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PubMed1999

[The incidence of irregular antibodies in pregnancy: a prospective study in the region of the 's-Hertogenbosch].

OBJECTIVE: To determine the incidence and clinical relevance of irregular erythrocyte antibodies (IEA), in multiparous women and in primigravidal with a history of blood transfusion. DESIGN: Prospective longitudinal cohort study. METHODS: In the 's-Hertogenbosch area, the Netherlands, both primigravidae with a previous blood transfusion and multiparous women were tested for IEA in addition to the regular blood tests during the first trimester of pregnancy. If IEA were discovered, the partners were tested for the presence of the antigen involved. Blood samples of children of positive fathers were tested immediately post partum for signs of haemolytic disease of the newborn (HDN). RESULTS: During a 2.5-year period (August 1995-January 1998) a total of 2392 pregnant women were screened for IEA: 2204 multiparous women and 188 primigravidae women. In 65 women 81 IEA were discovered. In the group of 30 children positive for the antigen involved, 12 (40%) had clinical symptoms of HDN; intrauterine death was diagnosed once, one child died immediately after delivery. One child had signs of hydrops fetalis and two children needed an exchange transfusion. Phototherapy and/or regular blood transfusion were given to 7 children. Most cases of HDN were caused by anti-D, anti-Kell and anti-c antibodies. CONCLUSION: Non-RhD-IEA were found in 1.6% of pregnant women screened. First-trimester screening for IEA is recommended as it can be of help in early diagnosis and treatment of HDN.

Adult↗
PubMed2000

Smoking during pregnancy increases the risk of preterm births among parous women.

BACKGROUND: We wanted to study a possible association between smoking during pregnancy and preterm birth. METHODS: A population based prospective study was performed among 7,236 consecutive pregnancies over seven years delivered at one birth clinic. Smoking habits were obtained at a routine ultrasound examination around 18 gestational weeks, and preterm birth was defined as delivery of a child between 24 and 37 gestational weeks. We estimated relative risk (odds ratio) between smoking, possible confounding variables and preterm birth using multiple logistic regression analysis. RESULTS: Overall, 1,769 (25%) women said that they smoked every day during their pregnancy. The smoking women had an increased risk of preterm delivery compared with non-smokers (odds ratio 1.53, 95% confidence interval 1.24, 1.89). However, this association was only demonstrated among the multiparous women (odds ratio 1.88, 95% confidence interval 1.39, 2.54). The association was statistically significant after adjusting for maternal age, diabetes, cervical conization, preeclampsia, placental abruption and placenta previa in a multivariate analysis, and we observed a dose-response effect of maternal smoking on preterm birth among multiparous women. CONCLUSION: For multiparous women smoking during pregnancy increases the risk of preterm delivery, and there seems to be a dose-response effect of smoking.

Adolescent↗
PubMed2001

[Neonatal outcome after a planned vaginal breech birth: no association with parity or birth weight, but more birth injuries than in planned cesarean section].

OBJECTIVE: To investigate if in a planned vaginal breech delivery parity or birthweight is associated with neonatal outcome. DESIGN: Retrospective analysis of local data from the National Obstetric Registration of the Netherlands. METHOD: The study concerned outcomes of 516 births of singletons with breech presentation after pregnancies > 37 weeks in the period 1 January 1995 to 31 December 1999 at the Medical Centre Leeuwarden, the Netherlands; there were 448 planned vaginal breech deliveries. Nulliparous and multiparous were separately studied in four birthweight groups (< 3000 g, 3000-3499 g, 3500-3999 g and > or = 4000 g). RESULTS: None of the neonates born by primary caesarean experienced birth trauma. In the group with planned vaginal breech delivery 2% of the neonates of nulliparous and 3% of multiparous mothers experienced neonatal morbidity. There was one case of perinatal mortality due to birth trauma (0.2%). The total perinatal morbidity was 6% with no differences between nulliparae and multiparae and between the birthweight groups. In nulliparous, the percentage of emergency caesarean sections rose from 20% in the < 3000 g birthweight group to 62% in the > or = 4000 g birthweight group. CONCLUSION: Following a planned vaginal breech delivery, no differences were observed in neonatal outcome between nulliparous and multiparous women and between the four birthweight groups. The extent to which the figures were influenced by the selection for primary caesarean section is not clear.

