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At least 379 records · Page 21Linked to original sources
PubMed1986

Cesarean section: a controversial feature of modern obstetric practice.

Cesarean section (CS) has been an integral part of modern obstetrics during the last decades. As safety has increased, so too has the range of problems that CS is used to solve, to a degree that it must cause medical concern. There is a great danger in the blind faith that CS is the only way out in every difficult obstetric situation. The problem can always be easily solved by CS in an acute difficult obstetrical situation. However, CS is a major abdominal surgery and it may present any complication that besets major surgery including severe intraoperative and postoperative complications, a much greater risk for maternal death compared to vaginal delivery and also late complications, i.e. secondary involuntary infertility. Therefore, CS should never be undertaken lightly and without serious consideration of the justifications, preparations and all ancillary support.

Abortion, Induced↗
PubMed2005

Birth outcomes in Colorado's undocumented immigrant population.

BACKGROUND: The birth outcomes of undocumented women have not been systematically studied on a large scale. The growing number of undocumented women giving birth in the United States has important implications for clinical care and public health policy. The objective of this study was to describe birth outcomes of undocumented immigrants in Colorado. METHODS: Retrospective descriptive study of singleton births to 5961 undocumented women using birth certificate data for 1998-1999. RESULTS: Undocumented mothers were younger, less educated, and more likely to be single. They had higher rates of anemia, were less likely to gain enough weight, and less likely to receive early prenatal care. They were much less likely to use alcohol or tobacco. Undocumented women had a lower rate of low birth weight (5.3% v 6.5%, P < .001) or preterm infants (12.9% v 14.5%; p = .001). Undocumented women experienced higher rates of labor complications including excessive bleeding (2.3% v 0.8%, p < .001) and fetal distress (8.7% v 3.6%, p < .001). CONCLUSION: Undocumented women have lower rates of preterm delivery and low birth weight infants, but higher rates of pregnancy related risk factors. Higher prevalence of some risk factors which are amenable to medical intervention reveals the need for improved prenatal care in this group.

Adolescent↗
PubMed2006

Maternal risk profiles and the primary cesarean rate in the United States, 1991-2002.

OBJECTIVES: We examined factors contributing to shifts in primary cesarean rates in the United States between 1991 and 2002. METHODS: US national birth certificate data were used to assess changes in primary cesarean rates stratified according to maternal age, parity, and race/ethnicity. Trends in the occurrence of medical risk factors or complications of labor or delivery listed on birth certificates and the corresponding primary cesarean rates for such conditions were examined. RESULTS: More than half (53%) of the recent increase in overall cesarean rates resulted from rising primary cesarean rates. There was a steady decrease in the primary cesarean rate from 1991 to 1996, followed by a rapid increase from 1996 to 2002. In 2002, more than one fourth of first-time mothers delivered their infants via cesarean. Changing primary cesarean rates were not related to general shifts in mothers' medical risk profiles. However, rates for virtually every condition listed on birth certificates shifted in the same pattern as with the overall rates. CONCLUSIONS: Our results showed that shifts in primary cesarean rates during the study period were not related to shifts in maternal risk profiles.

Adult↗
PubMed1989

The unborn and newborn child. II. Risk factors predicting perinatal morbidity and mortality in 4,138 infants.

In this study, antenatal risk factors (RF) predicting perinatal morbidity and mortality (PMM) were identified among 56 RFs defined by the Danish National Board of Health. The association with parity, age, social class, civil status, complicated delivery was also analysed. The RFs predicting complicated delivery have been described in Part I (1). All events, both prenatal and during the perinatal period, in 4,138 infants borne by 4,102 women in an entire Danish district were analysed. The frequency of perinatal mortality was 0.8% and of perinatal morbidity, 12.7%. The original 56 RFs affected 56% of the population. Fourteen 'new' RFs among the original 56 RFs predicted PMM and affected 27% of the population. The prepregnancy RFs affected 4.5% of all women with singleton pregnancies and their infants had a PMM rate of 21%; the pregnancy RFs affected 18.1%, the PMM rate being 25%; 3.4% had both prepregnancy and pregnancy RFs, their PMM rate was 41%. Twin pregnancies occurred in 0.9%, with a PMM rate of 47%. Apart from these groups, the PMM rate was only 8%. Parity, social class and civil status were of no significance for PMM. Some delivery complications, termed labor RFs, raised the odds of PMM by a factor of 1.92.

Adolescent↗
PubMed2001

Relaxin (Connetics/Celltech).

