The aim of this study was to determine clinicians' perceptions of placing a fetal oximetry sensor. A survey was developed seeking details of staff category, birth suite experience, previous sensor placement, ease of application and use of epidural analgesia. Following staff feedback, the survey was revised from asking clinicians to ...

PURPOSE: An increasing number of women with cirrhosis are conceiving and carrying their pregnancies to term. However, the maternal mortality rate remains high (10-61%). This case report describes the management of a parturient with esophageal varices and thrombocytopenia. She was also a Jehovah's Witness. CLINICAL FEATURES: A 25-yr-old Jehovah's Witness ...

This is a comparative study of the annual statistical returns to the Royal College of Obstetricians and Gynaecologists for 1993, 1994 and 1997/8. Over the study period there has been a decrease in normal vaginal deliveries of the order of 3% which is mirrored by a similar increase in caesarean ...

We report the occurrence of severe hypoxaemic episodes associated with the use of Entonox in labour, in an otherwise healthy woman. These did not occur when the parturient breathed room air during contractions and did not recur when epidural analgesia was established. Possible mechanisms of arterial desaturation associated with the ...

The purpose of this study was to assess, in women with gestational diabetes mellitus (GDM): 1) metabolic control during labour using a standardised protocol; 2) the influence of therapy during pregnancy in intrapartum metabolic control and insulin requirements; and 3) the impact of maternal glycaemia during labour on neonatal hypoglycaemia. ...

Electrical impedance may be measured using electrodes on the surface of the cervix and recording the potential that results when an electrical current is passed. Increased hydration of the cervix has been described throughout pregnancy and occurs most dramatically before labour. This study compared tissue impedance measurements of the pregnant ...

OBJECTIVE: To examine changes in maternal serum levels of activin A and follistatin during pregnancy and labour. DESIGN: In three cross sectional and three longitudinal studies venous blood was collected from women during pregnancy, spontaneous labour, labour induction and prior to elective caesarean section for the measurement of activin A ...

The objective of the study was to determine the justification or otherwise of admission speculum examination in women presenting with antepartum haemorrhage and the outcome/ benefits of the practice on women with antepartum haemorrhage presenting to the delivery suite of a UK teaching hospital. Factors studied included gestational age at ...

This study reviews the outcome of the next labour in women who are delivered vaginally in their first pregnancy. The influence of the method of delivery in the first pregnancy and of factors in both the first and next labour on the type of delivery in the second pregnancy, are ...

Music is an ancient method for healing. In the year 550 B.C., Pythagoras from Greece developed a concept for the use of music in medicine, esteeming music higher than many other medical treatments. The Medical Resonance Therapy Music (MRT-Music) of the German classical composer and musicologist Peter Huebner is built ...

BACKGROUND: The spread of epidural analgesia is facilitated by pregnancy. Changes in the epidural structure during pregnancy may affect the spread of analgesia in pregnant women. To investigate the changes in the epidural space produced by pregnancy, the authors performed epiduroscopy in pregnant women. METHODS: Using a flexible fiberscope, the ...

Parturition in the ewe is preceded by an increase in the synthesis of prostaglandins (PGs) by gestational tissues. To establish the uterine source of these PGs, placental cotyledons, fetal membranes and maternal uterine tissues were collected from ewes (n=6) at spontaneous parturition. Solubilised tissue extracts were prepared and analysed by ...

Serum interleukin-18 (IL-18) levels were measured in women in different trimesters of pregnancy, in labour, puerperium and in various complicated pregnancies. There was a significant elevation of IL-18 levels in pregnant sera from the first trimester until the onset of labour. Once labour began, IL-18 levels increased further and remained ...

We experienced three cases and four successful deliveries with congenital afibrinogenaemia and propose the following guidelines for the prenatal and peripartum management: (i) genital bleeding usually begins at 5 weeks' gestation and spontaneous abortion always occurs at 6-8 weeks' gestation without fibrinogen infusion; (ii) the fibrinogen level must be at ...

In an attempt to review our experience with prostaglandin E2 vaginal tablets in induction of labour in grandmultiparae (parity 5-9) and great grandmultiparae (parity > 9) a retrospective study was carried out at King Faisal Military Hospital in Saudi Arabia over a 2-year period. An evaluation of our protocol for ...

There is no certainty about the best way of dealing with a breech presentation first diagnosed in labour. In our unit, the decision to allow a trial of vaginal delivery rested on the clinical assessment of the size of the baby and the maternal pelvis, and the progress of labour. ...

If you are at term after a normal pregnancy and are not lucky enough to live in Portsmouth, then your chance of losing the baby during labour is higher in Great Britain than in nine other European countries, including Slovenia. The NHS Litigation Authority have put aside 1.3 billion Pounds ...

