We report a case of a pregnant woman with acute spinal cord injury (C5) caused by gunshot wound and discuss the respective maternal and fetal considerations. Neither decompressive surgery nor corticosteroid protocols were used. At 37 weeks, the patient delivered a normal female infant after induction of labor and epidural ...

AIM: To discuss maternal and fetal metabolic events during labor and the possible role of glucose administration. RESULTS: The oxidative pathway covers the largest part of the energy demand of labor, although in the second stage or, in polysystolic labor, the non-oxidative pathway becomes important as well. Glucose is the ...

BACKGROUND: The application of music in pain management has become popular in the past two decades. This article describes the responses of primiparas to the use of music therapy during the births of their children. METHOD: Eleven women who attended childbirth education classes in Brantford, Ontario, Canada, volunteered to participate ...

Our goal was to characterize the changes in maternal lipid peroxidation levels and antioxidant enzymatic activities before and after delivery. Predelivery and 1, 24, and 48 hours post-partum plasma concentrations of malondialdehyde, erythrocyte enzyme superoxide dismutase, glutathione peroxidase and catalase were measured in uncomplicated pregnancies. Malondialdehyde levels increased slightly from ...

BACKGROUND: Misoprostol, a prostaglandin E1 analog registered for the prevention of gastric ulcers in NSAID-drug users, has been reported to be more effective for labor induction than the standard prostaglandin, dinoproston after vaginal application. There have been some concerns about possible hyperstimulation of the uterine activity and about the safety ...

OBJECTIVE: The mechanism for the initiation of human labor remains unknown and is under extensive investigation. Myometrium from patients in labor and not in labor is the ideal tissue to study structural, cellular, and molecular changes that occur during parturition. This study was designed to determine whether myometrial sampling at ...

BACKGROUND: To examine the effect of implementation of guidelines for induction of labor on the process of care and outcome measures. METHOD: Guidelines for induction of labor were implemented in January 1996 following an audit report identifying inconsistency in clinical practice. A prospective audit was carried out following the implementation ...

Post-term pregnancy (longer than 42 weeks or 294 days) occurs in approximately 10% of all singleton gestations. The adverse outcomes of post-term pregnancy include a substantial increase in perinatal mortality and morbidity. ACOG currently recommends induction of labor for low-risk pregnancy during the 43rd week of gestation. However, that recommendation ...

OBJECTIVE: This study was undertaken to compare the rates of uterine rupture during induced trials of labor after previous cesarean delivery with the rates during a spontaneous trial of labor. STUDY DESIGN: All deliveries between 1992 and 1998 among women with previous cesarean delivery were evaluated. Rates of uterine rupture ...

OBJECTIVE: To describe a second-stage partogram based on a system of scoring the descent and position of the fetal head and to use this system for studying progress in the second stage of labor and predicting mode of delivery and obstetric outcome. METHODS: A prospective observational study of 1413 women ...

OBJECTIVE: We sought to identify regional differences in prostaglandin H synthase 2 messenger ribonucleic acid expressions in various intrauterine tissues in the pregnant baboon as an indicator of prostaglandin production capability to explain the various interactive roles of different intrauterine tissues in the processes that precede, promote, and complete labor. ...

OBJECTIVE: To compare gestational days gained with oral versus subcutaneous terbutaline for maintenance tocolysis. STUDY DESIGN: In retrospective fashion 386 women enrolled in an outpatient preterm labor identification program met the following criteria: twin gestation, development of threatened preterm labor resulting in treatment with oral terbutaline, and subsequent recurrence of ...

From ethical and moral reasons, the progress in neonatology and anesthesiology must not obscure the iatrogenic labors, which begin at the time improper for individual child, especially after induction and - because of that - very often instrumental. Enzymatic monitoring has enabled reduction of the number of preterm and instrumental ...

OBJECTIVE: To determine whether cervical membrane sweeping (stripping) during induction of labor is beneficial. METHODS: We compared outcomes of labor after induction in pregnant women at term in a randomized trial. Women were assigned to having their membranes swept or not during induction. Outcome measures included duration of labor, maximum ...

BACKGROUND AND OBJECTIVES: Numerous studies have found an association between epidural analgesia for labor and maternal fever (temperature > or =38 degrees C). Maternal fever often results in treatment with maternal or neonatal antibiotics, neonatal sepsis evaluation, and increased costs. METHODS: Medline was used to identify literature regarding the association ...

OBJECTIVE: To determine the risk factors for neonatal acidemia with trial of labor among parturients with a prior cesarean delivery. METHODS: From a prospectively collected database on all parturients attempting a trial of labor, newborns with umbilical arterial pH < 7.15 were selected as cases and the controls (1:4) were ...

Recent analysis of mice deficient in both oxytocin (OT) and cyclooxygenase-1 has shown that OT exerts significant effects on both the ovarian corpus luteum and the uterine myometrium during pregnancy. To better define the roles of OT during pregnancy, we evaluated OT action and OT receptor regulation in wild-type and ...

