OBJECTIVE: To evaluate intrapartum risk factors for anal sphincter tear. DESIGN: A prospective observational study. SETTING: Delivery unit at the University Hospital in Göteborg, Sweden. PARTICIPANTS: 2883 consecutive women delivered vaginally during the period between 1995 and 1997. Information was obtained, from patient records and from especially designed protocols which ...

OBJECTIVES: 1. To describe the relation between birthweight and risk of emergency caesarean section at term; 2. to determine whether the relation between birthweight and caesarean section differed between male and female babies; and 3. to determine what proportion of the increased rates of caesarean section could be related to ...

Population-based data from the Cardiff Births Survey has been used to examine the trends in obstetric intervention with increasing maternal age. As maternal age increases, spontaneous vaginal delivery rates fall, instrumental delivery rates, elective and emergency caesarean section, induction of labour and epidural rates rise. Induction of labour and epidural ...

OBJECTIVE: After childbirth-related third- or fourth-degree perineal lacerations, the estimated incidence of wound disruption, fecal incontinence, or fistula ranges from 1% to 10%. Risk factors associated with severe laceration were analyzed at a single large teaching institution. Study Design: This study consisted of an analysis of data from the delivery ...

OBJECTIVE: To describe perinatal practices from a community perspective and identify factors associated with perinatal death. DESIGN: Cross sectional community based survey. SETTING: Murewa and Madziwa rural areas, Zimbabwe. SUBJECTS: Women aged 15 to 50 years who had been pregnant within the 24 months preceding the survey. MAIN OUTCOME MEASURES: ...

BACKGROUND: Several reports postulate that manic depression and schizophrenia share environmental risk factors. Although obstetric adversity has been suggested as a risk factor for schizophrenia, few studies have examined its relationship to bipolar affective disorder. AIMS: To assess the rate of obstetric complications incurred by patients with mania compared with ...

This study compares the childbirth outcomes of women whose husbands were present during labour with those whose husbands were absent. A retrospective comparative design was used. Sixty-three Hong Kong Chinese primigravid mothers recruited from childbirth education classes were allocated to one of two groups: those whose husband attended labour (n ...

We present a clinical study of 204 cases of obstructed labour admitted over a period of 5 years between 1991-92 and 1996-97 in a rural institute in central India. They constituted 1.9% of births. Seventy-one per cent of the cases were from the rural area (similar to the overall patient ...

OBJECTIVE: A study was carried out to ascertain maternal and perinatal outcome of cases presented as breech versus their mode of delivery so that appropriate management strategy could be mapped out without compromising fetomaternal wellbeing. METHODS: The study was carried out in one of the units of the Department of ...

The Oricult-N semiquantitative dipslide (Orion Diagnostica, Espoo, Finland) was evaluated for the laboratory diagnosis of vaginal candidiasis. It was compared with broth culture (Vagicult; Orion Diagnostica). Oricult-N was positive for 14.5% of 124 symptomatic patients and 12% of 50 asymptomatic controls. The results for broth cultures were 17 and 22%, ...

Retrospective analysis of medical records and individual case review was undertaken at 11 major obstetric hospitals for a 5 year period from July 1992 to June 1997 to investigate rates of vaginal birth after Caesarean section (VBAC), the occurrences of uterine rupture, and the outcomes for mother and infant following ...

Data on 636,708 women delivering a singleton infant of gestational age > or =37 weeks in NSW from 1 January 1990 to 31 December 1997 were used to examine trends in breech births at term and the mode of delivery. From 1990 to 1997, although the crude rate of breech ...

Proponents of vacuum delivery argue that it should be chosen first for assisted vaginal delivery, because it is less likely to injure the mother. The objective of this review was to assess the effects of vacuum extraction compared to forceps, on failure to achieve delivery and maternal and neonatal morbidity. ...

An increase in preterm deliveries in Ribeirão Preto stimulated an analysis of possible explanatory factors. Two cohorts of singleton livebirths were studied, the first based on 6746 births in 1978-9 and the second based on 2846 births in 1994. A logistic regression was carried out to assess the association of ...

OBJECTIVE: We studied the role of sonography in the management of 370 breech presentations > or = 34 weeks maturity. METHOD: 185 cases had sonographic confirmation of breech presentation prior to the delivery at the Korle Bu Teaching Hospital. A control group of 185 cases did not have prior scanning. ...

Intra-oral masses in neonates can seriously compromise the airway, potentially causing hypoxia and death if not recognized and managed appropriately. We report a case in which an intra-oral mass was diagnosed on antenatal ultrasound scan. Preparation for delivery involved a multidisciplinary team approach, with a strategy for management at delivery. ...

Five fetuses, each with a sacrococcygeal teratoma (SCT) were delivered at the Royal Women's Hospital while 2 fetuses, each with a SCT were delivered at Monash Medical Centre in 1998. The number of cases reported in this series is higher than expected but it most likely occurred due to chance. ...

