Adverse fetal heart rate (FHR) changes suggestive of fetal hypoxia are seen in patients with normal term pregnancies after initiation of epidural block for labour analgesia. It was our hypothesis that, in some parturients, these changes were a consequence of concealed aortocaval compression resulting in decreased uterine blood flow. We ...

Previous studies have shown that MBP levels rise before labour and have suggested the use of pMBP levels as a predictor of labour. We hypothesize that pMBP levels show a common pattern in pregnant women including a late third trimester rise in pMBP which predicts the onset of labour. Serum ...

OBJECTIVE: To review the current research and formulate a rational approach to the cause, prevention and treatment of postdural puncture headache (PDPH). DATA SOURCES: Articles published from January 1980 to April 1992 were obtained through a search of MEDLINE and Index Medicus. Key reference articles published before 1980 were also ...

OBJECTIVE: To determine whether sweeping the membranes in pregnancies of longer than 40 weeks gestation results in an accelerated onset of labour and a reduction in the incidence of induction of labour. DESIGN: A prospective randomised controlled study. SETTING: The antenatal clinic of a district general hospital. SUBJECTS: One hundred ...

The departments of Obstetrics and Gynaecology of the Universities of Bonn and Copenhagen and the Free University of Amsterdam cooperated in the European Community Concerted Action Project 'New methods for Perinatal Surveillance'. In 95 patients fetal transcutaneous PCO2 (tcPCO2) recording (measuring temperature 41 degrees C) during labour was evaluated regarding ...

The factors affecting choice of destination of U.K. internal migrants are analyzed using Labour Force Survey data. "A logit analysis of destination choice indicates that job movers are attracted to areas with high wages but are not affected by high house prices in such areas. In contrast, active non-job movers ...

A 28-week pregnancy is reported after a planned partial endometrial resection in an infertile patient. The fetus died 32 hours after birth because of prematurity consequent to premature membrane rupture and premature labour. A partial placenta accreta was dealt with at Caesarean section. Complete endometrial resection may not be required ...

A randomised controlled study of the clinical value of single insertion of vaginal tablets of prostagladin E2 (PGE2) containing 3mg of dinoprostin for induction of labour in patients with Low Bishop Scores (B/S less than 5) was carried out on 20 singleton pregnant Nigerian women, of different parity. (Primiparae n ...

OBJECTIVES: To assess the proportion of breech presentations diagnosed in labour and to compare their outcomes with those diagnosed prior to the onset of labour. DESIGN: Retrospective casenote review. SETTING: Mill Road Maternity Hospital, a teaching hospital in central Liverpool. SUBJECTS: Three hundred and five singleton breech presentations delivered in ...

Balancing the risks of prolonged gestation against those of induced labour is difficult. Risks to the fetus increase slightly after 42 weeks' gestation but women having labour induced are more likely to have instrumental deliveries or babies with low Apgar scores. Since many women are now expressing a preference for ...

AIMS: To perform a prospective audit of inductions of labour using prostaglandins to assess the protocols for induction in use at that time. METHODS: Data on 123 patients was obtained over a six-week period. Information regarding gestation, indication for induction and relevant details of labour and delivery were obtained. RESULTS: ...

Cervical state plays an important part in the outcome of induced labour. The mechanism governing the process of ripening, which is part of the continuum ending in labour, is still not fully understood, but is thought to involve several hormonal interactions including oestrogens, progesterone, and prostaglandins. The prostaglandins have been ...

Twenty one pregnant patients with cardiac disease had induction of labour for various obstetric reasons with a modified oxytocin infusion method. All of them went into labour and delivered within 20 hours. Twenty patients delivered vaginally. Three neonates had birth asphyxia (Apgar score < 7) and 1 of them died ...

To see if a pulse oximeter can monitor the fetus during labour we recruited 100 Caucasian women in normal uncomplicated labour. Our primary objective was to compare the predictive value of fetal pulse oximetry and cardiotocography using neonatal condition and cord blood acidaemia or hypoxaemia at birth as outcome variables. ...

During pregnancy, stress and vigorous exercise often result in pronounced tachycardia. Generally, a vagal stimulatory effort will interrupt the episode; however, intrapartum supraventricular tachycardia may not respond to vagal stimulation, necessitating drug therapy. This article is a case report of idiosyncratic supraventricular tachycardia following initiation of epidural analgesia; use of ...

We studied 1250 primiparous women with a singleton pregnancy, gestational age at delivery of 37-42 weeks, with a single live fetus, vertex presentation whose first and second stages of labour were managed according to strict criteria for the active management of labour. 568 (45%) received epidural analgesia (bupivacaine 0.25%) during ...

The study was conducted on 200 normal pregnant women who were randomly classified into 2 groups of 100 cases each. The control group comprised mothers in supine position throughout labour and delivery (46 primigravidae and 54 multigravidae). The squatting group consisted of cases who were kept ambulatory during the 1st ...