Birth Injuries↗
PubMedDate not supplied

[Screening for carential anemia in pregnant women: prospective study. Report of 200 cases].

To report the frequency and intensity of anemia in a population of pregnant tunisian women. Our retrospective study concern 200 patients collected from january to july 1999 in a population of pregnancies. Mean age was 30.1 years and 68.5% of patients consult in the third trimester with a 33.5% rate of multiparity. The frequency of anemia is 37.5%. Anemia was ferriprive in 97.3% and hypochromic in 24% of cases. Mean ferritinemia is 4.19 ng/ml after 24 weeks of amenorrhea with a marqued decrease in case of multiparity and pregnancy evolution. Mean transferrinemia is significantly low in anemic (3.98 g/dl) versus non anemic (3.60 g/dl) patients (< 0.05). The comparison of anemia with parity, the delay between two pregnancies and term of pregnancy showed a higher risk with multiparity, short delay between two pregnancies and advanced term. The frequency of anemia in tunisian pregnant women is relatively high, prevention is based on iron supplementation and hygienodietetic advices.

Adult↗
PubMed2002

[Indication for labor induction by prostaglandin E2 vaginal gel. Retrospective study of a continuous series of 170 patients].

OBJECTIVE: To assess the factors of efficacy, side effects and complications following vaginal application of prostaglandin E2 (PGE2). METHODS: Retrospective study of 170 women in whom a PGE2 vaginal gel was administered between June 1, 1999 and June 1, 2000. The efficacy (labor effectively induced), quality of myometrial response, side effects and complications were studied globally and in each clinical context: intra-uterine delayed growth (IUDG), pre-eclampsia without IUDG, diabetes, pregnancy prolonged without IUDG, anomaly in fetal heart rate (FHR) and/or in amniotic liquid without IUDG discovered during the systematic monitoring at the end of pregnancy, premature rupture of the membrane without IUDG. RESULTS: The overall success (defined as the onset of labor) was of 94.1%. This rate was of 90.7% in primiparous and of 100% in multiparous women. Twenty-three patients (13.5%) experienced side effects (hyperkinesia or hyperthermia) and 35 patients (20.6%) complications (hyperkinesia or hypertonia with fetal repercussion). The maternal-response to infection was significantly improved (p < 0.05) in cases of prolonged rupture of the membranes or anomaly discovered during monitoring, but only in patients with diabetes. In cases of IUDG of vascular etiology with multiparity, the total quantity of PGE2 necessary was only of 1.14 mg and 85% of patients subsequently delivered without ocytocine. CONCLUSION: IUDG and prolonged pregnancy are the principle indications for PGE2 vaginal gels. The quality of response depends on the clinical context. In cases of premature rupture of the membranes or of anomaly discovered during monitoring (FHR and amniotic liquid), response was only improved in diabetic patients. In cases of vascular IUDG and multiparity, the response was excellent and the majority of women subsequently delivered without ocytocine, thus confirming the quality of myometrial response. Hence, the quantity of PGE2 required varied, depending on the subjecent pathology. This strategy could limit the risk of excessive myometrial response (hyperkinesia or hypertonia) and thus improve fetal tolerance.

Administration, Intravaginal↗
PubMed2003

Vaginal hysterectomy in nulliparous women without prolapse: a prospective comparative study.

