Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “LABOR COMPLICATIONS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources
PubMed1978

The single-unit delivery system--a safe alternative to home deliveries.

The need has arisen for the development of a health care/delivery system that can allow for a natural and personalized childbirth experience, within the safe confines of a modern obstetric unit. The single-unit delivery system (SUDS) is designed to achieve this objective by: strict prenatal screening of patients into low- and high-risk categories, utilization of a single room for the entire labor process, and close personalized supervision of women in "normal" labor by trained midwives/monitrixes. Physicians supervise the entire unit and are directly responsible for the management of all high-risk and complicated labors. The SUDS concept has been tried in clinical practice and has been proved to be an effective method of providing safe and satisfying obstetric care without compromising modern obstetric standards.

Delivery, Obstetric↗
PubMed2004

Obstetrical and neonatal outcome in young adolescents of low socio-economic status: a case control study.

OBJECTIVE: The purpose of this study was to determine obstetrical and neonatal outcome among early adolescent pregnancies (< or =15 years). METHOD: We compared obstetrical and neonatal outcome of early adolescent nulliparas with outcome of nulliparous women aged 20-30 years. RESULTS: Two hundred and one (201) early adolescent nulliparous patients of low socio-economic status were enrolled at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil-Ecuador, and matched for gestational age with 201 low socio-economic nulliparous controls aged 20-30. Mean maternal age of the adolescent group was 14.2+/-0.6 years. The incidence of cervicovaginal infections during current pregnancy was significantly higher among adolescents (trichomoniasis: 11.4% vs. 5% and candidiasis: 27.8% vs. 12.4%, p<0.05). The incidence of eclampsia was higher in adolescents (2.5% vs. 0%, p<0.05). The preterm rate in each group was 4.9%. There were no differences in labor characteristics and the rate of cesarean section, labor complications and abnormal puerperium between both studied groups. Nevertheless, mean neonatal weight was lower and the incidence of low birth weight infants (<2,500 g) and adverse neonatal outcome was significantly higher in the adolescent group (2,837.6+/-454 g vs. 3,017+/-547 g; 19.9% vs. 11.4% [OR=1.92, 95% CI: 1-3.5] and 9.5% vs. 3.5% [OR=2.9, 95% CI: 1.1-7.7] respectively, p<0.05). CONCLUSION: Pregnancy in young adolescents (< or =15 years) of low socio-economic status did not impose adverse obstetrical outcome, however it did increase the risk for low birth weight, adverse neonatal outcome and cervicovaginal infections.

Adolescent↗
PubMed1999

Perinatal outcome in grand and great-grand multiparity: effects of parity on obstetric risk factors.

OBJECTIVE: We sought to compare obstetric and neonatal complications among great-grand multiparous, grand multiparous, and multiparous women. STUDY DESIGN: One hundred thirty-three great-grand multiparas, 314 grand multiparas, and 2195 multiparas who were delivered of their infants between 1988 and 1998 were selected for the study. To facilitate comparison, the patients were all >35 years old and had similar socioeconomic characteristics. RESULTS: The incidence of malpresentation at the time of delivery, maternal obesity, anemia, preterm delivery, and meconium-stained amniotic fluid increased with higher parity, whereas the rate of excessive weight gain and cesarean delivery decreased. Compared with grand multiparas, great-grand multiparas had significantly elevated risks for abnormal amounts of amniotic fluid, abruptio placentae, neonatal tachypnea, and malformations but lower rates of placenta previa (P <.05). The incidence of postpartum hemorrhage, preeclampsia, placenta previa, macrosomia, postdate pregnancy, and low Apgar scores was significantly higher in grand multiparas than in multiparas, whereas the proportion of induction, forceps delivery, and total labor complications was significantly lower than in the multiparous group (P <.05). Similar frequency of maternal diabetes, infection, uterine wall scar rupture, variations in fetal heart rate, fetal death, and neonatal mortality was found in the 3 groups. CONCLUSION: Both high-parity groups have their own risk factors, but the rate of some complications decreases with higher parity. In addition, perinatal mortality remains low in these patients, and therefore, under satisfactory socioeconomic and health care conditions, high parity should not be considered dangerous.