Maternal peripheral venous plasma interleukin 6 (IL-6) concentrations were determined during human pregnancy and labour at term and preterm. During preterm labour, IL-6 concentrations were significantly elevated (p < 0.02) compared to gestationally matched, non-labouring controls (53.7 +/- 15.7 pg/ml, n = 17, and 15.4 +/- 6.4 pg/ml, n = ...

262 obstetric patients received epidural analgesia during labour or for delivery. 6-8 weeks post partum they received a postal questionnaire. No association was found between backache and maternal age, height, weight, parity or mode of delivery, operator or difficulty with epidural insertion. However, in women who had had epidural analgesia, ...

All pregnancy-associated tissues are capable of producing prostaglandins including PGI2 and TXA2. In normal pregnancy there is a dominance of PGI2 over TXA2 which may contribute to the maternal circulatory adaptation to pregnancy. Furthermore, both fetoplacental PGI2 and TXA2 production are important regulators of the fetal blood supply. It has ...

The dramatic capabilities of prostaglandins to modify the condition of the uterine cervix have been exploited to the considerable benefit of patients who require therapeutic interventions for labour induction and termination of pregnancy. This will continue to be an important facet of clinical obstetric and gynaecologic practice, although further refinements ...

OBJECTIVE: To investigate whether ultrasound examination of the fetus and amniotic fluid before induction of labour can provide useful prognostic information about the course of labour and mode of delivery. DESIGN: A prospective observational study. SETTING: The delivery suite of St Mary's Hospital, London. SUBJECTS: 101 women undergoing induction of ...

Entonox (50% nitrous oxide premixed in oxygen) was compared with a mixture of Entonox and approximately 0.25% isoflurane (Entonox-isoflurane) for pain relief in the first stage of labour in 39 mothers. An Oxford Miniature Vaporizer was incorporated as the draw-over vaporizer for adding isoflurane to Entonox. The mixture was self-administered ...

This study reports on the urinary albumin to creatinine ratio during normal pregnancy, with special emphasis on the pre-delivery and labour periods. Albumin was determined in single voided urine specimens obtained from healthy non-pregnant women (n = 16) and healthy pregnant women (n = 203; Groups A and B, 133 ...

We have compared three techniques used to provide extradural analgesia during the first stage of labour: 0.25% plain bupivacaine 10 ml demand top-ups delivered by the midwife; continuous infusion of 0.125% plain bupivacaine 10 ml h-1; and patient-controlled extradural analgesia (PCEA) delivering 3-ml boluses of 0.25% bupivacaine. Each technique produced ...

The relationship between electrical activity (EMG) of the uterus, progesterone levels and gap junctions was studied in pregnant rabbits delivering either prematurely (cortisol-induced) or spontaneously at term. Electrodes were implanted in the myometrium and a catheter was inserted into the jugular vein for continuous infusion of saline or cortisol from ...

We present what we believe is the first case of pregnancy occurring in a patient on CAPD, and indeed end stage renal disease (ESRD), in Kenya. Pregnancy progressed very well until the thirtieth week when foetal movements and heart sounds were noted to be absent and this was confirmed by ...

OBJECTIVE: To define the contemporary characteristics of the second stage of labour in one Health Region. DESIGN: Retrospective analysis of a regional obstetric database. SETTING: Seventeen maternity units in the North West Thames Health Region. SUBJECTS: Selected from 36,727 consecutive singleton deliveries in 1988. The analysis was confined to the ...

A 24 year old patient presented with incessant atrial tachycardia during the course of a twin pregnancy. Medical treatment slowed the ventricular response without restoring sinus rhythm. During labour the tachycardia spontaneously reverted to sinus rhythm. Subsequently the same arrhythmia was documented with a slower ventricular response than during pregnancy.

Phospholipase A2 activity (EC 3.1.1.4) was estimated in low-speed supernatants of human placenta by measuring the release of arachidonic acid from phosphatidylcholine, 1-stearoyl-2-[3H]arachidonyl and other phospholipids under alkaline conditions (pH 8). Activity was calcium dependent and followed Michaelis-Menten kinetics with an apparent Km of 0.19 (SD 0.04) mM and a ...

Pregnancy and labour produce significant changes in salivary calcium, magnesium, phosphate and chloride when pregnant patients in labour are compared with non-pregnant patients. There is a decrease in concentration of these constituents in the 3rd trimester of pregnancy followed by a marked increase when labour occurs. Magnesium and chloride are ...

OBJECTIVE: To relate the T/QRS ratio of the fetal electrocardiogram (ECG) to the cardiotocogram (CTG) and fetal pH during labour. DESIGN: Prospective data collection from selected monitored labours. SETTING: A postgraduate teaching hospital delivery suite. SUBJECTS: 113 women in labour at term. MAIN OUTCOME MEASURES: Correlation of fetal T/QRS ratio ...

We investigated the course and outcome of pregnancy and its influence on muscle weakness in 12 females with proximal spinal muscular atrophy (SMA) who delivered a total of 17 infants when aged 18-32 years. In 4 females the SMA clearly followed an autosomal recessive mode of inheritance. The disease was ...

