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At least 181 records · Page 10Linked to original sources
PubMed1988

The convergence between in-labor report and postpartum recall of parturition pain.

This non-experimental study was designed to investigate the congruence between in-labor report and postpartum recall of labor pain as measured by the McGill Pain Questionnaire (MPQ). Fifty married parturients, ages 19 to 39 at term with a normal pregnancy, served as subjects. Analysis of variance showed that postpartum report of labor pain on the Present Pain Intensity scale of the MPQ was not consistently congruent with pain reported during labor. In contrast, the Pain Rating Index of the MPQ provided postpartum data that was congruent with the in-labor report. Significant interaction effects, however, suggested that postpartially the women tended to devaluate the pain of early labor and inflate the pain of transitional labor when compared to their in-labor report. Theoretical and practical implications of the results for the measurement of labor pain are discussed.

Adult↗
PubMed2006

Labor pain and its management with the combined spinal-epidural analgesia: what does an obstetrician need to know?

Most women rate pain of childbirth as the most painful experience of their lives. Lumbar epidural analgesia is widely considered as the most effective method of providing pain relief in labor. However, lumbar epidural analgesia for labor is not a standard (generic) procedure and many technical modifications have been developed and introduced into clinical practice over time. The combined spinal-epidural labor analgesia technique (CSEA) has attained widespread popularity in obstetric anesthesia worldwide. The onset of analgesia is rapid and reliable, and maternal satisfaction is very high. While there still remains some concern about dural puncture, and while the pros and cons of using the CSEA as opposed to traditional epidural for labor pain are still being debated, it appears certain that the CSEA technique offers many unique advantages to the pregnant woman.

Analgesia, Obstetrical↗
PubMed1976

Observations on maternal oxytocin release during human labor and the effect of intravenous alcohol administration.

Serial blood samples were obtained from 97 women in spontaneous labor, and oxytocin levels were determined by a sensitive and highly specific radioimmunoassay. The following observations were made: (1) The hormone is released in a series of "spurts"; (2) the peak levels achieved are usually 2 to 5 muU per milliliter and never exceed 12.5 muU per milliliter; (3) the frequency of spurt release increases as labor progresses, reaching a maximum in the second stage; (4) the frequency of spurt release is reduced during intravenous infusion of alcohol at levels which produce no obvious effect on uterine activity.

Ethanol↗
PubMed1978

The relationship of maternal anxiety, plasma catecholamines, and plasma cortisol to progress in labor.

The relationships among maternal anxiety, selected stress-related biochemical factors, and progress in three defined phases of labor were determined for 32 married, normal, primigravid women, 20 to 32 years of age. Comparisons of plasma epinephrine, norepinephrine, and cortisol in third-trimester pregnancy, during labor, and after delivery are provided. At the onset of Phase 2 of labor (3 cm. of cervical dilatation), self-reported anxiety and endogenous plasma epinephrine are significantly correlated. With the deletion of subjects to control for the effect of medications, higher epinephrine levels are significantly associated with lower uterine contractile activity at the onset of Phase 2 and with longer labor in Phase 2 (3 to 10 cm. of cervical dilatation). The relationship between epinephrine and progress in labor is explained by an adrenoreceptor theory.

Adult↗
PubMed1985

Anxiety and epinephrine in multiparous women in labor: relationship to duration of labor and fetal heart rate pattern.

The duration of labor in multigravid subjects in phase 1 labor at term (from 3 to 6 cm of cervical dilatation; mean duration = 2.7 hours) was significantly related to measures of plasma epinephrine and norepinephrine obtained at the onset of the phase (n = 50). Epinephrine was significantly related to observer ratings of subject stress and the scores from the three dimensions of our self-report Labor Anxiety Inventory. The fetal heart rate pattern in phase 2 labor (7 to 10 cm of cervical dilatation; mean duration = 1.2 hours) was significantly related to phase 1 measures of epinephrine, observed stress, and two of the anxiety dimensions (n = 44 to 47). The results provide support for the hypotheses that, under normal clinical conditions, several types of patient anxiety are related to catecholamine levels and that anxiety and epinephrine are related to duration of labor and fetal well-being. The results suggest that medical/nursing evaluation and management of patient anxiety should include a self-report measure of three dimensions of anxiety (coping, safety, and pain), which are relatively independent of observed physical stress and which may relate to maternal labor progress as well as fetal heart rate pattern.

Adult↗
PubMed1986

Immunologic factors contributing to the initiation of labor--lymphocyte reactivity in term labor and threatened preterm delivery.