Relaxin, a two-chain peptide from the insulin family that regulates the turnover of connective tissue, is being developed by Connetics and Celltech for the potential treatment of infertility and labor complications. It was also under development by the companies for scleroderma, but development has been discontinued for this indication due to disappointing results in its phase III trial [385058,385485]. In addition, Connetics is conducting preclinical studies to evaluate the potential use of relaxin for the treatment of organ fibrosis and infertility [311269]. Relaxin may also have potential for development in the treatment of other connective tissue diseases. In October 2000, preclinical results assessing the ability of relaxin to selectively induce angiogenesis were published [387968]. The results showed relaxin induced significantly more blood vessel growth at ischemic sites compared to animals treated with vehicle alone and, when administered systemically, it did not cause an increase in VEGF in non-wound cells. The data suggest that relaxin may be useful in the treatment of ischemic conditions [387968]. Connetics presented data at the Wound Healing Society 2000 meeting in Toronto, which suggested that relaxin could be an effective treatment for non-healing ulcers as it improves blood flow to oxygen-deprived tissue. The presented research demonstrated that relaxin stimulated wound healing when administered to animals with impaired blood flow, or a genetic defect rendering them diabetic [370335].

Journal Article↗
PubMedDate not supplied

[Epilepsy and pregnancy].

A total of 132 women with epilepsy were confined in the period from 1978-1989. Their pregnancies and outcomes were analysed. The special aim was to find out if the anticonvulsive therapy has any correlation with the occurrence of fetal malformations in the studied group of women. In 43.9% of pregnant women with epilepsy, methyl-phenobarbitone as an anticonvulsive drug was administered, while carbamazepine was applied in 13.6% cases. A combination of phenytoin and phenobarbitone was prescribed in 18.9% of cases. Primidone was the drug of choice in 8% cases and 5.3% of patients were treated with various combinations of anticonvulsive drugs. Hyperemesis, threatened spontaneous abortion and premature labor complicated significantly more pregnancies in patients with epilepsy than on controls. Pregnancies from the studied group were terminated by the cesarean section in significantly more cases (11.2%) than in the control group (5.4%). Newborns from mothers with epilepsy had a statistically lower birthweight (3173 +/- 575 g) than those born from healthy mothers (3376 +/- 510g). Fifteen newborns or 11.2% were born with congenital malformations, while among the control group of newborns only two were malformed. It is noticed that the newborns from mothers treated with phenitoin and phenobarbitone had dysmorphic anomalies of the face more frequently. The drugs mentioned above interfere with the metabolism of K vitamin and as a result of this interreaction, mothers and newborns can suffer from coagulation disorders. In conclusion it is important to mention that no anticonvulsant drug seems to be absolutely safe when used during pregnancy since each of them has a teratogenic effect on the fetus.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

[A clinico-statistical analysis of the risk factors for the occurrence of maxillodental anomalies in children].

The informative value of maxillodental abnormality risk factors was assessed in 421 children with deciduous occlusion in bits (information units). Sixteen real risk factors were distinguished, whose informative value depended on the type of abnormality. The factors that rank first are as follows: finger sucking, untimely loss of two or more molars and premolars, oral respiration, dummy sucking for more than one year, labor complications. The author claims that study of the informative value of risk factors is conducive to a differentiated approach to elimination of these factors with due consideration for the type of the abnormality.

Child, Preschool↗
PubMed1986

Amnionic fluid volume in prolonged pregnancy.

The evidence implicating reduced amnionic fluid volume as a major problem in prolonged pregnancy seems clear. Oligohydramnios serves to explain the association of umbilical cord compression fetal heart rate patterns in labors complicated by fetal distress and such cord entrapment may even explain the release of meconium into the amnionic fluid. Ultrasonic assessment of amnionic fluid volume, regardless of the definition of oligohydramnios used, appears to single out the prolonged pregnancy where the fetus is at risk. Important questions remain as to how best to quantify fluid volume using sonography and, importantly, whether normal amnionic fluid volume reliably predicts fetal well being for a predictable period of time. That is, oligohydramnios diagnosed using ultrasound seems meaningful, but whether a normal fluid volume permits safe expectant management needs further evaluation. This is particularly relevant if the liquor volume may subside within 24 to 48 hours as reported by Beischer et al. Unfortunately, the mechanisms by which amnionic fluid volume decreases in prolonged pregnancies remain unknown. As in Ballantyne's time, we still do not know ". . . what functions the fetus is performing during these accessory weeks . . . nor how he is performing them . . . ." But we have learned that oligohydramnios has a central role in producing some of the fetal complications associated with prolonged pregnancy.

Amniotic Fluid↗