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At least 217 records · Page 12Linked to original sources
PubMed1994

Emergency complications of labor and delivery.

The care of the pregnant patient presenting to the emergency department with labor or delivery complications requires an understanding of signs and symptoms of disease for the maternal and fetal patient. This article reviews management of common labor and delivery complications that may occur in the emergency department. The management of premature labor, premature rupture of the membranes, emergency delivery procedure, resolution of shoulder dystocia, prolapsed umbilical cord, and perimortem cesarean section are discussed.

Delivery, Obstetric↗
PubMed2004

Neurologic complication of labor analgesia: facts and fiction.

Regional anesthesia has become a hallmark of modern obstetric anesthesia practice and a paramount technique for labor analgesia. Neurologic complications associated with present-day labor analgesia are thought to be unusual; however, they can occasionally complicate peripartum obstetric and anesthetic management of pregnant patients. To date, no review article in obstetric literature has specifically addressed the issue of possible neurologic anesthetic complications attributed to labor analgesia. Therefore, a series of systemic literature searches (Medline) to identify the articles on neurologic complication of labor analgesia was conducted. This review article summarizes the evidence from published articles on this topic, with particular emphasis on the mechanism of neurologic injury, lidocaine-related transient neurologic symptoms, anticoagulation and vascular compromise, diagnostic evaluation, and prevention of neurologic obstetric anesthesia-related neurologic injury in pregnancy.

Analgesia, Obstetrical↗
PubMed1987

The grand multipara--maternal and neonatal complications.

During the period of 1974-83 the records of all grand multiparous women were analysed and compared with an equally large control group consisting of second and third parae. Antenatal complications, the management of and complications in labor, complications in the puerperium, perinatal mortality and neonatal morbidity were recorded and compared with the control group. Although there was no statistically significant difference in the frequency of abruptio placentae and placenta praevia in the groups, the increased tendency in the grand multipara group resulted in a high frequency of induced preterm delivery. There was also an increased occurrence of abnormal presentations and positions. The perinatal mortality was high, 23.5% compared with none in the control group. Furthermore there was an increased incidence of neonatal morbidity. One mother in the grand multipara group died from dissecting aortic aneurysm during the puerperium.

Adolescent↗
PubMedDate not supplied

[Prognosis, monitoring and intensive therapy in the prevention of the development of hemorrhagic complications in labor].

Blood clotting system has been studied over the course of pregnancy. The detected close correlations between hemostasiograms and labor hemorrhages suggested the possibility of predicting hemorrhagic complications. Based on informative signs, the authors formulate the rules for predicting hemorrhagic complications of labor starting from the first trimester and define the algorithm of monitoring the hemostasis system. Application of this system helped decrease the incidence of labor hemorrhages by half by means of appropriate preventive therapy.

Adult↗
PubMedDate not supplied

Obstetric complications during labor and delivery: assessing ethnic differences in California.

PURPOSE: We sought to compare obstetric complications during labor and delivery among white non-Latina (white), black, Asian, and Latina women who delivered in California hospitals. Many intrapartum complications are preventable. METHODS: We used linked 1996-1998 state hospital discharge and birth certificate data to examine obstetric complications International Classification of Diseases, 9th Revision, Clinical Modification codes considered relevant for population surveillance. We compared the observed and adjusted odds of experiencing a complication among women of color, using white women as the reference group. FINDINGS: One out of 5 deliveries had >or=1 complication. White (21.3%) and Asian women (21.1%) had similar prevalence rates, whereas black women (24.2%) had higher and Latina women (19.6%) had lower rates. After adjusting for covariates, the odds of experiencing >or=1 complication was lower for Asians (odds ratio [OR] = 0.95; 95% confidence interval [CI] = 0.93, 0.96) and Latinas (OR = 0.97; 95% CI = 0.96, 0.98) than whites; the odds for black women remained elevated (OR = 1.25; 95% CI = 1.23, 1.27). Asian women stood a higher risk of deliveries with major lacerations, postpartum hemorrhage, and major puerperal infections. Rates for the latter complication were higher among all women of color. CONCLUSIONS: The burden of morbidity is high for all women, regardless of ethnicity. Yet, compared to white women, blacks suffer more aggregate morbidities, and Asians stand a high risk of all 3 intrapartum care-sensitive conditions. Furthermore, all women of color experience disproportionate rates of puerperal infections. Collective action is needed to reduce these disparities and improve maternal health.

Adult↗
PubMed1981

Complications of labor and delivery following uncomplicated pregnancy.