This retrospective review of the case records was designed to determine the relationship between previous caesarean section and subsequent development of placenta praevia and placenta praevia with accreta. All women delivered with the diagnosis of placenta praevia at Princess Badeea Teaching Hospital from 1 January 1995 to 31 December 1996 ...

OBJECTIVE: Our purpose was to evaluate maternal and neonatal morbidity associated with rotations performed with Leff forceps in comparison with nonrotational forceps deliveries. STUDY DESIGN: A review of 267 rotational and nonrotational forceps deliveries from August 1996 through February 1998 was performed. Multiple maternal and neonatal outcome measures were compared ...

OBJECTIVE: To establish the role played by spiritual churches in the observed increase rate of antenatal clinic default in Calabar, Nigeria. DESIGN: Cross sectional comparative study. SETTING: Calabar, an urban community, the capital of Cross River State in south-eastern part of Nigeria. SUBJECTS: Women who booked for antenatal care in ...

OBJECTIVE: The objective of this study was to evaluate the relationships between 3 labor and delivery characteristics (duration of labor, interval between membrane rupture and delivery, and route of delivery) and 4 neonatal cranial ultrasonographic abnormalities (intraventricular hemorrhage, ventriculomegaly, echodensity of cerebral white matter, and periventricular leukomalacia). STUDY DESIGN: We ...

BACKGROUND: Forceps delivery has become rare in Finland since the introduction of the vacuum extractor. Our aim was to survey the number of forceps deliveries in Finland and analyze our own material of 130 forceps deliveries during a 15-year period between 1984 and 1998. During this period there were 17,887 ...

OBJECTIVE: To examine fetal size as a risk factor for breech birth at term. METHODS: Singleton breech or cephalic births of gestational age > or = 37 weeks in New South Wales (NSW), Australia from 1990 to 1996 were analyzed. Birthweight percentile was used as a measure of fetal size ...

OBJECTIVE: To evaluate whether activin A, inhibin A, and inhibin B levels in maternal and umbilical artery serum change according to the mode of delivery. DESIGN: Maternal and cord blood specimens were collected at term after spontaneous labour and vaginal delivery, or elective caesarean section. SETTING: Universities of Pisa, Turin, ...

The aim of the study was to determine the influence of intended mode of delivery on neonatal outcome in term breech delivery and to identify risk factors at intended vaginal delivery. Based on register data on all deliveries of non-malformed, singleton fetuses in breech presentation at term (n = 19,476) ...

OBJECTIVE: To examine trends in the distribution of births at and beyond term in New South Wales and in particular, to determine whether any changes are associated with changes in the obstetric practices of induction and elective caesarean section. DESIGN: Cross-sectional analytic study. SETTING: New South Wales, Australia. POPULATION: All ...

An audit of failed instrumental deliveries was undertaken to assess the incidence of complications and the adequacy of documentation. When one instrument has failed to effect delivery, the use of a second instrument could in most cases be used to complete the delivery without harm to the mother or baby. ...

Sera from one thousand pregnant primiparous women from the antenatal clinic of the University Hospital of the West Indies (UHWI) were screened for lupus anticoagulant. Twenty-three women (2.3%) were seropositive. A review was performed after delivery and eight hundred and sixty-eight (87%) of the case notes were found: 20/23 (87%) ...

BACKGROUND: Brazil has the highest caesarean section (CS) rate in the world (36.4% in 1996). METHODS: Risk factors for increasing CS rate were studied in two population-based cohorts of singleton live births in families residing in the municipality of Ribeirao Preto, State of Saõ Paulo, Southeast Brazil. The first comprised ...

The purpose of this study was to determine whether chlorhexidine vaginal douching, applied by a squeeze bottle intra partum, reduced mother-to-child transmission of vaginal microorganisms including Streptococcus agalactiae (streptococcus serogroup B = GBS) and hence infectious morbidity in both mother and child. A prospective controlled study was conducted on pairs ...

OBJECTIVE: To evaluate the effect on fetal outcome of changing the estimated day of delivery as calculated according to ultrasound measurements more than 14 days later than the day estimated according to the last menstrual period. DESIGN: A non-selected population comprising 15,241 women was evaluated. A study group (the day ...

BACKGROUND: While rising Caesarean section rates have been the subject of much attention and debate worldwide, there is not much information available on this rate and its potential adverse impact in India. METHODS: Our survey was a standard Expanded Programme on Immunization 30-cluster design, carried out in an urban educated, ...

The aetiology of both term and preterm labour remains incompletely understood. Maternal infectious diseases as well as intra-uterine infections were shown to be a well established cause of uncontrollable preterm delivery, indicating that inflammatory reactions, regulated by maternal immunecompetent cells, are implicated in labour-promoting mechanisms. To investigate the possibility that ...

OBJECTIVE: To determine whether outcomes of infants with gastroschisis differed by mode or site of delivery, diagnostic method, or when maternal-fetal medicine consultation was given. METHODS: Charts of 32 infants born at the University of Mississippi Medical Center or admitted to the neonatal intensive care unit between September 1992 and ...