OBJECTIVE: To compare vaginal hysterectomy success and complication rates in nulliparous and primiparous or multiparous women. DESIGN: A comparative prospective study. SETTING: Department of Gynaecology, La Conception Hospital, Marseille, France. POPULATION: Three hundred and forty-five consecutive patients without genital prolapse requiring hysterectomy for benign conditions and without previous pelvic surgery or caesareans were treated prospectively by vaginal hysterectomy. Fifty-two patients were nulliparous and 293 were primiparous or multiparous. METHODS: Data of patients were collected prospectively. MAIN OUTCOME MEASURES: Operative time, length of hospital stay, oophorectomy, conversion to laparotomy, intra- and post-operative complications. RESULTS: The mean operative time was significantly longer in nulliparous patients [95 (55.2) vs 79.9 (34.9) minutes, P < 0.01]. The overall complication rate was significantly higher [7/52 (13.46%) vs 13/293 (4.44%), P = 0.02, RR = 3.03 (1.27-7.23)] as was the haemorrhage rate in nulliparous compared with the primiparous and multiparous women [4/52 (7.69%) vs 5/293 (1.7%), P = 0.03, RR = 4.51 (1.25-16.23)]. Vaginal hysterectomy was successfully performed in 96.2% (50/52) of the nulliparous and 99.7% (292/293) of the parous patients [P = 0.06, RR = 1.04 (0.98-1.09)]. CONCLUSION: The success rate of vaginal hysterectomy in nulliparous women is high. However, the risk of complications seems higher than in the parous women. Laparoscopy assisted vaginal hysterectomy in nulliparous women needs further investigations.

Body Mass Index↗
PubMed1992

Effect of recombinant bovine somatotropin (somidobove) in a sustained release vehicle on plasma somatotropin level and lactational performance of dairy cows.

The effects of administration of recombinantly derived bovine somatotropin (somidobove) in a sustained-release vehicle on the profiles of concentrations of bovine somatotropin (bST) in the blood plasma and on the milk yield of dairy cows of three herds were examined. Cows (36-87 days post partum) were treated subcutaneously with recombinant bST at 28-day intervals. In control animals, basal concentrations of bST averaged 1.4 ng.ml-1 in first-calf heifers and 1.5 ng.ml-1 in multiparous cows. In somidobove treated first-calf heifers, the concentration of bST was increased to 10.7, 14.5, and 27.0 ng.ml-1 at 24 h postinjection and in multiparous cows to 6.6, 11.0, and 11.7 ng.ml-1 on day 2 postinjection of 320, 640, and 960 mg of somidobove, respectively. On day 8 postinjection the average plasma bST levels of both parity groups are similar (on the average 3.4, 8.6, and 12.5 ng.ml-1 for three doses of somidobove respectively) and for the two highest doses being still significantly increased. During the 2nd week postinjection plasma bST concentration declined returning to control levels on day 15 postinjection. Somidobove-treated first-calf heifers produced 10.9, 16.7 and 17.9% and multiparous animals 25.5, 24.2 and 32.5% more milk than the controls when given 320, 640 and 960 mg somidobove, respectively. The cyclic pattern in milk yield within each 28-day injection interval was observed consistently in all herds. The milk yield increased to a maximum between day 4 to 8 postinjection and then slowly declined. Milk composition was not affected by somidobove treatment.

Animals↗
PubMed2003

Costing the cascade: estimating the cost of increased obstetric intervention in childbirth using population data.

OBJECTIVE: To estimate the cost of "the cascade" of obstetric interventions introduced during labour for low risk women. DESIGN: A cost formula derived from population data. SETTING: New South Wales, Australia. POPULATION: All 171,157 women having a live baby during 1996 and 1997. METHODS: Four groups of interventions that occur during labour were identified. A cost model was constructed using the known age-adjusted rates for low risk women having one of three birth outcomes following these pre-specified interventions. Costs were based on statewide averages for the cost of labour and birth in hospital. MAIN OUTCOME MEASURES: The outcome measure is an "average cost unit per woman" for low risk women, predicted by the level of intervention during labour. Obstetric care is classified as either private obstetric care in a private or public hospital, or routine public hospital care. RESULTS: The relative cost of birth increased by up to 50% for low risk primiparous women and up to 36% for low risk multiparous women as labour interventions accumulated. An epidural was associated with a sharp increase in cost of up to 32% for some primiparous low risk women, and up to 36% for some multiparous low risk women. Private obstetric care increased the overall relative cost by 9% for primiparous low risk women and 4% for multiparous low risk women. CONCLUSIONS: The initiation of a cascade of obstetric interventions during labour for low risk women is costly to the health system. Private obstetric care adds further to the cost of care for low risk women.