To obtain data on the immunologic events during labor, we investigated cytotoxic activity, progesterone-prostaglandin F2 alpha and prostaglandin E2 sensitivity of the lymphocytes in late pregnancy at early and late stages of labor and in the puerperium. In an attempt to investigate common determinants between the behavior of lymphocytes during labor and threatened preterm delivery, the same parameters of lymphocytes obtained from women with threatened preterm delivery were tested in parallel. At the beginning of labor, cytotoxic activity of the lymphocytes significantly increased and remained at a high level till the end of labor. A negative correlation (r = -0.803) was found between the increase of cytotoxicity and the duration of labor. High progesterone sensitivity of pregnancy lymphocytes decreased while low sensitivity to prostaglandin E2 increased during labor. Sensitivity of the lymphocytes to prostaglandin F2 alpha was similar in all of the groups examined. Except for prostaglandin E2 sensitivity all parameters of the lymphocytes obtained from women with threatened preterm delivery were similar to those of lymphocytes obtained during labor.

Cytotoxicity, Immunologic↗
PubMed1986

Plasma vasoactive intestinal polypeptide, insulin, gastric inhibitory polypeptide, and blood glucose in late pregnancy and during and after delivery.

The plasma levels of the gastrointestinal regulatory peptides vasoactive intestinal polypeptide, insulin, and gastric inhibitory polypeptide, as well as blood glucose, were measured in six healthy women before, during, and after normal parturition at term. Plasma levels of vasoactive intestinal polypeptide increased significantly (p less than 0.05) during delivery and remained significantly elevated for 15 minutes post partum. Plasma insulin levels rose significantly (p less than 0.05) within 5 minutes after delivery and stayed three-fold and significantly elevated for 120 minutes post partum. Plasma levels of gastric inhibitory polypeptide decreased significantly (p less than 0.05) between 5 and 30 minutes after delivery. Blood glucose levels were significantly (p less than 0.05) increased during labor, delivery, and the early postpartum period compared to late pregnancy. These findings suggest a mediating role for vasoactive intestinal polypeptide, insulin, and gastric inhibitory polypeptide in the physiologic adaptations to normal pregnancy, delivery, and the postpartum period.

Adolescent↗
PubMed1986

Amniotomy and oxytocin treatment of functional dystocia and route of delivery.

The details of clinical management were examined in 101 nulliparous patients with functional dystocia who underwent amniotomy and were treated with oxytocin in the first stage of labor. It was our hypothesis that if the alleged "high" rate of cesarean sections was the result of mediocre or flawed practices, these should be most evident in patients delivered abdominally. A group of 68 patients delivered vaginally are compared with 33 patients delivered by cesarean section. The means of many variables were statistically similar. The cesarean group was characterized by less cervical dilatation at admission, greater birth weights, larger maximum doses of oxytocin, and longer durations of oxytocin therapy. We conclude from our analysis that the decision to perform cesarean section in nulliparous women with functional dystocia arises from disabilities of the patient and not from differences in the application of our management principles, services, or treatments.

Adult↗
PubMed1991

Computerized analysis of episodic changes in fetal heart rate variation in early labor.

Fetal heart rate variation in early labor was measured by computerized analysis in cyclic episodes of low or high variation in 136 women at 37 to 42 weeks' gestation. The amplitude (mean +/- SE) in episodes of low variation was 20.6 +/- 0.4 milliseconds; in high variation it was 57.3 +/- 1.1 milliseconds. The duration (mean +/- SE) of low episodes (24.3 +/- 1.3 minutes) was less than that of high episodes (45.1 +/- 2.7 minutes) but was sometimes greater than 1 hour. In episodes of low variation the amplitude was less than 5 beats/min long term in 11% and less than 2.5 milliseconds (pulse intervals) short term in 8%; these measures would be predictive of intrauterine death if persistent before birth. We conclude that the use of decreased fetal heart rate variation as a diagnostic sign of acute fetal hypoxemia in labor is incorrect, because changes of this size occur randomly as a consequence of fetal sleep states. There was no significant correlation between fetal heart rate variation over the last hour of labor and umbilical arterial base deficit on delivery.

Adult↗
PubMed1978

Intrauterine detection of fetal phonocardiosignals.

In this paper the application of an open-tip phonocatheter for the detection of fetal phonocardiosignals during parturition is described. The phonocatheter is easily inserted with a conventional polythene guide via the cervical route. The fetal heart sounds are detected by the sound pick-up element located in the catheter tip. Intrauterine pressure is measured simultaneously with the help of a Statham uterine pressure transducer externally connected via the lumen to the open tip of the phonocatheter. Since fetal heart sounds can also be detected before rupture of the membranes, it is possible to measure intrauterine pressure and fetal heart activity simultaneously using only one catheter and without being limited to a particular stage in parturition.

Female↗
PubMed1982

Outcome of pregnancy after cone biopsy--a case-control study.

In a case-control study on 79 cone biopsy treated women under 35 yr of age the subsequent pregnancies were followed. The women of the control group were matched to maternal age, parity and the time of delivery. There were more 'abnormal' deliveries in the surgical treated group such as more bleedings, more cervical insufficiencies and a faster descent-time curve of the presenting part of the fetus. The premature frequency was 13.2% in the conized group and only 3.8% in the control group. The study gives support to a primarily more conservative policy in young women with positive smears.

Adult↗