Adult↗
PubMed2006

Induction of labor with oral misoprostol in nulliparous mothers of twins.

The efficacy and safety of oral misoprostol for labor induction of twins is unknown. We conducted a retrospective case-control study to evaluate the use of oral misoprostol in near term (> or =35 weeks) twin pregnancies in nulliparas. Eligible cases were given 100 mcg oral misoprostol, which was repeated after 6 h if labor did not start. Either a third dose or diluted oxytocin infusion were given in intractable cases. Diluted oxytocin infusion was used for augmentation. Controls were nulliparas delivered at > or =35 weeks by elective cesarean section. The two groups were comparable in most aspects, except for fetal malpresentation, which was the major reason for avoiding induction. Of the 69 patients in whom labor was induced, 53 (76.8%) had a vaginal birth, 3 (4.3%) had a combined twin delivery, and 13 (18.8%) had a cesarean during labor. The mean length of stay of the neonates was significantly shorter among study cases, without significant difference in the frequency of delayed discharges as an overall proxy for neonatal complications. Labor induction with oral misoprostol could be offered to patients in whom near term vaginal twin delivery is unequivocally permitted and wish to deliver by the vaginal route.

Administration, Oral↗
PubMed1988

Differing fetal growth patterns in pregnancies complicated by preterm labor.

Previous studies have demonstrated diminished ultrasonic fetal growth parameters in women delivering preterm. In this study, we tested the following hypothesis: In pregnancies complicated by spontaneous preterm labor, 1) unsuccessful tocolysis is likely to be associated with diminished fetal growth, and 2) successful tocolysis is likely to occur when fetal growth is normal. Ultrasound examinations were performed in 78 pregnancies complicated by preterm labor before 35 weeks' gestation. Tocolysis was attempted unless contraindicated or unless cervical dilatation was advanced (4 cm or greater). Pregnancies delivering before 36 weeks' gestation were compared with those delivering after this gestational age. Among the 48 pregnancies delivered before 36 weeks' gestation, a significantly greater proportion had ultrasonic growth parameters lower than normal values at corresponding gestational ages. In contrast, those pregnancies that had successful tocolysis and delivered near term demonstrated a normal distribution of ultrasound growth parameters. In pregnancies complicated by preterm labor, ultrasonic documentation of diminished fetal growth may identify the subgroup at increased risk for preterm delivery.

Adult↗
PubMed2005

[Maternal obesity as a risk factor for complications in pregnancy, labor and pregnancy outcomes].

Obesity is a worldwide growing epidemic. The negative influence of obesity is huge and considered to be one of the major contributors to health problems in the western world. There is a significant association between obesity and diabetes mellitus, ischemic heart disease, some cancers and syndromes of sleep apnea. Furthermore, obesity was described to have a negative influence on fertility, pregnancy, labor and pregnancy outcomes. It was also discovered that obesity was significantly associated with gestational hypertension, preeclampsia, gestational diabetes mellitus and complications in cesarean delivery and anesthesia. This review aims to present updates on the relationship between obesity and pregnancy and labor outcomes, emphasizing the significance of obesity as a risk factor for adverse pregnancy outcome.

Female↗
PubMed1997

A comparison of intravaginal misoprostol and intracervical prostaglandin E2 gel for ripening of unfavorable cervix and labor induction.

