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At least 271 records · Page 15Linked to original sources
PubMed2005

Ischemia-modified albumin levels in cord blood: a case-control study in uncomplicated and complicated deliveries.

BACKGROUND: In the past few years ischemia modified albumin (IMA) has emerged as a new biomarker of ischemia in the area of monitoring acute coronary syndromes. We hypothesized that reduced blood flow, such as that resulting from vascular compression in complicated labors or placental ischemia, may increase IMA. IMA level in cord blood could then serve as an indicator of fetal hypoxia and fetal tissue ischemia and serve as a biomarker of the severity of these conditions. METHODS: We performed a case-control study with 26 newborns (12 normal term deliveries, Apgar 8-9; and 14 complicated labors or pre-term deliveries, Apgar 5-8). Complications were: prematurity (3), fetal distress (6), premature rupture of membranes (6), intrauterine growth retardation (3), pre-eclampsia (1). We also studied 30 healthy adults. IMA was measured in serum from cord blood (or venous blood for adults) by the decrease in cobalt 2+ binding. RESULTS: IMA levels in neonates from non-complicated deliveries are significantly higher (45%, p < 0.005) than those of an adult control population, suggesting that IMA may increase as a consequence of labor. This increased IMA in neonates could not be accounted for by the changes in albumin concentration. It is conceivable that a transient increase in IMA reflects, in part, transient localized tissue ischemia due to the external forces exerted on the fetus during the mechanism of labor. IMA levels in cord blood from neonates from complicated deliveries are 50% higher than in neonates from uneventful deliveries (p < 0.05) while their albumin values are not significantly different (32 +/- 3 vs. 33 +/- 2 g/l). Moreover, IMA seems to be responsive to hypoxic fetal distress, showing values more than 300% higher in cases of severe fetal hypoxia (Apgar 5 n = 2: 2.19 +/- 0.01 AU vs. 0.64 +/- 0.24 for controls). IMA values did not correlate significantly with either lipoperoxides or CRP levels. CONCLUSIONS: This is the initial reporting of IMA levels in cord blood from normal deliveries compared to healthy adult ranges and neonates from complicated deliveries. Cord blood IMA levels may be an indicator of fetal ischemia and/or hypoxia. This test could become an additional biomarker to be used in conjunction with other markers and/or clinical scores aimed at determining risk of neurological complications of fetal distress.

Adult↗
PubMed1977

[Complication-free labor in operated-on Cushing's syndrome].

By the casuistical report on a successfully carried out gravidity of a 21 years old female patient without suprarenal glands which have been removed totally because of a hyperplasia of the suprarenal cortex on both sides, the problems of gravidities and their successful carrying to the term of operated femal patients with Cushing's disease are dealt with. Under experienced substitution therapy and an intensive care a gravidity without complications is to be expected. The apprehension is unfounded that overdosage of corticoid during gravidity could induce malformations of new-born children. The substitution dosis during gravidity is discussed by literature.

Adrenalectomy↗
PubMed2004

Pressure sore as a complication of labor epidural analgesia.

UNLABELLED: Lumbar epidural analgesia has become a common mode of pain control for laboring patients. Side effects, such as hypotension, motor blockade, respiratory depression, dural puncture, and urinary retention, are well described. Although pressure sores have been thought of as a complication limited to elderly, emaciated, unconscious, or bedridden patients, we describe the occurrence of pressure sores in a young and healthy parturient after lumbar epidural analgesia. IMPLICATIONS: We report a pressure sore that resulted from lumbar epidural analgesia for labor.

Adult↗
PubMedDate not supplied

[Cervical ultrasound assessment for predicting the risk of premature delivery].