Peripheral plasma concentrations of immunoreactive phospholipase A2 (irPLA2) (Type II, non-pancreatic) were determined in 110 women during pregnancy. The concentration of irPLA2 did not significantly change during pregnancy (5.7 +/- 0.6 ng/ml, n = 72) until the onset of labour. When compared with non-labouring women, irPLA2 concentrations were significantly elevated ...

OBJECTIVE: To assess the potential clinical value of fetal electrocardiographic (ECG) monitoring in labour. DESIGN: Descriptive study of the use of ECG waveform analysis during labour and its correlation with other indices of fetal and neonatal well-being. SETTING: Teaching hospital in Oxford. SUBJECTS: 86 high risk pregnancies. MAIN OUTCOME MEASURES: ...

OBJECTIVE: To assess the outcome of pregnancy for women booking for home births in an inner London practice between 1977 and 1989. DESIGN: Retrospective review of practice obstetric records. SETTING: A general practice in London. SUBJECTS: 285 women registered with the practice or referred by neighbouring general practitioners or local ...

A total of 92 fetuses have been studied during labour using a technique of real-time fetal electrocardiography. This study showed differences in the PR and QRS intervals between male and female infants and also confirmed previous findings of a positive correlation between QRS width and fetal birthweight. The importance of ...

OBJECTIVE: To investigate the association between a slow progress of labour and insufficient remodelling of the uterine connective tissue. DESIGN: An open comparative study. SETTING: Danderyd Hospital, Department of Obstetrics and Gynaecology, referral centre. SUBJECTS: Eleven women (study group) in oxytocin augmented labour but with an unripe cervix in whom ...

The presence of an intracranial neoplasm (ICN) during pregnancy has serious implications for the anaesthetic management of labour and delivery. The physiological changes of pregnancy and labour are potentially hazardous to women with ICN, but the provision of adequate pain relief during labour reduces the risk to the mother. Extradural ...

In a retrospective study of 362 cardiotocographic recordings of primigravidae in labour we found 8% biphasic or coupled uterine contractions. In augmented labour, biphasic contractions occurred almost twice as often as in spontaneous and induced labour. The duration of labour complicated with biphasic contractions was increased significantly in all types ...

The relationship between epidural analgesia and a number of labour and delivery factors, relevant to fetal and neonatal condition, was considered in a prospective study of 200 labours reaching the second stage of labour. The group was representative of the hospital population with regard to the proportion of nulliparous women, ...

The stretch modulus (stress/strain) of strips of ovine cervical tissue in vitro was measured at different stages of gestation. A decrease in stretch modulus implies softening of the tissue. There was a gradual but progressive reduction in the stretch modulus with advancing pregnancy between 30 and 140 days gestation with ...

While Horner's syndrome is a rare but occasionally reported side-effect of epidural block administered for labour, trigeminal nerve palsy has been described only once. The cases described in this report confirmed the benign nature of these neurological complications of epidurally administered anaesthetics which were not detrimental to fetal viability. The ...

Seven pregnancies complicated by partial placenta membranacea occurring over a 2-year period are described. The condition is encountered more frequently than the total or near-total form, but is similarly associated with recurrent antepartum haemorrhage, miscarriage or preterm delivery. Diagnosis by ultrasound scan may prove difficult. Five pregnancies had histological evidence ...

The effect of parity on intrapartum fetal scalp pH was investigated in 6466 patients in labour with a live fetus who were delivered in 1987. 350 (5.4%) required fetal scalp blood sampling for pH (FBS), 236 primigravidae (10.4%) and 114 multigravidae (2.7%) (P less than 0.001). Fetal acidosis (pH less ...

70 normal pregnant females were used for the study, 47 of whom had vaginal cytological follow-up from week 32 till the first stage of labour. 23 additional patients had vaginal smears made in the first stage of labour. The combined intermediate cell value was used as an index of impending ...

This study was designed to investigate the range of beat-to-beat changes in fetal inter-beat (RR) intervals during routine clinical monitoring in labour. Fetal RR intervals were automatically measured and collected from 10 fetuses. Intervals which were incorrectly measured were excluded, and the remaining 23,510 intervals were used to compile the ...

Continuous fetal monitoring was achieved with a fetal scalp pulse oximetry sensor in 86 labours. The average recorded fetal oxygen saturation in early labour (cervical dilatation less than 5 cm) was 68% (SD 13%). At the end of labour (cervical dilatation greater than or equal to 9 cm) the recorded ...

The repercussions of the emotional state of a pregnant woman on the course of her labour and delivery and on the state of health of the newborn have been the subject of numerous researches which have yielded contrasting results. The present inquiry was carried out on a group of 34 ...

One hundred and ninety-four primiparae with lumbar epidural analgesia established during the first stage of labour were discouraged from pushing until the fetal head was visible at the perineum or until three hours had elapsed since full dilation of the cervix. The outcome in this group was compared with a ...