OBJECTIVE: To study the effectiveness of single application of intravaginal misoprostol versus intracervical prostaglandin E2 gel for ripening the unfavorable cervix and labor induction. METHOD: One hundred and ten patients with indications for induction of labor with unfavorable cervices were randomized to receive either 100 microgram tablets of misoprostol placed in the posterior vaginal fornix or prostaglandin E2 1.5 mg in gel placed into the endocervix. Those, who were not in active labor after 24 hours, had labor induced with amniotomy and oxytocin. RESULTS: Among 110 patients recruited, 60 received misoprostol and 50 received prostaglandin E2 gel. The average interval from start of induction to vaginal delivery was 19.14 +/- 10.64 hours in misoprostol group and 21.37 +/- 13.09 hours in the prostaglandin E2 group (p = 0.33). Five patients (8%) in the misoprostol group had induction of labor after 24 hours of the treatment compared with 13 patients (26%) in the PGE2 group. The difference was significant (p = 0.03). Oxytocin augmentation was 35% in the misoprostol group and 34% in the prostaglandin E2 group (p = 0.86). There were no significant differences between routes of delivery. Nineteen patients (31%) in misoprostol group and 16 patients (32%) in the PGE2 gel group had cesarean deliveries. There was one case (1.7%) of uterine hyperstimulation in the misoprostol group and none in the PGE2 gel group. There were no significant difference in Apgar scores < 7 at 1 and 5 minutes, or admission to the neonatal intensive care unit between the 2 groups. CONCLUSION: Vaginal misoprostol is an effective agent for cervical ripening and induction of labor. Complications associated with prostaglandin administration were not statistically different between the 2 groups, but hyperstimulation occurred more in misoprostol group.

Administration, Intravaginal↗
PubMed1991

Rupture of low transverse cesarean scars during trial of labor.

We report eight cases of rupture of low transverse cesarean scars occurring during trials of labor. The cases occurred in five hospitals in the Denver metropolitan area during a 13-month period. The estimated incidence was 0.7% of planned trials of labor. Complications of rupture included one neonatal death, two cases of severe neonatal asphyxia, three maternal bladder lacerations, and one hysterectomy.

Adult↗
PubMed2003

Dilemma of increased obstetric risk in pregnancies following IVF-ET.

PURPOSE: To determine the rates of pregnancy complications following in vitro fertilization in comparison with those in a matched control group. METHODS: A total of 13,543 deliveries at the Department of Obstetrics and Gynecology, University of Szeged, between January 1, 1995 and February 28, 2002 were subjected to retrospective analysis The 230 (1.7%) pregnancies following IVF-ET were evaluated and matched with spontaneous pregnancies concerning age, parity, gravidity, and previous obstetric outcome. Demographic and selected maternal characteristics, pregnancy and labor complications, and neonatal outcome were compared in the two groups RESULTS: The pregnancy complication rate was partly significantly higher among the singleton IVF-ET pregnancies. The obstetric risk was elevated, though not significantly concerning twin pregnancies. CONCLUSIONS: IVF-ET presents an additional obstetric risk. The neonatal outcome displays a significant difference only concerning an increased premature birth rate of singleton pregnancies. Triplet IVF-ET pregnancies involve a much higher risk of both pregnancy complications and neonatal outcome.

Birth Weight↗
PubMed1993

[Myocardial infarction in pregnancy].

We report two cases of pregnant women who developed an acute myocardial infarction. The proposed cause of massive myocardial anterior and interventricular wall infarction of the first patient appears to be bacterial intracoronary thrombus during the course of bacterial endocarditis. Acute insufficiency of the mitral valve caused by rupture chordae tendineae of the anterior mitral left was another complication. Labor contractions occurred on the 13th day of treatment. On the next day the patient gave birth to a healthy child by elective cesarean section. She was also qualified for an operation because of increased signs of left ventricular heart failure. Preoperative coronary angiography revealed occlusion of the anterior descending branch and reconstruction of its periphery. Other vessels were not changed. The patient was subjected to implantation of artificial valve, an aortocoronary by-pass and repair of atrial septal defect. Eighteen months follow up was uneventful. The second case was a 29 year-old pregnant woman who had previously undergone mitral commissurotomy admitted because of an acute myocardial infarction in the II trimester. No complication of the disease was observed.

Adult↗
PubMed2006

Grandmultiparas in modern obstetrics.