Iniencephaly is a rare malformation characterized by the triad of occipital bone defect, cervical dysraphism and fixed retroflexion of the fetal head. Because of its almost invariable lethal prognosis, termination of pregnancy is commonplace when this condition is diagnosed before viability. In this report we describe eight cases of iniencephaly ...

BACKGROUND: There is a need to improve the sensitivity and specificity of fetal monitoring during labour. We compared the gold standard, cardiotocography, with cardiotocography plus time-interval analysis of the fetal electrocardiogram in fetal surveillance. The aim was to find out whether time-interval analysis decreased the need for operative intervention due ...

OBJECTIVE: To study the relationship between cord blood hepatic enzymes and obstetric and neonatal outcome in a Chinese population. MATERIALS AND METHODS: The study group consisted of 288 low-risk Chinese women with singleton term pregnancies. The following enzymes were assayed in cord blood: lactate dehydrogenase (LDH), glutamyl transferase (GGT), aspartate ...

Induction of labour is a valuable obstetric procedure, providing obstetricians with the means to intervene should the health of the fetus be in jeopardy. Currently the most common reason for induction of labour is prolonged pregnancy, as obstetricians and midwives are concerned about the risks of postmaturity such as stillbirth, ...

PURPOSE: To describe the anesthetic and obstetrical management of a pregnant patient with co-existing Familial Hypokalemic Periodic Paralysis (FHPP) and Wolff-Parkinson-White syndrome (WPW). CLINICAL FEATURES: A 29 yr-old primigravida with FHPP and WPW presented to the antenatal clinic at 18 wk gestation, for consideration of her anesthetic and obstetrical management ...

OBJECTIVE: To determine the relationship of prostaglandin endoperoxide H synthase (PGHS) expression in the gestational tissues and fetal fibronectin in cervico-vaginal fluids before the onset of labour at term. DESIGN: Cross-sectional, observational study. SAMPLES: Amnion, chorion laeve and decidua were collected from 24 term pregnant women following elective caesarean section. ...

The cholesterol biosynthetic activity was assessed using [2-(14)C]-acetate as substrate in the homogenates of amnion and chorion obtained from women (n = 6, age 26-39 years) after spontaneous labour at term (37-40 weeks of gestation) having uncomplicated pregnancies. Reverse-isotope dilution analysis gave positive identification of [(14)C]-cholesterol acetate in all incubations ...

BACKGROUND: Immersion in warm water may help with relaxation, pain relief and increased elasticity of the birth canal. On the other hand, there may be risks associated with decreased mobility and inhalation of water by the baby, as well as increased risk of maternal infection. OBJECTIVES: The objective of this ...

BACKGROUND: Over the past four decades, continuous electronic fetal monitoring (EFM) has been increasingly employed to detect fetal acidemia in labor, with a view toward prevention of hypoxic ischemic encephalopathy, permanent neurologic injury, and death. Although very sensitive, this technology has low specificity, and a high false positive rate. This ...

BACKGROUND: Maternal oxygen administration has been used in an attempt to lessen fetal distress by increasing the available oxygen from the mother. OBJECTIVES: The objective of this review was to assess the effects of maternal oxygenation for fetal distress during labour and to assess the effects of prophylactic oxygen therapy ...

BACKGROUND: Stripping or sweeping of the membranes aims to initiate labour through a cascade of physiological events. These may reduce pregnancy duration or pre-empt formal induction of labour with either oxytocin, prostaglandins or amniotomy. OBJECTIVES: The objective of this review was to assess the effects of membrane sweeping to promote ...

BACKGROUND: Lateral and posterior position of the fetal presenting parts may be associated with more painful, prolonged or obstructed labour and difficult delivery. It is possible that maternal posture may influence fetal position. OBJECTIVES: The objective of this review is to assess the effects of adopting a hands and knees ...

BACKGROUND: It is thought that adding fetal electrocardiography (ECG) to cardiotocography (CTG) alone may provide better information about fetal heart activity. OBJECTIVES: The objective of this review was to assess the effects of simultaneous recording of fetal electrocardiographic waveforms plus conventional cardiotocography, with cardiotocography alone, during labour. SEARCH STRATEGY: We ...

BACKGROUND: Suspected macrosomic fetuses are usually induced in order to reduce the risk of difficult operative delivery. OBJECTIVES: The objective of this review was to assess the effects of a policy of labour induction for suspected fetal macrosomia on method of delivery and maternal or perinatal morbidity. SEARCH STRATEGY: We ...

BACKGROUND: Intravenous prostaglandin E2 and F2 alpha can be used to induce labour. The use of intravenous prostaglandins in this context has been limited by perceived unacceptable maternal side effect profiles. This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology. ...

OBJECTIVES: To test the T/QRS ratio of the fetal electrocardiogram for normal distribution and assess the potential value of an individualised T/QRS ratio threshold to depict abnormality in the detection of fetal compromise during labour. STUDY DESIGN: A retrospective analysis of twenty intrapartum fetal electrocardiogram recordings obtained on the labour ...