Analgesia, Epidural↗
PubMed2005

[Detection of major gene on litter size in sheep].

The current study was designed to detect SNPs within BMP15 and BMPR-IB gene and investigate the effect of the genes on sheep litter size. Four sheep lines, HU-Yang, Chinese Merino monotocous, Chinese Merino multiparous for wool production and Chinese Merino multiparous for mutton production, were used in this study. Litter sizes were recorded for each ewe in the four lines. Primers for BMP15 and BMPR-IB gene were designed from database sheep sequence and polymorphisms were detected by PCR-RFLP method. The results showed that there was no polymorphism with BMP15 gene among the four lines, and there was an A / G SNP with BMPR-IB gene at base 746 among the four lines. Three types of genotype (BB, B+ and ++), based on A / G locus, were found within each line. The frequencies of genotypes were significantly different among the lines (P<0.001), with BB genotype primarily existing in HU-Yang, ++ genotype in Chinese Merino monotocous line, and B+ genotype in Chinnese Merino multiparous lines. The A / G mutation influence significantly the sheep litter sizes, and the BB and B+ ewes had significant higher litter sizes than ++ ewes. The results of present study showed simultaneously that the genotype of BMPR-IB was a perfect predictor of the sheep litter sizes. These results intensively indicated that BMPR-IB is a major gene to affect litter size in sheep, and could be used as the molecular genetic marker to select litter size in sheep.

Animals↗
PubMed2005

Prevalence of lower urinary tract symptoms during pregnancy in Taiwan.

BACKGROUND AND PURPOSE: Women often complain of symptoms related to urination during their pregnancy, but data are limited on the clinical profile and lower urinary tract symptoms (LUTS) of pregnant women in Taiwan. This study assessed the prevalence and predisposing factors of LUTS in Taiwanese women during pregnancy. METHODS: A cross-sectional survey was designed to collect data on the prevalence of LUTS during pregnancy. Women attending the antenatal clinic of a medical center in central Taiwan were recruited and asked to complete a LUTS questionnaire including 12 questions on symptoms related to urination. RESULTS: 799 normal pregnant women were included in this study. The most common LUTS were nocturia (60.2%) and stress urinary incontinence (SUI; 46.1%), followed by urgency (34.1%), frequency (27.8%), incomplete emptying (26.2%), a bearing-down sensation (23.8%), and voiding difficulty (12.6%). The prevalence of nocturia, SUI, urgency, and frequency generally increased as gestational age advanced. There was a significantly higher prevalence of SUI in multiparous women than in nulliparous women; however, the prevalence of urgency, frequency, incomplete emptying, bearing-down sensation, and straining was significantly higher in nulliparous women than in multiparous women. High parity, high body weight before pregnancy and advanced gestational age were the predisposing factors of SUI during pregnancy. Only 6.5% of the pregnant women studied complained that SUI caused a social or hygienic problem based on the International Continence Society (ICS) criteria. CONCLUSIONS: This study provides a profile of LUTS in Taiwanese women during pregnancy. Nocturia was the most common lower urinary tract symptom. Nocturia, SUI, urgency, and frequency increased as gestational age advanced. Parity was a predisposing factor for LUTS during pregnancy, with multiparous women experiencing significantly more SUI while nulliparous women had higher prevalence of other LUTS.

Adult↗
PubMed2005

Incidence of vaginal breech delivery in singleton in Siriraj Hospital.