The objective of this study was to compare incidence of antenatal and intrapartum complications among women who had previously delivered five or more times (grandmultiparas cases, 155) with that of age-matched women with two to three previous deliveries (multiparas controls, 155) from 1998 to 2003. Grandmultiparity was associated with a low socioeconomic status, higher incidence of smoking, and a higher body mass index. Grandmultiparas had approximately 2-fold increased risk of gestational diabetes, hypertensive disorders, malpresentation, and preterm delivery, and a 3-fold increased risk of abruption; none reached statistical significance. No significant differences were found in antepartum hemorrhage, anemia, postdatism, polyhydramnios, or placenta previa. Intrapartum complications (labor induction, nonreassuring fetal heart, primary cesarean delivery, and intrapartum fever) were similar; however, operative vaginal delivery was significantly lower in grandmultiparas cases. Both groups were similar regarding birthweight, macrosomia, intrauterine growth restriction, Apgar scores, and stillbirth rates. Our study shows a trend toward an increased risk of adverse obstetrical outcome in grandmultiparas compared with multiparas independent of maternal age.

Adult↗
PubMedDate not supplied

The reliability and validity of birth certificates.

OBJECTIVES: To summarize the reliability and validity of birth certificate variables and encourage nurses to spearhead data improvement. DATA SOURCES: A Medline key word search of reliability and validity of birth certificate, and a reference review of more than 60 articles were done. STUDY SELECTION: Twenty-four primary research studies of U.S. birth certificates that involved validity or reliability assessment. DATA EXTRACTION: Studies were reviewed, critiqued, and organized as either a reliability or a validity study and then grouped by birth certificate variable. DATA SYNTHESIS: The reliability and validity of birth certificate data vary considerably by item. Insurance, birthweight, Apgar score, and delivery method are more reliable than prenatal visits, care, and maternal complications. Tobacco and alcohol use, obstetric procedures, and delivery events are unreliable. Birth certificates are not valid sources of information on tobacco and alcohol use, prenatal care, maternal risk, pregnancy complications, labor, and delivery. CONCLUSIONS: Birth certificates are a key data source for identifying causes of increasing U.S. infant mortality but have serious reliability and validity problems. Nurses are with mothers and infants at birth, so they are in a unique position to improve data quality and spread the word about the importance of reliable and valid data. Recommendations to improve data are presented.

Alcohol Drinking↗
PubMed2000

Rapid resolution of fetal goiter associated with maternal Grave's disease: a case report.

The incidence of abnormal fetal thyroid function with maternal Grave's disease is about 2-12%. The development of larger fetal goiters can complicate labor and precipitate life-threatening airway obstruction at delivery. A case is presented of a large stable goiter confirmed by sonography, which unexpectedly resolved by the time of parturition. A 3 x 6 cm fetal goiter was detected at 34 weeks gestation in a mother treated with propylthiouracil for Grave's disease. A repeat sonogram at 36 weeks showed no change in goiter size. Umbilical blood sampling showed the fetus to be markedly hyperthyroid. Planned Cesarean section took place 11 days after the final sonogram. A multi-disciplinary operative team was present including the Otolaryngology service with equipment for emergency intubation, bronchoscopy and tracheotomy. Upon delivery, the infant had no evidence of goiter and no airway compromise. Fetal goiter is a rare entity, and recent advances in the field of maternal-fetal medicine have enabled intra-uterine diagnosis and treatment of such conditions. A review of published case reports demonstrates two trends in treated fetuses: preterm progressive resolution of the goiter, or delivery with gross evidence of goiter. This reported case is unique, as a persistent goiter resolved completely in less than 2 weeks. Otolaryngologic response to and management of potential congenital airway compromise is discussed.

Adolescent↗
PubMed1981

Fetal and maternal serum copper levels before and during labor in normal and complicated pregnancies.

The effect of labor on maternal serum copper levels was determined in normal and complicated pregnancies. The mean value +/- SD (3.16 +/- 0.48 micrograms/ml) in 82 clinically normal subjects at term during labor was compared with that (2.22 +/- 0.49 micrograms/ml) obtained from 50 controls matched for gestational age who were not in labor. Similarly, the mean value in labor (3.56 +/- 0.46 micrograms/ml) in 25 subjects with a complicated pregnancy was compared with that (2.87 +/- 0.43 micrograms/ml) obtained from 25 similar subjects prior to labor. A statistically significant difference (P less than .001) was observed in both comparisons. Copper levels in the corresponding fetal serum from the subjects in labor (normal and complicated) were compared with those of the maternal serum samples. The mean value of fetal serum samples in mothers with complications was higher than that in normal mothers, but the difference was not statistically significant. This trend of a rise in serum copper level during labor was further confirmed by analysis of the same subject during and before labor in normal (12 subjects) and complicated pregnancies (9 subjects). Moreover, maternal serum estriol and estetrol levels were determined from the same samples in the 4 groups to find a possible relationship with the corresponding copper levels. No statistically significant correlation was noted. A possible explanation for the rise of the serum copper level with the onset of labor and its clinical implications are also discussed.