BACKGROUND: Although not yet registered for such use, misoprostol has been widely used for obstetric and gynaecological indications, such as induction of abortion and of labour. OBJECTIVES: The objective of this review was to assess the effects of vaginal misoprostol for third trimester cervical ripening or induction of labour. SEARCH ...

BACKGROUND: The conventional method of induction of labour is with intravenous oxytocin. More recently, induction with prostaglandins, followed by an infusion of oxytocin if necessary, has been used. OBJECTIVES: The objective of this review was to assess the effects of induction of labour with prostaglandins compared with oxytocin, at or ...

The aim of this study was to determine the relative contributions of cyclo-oxygenase (COX) types 1 and 2 to prostaglandin synthesis at term. METHODS: Fetal membranes were collected from 6 pregnancies after elective caesarean section at term, prior to labour. The presence of COX-1 and COX-2 protein was determined using ...

The finding that a brow presenting within the pelvic cavity in the mento-anterior position during the second stage of labour could be easily and safely delivered by means of Kielland's forceps rotation and extraction led to a search for the cause of this rare phenomenon since normally brows are associated ...

BACKGROUND: It has been suggested that low serum zinc levels may be associated with abnormalities of labour, although this has not yet been established. OBJECTIVES: The objective of this review was to assess the effect of zinc supplementation in pregnancy on maternal and fetal mortality and morbidity. SEARCH STRATEGY: The ...

Amnioinfusion aims to relieve umbilical cord compression during labour by infusing a liquid into the uterine cavity. The objective of this review was to assess the effects of prophylactic amnioinfusion for oligohydramnios compared with therapeutic amnioinfusion only if fetal heart rate decelerations or thick meconium-staining of the liquor occur. The ...

BACKGROUND: Cardiotocography is a form of fetal assessment which simultaneously records fetal heart rate, fetal movements and uterine contractions to investigate hypoxia. OBJECTIVES: The objective was to assess the effects of antenatal cardiotocography on perinatal morbidity and mortality and maternal morbidity. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth ...

The aim of this study is to assess the interactive dynamics of power, passenger and passage in relation to an adverse course of labour. The design was a community-based follow-up of all women with singleton pregnancies experiencing spontaneous term labour. Median of first stage was 2.6 h for multiparas and ...

BACKGROUND: Perinatal mortality and morbidity is increased in pregnancies of more than 42 weeks that are otherwise low risk. OBJECTIVES: The objective of this review was to assess the effects of interventions aimed at either reducing the incidence or improving the outcome of post-term pregnancy. SEARCH STRATEGY: The Cochrane Pregnancy ...

BACKGROUND: Induction of labour after prelabour rupture of membranes may reduce the risk of neonatal infection. OBJECTIVES: The objective of this review was to assess the effects of induction of labour with oxytocin versus expectant management for prelabour rupture of membranes at or near term (34 weeks or more). SEARCH ...

The health background management and outcome of five pregnancies in women affected by Cooley Disease are described and the preconceptual guidance and care are considered. The patients were selected from a group of 103 thalassemic women divided into three subgroups according to their first and successive menstruation characteristics. Only one ...

BACKGROUND: The routine prophylactic administration of an oxytocic agent is an integral part of active management of the third stage of labour. These agents help prevent postpartum haemorrhage. OBJECTIVES: The objective of this review was to assess the effects of ergometrine-oxytocin (syntometrine) with oxytocin alone in reducing the risk of ...

BACKGROUND: Prophylactic tocolysis with betamimetics and other agents has become widespread as a treatment for fetal distress. Uterine relaxation may improve placental blood flow and therefore fetal oxygenation. However there may also be adverse maternal cardiovascular effects. OBJECTIVES: The objective of this review was to assess the effects of prophylactic ...

It is not known whether human labour is associated with increased fetal oxytocin production or transfer of oxytocin across the placenta. Previous reports are contradictory, due in part, to the influence of maternal analgesia on fetal production. We determined plasma oxytocin concentration in the umbilical artery and vein of women ...

In 1993 Lowe developed the Childbirth Self-Efficacy Inventory (CBSEI). This is a self-administered, 62-item, Likert tool which measures women's confidence in their ability to cope with labour. The tool is valid and reliable for use in American culture but had not been tested in Northern Ireland, therefore a replication study ...

Babies of 37-41 wk gestation are, by international convention, said to be born at 'term', but some still develop respiratory distress. It is not clear how mature a baby has to be to be free of risk of primary surfactant deficiency. An area-based retrospective study of all the 179,701 babies ...

A study was done in 75 patients who underwent induction of labour with Prostaglandin E2 gel. All these patients had an unripe cervix. The commonest indications were post-datism, intrauterine growth retardation and pregnancy-induced hypertension. All patients were primigravidas with singleton pregnancy and beyond 35 weeks of pregnancy. The mean Bishop ...