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At least 721 records · Page 40Linked to original sources
PubMed1978

[Subanaesthetic doses of ketamine for obstetric delivery (author's transl)].

Twenty five parturients were anaesthetized by administration of 0.3 mg ketamine per kg body weight intravenously before emergence of the head of the newborn infant. 20 patients had complete amnesia for the time of delivery, but most of them remained cooperative, nevertheless. Of the other 5 patients, 3 recounted that they recalled the birth of their child like remembering a dream, but they did not remember pain. The method proved a failure in the case of two patients. The main advantage of this technique lies in keeping most of the parturients cooperative and able to help with pushing, while offering them amnesia and analgesia for this period. Comparison with thiopental and propanidide is discussed.

Adolescent↗
PubMed1984

Clinical assessment of the Kobayashi vacuum extractor.

Four hundred and thirty-one vacuum extraction deliveries were reviewed during a five-year period from 1978 to 1983. All cases involved the use of the Kobayashi silastic cup vacuum extractor with nine participating obstetricians performing the procedures. Specific attention was directed toward maternal and fetal morbidity associated with the use of the silastic cup extractor. No maternal or fetal deaths occurred. Vaginal and cervical lacerations accounted for a 4% maternal morbidity rate. Seventy-five percent of the infants had Apgar scores greater than 7 at one minute, and 97% had scores greater than 7 at five minutes. Fetal morbidity was impressively low, with a cephalohematoma rate of 6% and only two instances of major fetal cranial hemorrhages. In comparison with the reported morbidity sited by other authors using the metal cup extractor, less fetal scalp trauma may be anticipated with the judicious use of the Kobayashi silastic cup vacuum extractor.

Apgar Score↗
PubMed1995

[Frequency and determinants of episiotomy in second-line obstetrics in The Netherlands].

OBJECTIVE: To study factors that influence the probability of episiotomy in Dutch gynaecologist-supervised deliveries. SETTING: Obstetric units of Dutch hospitals. DESIGN: Observational study. METHODS: Data of 65,313 gynaecologist-supervised, vaginal deliveries of live-born singletons registered in the Dutch National Obstetric Database of 1990, were used. Firstly, the effect of characteristics of the mother, the child, the pregnancy, and the delivery on the probability of episiotomy were assessed in univariate analyses. Subsequently logistic regression analysis was used to determine the effect of each variable, while adjusting for the other variables. RESULTS: The episiotomy rate in the total group of gynaecologist supervised deliveries was 39%. In the subgroup of vaginal deliveries of live born singletons, the rate was 46%. Besides the well-known risk factors such as parity, instrumental delivery and length of second stage of labour, ethnicity was also found to have an independent effect on the risk of an episiotomy. Mediterranean, Creole and Hindu women had a lower episiotomy risk than Dutch women (OR: 0.47 and 95% CI: 0.44-0.51). Gynaecologists more often performed episiotomy than midwives, after adjusting for possible confounding factors (OR: 1.54; 1.46-1.63). In University hospitals fewer episiotomies were performed than in large non-university hospitals (OR: 0.81; 0.76-0.87. CONCLUSION: The decision to perform episiotomy appears not to depend solely on factors related to perineal rupture or foetal complications. The probability of episiotomy is also influenced by attendant at delivery and type of hospital.

Academic Medical Centers↗
PubMed1994

Peripheral nerve and neuromuscular disorders.

Mononeuropathies, plexopathies, and radiculopathies may occur with increased incidence during pregnancy and the puerperium. Immunologically mediated disorders of peripheral nerve, neuromuscular junction, and muscle have distinctive management problems when they occur during pregnancy.

Anesthesia, Obstetrical↗
PubMed1994

A case report on the use of guaifenesin-ketamine-xylazine anesthesia for equine dystocia.

In 4 mares suffering from dystocia, general anesthesia was induced with xylazine (1.1 mg/kg, IV) and ketamine (2.2 mg/kg, IV) and maintained with continuous intravenous infusion of ketamine (2 mg/ml), xylazine (0.5 mg/ml) and guaifenesin (50 mg/ml) in 1 L of 5% dextrose. The duration of the procedure of these mares were 40, 45, 180, and 35 minutes, respectively. For procedures required more than 1 hour (Mare 3), the dose of ketamine and xylazine in the mixture was reduced to 1 mg/ml and 0.25 mg/ml, respectively. Average infusion rate of the mixture used to maintain anesthesia for each mare was 2.5, 2.67, 2.28, and 2.21 ml/kg/hr. Recovery to standing occurred at 55, 75, and 180 minutes after termination of infusion for mares 1, 2, and 3, respectively. Xylazine reversal agent, tolazoline (2.2 mg/kg), was given to mare 1 to hasten the recovery; the mare stood within 30 minutes after tolazoline administration. Continuous infusion of guaifenesin-ketamine-xylazine can be an alternative anesthetic technique for prolonged obstetrical procedures under field conditions when suitable anesthetic equipment is not available. If recovery to standing is extended over 30 to 40 minutes, yohimbine or tolazoline can be administered to hasten recovery.

Anesthesia, General↗
PubMed1995

Does ethnicity influence obstetric intervention?

AIMS: To examine whether the high proportion of Polynesian women giving birth at Middlemore Hospital contributes to its low interventional delivery rate. METHODS: A study of a one-year cohort of women delivering at Middlemore Hospital. Delivery suite records were scrutinised to determine ethnicity and mode of delivery. Statistical comparisons were made. RESULTS: In Maori, Pacific Island and European women the caesarean section rates were 6.5%, 9.5% and 11.5% respectively. Maori women have a significantly lower rate of caesarean section than Pacific Island women and both groups have a significantly lower rate than European women. The spontaneous vaginal delivery rates in Maori, Pacific Island and European women were 89.0%, 87.4% and 74.8% respectively. CONCLUSION: The high proportion New Zealand Maori and Pacific Island women contributes to, but does not fully explain, the low interventional delivery rate at Middlemore Hospital.

Adult↗
PubMed1976

[Neurologic pathology in children born using vacuum extraction].

In a vacuum extraction 36.2% of the children were born in asphyxia, in 20.9%-with symptoms of disturbed cerebral circulation. In children from the age of 1-7 years-16.3% of them demonstrated pathological signs of the different parts of the nervous system. In this connection the authors suggest a screening by the neurologists during the first days of life of all children born by vacuum extraction.

Birth Injuries↗