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PubMed2002

Detection of the cervical gland area in threatened preterm labor using transvaginal sonography in the assessment of cervical maturation and the outcome of pregnancy.

OBJECTIVES: To detect the cervical gland area in threatened preterm labor, and to determine its detection rate and relationship with cervical maturation and outcome of pregnancy in preterm labor. METHODS: This was a mixed longitudinal and cross-sectional study involving 615 transvaginal scans performed to detect the cervical gland area and measure cervical length in 101 singleton pregnancies with threatened preterm labor. The patients were treated with intravenous administration of ritodrine chloride for regular uterine contractions at 16-35 weeks of gestation. 260 normal singleton pregnancies served as controls. Simultaneously conventional digital examination was used to assess the cervical maturation index. The detection rates of the cervical gland area, measurements of cervical length by sonography, and assessment of the cervical maturation index by digital examination in threatened preterm labor were compared with those of normal singleton pregnancies. In the threatened labor group, the outcome of pregnancy was assessed according to the sonographic absence or presence of the cervical gland area. RESULTS: In the normal pregnancy group, the detection rate of the cervical gland area remained practically constant until the 31st week of pregnancy (97%), but substantially decreased thereafter (70.2% in gestational weeks 32-35). In the threatened preterm labor group, the detection rate of the cervical gland area was constantly lower (44.5%) and the cervical maturation index was higher (4.65 score) than in the normal pregnancy group (83.1% and 1.80 score, respectively). The outcome of pregnancy in the threatened preterm labor group was poorer in the subgroup with the absence of a cervical gland area than in the subgroup with the presence of a cervical gland area (duration of pregnancy 257.0 vs. 271.0 days, birth weight 2,597.2 vs. 2,990.0 g, and admission to delivery interval 38.8 vs. 60.8 days). Highly significant correlations were noted among the detection rates of a cervical gland area and cervical length, cervical maturation index, and outcome of pregnancy. CONCLUSIONS: This study demonstrates for the first time that the sonographic absence of the cervical gland area reflects cervical maturation and could be considered as a predictor of threatened preterm labor and a sign of poor outcome of pregnancy in this condition.

Adolescent↗
PubMed2004

The effects of prolonged ambulation on labor with epidural analgesia.

UNLABELLED: Ambulation during labor is becoming more popular, although its impact on the progress of labor and on pain intensity remains unclear. We wondered whether prolonged ambulation with epidural analgesia had a possible effect on duration of labor and pain. In this prospective, randomized trial, 61 parturients with uncomplicated term pregnancies were allocated to be recumbent (n = 31) or to ambulate (n = 30). Epidural analgesia was provided with intermittent administrations of 0.08% bupivacaine-epinephrine plus 1 microg/mL of sufentanil. Of the 30 women assigned to the ambulatory group, 25 actually walked. Their ambulating time was 64 +/- 34 min (mean +/- SD), i.e., 29% +/- 16% of the first stage. There were no differences between the two groups in the length of labor and in pain visual analog scale scores. However, the ambulatory group received smaller doses of bupivacaine (6.4 +/- 2.2 mg/h versus 8.4 +/- 3.6 mg/h; P = 0.01) and of oxytocin (6.0 +/- 3.7 mUI/min versus 10.2 +/- 8.8 mUI/min; P < 0.05). A greater ability to void was also found in the ambulatory group (P < 0.01). Although the duration of labor and pain relief was unchanged, these findings support that ambulation during labor may be advantageous. IMPLICATIONS: This study compared the duration of labor and pain relief between parturients receiving epidural analgesia who were ambulated or were recumbent. Whereas walking had no impact on either duration of labor or pain relief, it was associated with a reduction in both bupivacaine and oxytocin requirements.

Adult↗
PubMed1975

Blood in amniotic fluid following intrauterine transfusion and its effect on premature onset of labor.

