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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↗
PubMedDate not supplied

[Cervical ripeness. I. The clinical criteria of assessment of ripeness and their variability at term].

Four clinical criteria of "cervical ripeness"--consistency, length, dilatation and station of the fetal head--were checked in cases of term and post-term pregnancy before labour had started, and analyzed for their variability. The frequencies in the consistency categories and also the distribution of cervical effacement indicate that in only 1 to 2,5% of all pregnant women ripening of the cervix had not yet begun at term. There were no differences in nulliparous and parous women. But about 2/3 of the nulliparous and 3/4 of the parous women had a soft cervix which was effaced 80% or more. At term the most common cervical dilatation was 1 to 2 cm in nulliparous women and 1/2 cm more in parous ones. But in only 2 to 8% there was found a dilatation of 3 cm ore more. Engagement of the fetal head was not very advanced at term, with the presenting part reaching or passing station -4 in 27% of the nulliparous and in 21% of the parous women. Only in 1% there was found a presenting part reaching station 0 at term before labour had begun. We do need further studies with serial and standardized examination to get better knowledge of the process and variability of cervical ripening in relation to duration of pregnancy, lag-time to spontaneous onset of labour, prelabour uterine activity and perhaps other conditions.

Cervix Uteri↗
PubMed1982

[Endogenous prostaglandins and steroid hormones in premature labor induction in diabetic patients].

Prostaglandins E and F2 alpha as well as two steroid hormones, progesterone and unconjugated oestriol, were measured in amniotic fluid of 30 diabetics. The prostaglandin levels of all patients went up with significance after the os uteri had clearly opened. No rise in prostaglandin levels was recordable from induction of labour without opening of the os uteri. High primary prostaglandin levels, prior to induction of labour, and low progesterone/oestriol quotients were observed along with short-time courses of parturition. On the other hand, low prostaglandin values prior to induction of labour and slow rise during induction were recordable from protracted courses of labour.

Amniotic Fluid↗
PubMed1982

Intracervical application of prostaglandin gel for induction of term labor.

A new gel for local application of prostaglandins has been elaborated. The new gel, based on a lyophilized prostaglandin E2 (PGE2) starch powder, seems to have solved most of the pharmaceutical and clinical problems associated with local administration of prostaglandins. In a randomized double-blind study, 50 nulliparous patients with an unfavorable cervical state at term were given 2 ml gel containing 0.5 mg PGE2 (PGE2 gel) or gel without PGE2 (placebo gel). The gel was deposited into the cervical canal. Among patients given PGE2 gel, 11 of 25 had induced labor, delivering without further stimulation within 24 hours. In patients given placebo gel, 2 of 25 were delivered with 24 hours. This difference is statistically significant (P less than .01). Patients undelivered after treatment with PGE2 gel achieved a considerable and statistically significant improvement of cervical score, whereas in patients in whom labor was not induced successfully by placebo gel treatment no significant changes in cervical score were registered. In a subsequent open study another 70 term patients of varied parity were given 0.5 mg PGE2 gel. Thirty-eight patients (54%) had successfully induced labor. Among the remaining undelivered patients, considerable ripening of the cervix occurred. Thus, the cervical score changed from a mean of 3.2 prior to treatment to a mean of 6.5 by 24 hours after treatment. Gastrointestinal discomforts were not observed. Signs of uterine hyperstimulation were registered in 1 patient.

Adolescent↗
PubMed1981

The labor curve.

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Cervix Uteri↗
PubMed1981

Peripheral white blood cell alterations in early labor.

The peripheral blood counts of 101 pregnant women in very early labor and 41 nonpregnant controls were compared through automated total and differential blood count techniques. There were profound quantitative changes in the peripheral bloods of the pregnant women. These included, in association with pregnancy, increases in the absolute number (per ml) of total white cell counts (p less than 0.0005), segmented neutrophils (p less than 0.0005), band neutrophils (p less than 0.0005), and monocytes (p less than 0.0005). In contrast, there was a significant decrease in the absolute number (per ml) of peripheral lymphocytes in pregnancy (p less than 0.05) and a significantly larger proportion of bloods from pregnant women had less than 10(6) lymphocytes per ml (p less than 0.0005). The percentage of segmented neutrophils increased significantly during pregnancy (p less than 0.0005) as did band neutrophils (p less than 0.0005). We also noted a significant decrease in the percentages of peripheral lymphocytes (p less than 0.0005). In contrast, there were no significant differences in the percentages of monocytes between pregnant women and nonpregnant controls. The increase in the absolute number of monocytes and the decrease in the absolute number of lymphocytes led to a significant decrease in lymphocyte-monocyte ratio (p less than 0.0005) during pregnancy. It is concluded that the maternal peripheral blood changes in late pregnancy may reflect immune changes required for the immune adaption between fetus and mother-host.

Female↗
PubMed1978

Reversal of active labour. A case report.

The clinical course of primiparous patient who presented in premature labour at 31 weeks' gestation is described. Cervical dilatation was reversed from 9 cm and pregnancy continued for 6 days. The possible causes and mechanism are discussed and the implications are considered.

Adult↗