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At least 631 records · Page 35Linked to original sources
PubMed1975

An assessment of the criteria for selection of patients for an obstetric intensive care unit.

Intensive care monitoring of the fetus during labour improves perinatal conditions in 'high-risk" Black women. If the available facilities and staff are to be used with maximal efficiency, a system of priorities is necessary. It would appear that patients with meconium staining of the liquor, with cephalopelvic disproportion, or with two or more indications for monitoring, should have priority for admission to our intensive care unit. Hypertension and antepartum haemorrhage are of less importance, but there are two other problems which need investigation. There is a group of patients in labour who arrive too late to be monitored. They have a considerable perinatal mortality and the reasons for their late arrival need to be ascertained. There is a second group of patients who begin labour before term and deliver babies with a high risk of perinatal death. These problems require further investigation.

Arrhythmias, Cardiac↗
PubMed2003

Clinical significance of the floating fetal head in nulliparous women in labor.

OBJECTIVE: To examine the course of labor in nulliparous women in active labor with a floating fetal head. STUDY DESIGN: A prospective, cohort study of nulliparous women presenting in active labor at term with a floating fetal head (station > or = -3, n = 108) or engaged fetal head (n = 241). All patients were examined by a senior physician. Assignment to the study or control group was noted in the investigator's records. However, management of labor was at the discretion of the labor ward team on duty. RESULTS: Cesarean section rates for failure to progress were significantly higher in the study group (17.1% versus 4.2%, P < .0001), and the second stage of labor was prolonged (65.3 +/- 27.1 versus 54.9 +/- 30.2 minutes, P < .03). None of the women who had a persistently floating fetal head at 7 cm of cervical dilation delivered vaginally. Birth weights were larger (P < .03) and Apgar scores lower (P < .0001) in the study group. The lengths of the active phase and instrumental delivery rates were similar in the two groups. CONCLUSION: Nulliparous women presenting in active labor at term with a floating head are at substantially increased risk of cesarean section for abnormal progress of labor. However, the majority of patients will still deliver vaginally. A persistently floating head with advanced cervical dilation (7 cm) should prompt consideration of cesarean section since little is to be gained by waiting.

Adult↗
PubMed1991

[Reflex analgesia in the combined treatment of pregnant women with a pathological preliminary period].

The impact of reflex analgesia via transcutaneous electrical neurostimulation and electrical acupuncture was studied in 46 patients with an abnormal preliminary period by using tests of pain sensations and personal and reactive anxiety, ECG, hysterography, and computer-aided prediction of labor complications. Reflex analgesia was found to contribute to effective abolishment of preliminary pain sensations, to normalization of central nervous system function, autonomic reactions, uterine contractility, to reduction in pharmacological agent use and treatment duration, and to better delivery.

Adult↗
PubMed1990

Oxytocin in active-phase abnormalities of labor: a randomized study.

Seven hundred fifty-nine of 926 women in abnormal labor (82%) were entered into an open randomized trial to compare the effects of oxytocin and saline. Patients were classified as having either primary dysfunctional labor or secondary arrest of cervical dilatation. The end points chosen were an increase in the rate of cervical dilatation or a change in cervical dilatation. Patients who failed to respond to the initial solution were crossed over to the other solution. Oxytocin was significantly superior to saline in treating both labor abnormalities. Administration of oxytocin did not increase the need for cesarean delivery for fetal distress.

Cesarean Section↗
PubMed1987

Maternal C-reactive protein and preterm labor.

Maternal C-reactive protein (CRP) was measured in 109 pregnant women: 34 who were in labor before 35 weeks, 25 who were in labor at term and 50 who were not in labor. CRP values were correlated with outcome of tocolysis and with gestational age. Among 34 women in preterm labor, a CRP of greater than of equal to 0.8 mg/dL had a sensitivity of 85% (17/20) and a value of 81% (17/21) in predicting delivery within one week. Ten of the 14 who delivered more than one week following tocolysis had a CRP less than 0.8 mg/dL (71% specificity). Maternal CRP of greater than or equal to 0.8 mg/dL identifies a subgroup of women in preterm labor at highest risk of preterm delivery.

C-Reactive Protein↗
PubMed1979

Pelvic dimensions and the outcome of trial labour in Shona and Zulu primigravidas.

Pelvic contraction is very prevalent in Africa while radiological facilities to assess pelvic size and shape are seldom available. A trial of labour using simple guidelines on a cervicograph can enable the midwife to detect dysfunctional labour and can help medical staff to manage these problems. Radiological checks in 116 Black primigravid patients with dysfunctional labour demonstrated that an active trial of labour is accurate in determining which of these patients have marked disproportion requiring caesarean section, minimal disproportion requiring assisted delivery, or primary uterine inertia responding to oxytocic stimulation. The role of radiological pelvimetry in African obstetrics is discussed, and the radiological features of the Shona and Zulu pelves in this series are described.

Black or African American↗