The most frequent cause of perinatal death following intrauterine transfusion in cases of severe rhesus hemolytic disease remains premature onset of labor and the resulting newborn so delivered. In the present study, 70% of all perinatal deaths were directly related to immaturity. A factor of decisive importance as an initiator of labor before the intended time is the leakage of blood into the amniotic fluid at the time of the procedure. (Mostly, this blood seems to originate from the fetal abdomen into which it was injected for therapeutic reasons.) The effect of blood-contaminated amniotic fluid on uterine activity is demonstrated on the material from Lewisham Hospital of London, where between 1 and 5 intrauterine transfusions were performed on 517 patients during a period between November 1963 and the end of March 1973. The presence of blood in the amniotic fluid was proved either by means of amniocentesis performed 2 days after intrauterine transfusion, or at the time of membrane rupture in labor. Patients who received a self-retaining catheter for any length of time were excluded from the material since the additive influence of the catheter on labor could not be assessed. Out of a total of 452 cases receiving single-use catheters, there were 208 cases (46%) with premature onset of labor. In 2-thirds of the cases this happened within the first week after the last intrauterinetransfusion. Further investigation of 332 case-histories with complete records was carried out. In 61.6% of the patients with labor before the intended time within 21 days after the last intrauterine transfusion, blood contaminated amniotic fluid was found, whereas this occurred in only 34.8% of the cases without premature onset of labor (p less than 0.001). From the same material, corresponding percentages for livebirths and stillbirths were calculated. As a consequence of these results, it is recommended that patients be kept under intensive hospital care following intrauterine transfusion whenever blood can be proved to be present in the amniotic fluid. Prophylactic measures to prevent premature onset of labor should also be considered.

Amniotic Fluid↗
PubMed1975

The development of the nursing labor force in the United States: a basic analysis.

In this article, we draw together some basic material on the objectives character of the nursing labor force in the United States. First, we present a statistical and descriptive picture of the nursing labor force as it exists today. Then we analyze the historical development of that labor force up to about 1950, stressing its general integration into a hierarchical and concentrated health industry. Finally, we look at the development of the nursing labor force over the past 25 years in terms of factors such as sex, race, age educational credentials, labor force participation, place of work, and the hierarchical division of labor, discussing the general implications of the changes in these factors for worker organization in the health industry. Our main conclusion is that the nursing labor force is in a kiey position to lead a movement for the restructing of the health industry to serve the health needs of the American people rather than the profit and power requirements of the health employers. The primary, and difficult, task ahead is to build labor organization which will have the vision and unity to work this goal.

Age Factors↗
PubMed1998

[Maternal serum cytokines concentrations during normal pregnancy and labor].

OBJECTIVES: The purpose of our study was to determine maternal serum concentrations of IL-8, IL-6, IFN-gamma during normal pregnancy and labor. MATERIALS AND METHODS: Maternal serum IL-8, IL-6 and IFN-gamma levels were measured by means of ELISA technique in 41 healthy pregnant women in 22-42 week gestation and 15 healthy women in labor at term. All newborns and afterbirths had no signs of infection. RESULTS: IL-8 values for pregnant women ranged from 1.98 to 35.2 pg/ml with the median value 10.24 pg/ml, and the 95th percentile 24.5 pg/ml. IL-8 values for women in labor at term ranged from 3.96 to 54.8 pg/ml with the median 10.4 pg/ml. No statistically significant changes in serum IL-8 concentration were observed during pregnancy or in labor. Serum IL-6 concentrations in pregnant women ranged from 0 to 21.7 pg/ml with the median value 0 pg/ml, and the 95th percentile 15.5 pg/ml. Serum IL-6 concentrations in women in labor at term were significantly higher (p < 0.05): ranged from 0 to 39.2 pg/ml with the median 10.1 pg/ml and 95-th percentile 33.5 pg/ml. Maternal serum IFN-gamma concentrations in pregnant women ranged from 0 to 9.8 pg/ml with the median value 3.9 pg/ml, the 95th percentile 9.2 pg/ml and didn't differ during labor at term: range from 0 to 14.5 pg/ml, median 1.9 pg/ml. CONCLUSIONS: Our data revealed that maternal serum IL-8 concentrations didn't changed during the course of pregnancy and in labor. Women in labor had significantly elevated serum IL-6 concentrations compared to those in pregnancy. We didn't observed such changes in serum IFN-gamma levels.

Adult↗
PubMed1985

Migrant labor in agriculture: an international comparison.