BACKGROUND: Cervix is very important structure that separates the fetus from external environment, it can be visualized very precisely by transvaginal ultrasonography. Cervical length in the pregnancy is one of the predictors of preterm delivery and diagnosis of cervical incompetence. MATERIALS & METHODS: We have investigated 119 pregnant women with diagnosis of preterm labor(n-62), with preterm labor complicated by diabetes mellitus(41) and hypertension (16). Transvaginal sonography was used to measure cervical length between 23 and 29 weeks gestation. Ultrasound examination was performed using 2000 with 5.0 MHz transvaginal transducer. The following measurements were obtained: endocervical canal length between the internal and external os, funneling of the cervix, funnel width, funnel length. RESULTS: The mean endocervical length was 16.3 +/- 0.5 mm in pregnancies delivered before term (n = 19) and 30.1 +/- 0.6 mm in pregnancies delivered at term (n = 100). The mean endocervical length measured in pregnant women without pregnancy complications other than preterm labor was 15.2 +/- 0.6 mm, in women with diagnosis of preterm labour complicated by diabetes mellitus was 16.7 mm + 1.0 and complicated by hypertension 15.9 mm + 0.8. No significant relationships were shown between length of the cervix in pregnancy complicated by diabetes mellitus, hypertension and uncomplicated pregnancy. The mean endocervical length in diabetic pregnancy was 34.7 +/- 4.7 mm; pregnancy with hypertension 32.9 +/- 5.8 mm and uncomplicated pregnancy 35.6 +/- 3.8 mm. CONCLUSION: Cervical length measured by ultrasonography between 23 and 29 week of pregnancy is very important predictor of preterm delivery. We found significant relationships between cervical length in pregnancies delivered before and at term. No significant relationships were shown between the length of the cervix and investigated pregnancy complications.

Adult↗
PubMedDate not supplied

Differential expression of transforming growth factor-beta 1 and transforming growth factor-beta receptors in myometrium of women with failed induction of labor, no labor, and preterm labor.

OBJECTIVE: Comparative analysis of transforming growth factor-beta 1 (TGF-beta 1) and TGF-beta receptor type I and type II messenger RNA (mRNA) and protein expression in myometrium of women who had unsuccessful labor induction, with those without labor or in preterm labor complicated by chorioamnionitis. METHODS: Small segments of myometrium were collected from women who were undergoing cesarean delivery for unsuccessful labor induction (n = 5), elective cesarean without labor (n = 5), or cesarean delivery for complications related to preterm labor and chorioamnionitis (n = 5). Total RNA was isolated from these tissues and subjected to competitive quantitative reverse-transcription-polymerase chain reaction (Q-RT-PCR) to determine the level of TGF-beta 1, and TGF-beta type I and type II receptor mRNA expression. Tissue sections were prepared from paraffin-embedded specimens and immunostained for TGF-beta 1 and receptor proteins using specific polycolonal antibodies. The data were analyzed by impaired Student t test and Kruskal-Wallis analysis of variance. RESULTS: Myometrium from women who had unsuccessful labor induction expressed higher levels of TGF-beta 1 mRNA (2.21 +/- 0.28 x 10(6) copies/microgram of total cellular RNA) than those with preterm labor (4.53 +/- 0.2 x 10(5) copies), or without labor [3.13 +/- 2.6 x 10(4) copies (P < .05)]. The level of TGF-beta type I receptor mRNA expression did not vary; however, type II receptor expression was significantly lower in myometrium from preterm labor (1.36 +/- 0.36 x 10(5) copies) compared with those from unsuccessful labor induction (3.42 +/- 0.42 x 10(6) copies) or without labor (9.65 +/- 3.2 x 10(5) copies). Immunoreactive TGF-beta 1 and TGF-beta receptor proteins were present in all myometrial tissues, and their intensity reflected that of the mRNA expression in these tissues. CONCLUSION: TGF-beta 1 and TGF-beta type II receptors are expressed differently in myometrium of women who had unsuccessful labor induction compared with those without labor or with preterm labor complicated by chorioamnionitis. Because TGF-beta is a key regulator of tissue remodeling which is central to initiation of normal labor, alterations in TGF-beta and/or TGF-beta receptor expression may lead to changes in the outcome of labor, at least at the myometrial level.

Cesarean Section↗
PubMed1983

[Complaints caused by episiotomy. Study of 413 women with spontaneous complication-free labor].

