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At least 379 records · Page 21Linked to original sources
PubMed1975

Engagement of the fetal head in primigravidae and its relationship to duration of gestation and time of onset of labour.

In a retrospective survey on the time of engagement of the fetal head in 462 unselected consecutive primigravidae it was seen that by the end of the 37th week of gestation (259 days), engagement had occurred in only 23 per cent of them. The highest rate of engagement was from 39 to 40 weeks of gestation (273 to 280 days) and in 50 per cent of patients, engagement occurred between 38 and 42 weeks (266 to 294 days). The mean interval between engagement and delivery was 1.39 weeks (9.7 days), the median was 7 days, and the mode was less than 7 days. In 80 per cent of patients the engagement-delivery interval was less than 14 days. These findings strongly suggest that in the majority of primigravid patients the fetal head does not engage between 36 and 38 weeks of gestation (252 to 266 days) as is commonly believed.

Female↗
PubMed1975

Characteristics of normal labour in different racial groups.

The characteristics of normal labour in 1306 white, Asian and black parturients have been established following a prospective study of 3217 consecutive labours. Asian patients were found to be of significantly shorter stature than white or black women (p less than 0-001) and their infants significantly lighter than those of white (p less than 0-001) and of black (p less than 0-05) women, and a low positive correlation was found between maternal height and infant birth weight. The mean duration of the first stage of labour, taken from the time of admission to the labour ward, was 5-6 hours in primiparae and 3-7 hours in multiparae. The mean durations of the second stage of labour were 41-5 and 17-4 minutes respectively. The correlations between the duration of the first and second stages of labour were too low to be of value in patient management. Similar low correlations were found between the duration of the second stage of labour and both infant birth weight and the Apgar score at one minute. Cervical dilatation-time curves, constructed with reference to the cervical dilatation found on admission to the labour ward, revealed no significant differences in the progress of normal labour in the different racial groups.

Apgar Score↗
PubMed1981

Subcutaneous oxygen tension in the fetal scalp during labour continuous monitoring with a needle electrode.

Continuous intrapartum PO2 recordings were made in 25 fetuses, using a needle electrode that measures PO2 in the subcutaneous (sc) tissue of the scalp or the breech. This small electrode is combined with a spiral ECG electrode and can be easily applied in early labour. One hour after application of the electrode in the early first stage, a mean fetal scPO2 of 29.4 +/- 7.5 mm Hg was found. In the course of labour, scPO2 gradually fell to a mean value of 22.2 +/- 5.6 mm Hg, recorded just before the onset of bearing down contractions, and stabilised in the second stage of labour. ScPO2 values of less than 20 mm Hg were not recorded for a longer period except in one case of severe fetal distress. The relation between scPO2 just before delivery and cord arterial PO2 revealed a coefficient of correlation of 0.85. In general, scPO2 appeared higher than tcPO2 as described in the literature. This is ascribed to the different technique of measurement: the needle electrode measures in the deeper layers of the scalp, whereas the tc electrode is supplied with oxygen form the more superficial capillaries, where blood flow is more liable to be affected by mechanical factors.

Electrodes↗
PubMed1984

A continuing use for Kielland's forceps?

A retrospective study over a 5-year period compared neonatal outcomes after birth by Kielland's forceps with those after caesarean section in the second stage of labour. The 253 babies born by these two modes of delivery showed no difference in Apgar score, the need for active resuscitation, incidence of jaundice or abnormal neurological behaviour. The neonatal outcome was no worse in the small number of patients where Kielland's forceps delivery was attempted but failed. This study offers support for the continuing role of Kielland's forceps in modern obstetrical practice.

Adult↗
PubMed1985

Failed induction of labour.

Over a 15-month period 1,057 consecutive inductions of labour were performed representing a 10% induction rate; 174 (16.5%) of these patients were delivered by Caesarean section of which 74 (7.0%) were for failed induction of labour, 58 (5.5%) for fetal distress, 19 (1.8%) for cephalopelvic disproportion, 6 for malposition and 17 for other reasons. The mean cervical score at induction of labour was 5.7 and 5.5 for cephalopelvic disproportion (CPD) and malposition respectively but was 4.0 for failed induction. The mean cervical dilatation at the time of Caesarean section was 5.7 cm and 6.6 cm for CPD and malposition respectively whereas it was 3.5 cm for failed induction. Mean maximum dose of oxytocin was 19.2 milliunits per minute (mu/min) and 22.5 mu/min for CPD and malposition respectively whereas it was 24.7 mu/min for cases of failed induction. Nulliparas with a cervical score of 3 or less had a 65.4% Caesarean section rate of which more than two-thirds were for failed induction of labour. Analysis of indications for induction of labour revealed that a fair number of inductions had debatable obstetric indications. Tailoring induction of labour to the cervical score and indication might reduce the Caesarean section rate for failed induction of labour. Rational management to ensure an adequate dose of oxytocin and sufficient time in the first stage of labour is important. Failed induction of labour may be differentiated from failure of labour progress due to CPD or malposition.

Adult↗
PubMed1977

A critical review of current methods for induction of parturition in the mare.

The efficacy and safety of oxytocin, dexamethasone and prostaglandin, used alone or in combination as inducing agents, are discussed. It is contended that insufficient evidence exists to support the routine application of any of these methods in practice. Oxytocin has been the most widely used and it is claimed by some to be free from side effects. However, the synthetic prostaglandin analogue, fluprostenol, seems to pose the least risk to the foetus and dexamethasone appears to be either ineffective, or too dangerous to use at all. The main indications for induced foaling are managerial convenience or for research and teaching purposes. There are few clinical indications, although ventral rupture and cases of prolonged gestation have been mentioned by various workers. It is considered that foetal maturity is the pre-requisite before a decision to induce should be made in practice, and 3 criteria are essential: 1) a gestational length of greater than 320 days, 2) substantial mammary development, 3) the presence of colostrum in the mammae.

Animals↗
PubMed1975

Practitioners'--breeders' approach to canine parturition.

Both veterinary surgeon and dog breeder should be involved in assessing the whelping capability of brood bitches as one essential point in the selection of sound stock. Normal parturition is described in a manner that might be used in the instruction of breeders and nursing auxiliaries in midwifery. In its classical three stages, the mechanics and hydraulics are explained in simple terms and the hormonal changes discussed in relation to each stage. The type of co-operation desired between veterinary surgeon and breeder is discussed and the instruction to be given on the recognition of dystocia is outlined. Some commonly met dystocias are described. Simple digitally-assisted delivery by the midwife/breeder is described as are the forceps techniques which may be applied by the veterinary surgeon in the course of diagnosis and delivery.

Animals↗