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At least 397 records · Page 22Linked to original sources
PubMed1976

Lack of correlation between clinical data and growth hormone concentrations in cord blood.

Growth hormone concentrations were measured in 182 umbilical cord blood samples taken at the time of birth. The mean value in 165 full-term, normal weight infants was 31.5 +/- 25.9 ng/ml SD. 14 prematures had significantly higher levels (50.0 +/- 38.4 p less than 0.01). There were no statistically significant correlations to any of the following parameters: complication of pregnancy by toxaemia, duration of labour, presence of umbilical cord contortion, perinatal distress, Apgar index, mode of delivery, body weight, body length, ratio of weight to length, and blood glucose. There was a wide scatter of individual values in this study as well as in previous investigations. We think it unlikely that those variations are purely accidental. Hence, yet undefined factors must play a major role in the regulation of GH secretion in the perinatal period.

Apgar Score↗
PubMedDate not supplied

A new understanding of the second stage of labor: implications for nursing care.

A reconceptualization of the second stage of labor is proposed, with an early phase of descent and a later phase of active pushing, as the basis for nursing care related to direction or support of expectant mother's bearing-down efforts. This reconceptualization challenges the rules that have accompanied second stage by providing criteria for the obstetric conditions optimal for fetal descent that develop during the initial phase of second stage as the fetal head rotates to an anterior position and descends to at least a 1+ station. The phase of active pushing is accompanied by a decline in fetal pH and should be shortened, not only by assisting the woman with effective bearing-down but also by allowing a longer early phase of second stage and encouraging the woman to push only when the obstetric conditions are optimal.

Delivery, Obstetric↗
PubMed2001

Induction of labour and scheduled cesarean deliveries in twin pregnancies at the Port-Royal Maternity Hospital in Paris France.

The study is a critical analysis of the decisions to induce labour or schedule cesareans in the practice of a third level referral centre, with as outcome criterion the reduction of fetal death. 783 women pregnant with twins were included from 1.1.1993 to 31.12.1998, in three groups: originally booked, referred for care during pregnancy, or transferred from another institution. The results show that an important proportion of preterm deliveries result from a medical decision to induce labour or from a scheduled cesarean in the originally booked group with even higher proportions in groups of referred and transferred women. These results are discussed in relation to fetal death rates and causes. Deaths related to fetal growth restriction were not observed in women originally booked for care. The hospital bias has been discussed. The conclusion is that decisions to minimize fetal deaths in twin pregnancies increased preterm deliveries by medical decision.

Cesarean Section↗
PubMed2004

Gestational diabetes mellitus--implications of different treatment protocols.

OBJECTIVE: To assess the impact of different management approaches to gestational diabetes mellitus (GDM) on perinatal outcome. PATIENTS AND METHODS: The study group consisted of 2,060 patients with GDM treated in our center from January 1980 through December 1999. Four time periods were defined on the basis of changes in treatment protocols. Perinatal complications were compared between the periods and with normal pregnancy controls. RESULTS: The last two periods (1993-1999) were characterized by lower mean glucose level, lower mean gestational age at delivery, and a decline in macrosomia, shoulder dystocia and perinatal mortality rates, but also by high rates of labor induction and Cesarean delivery. A significant difference was found between the GDM and normal control groups in rates of labor induction (38.6% vs 10.8%, p < 0.001) and Cesarean delivery (34% vs 20%, p < 0.001) for the last period. CONCLUSIONS: Perinatal complications are preventable with good glycemic control and early induction of labor, but at a cost of a higher Cesarean section rate.

Blood Glucose↗
PubMed2002

Incidence of cranial asymmetry in healthy newborns.