Cyclooxygenase (COX)-derived prostaglandins (PGs) regulate numerous maternal-fetal interactions during pregnancy. PGs stimulate uterine contractions and prepare the cervix for parturition, whereas in the fetus, PGs maintain patency of the ductus arteriosus (DA), a vascular shunt that transmits oxygenated placental blood to the fetal systemic circulation. However, the origin and site ...

The female military population represents a high-risk group for preterm labor and other adverse pregnancy outcomes. As the number of women entering the armed forces continues to increase, concerns regarding the effects of military service on pregnancy must persist. Although active duty females have access to prenatal care and maintain ...

OBJECTIVE: To assess pregnancy outcomes at 40, 41, and 42 weeks' gestation when labor induction is done routinely at 42 but not 41 weeks. METHODS: We reviewed all singleton pregnancies delivered at 40 or more weeks' gestation between 1988 and 1998 at Parkland Memorial Hospital, Dallas, Texas. We excluded women ...

The events of parturition (labor, delivery, maternal care, placentophagia, and onset of nursing) were analyzed in female Norway rats (Rattus norvegicus) flown on either 11- or 9-day-long spaceflights beginning at the approximate midpoint of their pregnancies. Each space shuttle flight landed on the 20th day of the rats' pregnancies, just ...

OBJECTIVE: To determine which of three methods of cervical ripening resulted in the lowest cesarean rate in women with unfavorable cervices and indications for labor induction. METHODS: Consenting women with singleton gestations, vertex presentations, and unfavorable cervices (dilatation under 2 cm and effacement under 75%) were randomly assigned to laminaria ...

Obstructed labor is one of the most common preventable causes of maternal and perinatal morbidity and mortality in developing countries. Among the common causes are cephalopelvic disproportion, malpresentation, and malposition. Recognizing the causes of obstructed labor is important if the complications are to be prevented. Adequate prevention, however, can be ...

BACKGROUND: Safe and effective labor analgesia is an important part of obstetric care. Intrathecally injected narcotics (ITN) are an effective alternative to epidural anesthesia, and are perceived less likely to interfere with the course and outcome of labor. Data on their effects, however, are sparse and contradictory. METHODS: Our retrospective ...

OBJECTIVE: Activation of neonatal and maternal fibrinolysis at birth has been shown earlier. To evaluate further on the effect of labor duration on the fetal fibrinolysis, we conducted this preliminary study. METHODS: An indirect assessment of activation of fetal fibrinolysis was carried out, by measuring the cord blood D-dimer. The ...

The goal of induction of labor is to achieve vaginal delivery by stimulating uterine contractions before the spontaneous onset of labor. According to the National Center for Health Statistics, the overall rate of induction of labor in the United States has increased from 90 per 1,000 live births in 1989 ...

Most studies indicate that epidural analgesia during labor is associated with maternal fever, although the nature of this fever is unclear. The consequences of maternal fever may include increased neonatal evaluations for sepsis, the increased use of antibiotics, and prolonged hospital stay. However, the need for such measures after epidural ...

OBJECTIVE: Our purpose was to compare the efficacy and safety of misoprostol and extra-amniotic sodium chloride infusion with oxytocin for induction of labor. Study Design: This randomized trial compared two methods of labor induction in women requiring cervical ripening. One hundred twenty-three women undergoing labor induction with a Bishop score ...

OBJECTIVE: The aim of this study was to quantify the association of cesarean delivery with epidural analgesia management, specifically with the timing of epidural catheter placement in relation to labor, the type of epidural analgesia, and the use of bolus dosing. Study Design: A retrospective cohort design was used to ...

OBJECTIVE: To compare the efficacy of intravaginal and intrarectal plus oral indomethacin for the treatment of preterm labor. METHODS: Between December 1996 and November 1998, 46 eligible gravidas admitted with singleton pregnancies and idiopathic preterm labor before 33 gestational weeks were randomized to receive 200 mg of intravaginal or intrarectal ...

OBJECTIVE: To review the experience of women who conceived after developing mastocytosis and who were observed at the National Institutes of Health. METHODS: We reviewed our patient database for the years 1984-1998 to identify women with mastocytosis who had conceived. We then reviewed each woman's record, asked each woman to ...

Nitric oxide (NO) has a relaxant effect on uterine smooth muscle and may be implicated in maintaining uterine quiescence during pregnancy. In order to investigate the role of nitric oxide in human parturition, we have measured NO metabolite levels in maternal and fetal compartments in association with labor, both at ...

OBJECTIVE: We sought to examine the relationship between epidural analgesia and cesarean and instrumental vaginal delivery rates. STUDY DESIGN: This is a retrospective analysis of the first 1000 nulliparous pregnancies in women with a cephalic presentation in spontaneous labor at term in each of 3 different years, over which the ...

OBJECTIVE: Cyclooxygenase inhibitors are effective tocolytic agents, but significant adverse effects limit their use. We hypothesized that selective inhibitors of the isozyme cyclooxygenase 2 would effectively diminish labor-associated prostaglandin production. STUDY DESIGN: We analyzed cyclooxygenase type 1 and 2 expression in amnion, chorion, decidua, and myometrium from laboring or nonlaboring ...