Copper↗
PubMed1990

Prenatal and perinatal antecedents of febrile seizures.

We examined prenatal and perinatal characteristics as possible risk factors for febrile seizures in a large pediatric population. Family history was among the few identified factors that made an important contribution to vulnerability to febrile seizures; however, no more than 6% of febrile seizures could be attributed to a characteristic of family history. Maternal illness, smoking history, and a few rare neonatal characteristics were associated with increases in risk. No complication of labor or delivery was an important risk factor for febrile seizures.

Anticonvulsants↗
PubMed2002

Development of a rapid and sensitive high-performance liquid chromatographic method to determine CYP2D6 phenotype in human liver microsomes.

Dextromethorphan is a probe substrate to determine CYP2D6 phenotype. The conversion of dextromethorphan to dextrorphan by CYP2D6 accounts for approximately 60% of total metabolism. Most analytical methods utilize complicated labor- and time-intensive sample processing methods with several liquid-liquid extraction (LLE) steps. Our goal was to develop a non-LLE based rapid and sensitive HPLC method, to measure dextromethorphan metabolism in human liver microsomes. A solid-phase filtration based reverse-phase HPLC method with fluorescence detection was developed and validated. Human liver (n = 6) microsomal incubations were carried out with dextromethorphan, under optimum conditions. The analytes were separated by one-step centrifugal filtration with Nanosep separation units. The filtrate was injected ( 50 microL) into a Waters Alliance 2690 HPLC system. Metabolic incubations were also conducted to determine levels using LLE for comparisons. The Nanosep separation step reduced the extraction time from 3h to 40 min. The limit of quantitation was 23.8 nM (9.7 ng/mL), recovery was approximately 98%, the mean precision values were <10% RSD for the controls (80, 320 and 640 nM) and mean percentage error was <5%. Michaelis-Menten parameters were determined to distinguish CYP2D6 phenotypes. A rapid and sensitive HPLC method is reported, which may be suitable for automation and allows phenotyping of human liver microsomes.

Antitussive Agents↗
PubMed1991

Traditional birth attendants in an endemic area of tetanus neonatorum in Thailand: pitfalls in the control program.

A survey of the characteristics of traditional birth attendants in Krabi Province, Thailand, where the incidence rate of tetanus neonatorum was the highest in the country, was conducted in order to obtain background information necessary for planning a training curriculum and to evaluate previous training courses. Five second year medical students were used as research assistants. After the questionnaire was constructed and tested, the students went to visit a sample of 116 traditional birth attendants (TBAs) to interview them about their personal backgrounds, techniques and practices in delivery and beliefs and attitudes towards midwifery. The study revealed that these TBAs were a mixture of Buddhist and Islamic females whose literacy rate was 53 percent. Ninety-one per cent knew about the availability of an injection for antenatal care at the health center, but only about half knew that it was for tetanus prevention. More than half provided antenatal care at their own home but 85 per cent conducted delivery at the client's home. About eighty per cent of the TBAs claimed that sterilization of instruments was performed. However, dressing of the umbilical cord was done inappropriately using various kinds of powders by about 40 per cent. The majority of TBAs had experience with complicated labors but only 30 per cent were referred, perhaps, due to excessive self-confidence and supernatural beliefs. The trained TBAs possessed a higher level of knowledge of immunization and sterile techniques for cord cutting and dressing of the stumps of the umbilical cord than the untrained group. However, knowledge of sterilization of instruments was not significantly different, indicating a need to improve teaching in this area.(ABSTRACT TRUNCATED AT 250 WORDS)

Asepsis↗