OBJECTIVE: To determine the incidence of vaginal breech delivery at Siriraj Hospital and to evaluate factor affecting mode of delivery. DESIGN: Cross-sectional study. SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University. SUBJECT: A total of 317 women with singleton breech presentation, > or =28 weeks of gestation, who had their deliveries at Siriraj Hospital during January 1st to December 31st 2003. MATERIAL AND METHOD: The medical records of these women were reviewed to determine the incidence of vaginal breech delivery. Characteristics regarding current pregnancy and delivery and maternal and fetal outcomes were evaluated, including parity, gestational age, estimate fetal weight, cervical dilation, membranes status, maternal complications, types of breech presentation, and being a private case. RESULTS: The incidence of vaginal breech delivery among these women was 17.7%. Univariate analysis showed that multiparity, gestational age of <32 weeks, estimate fetal weight of < or =2500 grams, advanced cervical dilatation, ruptured membranes, and not being a private case increased the risk of vaginal breech delivery. Multiple logistic regression analysis demonstrated that only advanced cervical dilatation (4-7 cm, adjusted OR 10.7, 95% CI 3.5-33.0; >7 cm adjusted OR 40.4, 95% CI 12.6-129.2), ruptured membranes (adjusted OR 2.9, 95% CI 1.3-6.3), multiparity (adjusted OR 6.4, 95% CI 2.6-15.7), and gestational age <32 weeks (adjusted OR 9.7, 95% CI 2.7-35.7) were independently associated with vaginal breech delivery. However, lower apgar scores and neonatal complications, especially prematurity, were more frequent in vaginal than cesarean delivery. CONCLUSION: Vaginal breech delivery was found in 17.7% of singleton breech presentation in Siriraj Hospital. Certain characteristics during labor and delivery were associated with mode of delivery including advanced cervical dilatation, ruptured membranes, multiparity, and preterm gestational age.

Adult↗
PubMed2005

[Risk factors associated with high birthweight deliveries].

OBJECTIVE: To examine the influence of possible risk factors, mainly abnormal pregravid maternal body habitus, age, education, parity and pregnancy complications (especially diabetes) on the prevalence of infants with fetal weight 4000 grams and more. The study was also aimed to investigate pregnancy outcome among weight categories. STUDY DESIGN: Retrospective cohort study. SETTING: Gynaecological and Obstetric Clinic Medical Faculty Palacky University and Faculty Hospital Olomouc. METHODS: maternal and neonatal records for 7156 singleton deliveries of two fetal weight categories (2500-3999 grams and > or = 4000 grams) during the 5-year period from 1.1. 2000 to 31. 12. 2004 were reviewed. Univariate and multivariate analysis were performed. Multiple regression models, including maternal age, pregestational BMI (body mass index), education, smoking, alcohol consumption, IVF, anemia in pregnancy, preeclampsia, diabetes, gestational age, pregnancy weight gain, gender of the newborn were constructed to examine relative effect of these factors on the risk of the delivery of a big baby. RESULTS: The prevalence of high birth weight infants was 10.8% in the study sample. There were 774 deliveries of infants birth weight category > or = 4000 g and 6382 deliveries of the babies 2500-3999 g. Significant risk factors from the univariate analysis were gestational age more than 40 weeks (18.2% vs 8.6%, P = 0.00000000), pregnancy weight gain over 13 kg (cutoff) (14.3% vs 7.5%, P = 0.00000000). Compared with normal BMI subjects (19.8-25 kg/m2), obese women (BMI > 30 kg/m2) were at elevated risk for high birth weight delivery (18.1% vs 10.5%, P = 0.00000629) as were overweight women (BMI 25.1-30 kg/m2) (16.6% vs 10.5%, P = 0.00000004). Multiparity versus nulliparity (13.4% vs 8.1%, P = 0.00000000), male gender vs female (13.4% vs 8.0%, P = 0.00000). There were no significant difference with diabetes (12.6% vs 10.8%, P = 0.49089558). Smoking (5.4% vs 11.5%, P = 0.00000052) and low pregravid BMI (< 19.8 kg/m2) (5.7% vs 10.5%, P = 0.00000004) were associated with a lower risk of macrosomia Multiple logistic regression revealed the independent influence of gestational age, pregnancy weight gain, abnormal maternal body habitus, multiparity, male gender and smoking on the fetal growth. Excess fetal weight affects delivery in higher frequency of active management of labor, induction (20.2% vs 16.6%, P = 0.01560228) and cesarean section (20.3 % vs 15.1%, P = 0.00021215). No significant differences were in prolongation of first and second stage of labor and frequency rate of operative vaginal deliveries. No significant differences were noted between the groups regarding health status of live birth children. CONCLUSION: Gestational age over 40 weeks, increased pregnancy weight gain, pregravid maternal body habitus, multiparity and male gender are independent risk factors for high birthweight deliveries.