The aim of this study was to evaluate whether sweeping of the membranes at term could shorten the length of pregnancy and reduce the incidence of postterm pregnancies. We randomly selected 104 nulliparas with uncomplicated pregnancy and gestational age between 281 and 287 days. Our patients were divided into three ...

The objective of this study is to determine if successful external cephalic version is followed by an increased likelihood of prolonged labor or operative delivery. Women having a successful external cephalic version of a normal singleton fetus > or =37 weeks' gestation between January 1, 1997 and December 31, 1998 ...

OBJECTIVE: To document radiographically the changes in pelvic dimensions created by McRoberts' maneuver. METHODS: Women at least 37 weeks' pregnant who presented to labor and delivery were eligible for study entry. Anterior-posterior and lateral x-rays were taken with women in the dorsal lithotomy position and after application of McRoberts' maneuver, ...

OBJECTIVE: To determine the concentrations of maternal serum interleukins (ILs) 1, 2, 6, 8 and IL-2 receptors (IL-2R) in patients in their second and third trimesters of pregnancy and in preterm labor and delivery without evidence of chorioamnionitis. STUDY DESIGN: The study was conducted in La Paz Maternal Hospital, Madrid. ...

The effectiveness of intracervical prostaglandin E2 (PGE2) was studied in 96 primigravidas with unfavorable cervix and need for induction of labor. Group A consisted of 49 oligohydramnios and group B of 47 cases with normal amniotic fluid volume (controls). A single dose of 0.5 mg PGE2 gel was applied intracervically ...

CONTEXT: Despite wide use of castor oil to initiate labor, the obstetric literature contains few references to this botanical laxative. Derived from the castor plant Ricinus communis, castor oil may possess properties that are useful in post-term pregnancies. OBJECTIVE: To evaluate the relationship between the use of castor oil and ...

A multigravida with gestational diabetes, mild pregnancy-induced hypertension and a previous curettage received four doses of misoprostol (100 microg) at three hourly intervals for induction of labor at term. Vaginal delivery of a live healthy baby occurred 1 h after the fourth dose. Hindwaters were bloodstained. Three hours later, she ...

Myotonic dystrophy is a rare autosomal dominant degenerative neuromuscular and neuroendocrine disease. Pregnancy can aggravate the maternal disease. Obstetrical complications include stillbirth, premature labor, polyhydramnion, abnormal presentation, prolonged labor, increased operative delivery, postpartum hemorrhages and anesthetic accidents. If the fetus is affected severe neonatal morbidity and mortality with arthrogryposis and ...

OBJECTIVE: This study was undertaken to investigate in human tissue samples the mechanisms underlying spontaneous and prostaglandin F(2)(alpha)-induced contractions during the final trimester of pregnancy and labor. STUDY DESIGN: Membrane potential and cytoplasmic calcium were recorded simultaneously with contraction in uterine strips obtained from the lower segment during cesarean delivery. ...

OBJECTIVES: To compare labor induction intervals between oral misoprostol and intravenous oxytocin in women who present at term with premature rupture of membranes. METHODS: One hundred eight women were randomly assigned to misoprostol 50 microg orally every 4 hours as needed or intravenous oxytocin. The primary outcome measure was time ...

OBJECTIVE: The objective of this study was to evaluate the risk of neonatal respiratory disorders when cesarean delivery is performed before labor in twin pregnancies. STUDY DESIGN: We reviewed the charts of all patients with twin pregnancies who underwent cesarean delivery before labor after 36 weeks' gestation. All cases in ...

OBJECTIVE: To identify factors associated with fear of childbirth during and after first labor. METHODS: We analyzed first deliveries of 100 primiparas who reported severe fear of vaginal childbirth during their second pregnancies and 200 age- and parity-matched controls who reported no later fear of delivery. The main outcome measures ...

BACKGROUND: To determine whether presence of fetal fibronectin in cervico-vaginal secretions at term will predict the cervical response to prostaglandin E2 (PGE2) pessaries and successful induction of labor amongst subjects with unfavorable cervices. METHODS: Cervico-vaginal secretion was tested for the presence of fetal fibronectin prior to cervical ripening with PGE2 ...

BACKGROUND: To investigate the influence of Body Mass Index on the incidence of labor complications in a population of women with a normal pregnancy. MATERIAL AND METHODS: From a local database, information on maternal weight and height was extracted concerning 4258 women who had an uncomplicated pregnancy. After calculation and ...

To elucidate the endocrine mechanism of human parturition, the expression of c-Jun and c-Fos mRNA were examined in relation to estrogen receptor (ER) and progesterone receptor (PR) in human myometrium. c-Jun mRNA was detected in all myometrial tissues (n=5) during labor but not before labor (n=5) and in oxytocin-resistant postterm ...

BACKGROUND: There are suggestions that T helper 1 cytokines may be detrimental to early pregnancy and T helper 2 cytokines protective of the pregnancy. Their role in preeclamptic pregnancy, labor and puerperium, is not clear. MATERIALS AND METHODS: Twenty-eight preeclamptic women and their matched controls were evaluated, at the Departments ...