fever or the consequences for the fetus and newborn of this elevated maternal temperature. This study evaluates the ...

OBJECTIVE: To evaluate the effectiveness, safety, and gastrointestinal tolerance of misoprostol taken orally for induction of labor, against our established protocol, with the interval from induction to vaginal birth as the primary outcome measure. METHODS: Two hundred seventy-five women who presented with indication for induction of labor were assigned randomly ...

Since our institution has a low cesarean rate (14%), it was our hypothesis that the rate of cesarean delivery in patients who underwent induction for macrosomia would be similar to the cesarean rate in patients with similar birth weights who entered labor spontaneously. A retrospective analysis of cases seen from ...

To determine the efficacy of the terbutaline pump for the prevention of preterm delivery, patients in preterm labor defined by progressive cervical change underwent intravenous magnesium sulfate tocolysis (with or without oral indomethacin, as necessary), and once labor was arrested, were randomized to one of three treatment arms: terbutaline by ...

Lumbar epidural analgesia has become the preferred method of pain relief for labor and delivery. Proper administration of epidural analgesia offers many advantages for both mother and fetus. With the availability of various local anesthetics, opioids, and infusion techniques, the analgesia can be tailored to the specific needs of the ...

Premature rupture of the amniotic membranes (PROM) occurs in up to 20% of all births. Although many studies have examined risk factors for PROM and, in particular, preterm PROM (PPROM, if less than 37 weeks' gestation), the aetiology of PROM recurrence has not been examined as closely. This study investigated ...

This prospective study was undertaken to test the hypothesis that parathyroid hormone (PTH) might be involved in preterm or term labor. Four groups of patients were formed, 15 patients in each group. The preterm labor group were patients who were admitted to our perinatal care unit with preterm labor and ...

The incidence of infant methemoglobinemia reported in three counties of Transylvania, Romania, was evaluated from medical records, field visits, and interviews. Well water was the main source of nitrate for induction of acquired infant methemoglobinemia, which occurred post-breast-feeding when the infants consumed nitrate-contaminated water used in mixing formula. The average ...

"Some previous Canadian studies have shown that considering the labor market as a whole and also pooling all immigrants as a group, immigrants do not have any job displacement effects on the Canadian born. This study presents some new evidence. It disaggregates immigrants by country of origin and by occupation ...

"Foreigners constitute 15 percent of the population and over 20 percent of the labor force in Singapore.... This large foreign labor force is managed by a comprehensive and highly selective foreign labor policy, which is described in this paper. The strict enforcement of a guestworker policy of transience on the ...

OBJECTIVE: It has been reported that neonatal bone abnormalities occur as a result of long-term intravenous magnesium administration (MgSO4) to pregnant women. The purpose of this retrospective study was to evaluate the frequency of such abnormalities and the clinical background of both mothers and neonates. PATIENTS AND METHODS: We reviewed ...

OBJECTIVE: To assess prospectively the utility of a modification of the Mueller-Hillis maneuver in predicting abnormalities of the second stage of labor. METHODS: The Mueller-Hillis maneuver was modified by limiting its use to the second stage of labor during a contraction. The maneuver was performed by one examiner; descent of ...

OBJECTIVE: The purpose of this study was to evaluate amniotic fluid lactate dehydrogenase level in comparison with other rapid markers in prediction of microbial invasion of the uterine cavity and preterm delivery < or = 36 hours after amniocentesis. STUDY DESIGN: One hundred thirty-one women in preterm labor with intact ...

OBJECTIVE: To evaluate and compare the safety, efficacy and cost of three cervical cytology sampling devices in pregnant women presenting for prenatal care to the obstetrics clinic, at Medical College of Pennsylvania Hospital. STUDY DESIGN: From September 7, 1993, to November 5, 1993, 61 cervical cytologic smears were obtained using ...

BACKGROUND: Showers and tubs in labor were not generally used in our center. When three whirlpool baths (Jacuzzis) were ordered as part of our renovations, a randomized, controlled trial was initiated to explore their effects on narcotic and epidural requirements. METHODS: This study employed an intent-to-treat design, and the sample ...

OBJECTIVE: To define factors causing prolonged labor in nulliparous women undergoing active management of labor. METHODS: We included all nulliparas delivered during 1990-1994 with spontaneous onset of labor lasting more than 12 hours, singleton gestation, cephalic presentation, and labor at greater than 37 weeks. Each patient was matched with the ...

This study estimates the effects of 23 factors on the prevalence of premature labor and fetal growth retardation across the entire birthweight spectrum. We studied risk factors for premature labor within the domain of babies of appropriate size for their gestational age (N = 9,490). We also studied risk factors ...

OBJECTIVE: Our purpose was to investigate the safety and efficacy of a synthetic intracervical hygroscopic dilator, Dilapan (Gynotech, Inc., Middlesex, N.J.), on ripening the cervix before medically indicated induction of labor. STUDY DESIGN: Two hundred forty patients with a Bishop score of < or = 4 were prospectively randomized to ...

We describe a case of colonic pseudo-obstruction occurring in a pregnant patient whose preterm labor was being treated with intravenous magnesium and nifedipine. Sequential colonoscopies were required to manage the recurrent colonic dilations prior to delivery of healthy twins. There was no recurrence after delivery and discontinuation of the tocolytics.

BACKGROUND: Intrapartum epidural analgesia has become increasingly popular because it is the most effective method of providing pain relief during labor. Much attention is given to its safety and efficacy, and many health care providers and consumers are unaware of its potential drawbacks. This article reviews the literature about the ...

The fetus as "patient" during labor and birth has become an increasingly important concept during the past 20 years. However, what is understood about fetal status during labor and how the fetus prepares for its approaching separation from its mother? Current information indicates that not only is the term fetus ...

BACKGROUND: Serious injury can result from improper use of the birthing bar. CASE: A 31-year-old woman delivered a neonate using a birthing bar for her entire second stage of labor. Shortly after delivery, she experienced bilateral upper extremity weakness from compression of the radial nerve. She was treated with physical ...

BACKGROUND: As the interval between rupture of the fetal membranes at term and delivery increases, so may the risk of fetal and maternal infection. It is not known whether inducing labor will reduce this risk or whether one method of induction is better then another. METHODS: We studied 5041 women ...