Birth Weight↗
PubMed2005

[Low-risk pregnant women in an obstetric department--how do they give birth?].

BACKGROUND: The aim of the study was to investigate the obstetric outcome for low-risk pregnant women delivering in a larger community hospital with 1800 deliveries annually. The investigation was carried out before the implementation of a differentiated plan for maternity care. MATERIAL AND METHODS: From January through June 2002, 920 women delivered. 520 were retrospectively considered low risk with spontaneous start of labour (56.5% of all labours). They were selected according to defined criteria. The results of this group with 197 nulliparous (37.7%) and 323 multiparous (62.1%) women are presented. RESULTS: There were 520 live newborns. 466 infants (89.6%) had an Apgar score > or = 8 after 1 minute; 509 a score > or = 8 after 5 minutes. In this low-risk group, 10.4% instrumental deliveries were performed, 2.7% caesareans and 7.7% vacuum extractions. In nulliparous women, the instrumental delivery rate was 19.7%, among the multiparous 4.6%. A surprisingly high number of low-risk women (38.7 %) were stimulated during labour with oxytocin, 62% of the primiparous and 24% of the multiparous. The indications for this were often obscure. Among oxytocin-stimulated primiparous women, 31.2% had an instrumental delivery, against 1.3% in non-stimulated women. Epidural analgesia was given to 22.3% of all low-risk women; of these, 91.4% received oxytocin. 3.1% had a perineal tear grade > or = 3. INTERPRETATION: The assistance given to women in a larger community hospital is more geared towards progress of labour than that given in smaller hospitals and midwife-controlled maternity homes. Frequent use of oxytocin to enhance contractions and epidural analgesia probably increases the rate of instrumental deliveries. This investigation points to the necessity of developing differentiated plans for maternity care given to low-risk women delivering in larger community hospitals, in line with a policy adopted by the Norwegian parliament.

Adult↗
PubMed2006

Nutritional status of pregnant women in Northeast Thailand.

A comparative study on the nutritional status of primiparous and multiparous women in the first trimester of pregnancy was conducted in the northeastern province of Thailand, Khon Kaen, to investigate differences in protein-energy-malnutrition, iron deficiency anaemia, vitamin A deficiency and carotenoid status between both parity groups. 94 subjects were recruited at first attendance of antenatal clinic. Data about weight, height, haemoglobin and haematocrit were obtained from hospital records. Anthropometric measurements of mid-upper arm circumference and triceps skinfold were done on a sub sample. Retinol, carotenoids and alpha-tocopherol were analysed using a reversed-phase high-performance liquid chromatography method. Ferritin, transthyretin and retinol-binding protein were determined by enzyme-linked immunosorbent assay. Primiparous women showed lower body mass index, mid-upper arm circumference, corrected arm muscle area (P<0.001) as well as lower retinol, cholesterol and triceps skinfold (P<0.05). After adjusting for age and socio-economical status the significant difference persisted for all parameters but triceps skinfold. No significant differences of alpha-tocopherol, serum proteins, carotenoids and iron indices could be observed, even though a tendency to higher values for ferritin, haemoglobin and haematocrit was shown in multiparous women. Prevalence of protein-energy-malnutrition (body mass index <18.5 kg/m2) in the primiparous group was significantly higher compared to the multiparous group (P<0.05). Prevalence of protein-energy-malnutrition, iron deficiency anaemia and vitamin A deficiency were 15.1%,6.3% and 3.3%, respectively, in the total study population. No differences between parity groups could be observed for prevalence of iron deficiency anaemia and vitamin A deficiency.