The May 1984 Conference on Migrant Labor in Agriculture at the University of California-Davis discussed papers by 22 farm labor experts from 12 nations. Each industrial nation utilizes a different set of public and private policies to supply workers for labor-intensive agriculture, but none is entirely satisfactory. Labor-intensive agriculture is becoming more dependent on workers who are shut out of labor markets. Some countries have simply accepted foreign workers in agriculture, while others have adopted policies to integrate farm and nonfarm labor markets. Polices to reduce agriculture's reliance on workers-without-options include restructuring employment practices to employ fewer seasonal workers for longer periods, mechanizing production, and importing fruits and vegetables from nearby developing countries. This article explains the salient features of labor-intensive agriculture, the various polices for obtaining seasonal farmworkers, and options to reduce farming's dependence on migrant labor.

Agriculture↗
PubMed2002

[Comparison study on transvaginal ultrasonographic measurement and cytokine in prediction of the cervical ripening and the onset time of term labor].

OBJECTIVE: To compare the level of interleukin-6 (IL-6), interleukin-8 (IL-8), human chorionic gonadotropin (hCG) with transvaginal ultrasonographic measurement in prediction of the cervix ripening and the time of term labor. METHODS: The 79 cases of primiparous women of term pregnancy were chosen as the research subjects. The maternal level of IL-6, IL-8, hCG in cervicovaginal secretions were measured. The cervical length, internal cervical os wedge width and forebag length were measured by transvaginal ultrasonography. The cervical Bishop score was also determined. RESULTS: (1) The levels of IL-6, IL-8, hCG in cervicovaginal secretions were significantly higher in women they are in labor than that of women at term not in labor (782 +/- 508) ng/L, (10,539 +/- 8 680) ng/L, (114 +/- 86) IU/L, versus (155 +/- 75) ng/L, (7,113 +/- 6 050) ng/L, (35 +/- 21) IU/L, respectively. (2) The levels of cervicovaginal secretions IL-6, IL-8, hCG and the length of cervical, forebag were significant correlation with the cervical Bishop score (P < 0.05, r = 0.42, 0.24, 0.44, -0.56, 0.35) respectively. (3) The levels of cervicovaginal secretions IL-6, IL-8, the length of cervical, forebag measured by transvaginal ultrasonography and the cervical Bishop score were significant correlation to the onset time of term labor (P < 0.01, r = -0.42, -0.46, 0.64, -0.52, -0.41) respectively, and all these markers also could predict the onset of term labor in < or = 7 days, The predictive value on onset labor within < or = 7 days by cervical length < or = 30 mm: the sensitivity, specificity, positive values and negative value are 0.83, 0.89, 0.91 and 0.81 respectively. (4) Among the several markers in predicting cervix ripening and onset of labor, the best one was the transvaginal ultrasonographic measurement of cervical length. CONCLUSIONS: The levels of cervicovaginal secretions IL-6, IL-8, the length of cervical and forebag measured by transvaginal ultrasonography and the Bishop score are valuable in prediction of cervix ripening and onset of labor. The cervical length measured by transvaginal ultrasonography is the best one.

Adult↗
PubMedDate not supplied

Does evidence of inflammation on Papanicolaou smears of pregnant women predict preterm labor and delivery?

BACKGROUND: Preterm delivery is the most common cause of neonatal morbidity and mortality in the United States. There is evidence that cervicovaginal infection could predispose to preterm labor. This study explored a possible association of evidence of inflammation on an otherwise normal Papanicolaou smear obtained during pregnancy with subsequent preterm labor and preterm delivery. METHODS: Using a retrospective matched cohort design, we studied women who gave birth to live singleton infants at the University of Missouri Hospital and Clinics during a 21-month period. Papanicolaou smears were obtained from 1 to 8 months before delivery and were interpreted in the same cytopathology laboratory. Data pertaining to outcome variables and potential confounding variables were collected from hospital charts. RESULTS: Incidence rates were 14.4 percent for labor < 37 weeks' gestation (preterm labor), 12.3 percent for hospitalization for preterm labor, 9.9 percent for delivery < 37 weeks (preterm delivery), 2.6 percent for delivery < 34 weeks, and 7.5 percent for birth weight < 2500 g. On univariate and multivariate analyses, there were no significant differences in any outcome between the 293 women with inflammation and the 284 women without inflammation on Papanicolaou smear. Results were unchanged when the analysis was limited to the 412 women who received no antibiotics during pregnancy. Among the 38 women with a history of preterm labor or preterm delivery, those with cervical inflammation had a higher rate of preterm labor than those without inflammation. CONCLUSIONS: In the sample as a whole, there was little evidence that findings of inflammation on Papanicolaou smear constituted a risk factor for preterm labor or preterm delivery. The data suggest that inflammation could be associated with an increased risk in a subgroup of women at higher risk by virtue of their obstetric history.