Factors that direct the immune responsiveness of the newborn beyond the immediate post-natal period are not known. We investigated the influence of mode of delivery and type of feeding on the phagocyte activity during the first 6 months of life. Sixty-four healthy infants (34 delivered vaginally and 30 by elective ...

OBJECTIVE: Safe and effective vaginally applied microbicides could help to control the continuing spread of sexually transmitted diseases. STUDY DESIGN: This study used nonhuman primates to test the effects of multiple applications of nonoxynol 9, benzalkonium chloride, or a combination on vaginal flora and lower reproductive tract tissues. Fourteen monkeys ...

OBJECTIVE: To determine the optimum mode of delivery of the early preterm fetus in breech presentation. DESIGN: Retrospective comparison of two cohorts of preterm breech fetus. SETTING: Two tertiary care centres: at one centre the preferred management for preterm breech presentation was vaginal delivery; at the other centre, the preferred ...

Twenty-four pre-term infants (24-32 weeks) were delivered by Caesarean section 'en caul', i.e. with the membranes left intact until the whole pregnancy sac had been delivered. Seventeen survived to discharge from hospital (29% mortality, 26% after exclusion of lethal congenital abnormality). Three babies had a cord haemoglobin below 15 g/dl ...

We examined the associations between Caesarean section and neonatal mortality in singleton liveborn very-low-birthweight (VLBW) infants (500-1499 g) born during 1984-95 in Washington State, USA, using data from the Washington State birth certificate files. The infants included in this study had no life-threatening congenital malformations and had not been delivered ...

BACKGROUND: To determine the possible risk factors in our population. METHODS: From 250 patients attending our clinic 28 patients with pelvic relaxation were the study group and the rest, 222 in all, were the control group. RESULTS: Age, marriage period, parity and number of abortus in pelvic relaxation group are ...

BACKGROUND: Results from observational studies suggest that caesarean-section delivery may reduce the risk of mother-to-child transmission of HIV-1 infection in comparison with vaginal delivery. We carried out a randomised clinical trial to address this issue and to assess the extent of postdelivery complications. METHODS: Eligible women were between 34 and ...

We reviewed the delivery records of 205 mothers aged 40 years and above who delivered from 1st January 1994 to 31st December 1996 to examine the influence of parity on their obstetric performance. There were 51 (24.9%) primiparous mothers. The incidences of antenatal complications (antepartum haemorrhage, hypertensive disorder, glucose intolerance, ...

AIM: To determine if terbutaline given to mothers before elective caesarean section facilitates neonatal respiration and metabolism. METHODS: A randomised controlled trial of 25 full term infants delivered by elective caesarean section was conducted. The mothers received a continuous infusion of terbutaline or saline 120-0 minutes before birth. Umbilical artery ...

OBJECTIVE: To investigate the value of maternal height and foot length as predictors of pelvic adequacy and to evaluate the influence of body components' proportions on the mode of delivery. METHODS: Retrospective study of the anthropometry of women having normal vertex deliveries (NVD), caesarean sections (CS) and vaginal birth after ...

OBJECTIVE: To study changes in the use of episiotomy since 1989, controlling for variables such as severe tears, epidural anaesthesia, duration of the second stage of labour, instrumental deliveries, birthweight and maternal position at delivery. DESIGN: Retrospective study. Data were obtained from original birth records and questionnaires. SETTING: Huddinge University ...

OBJECT: Although recent studies have shown that convection can be used to distribute macromolecules within the central nervous system (CNS) in a homogeneous, targeted fashion over clinically significant volumes and that the volume of infusion and target location (gray as opposed to white matter) influence distribution, little is known about ...

This is a 5-month prospective study to determine the decision emergency caesarean delivery interval in a Nigerian tertiary hospital, the factors responsible for the delays and the consequent maternal and perinatal complications. One hundred and thirty-four emergency caesarean deliveries were analysed and the main indications were failure to progress/ prolonged ...

Vaginal birth is a recognized factor in perineal tissue damage and postpartum perineal pain. This study examined outcomes of 39 primiparous women who had spontaneous vaginal births. In a retrospective survey, women were asked to describe the type of pushing used to give birth and what the level of pain ...

This study correlates the mode of breech delivery to the immediate neonatal outcome in preterm breeches. We had 9816 deliveries in the period between 1st January 1994 to 31st August 1996. The incidence of breech deliveries was 3.95% and the incidence of preterm breech deliveries was 1.9%. Totally 112 (69%) ...

OBJECTIVES: Our purpose was to evaluate the perinatal mortality and morbidity of deliveries with fetuses presenting by the breech comparing outcomes of two groups according to mode of delivery: vaginal and cesarean section. RESULTS: Of 756 fetuses studied, 271 were delivered vaginally and 485 by cesarean section. In infants weighing ...