Adolescent↗
PubMed1990

Midline episiotomies: more harm than good?

The association between episiotomy and severe (third- and fourth-degree) perineal lacerations was studied in 24,114 women. The overall rates of severe lacerations were 8.3 and 1.5% for primiparous and multiparous women, respectively. Women who had midline episiotomies were nearly 50 times more likely and women who had mediolateral episiotomies were over eight times more likely to suffer a severe laceration than were women who did not undergo an episiotomy. Severe lacerations were also more common after use of forceps, in occiput transverse and posterior presentations, among women with smaller pelvic outlet measurements or lower prepregnant weight, and with larger fetuses. The same factors that caused a woman to have an increased risk of laceration also made performance of an episiotomy more likely. After statistical adjustment for these risk factors, mediolateral episiotomy was associated with a 2.5-fold reduction in the risk of severe lacerations among primiparous women, and a statistically nonsignificant 2.4-fold increase among multiparous women, compared with no episiotomy. Midline episiotomy was associated with statistically significant 4.2- and 12.8-fold increases in the risk of lacerations among primiparous and multiparous women, respectively. We conclude that the risks and benefits of midline episiotomy should be evaluated in a randomized clinical trial that compares policies of "usual" versus conservative use of episiotomy.

Delivery, Obstetric↗
PubMedDate not supplied

[Pregnancy, labor and the neonate in pluriparas and multiparas].

From 1971 to 1988, out of 22001 deliveries (multiple pregnancies excluded) 212 (0.96%) occurred in multiparas with five or more deliveries. The control group included 7340 pluriparas (two to four deliveries) from the same period. In 82.1% cases the multiparas were para 5 and 6, and 63 (29.7%) were less than 34 years of age. 15.9% had no antenatal visit; for the most part they were housewives and rural pregnant women. Transverse presentation, preterm delivery, meconium-stained amniotic fluid, and placental lysis or uterine exploration were more frequent in the multiparous group (P less than 0.001), whereas cervical cerclage and episiotomy were more frequent in the control group (P less than 0.05). Newborn infants in the multiparous group were severely asphyxiated at birth more frequently than those in the control group (P less than 0.05). There were no differences as regards late fetal and early neonatal deaths between the two study groups. The overall perinatal death rate in the multiparas and pluriparas was 2.83% and 1.81%, respectively (P less than 0.05). There was no case of uterine rupture or maternal death in the multiparous and pluriparous group.

Adult↗
PubMed1990

Maternal birthing positions and perineal injury.

A study to evaluate the relationship between maternal birthing position and perineal outcome was undertaken on 335 patients in a rural family physician's practice whose babies were delivered vaginally between December 1980 and December 1988. The most common birthing position used by the women was the semi-sitting position in the birthing bed (44%, n = 146). Ninety-four women (28%) gave birth from the conventional lithotomy position, 80 (24%) used the birthing chair, and less than 5% used a side-lying position. Almost 30% of the women gave birth with intact perineum; the incidence of episiotomy was 44%. The use of a particular position for delivery varied with parity, and multiparous women used the semi-sitting position in the birthing bed more frequently than did primiparous women. There was no statistically significant relationship between birthing position and perineal outcome for primiparous women. A statistically significant relationship between delivery position and perineal outcome was found for multiparous women. Multiparous women using the birthing bed were more likely to have less perineal trauma than women giving birth on the delivery table.

Adult↗
PubMed1986

[Evaluation of the usefulness of histological studies of the uterus of cows for confirmation of past pregnancies].

The material for studies were uteri of heifers, primiparous and multiparous cows taken directly after slaughter. From the excised uterus segments (uterus corni) histological preparations stained with hematoxylin and eosin were made. The studies did not show any observable differences in the histological structure of the uteri of heifers and primiparous cows. However, such differences were found in multiparous cows. They were found in the structure of the vascular layer, which distinctly separated the orbicular layer from the oblong muscular coat in multiparous cows. In heifers and primiparous cows the vascular layer was formed by single agglomerations of blood vessels distributed in the muscular layer of the uterus.

Animals↗