Adult↗
PubMed2004

[Risk factors of postpartum hemorrhage during labor and clinical and pharmacological prevention].

Prevention of postpartum hemorrhage (PPH) is a major concern in regards to its impact on maternal morbidity and mortality. While established risk factors can be identified among risk factors of PPH during labor after multivariate analysis: prolonged labor, oxytocin stimulation of labor, cesarean section, instrumental delivery, genital lacerations and episiotomy, prolonged third stage of labor, retained placenta; other risk factors are still uncertain: induction of labor, hyperthermia or chorioamniotitis, analgesia or anesthesia, macrosomia, various cesarean section techniques. Isolated identified risk factors have a moderate incidence on PPH, but their cumulation in one patient is a potential high risk. Among active management schemes of third stage of labor for PPH prevention, the most efficient technique seems to be direct injection of oxytocin when the baby's shoulders are delivered, associated with controlled cord traction. If this technique is a must for high-risk patients for PPH, and seems efficient for every patient, a correctly performed procedure requires the presence of a competent professional in addition to the midwife or obstetrician in charge of delivery, and a permanent attention so the length of third stage of labor is shortened. The alternative use of prophylactic misoprostol in the third stage of labor is less effective than injectable uterotonics in reducing PPH, and is associated with more side effects (severe shivering, pyrexia, diarrhea). None of other described prophylactic methods have proved efficiency: early suckling, umbilical blood drainage, oxytocin umbilical vein injection, among others. A decrease in PPH prevalence should be obtained by particular attention on data from the early postpartum period, active diffusion of effective prophylactic techniques, and an appropriate choice in regards to each delivery unit organization.

Delivery, Obstetric↗
PubMed2005

Reducing cesarean delivery rates: an active management labor program in a setting with limited resources.

OBJECTIVE: To determine the effect of an active management of a labor program on the rate of cesarean section and labor outcomes in low-risk nulliparous pregnancies in a setting with limited resources. MATERIAL AND METHOD: Nine hundred and seventy-five low risk nulliparous pregnant women were randomized to receive either active management of a labor program (n = 325) or conventional management (n = 650). The rate of cesarean section and labor outcomes were compared between the two groups using Chi-square and t-tests. RESULTS: The subjects in the active management program had significantly shortened first stage of labor and total duration of labor compared with the conventional group (538.0 +/- 242.9 min vs 589.4 +/- 263.8 min, p < 0.05, 539.3 +/- 261.4 min vs 610.3 +/- 264.4 min, p < 0.001, respectively). There was no statistical difference found in the rate of cesarean section and other labor outcomes. CONCLUSION: The active management program shortened the first stage and duration of labor in low-risk nulliparous pregnant women.

Adult↗
PubMed1990

Uterine activity compared with symptomatology in the detection of preterm labor.

The relative contribution of uterine activity obtained by home monitoring with a guard ring tocodynamometer compared with seven specific signs and symptoms reported during patient/nurse contact as an aid in detecting preterm labor has not been studied. In this prospective, multicenter study, patients at risk for developing early labor who were randomized to receive home uterine activity monitoring and perinatal nursing support were assessed. The initiator of provider contact (uterine activity detected on routine transmission, patient-perceived signs and symptoms of preterm labor during perinatal nurse contact, or both) resulting in a diagnosis of preterm labor was recorded. Contraction data were then analyzed for an association with preterm labor. There was a strong association of increased uterine activity (four or more contractions per hour) on a repeat monitoring strip with preterm labor (P less than .001). Among patients diagnosed with preterm labor, 31% had increased uterine activity detected on a routine transmission without patient-reported signs and symptoms, compared with 24% who were diagnosed as the result of patient-reported symptoms without increased uterine activity. Daily objective uterine activity data alone have greater incremental value over and above other signs and symptoms as an aid to the physician in diagnosing preterm labor.

