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PubMed1984

Obstetric factors in the causation of early periventricular--intraventricular hemorrhage.

On routine fontanelle scanning of neonates weighing less than or equal to 2000 g within the first 24 hours of life, 21% had abnormal findings related to peri/intraventricular hemorrhage. These findings occurred almost exclusively in patients who were in labor, with one exception, and were not observed without labor. Once labor ensued, the performance of cesarean section did not prevent periventricular and intraventricular hemorrhage. Other obstetric factors including fetal heart rate monitoring and umbilical artery pH values were not related to early periventricular and intraventricular hemorrhage. The practical significance of these findings is discussed.

Anesthesia, Obstetrical↗
PubMed1984

Characteristics and significance of the latent phase in the outcome of labor among Nigerian parturients.

The characteristics and significance of the latent phase in labor among 716 West African parturients were studied. A wide variation in duration (1 to 70 hours) of this phase was noted. A consistent correlation was found between the duration of the latent phase and subsequent events, such as the duration of the active phase, duration of ruptured membranes, and the total modes of delivery. This correlation holds true to all parities even when latent phase duration is within normal limits. No difference was noted in the incidence of abnormal latent phase between the primigravida and the multigravida. Although these findings have potentially useful but limited application, the significant correlation with Apgar score at 1 minute and the association of larger breeches with prolonged latent phase are sufficient predictive indices of great value to the obstetrician in the prompt management of such labors.

Adolescent↗
PubMed1983

The effect of parturition on umbilical blood plasma levels of norepinephrine.

The norepinephrine concentration in 77 umbilical, arterial, and venous plasma samples, and in 31 simultaneous maternal plasma samples, was measured. The mean (+/- SEM) of 8.7 +/- 1.9 ng/ml in the umbilical artery was higher (P less than .001) than that of 3.6 +/- 0.9 ng/ml in the umbilical vein. In paired fetal-maternal venous samples the norepinephrine concentration of 3.8 +/- 1.7 ng/ml in the fetus was higher (P less than .05) than that of 0.3 +/- 0.1 ng/ml in the mother. Among the different types of vaginal deliveries the umbilical arterial norepinephrine concentrations were: 5.8 +/- 2.1 ng/ml in uncomplicated vaginal deliveries; 16.4 +/- 2.1 ng/ml in breech deliveries (P less than .05 as compared with uncomplicated vaginal deliveries); 8.8 +/- 2.5 ng/ml in vacuum extraction deliveries; and 0.8 +/- 0.3 ng/ml and 11.3 +/- 7.7 ng/ml in twin A and twin B deliveries, respectively. All these values were higher (P less than .001) than those after elective cesarean section, except that for twin A, which was lower (P less than .01) than that for twin B, indicating that labor and vaginal delivery induced activation of the fetal sympathoadrenal system.

Adult↗
PubMed1978

[Delivery and post partum period associated with surgical closure of the cervix (author's transl)].

The course of delivery and the post partum period of 211 gravidae with closure of the cervix during pregnancy were compared with a compatible collective of another 221 gravidae without surgical closure. There were significant differences in some respects: The duration of labor (primiparae: 9,2 hours, multiparae: 6,7 hours) was longer than in the control-group (primiparae: 8,1 hours, multiparae: 5,0 hours); the necessity of administration of drugs and the frequency of dystocia (primiparae: 13%, multiparae: 9,2%) was higher than in the control-group (primiparae: 1,0%, multiparae: 0%). These and the higher incidence of lacerations of the cervix (13,4% respectively 1,7%) will be due to the scar, caused by the suture in the cervix. The rate of caesarean section was significantly higher (9,5% respectively 4,1%). There were more complications in disconnecting of the placenta. These and the higher rate of dystrophic newborn could be correlated with anamnestic dispositions of the gravidae. The higher rate of perinatal mortality (9,9%) than in the controlgroup (3,6%) is associated with the higher rate of prematurity (22,1%) than in the control-group (8,5%). A higher incidence of malformation was not observed, but a higher rate of neurological complications in the newborn. The post partum period of the mother was not significantly different than those of the control-group

Apgar Score↗
PubMed1983

[Prognosis for delivery in women with previous cesarean section. Apropos of 209 cases].

The authors have attempted to show the following with the help of 209 cases of delivery in women who had previously had Caesarean sections: Vaginal delivery is possible in approximately one out of every two cases, providing certain precautions have been taken and these are: Maternal morbidity rises to about 12% when a woman is delivered after a previous Caesarean section, whether the delivery is vaginal or, a repeat Caesarean. Furthermore, morbidity rises greatly after a failure of a trial of labour for which the indications should be very carefully considered. The outlook for the fetus is better after a vaginal delivery. In fact, this result seems to be allied to pathology which results from the surgical procedure itself. All the same, respiratory distress in the newborn is more frequent after Caesarean operation, which exposes the fetus to the risks of a uterine rupture and also of increased incidence of instrumental delivery following a previous Caesarean.

Apgar Score↗