Renewed interest in less costly, less technologically oriented obstetrical care requires the accurate selection of women who may safely benefit from such alternatives. The distribution of complications of labor and delivery, among healthy women who had had uncomplicated pregnancies, was investigated by studying data from more than 240,000 birth certificates filed with the New York City Department of Health during the period 1971-1974. Complications of labor or delivery were reported for 21.0 per cent of births following apparently uncomplicated antepartum courses. Significantly higher rates of recorded complications were found for women who had initiated prenatal care earlier in pregnancy, for private patients as opposed to general service patients, for white patients compared to nonwhite patients, for married women than for unmarried women, and for better educated patients as opposed to those with less schooling. Labor and delivery complication rates were also noted to rise with maternal age. The positive association between earlier prenatal care and higher complication rates was found within all service, racial, marital, educational and age categories, and appeared to be independent of these variables. Factors which may contribute to these unexpected patterns, and further research to clarify them, are discussed.

Adolescent↗
PubMed1999

Does preexisting abnormality cause labor-delivery complications in fetuses who will develop schizophrenia?

Many authors have suggested that theoretically the labor-delivery complications (LDCs) that frequently appear in the histories of individuals with schizophrenia represent the secondary consequence of preexistent abnormality in the fetus. The question of whether LDCs are systematically associated with prenatal complications and fetal abnormality was studied in 70 singleton schizophrenia patients, in 23 monozygotic twin pairs discordant and 10 pairs concordant for schizophrenia, and in 33 individuals with inferred genetic risk for schizophrenia. Schizophrenia cases with signs of prenatal abnormality (reduced head size, increased minor physical anomalies, greater within-twin-pair birthweight differences) did not have more LDCs than other schizophrenia cases. LDCs were not more frequent in genetic-risk cases with congenital malformations than in genetic-risk cases without malformations. Instead, individuals with schizophrenia who had a history of abnormal length of labor had significantly fewer pregnancy complications and minor physical anomalies than did other individuals with schizophrenia. No support was found for suggestions that LDCs among individuals who have not yet developed schizophrenia are the result of identifiable preexistent fetal abnormality.

Adult↗
PubMed1999

Birth trauma in the head and neck.

OBJECTIVES: To review the medical records of neonates found to have birth-associated trauma of the head and neck region. To describe the anomalies, physical findings, and possible sequelae of these injuries and to bring attention to the cause of mechanical birth injury as a potential cause of anomalies in the infant. DESIGN: Case-controlled retrospective chart review of a cohort of patients identified with birth-associated trauma to the head and neck from January 1, 1991, to March 1, 1997. SETTING: Academic tertiary care medical center. PATIENTS: Medical records from infants born or transferred with the diagnosis of birth trauma were reviewed. Medical records from a control group of 148 uninjured full-term infants born during the same period were reviewed for comparison. Neonatal charts, including labor and delivery records, were analyzed. MAIN OUTCOME MEASURES: Each patient record was reviewed for diagnosis, associated injuries, maternal statistics, gestational age, birth weight and size, Apgar scores, type of delivery, length of labor, complications of labor, and length of hospital stay. RESULTS: One hundred sixty-four infants (incidence, 0.82%; prevalence, 9.5 per 1000 live-births) were identified with 175 birth-associated injuries to the head and neck. The most common finding was cephalhematoma (56.6%). Other findings included scalp and/or facial lacerations (12%) and hematomas (2.3%), facial nerve paresis (8.6%), brachial plexus injuries (5.1%), clavicular (9.1%) and skull fracture (2.9%), nasal septal dislocation (0.6%), and phrenic (1.7%) and laryngeal nerve injuries (0.6%). Risk factors included birth weight (P = .001) , vaginal delivery (P = .001), primiparity (P = .02), forceps delivery (P = .005), vacuum delivery (P = .001), infants categorized as large for gestational age (P = .02), and male infant sex (P = .03). Apgar scores were also noted to be lower in our study population (P = .001). Risk factors for specific types of injuries varied. However, facial nerve paralysis was associated with multiple birth injuries (P = .001), and 2 of 3 phrenic nerve injuries co-occurred with brachial plexus injuries. Correlation coefficients for factors such as maternal age, gravidity, and race were low. CONCLUSION: Birth-associated head and neck trauma is rare. However, mechanical birth-associated trauma must be considered when assessing anomalies, injuries, respiratory difficulty, or feeding difficulties in the neonate or infant. A comprehensive approach is required to diagnose and manage these patients.

Birth Injuries↗