Female↗
PubMed1987

Serum unconjugated estriol levels during spontaneous labor.

We measured maternal serum unconjugated estriol (SUE3) levels in 244 cases (218 cases with labor and 26 without labor) and investigated the relationships among several obstetrical factors and SUE3 levels. There was no significant difference in the SUE3 level between the group with labor and the group without labor. However, the SUE3 level decreased gradually with prolonged duration of labor in multipara. There were significant positive correlations between the SUE3 levels and birth weights (n = 82, r = 0.375, p less than 0.01) or placental weights (n = 82, r = 0.381, p less than 0.01) in the multipara with labor. The SUE3 levels of fetal distress cases (n = 30, 20.0 +/- 8.6 ng/ml) were significantly (p less than 0.05) lower than those without fetal distress (n = 188, 24.5 +/- 9.7 ng/ml). These data suggest that maternal SUE3 might have been affected with feto-placental function, even after the onset of labor SUE3 levels decrease with prolonged duration of labor.

Cesarean Section↗
PubMed1981

[Changes of oxytocin, progesterone, estradiol and CAP around the labor by prostaglandin F2 alpha (author's transl)].

In order to elucidate the mechanism of prostaglandin F2 alpha (PGF2 alpha) action to onset of labor, the author observed the changes in maternal peripheral plasma oxytocin, progesterone, estradiol and cystine-aminopeptidase (CAP) activity around the onset of labor by PGF2 alpha. For the investigation, 66 normal pregnant women from 6 to 10 gestational months and same numbers from 39 to 41 gestational weeks were chosen. The blood samples for the latter were drawn just before drip infusion of PGF2 alpha, 5-minutes interval, 3-minutes interval of pain and just after labor. PGF2 alpha administered for labor induction intravenously, and 55 pregnant delivered. 1) The maternal peripheral mean plasma concentrations of them showed increase during pregnancy. There were positive correlations between oxytocin and progesterone, estradiol, CAP. 2) During labor, oxytocin levels increased significantly (p less than 0.01) and progesterone levels decreased significantly (p less than 0.01). On the other hand estradiol levels did not change significantly. CAP levels showed irregular changes. Estradiol-progesterone ratio showed gradual increase. 3) Then during labor, progesterone levels showed negative correlation with oxytocin levels. From this study, the results indicate that significant changes in oxytocin and progesterone and gradual increase estradiol-progesterone ratio are concerned in the onset of labor caused by PGF2 alpha, so labor may progress dynamically.

Aminopeptidases↗
PubMed1982

Case-control analysis of post-term induction of labor.

At Akershus Central Hospital the main indication for induction of labor is post-term pregnancy, and induction is carried out by i.v. oxytocin drip. During 3 years between 1974 and 1977, labor was induced in 11.6% of all births in this hospital. Thirty per cent of first induction attempts were unsuccessful; the success rates, implying labor contractions and delivery consequent upon induction, were slightly higher among mothers of parities 1 + than among those giving birth for the first time. Most of the induced births took place between noon and 8 p.m. In a case-control study of post-term inductions of live single fetuses in cephalic presentation, comprising 721 sets of cases and controls, unreliable term dating was more frequent among induced than among control mothers, significantly so in the para 1 + group. Mothers requiring induction were slightly shorter and slightly heavier than those with spontaneous onset of labor, and pregnancy hypertension was more frequent among the former. Labor was of shorter duration in induced cases than in those with labor of spontaneous onset, and operative intervention during delivery was significantly more frequent in the induction groups. Birth weight and crown-heel length were similar in the two groups, but Apgar scores of the infants born after induction were significantly lower than of those born after spontaneous labor, at both 1 and 5 minutes. While the frequency of diseases and injuries in the newborns were similar, more children born after induction were transferred to the intensive care unit. There was a striking preponderance of boys born after induction, both to para 0 and para 1 + mothers. In spite of matching, the comparability of cases and controls is always an object of criticism in studies like this one. Therefore, although the information obtained is valuable, there is a need for large-scale randomized studies on induction of labor.