OBJECTIVE: During recent years, coincident with the recommendation to position infants supine, the incidence of posterior deformational plagiocephaly has increased dramatically. The purpose of our study was to determine whether early signs of cranial flattening could be detected in healthy neonates and to document incidence and potential risk factors. DESIGN: A cross-sectional study was performed in healthy newborns. Physical findings, anthropometric cranial measurements, and data on pregnancy and birth were recorded. RESULTS: The incidence of localized cranial flattening in singletons was 13%; other anomalous head shapes were found in 11% of single-born neonates. In twins, localized flat areas were much more frequent with an incidence of 56%. The following risk factors for cranial deformation were identified: assisted vaginal delivery, prolonged labor, unusual birth position, primiparity, and male gender. CONCLUSION: We propose that localized lateral or occipital cranial flattening at birth is a precursor to posterior deformational plagiocephaly. The infant lies supine, with the head turned to the flattened area, and is unable to roll. Intrauterine risk factors for localized cranial flattening are the same as for deformational plagiocephaly. To avoid postnatal progression from a localized cranial flattening to posterior-lateral deformational plagiocephaly, we suggest amending the recommendation of the American Academy of Pediatrics on sleep position: Alternate the head position and allow sleeping on the side and, when awake, supervise prone time.

Abnormalities, Multiple↗
PubMed1976

Human maternal and fetal serum insulin and growth hormone (HGH) response to glucose and leucine.

Maternal and fetal serum insulin and HGH responses to glucose, leucine, and glucose plus leucine were examined by infusions to pregnant women at term immediately before cesarean section. Leucine (15 gm.) with glucose (50 gm.) administered for 30 minutes to the mothers stimulates markedly maternal and fetal insulin secretion while infusion of glucose (50 gm.) causes a lower insulin response. When infusing glucose alone we noted that the duration rather than the degree of hyperglycemia determined the fetal insulin response. In fact, when glucose is given to the mother for 60 minutes the fetal insulin response is higher than when the same dose is infused for 30 minutes. Maternal infusion of leucine (15 gm.) for 30 minutes elicits only a very slight increase of insulin secretion in the mother and no change in the fetus. None of the infusions causes any alteration whatsoever in either maternal or fetal HGH secretion.

Blood Glucose↗
PubMed1998

Prevention strategy for vibration hazards by portable power tools, national forest model of comprehensive prevention system in Japan.

In the 1950s, the introduction of portable power tools into the production process of many industries began on a large scale around the world and resulted in many cases of occupational vibration syndrome after the 1960s. There was an urgent world wide need to undertake preventive steps, medical assessment and therapy. At the end of 1964, our investigation began in Japanese national forests, and then in mines and stone quarries. The Japanese Association of Industrial Hygiene established a "Committee for Local Vibration Hazards" (1965), and many researchers in the medical and technological fields joined this Committee. After 10 years, a comprehensive system for the prevention of vibration syndrome was established in the national forestry. It consists of 1) improvements in vibrating tools, 2) hygienic regulation of operation time with an alternative working system, 3) health care system involving early medical checks, early therapy and age limitations in operation of vibrating tools, 4) protection against cold in the workplace and while commuting, and 5) education and training for health and safety. The prevention strategy for vibration syndrome in our national forests is to establish a comprehensive prevention system in cooperation among researchers in the medical and technological fields, workers and administration. The Ministry of Labor presented that strategy as good model of prevention for other industries (1976). New designs for this model were developed and adapted according to the special conditions of each industry. Thus comprehensive system for prevention of vibration syndrome developed successfully from the late 1970s to 1980s in Japan.

Forestry↗
PubMed1979

Segmental epidural analgesia in labour: related to the progress of labour, fetal malposition and instrumental delivery.

The effect of low-dose continuous segmental epidural analgesia given during the first stage of labour on the progress of labour, the frequency of fetal malpositions and the rate of vacuum extractions was studied prospectively in 100 parturients (epidural group). The results were compared with 100 parturients given none or conventional analgesia (control group). The results showed that in the primiparous epidural group the progress of labour before analgesia was induced was significantly slower than in the control group. After the block, however, the subsequent course of the labour was of equal duration in both groups. The durations of the second stages of labour did not differ significantly between the groups. The differences in fetal malpositions at delivery were statistically insignificant. Nor did the rate of vacuum extractions, 8% in the primiparous and 0% in the multiparous epidural group, differ statistically from the corresponding rate in the control groups. The results signify a normal progress and outcome of labour after low-dose segmental epidural analgesia.

Adolescent↗