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PubMedDate not supplied

[Can the indications for the presence of the neonatal emergency service be determined before the onset of labor?].

The purpose of this study was to recommend guidelines for the consultation of the Neonatal Emergency Service when birth risks appear. Data from 39.479 births in 20 obstetric clinics and 1.723 emergency transports to the same clinics during the period 1979-1981 were analysed. The criteria applied for neonatal distress were necessity of resuscitation measures in the delivery room and perinatal mortality. It is recommended that the Neonatal Emergency Service should be called in before birth in the following cases: all premature births up to 34 weeks of gestation; from 35 to 37 weeks in case of additional risk factors; from 38th week onward in case of intrapartum bleeding, umbilical cord prolapse or tear, multiple births, transverse or face presentations and continuous heart rate deceleration.

Asphyxia Neonatorum↗
PubMed1982

The Florence sextuplets. Report of a case. Part two: progression of pregnancy, the onset of labor and delivery.

The paper presents a successful case of sextuplet pregnancy after HMG-HCG induced ovulation. The pregnancy was brought to 34, 5 weeks of gestation with all six babies in good conditions and high birth weight (1200-1750 gr.). The effectiveness of early diagnosis, intensive follow-up, and elective caesarean section is discussed. Suggestions are made for the prenatal, intrapartum, and post natal problems connected with mulitple gestation of high fetal number.

Adult↗
PubMed2002

[The clinical onset of spontaneous labor in obstetrical research].

The onset of labour is a cornerstone in the process of childbirth, albeit difficult to define. When a woman's subjective assessment that labour has started is not accompanied by cervical changes, discrepancies can arise between her and her caregivers' perceptions of what labour and childbirth is all about. In this review we examine how definitions and operational terms for the onset of labour evolved and varied with the prevailing paradigms in the clinical research agenda. In the 1950's, the relatively simple concept of labour, divided in a first stage of dilatation and a second stage of expulsion, changed to encompass a latent and active phase of dilatation, based on the work of Friedman and Sachtleben. Later on, the resulting wide variation in the total duration of labour shrank drastically with the emergence of "active management of labour", which required a different operational definition. Subsequently, the transition from observational to controlled clinical research required firmer starting points. Thus, more readily defined starting points, such as admission to hospital or even time of randomisation, replaced the nebulously vague and erratic "onset of labour" in the clinical research agenda. As the paradigms shifted from labour itself to the outcome of labour, the onset of labour and its vagaries became an embarrassment that needed to be overcome. Yet, within the goal of effective care during labour and childbirth, the onset of labour remains as much of a cornerstone as it has been for a long time. Thence outcome-centred thinking may need to take a step back and also embrace process evaluation, if clinical research in maternity care is to achieve its ultimate aim: optimal care for both mother and baby.

Female↗