In 413 women following normal spontaneous delivery the short and long term complaints due to the episiotomy were studied. Every fifth woman found the cutting of the episiotomy painful. Episiotomies done by specialist's or chief residents were found to be less-painful. The suturing of the episiotomy was found to be painful by 4 of 10 women. The more experienced the surgeon the less was the pain. Only every tenth woman had no pain in the episiotomy immediately post-partum independent of the experience of the obstetrician. Medilateral episiotoma were twice as often very painful (21%) as median episiotomies (11%). Every fifth woman had pain in the perineum for more than one month. A third of these women had more pain with sexual intercourse than prior to delivery. Every tenth woman had infections in the episiotomy, half of these required treatment. Following medio-lateral episiotomy there were twice as many complication with the episiotomy than following median-episiotomy. Every fifth woman though that her vagina and perineum was disfigured by the episiotomy scar. This impression was independent of the type of episiotomy and of the experience of the obstetrician. More dyspareunia than prior to delivery was reported by twice as many primipara (20%) as multipara (11%). 18% of the women reported that the vaginal introitus appeared to be narrower than prior to the delivery.

Dyspareunia↗
PubMedDate not supplied

[Urinary incontinence in pregnancy and prevention of perineal complications of labor].

BACKGROUND: Female urinary incontinence often manifests itself for the first time during pregnancy in a great number of women (23-50%). In many cases it is transitory in nature, the result of the stress induced by the pregnancy on the pelvic floor. In this study the authors discuss the frequency of urinary incontinence on the basis of a questionnaire administered to a limited sample group of obstetrics patients in order to identify the potential risk factors and to plan protective and rehabilitative strategies for the pelvic floor both during pregnancy and before and after delivery. METHODS: From November 1998 until June 1999 at the Obstetrics and Gynecology Clinic of the University of L'Aquila (Italy) 150 women were surveyed by written questionnaire both before delivery and on the second day following delivery. Those who were identified as having urinary incontinence during pregnancy were readministered the questionnaire at three months following delivery. RESULTS: Urinary incontinence was reported during pregnancy by 48% of the women under examination, which appeared, for the most part, during the third trimester of the pregnancy (in 43% of the women). No differences related to age were discovered, while a cesarean section played a protective role. For women with preexisting IUS the new pregnancy was an aggravating factor. Of the women with IUS during pregnancy who did not demonstrate preexisting symptoms only 9.4% reported persistent urinary incontinence at three months following delivery. Among women pregnant for the first time with persistent symptoms all had received episiotomies by the third month following delivery. CONCLUSIONS: The authors of this study wish to direct their attention to the identification of women with IUS during pregnancy so that damage from delivery can be reduced to a minimum and rehabilitation strategies for the functioning of the pelvic floor can be imitated as soon as possible.

Adult↗
PubMed1992

Prophylactic amnioinfusion improves outcome of pregnancy complicated by thick meconium and oligohydramnios.

OBJECTIVE: The null hypothesis is that the use of intrapartum amnioinfusion in labors complicated by the presence of thick meconium and oligohydramnios will not decrease the incidence of fetal distress, cesarean delivery, meconium aspiration, or meconium aspiration syndrome. STUDY DESIGN: One hundred seventy term and postterm patients with thick meconium and oligohydramnios were randomly chosen to receive amnioinfusion or standard obstetric care without amnioinfusion. The frequency of fetal distress, cesarean section, meconium aspiration, and meconium aspiration syndrome were subject to chi 2 analysis, Student's t test, or Fisher's exact test. RESULTS: The rate of fetal distress was significantly reduced in the amnioinfusion group compared with controls (three of 85 vs 19 of 85, relative risk 0.15, 95% confidence interval 0.06 to 0.42). The rate of cesarean section for fetal distress was significantly reduced in the amnioinfusion group (two of 85 vs 17 of 85, relative risk 0.118, confidence interval 0.03 to 0.49). The rates of meconium aspiration (four of 85 vs 33 of 85, relative risk 0.12, confidence interval 0.0449 to 0.327) and meconium aspiration syndrome (0 of 85 vs five of 85, relative risk 0.09, confidence interval 0.009 to 0.872) were significantly reduced by amnioinfusion. CONCLUSIONS: Amnioinfusion improves the outcome in pregnancies complicated by thick meconium and oligohydramnios.

Amnion↗