Cesarean Section↗
PubMed1995

Comfortable labor with intrathecal narcotics.

Aggressive pursuit of high-quality health care had guided the Health Service of the United States Army to establish a labor analgesia program within its hospitals. A dedicated Labor Epidural Service can be quite expensive, especially from the manpower standpoint. Therefore, the Anesthesia Service at Reynolds Army Community Hospital, Fort Sill, Oklahoma, implemented a program of intrathecal narcotic injection as an alternative to costly labor epidural analgesia. After reviewing a patient fact sheet, 150 laboring patients volunteered for labor intrathecal analgesia (LIA). Once active labor began, the patient received intrathecal morphine (0.25 mg) and fentanyl (25 micrograms). The pain level before and after the LIA was evaluated by the visual analog schedule method. At 2 weeks follow-up the intrathecal narcotic-assisted labor was subjectively reported by the patients. Ninety-four percent of the patients agreed that the LIA worked well and that they would do it again. LIA was found to be a well-accepted, cost-saving, very effective approach to labor analgesia.

Adolescent↗
PubMed1995

Induction of labor using prostaglandin E2 (PGE2) vaginal gel in triacetin base. An efficacy study comparing two dosage regimens.

OBJECTIVE: To compare two dosage regimens for the administration of vaginal prostaglandin gel in triacetin base for induction of labor. METHODS: Seventy subjects planned for elective induction of labor at term were randomized to treatment with PGE2 vaginal gel every 6 or 12 hours. The 6-hourly group received an initial dose of 1 mg, followed by 2 mg at 6 hour intervals for a maximum of two additional doses if not in active labor. The 12-hourly group had an initial dose of 2 mg followed by two additional doses at 12 hour intervals if not in active labor. RESULTS: Successful induction rate was higher in the 12-hourly as compared to 6-hourly gel regimen (100% vs. 91%, P > 0.05). Twelve hours after the initial dose, delivery occurred in 34% delivery had occurred in 57% and 37% respectively (P < 0.01). We found no difference in the induction-active labor interval (P > 0.05), and the induction-delivery interval (P > 0.05) between the two groups. Active labor followed a single dose of gel in 66% of the 12-hourly group compared to 40% of the 6-hourly group (P < 0.01). Syntocinon augmentation was needed in 6% of subjects in the 12-hourly group as compared to 26% in the 6-hourly group (P < 0.01). The cesarean section rate was similar in both groups. Uterine hyperstimulation occurred less frequently in the 12-hourly group (P < 0.05). The perinatal outcome was similar in both groups. CONCLUSIONS: The 12-hourly regimen was more effective than the 6-hourly regimen in initiating labor. The majority of the subjects in the 12 hourly group achieved labor following a single dose of gel. Induction delivery interval, however, was similar in both groups.

Adult↗
PubMed1996

Maternal plasma and amniotic fluid cortisol and progesterone concentrations between women with and without term labor. A comparison.

OBJECTIVE: The purpose of the present study was to determine the amniotic fluid and maternal plasma concentrations of cortisol and progesterone in nonlaboring women at term and to compare them to those in women with active labor at term. STUDY DESIGN: A prospective, cross-sectional study. Soroka Medical Center of Kupat Holim, Faculty of Health Sciences, Ben-Gurion University of the Negro, Beer-Sheva, Israel. Thirty-five healthy women with normal term pregnancies were classified according to labor status into two groups: group A (16 women with spontaneous, active labor at term) and group B (19 women not in labor). RESULTS: We found a significant increase in the median concentration of plasma cortisol in women at term in active labor in comparison to those not in labor. In addition, the median concentration of cortisol in amniotic fluid in women in labor was also significantly higher than that in women not in labor. In contrast, no significant changes in median maternal plasma or amniotic fluid progesterone concentrations were detected between the groups. CONCLUSION: Human parturition is associated with a significant increase in the concentration of cortisol in both maternal plasma and amniotic fluid. These findings suggest that cortisol plays an important but still-undetermined role in human parturition.

Adult↗
PubMedDate not supplied

Labor pain before elective cesarean section reduces neonatal respiratory distress.

Neonatal respiratory distress is a major complication of elective Cesarean section. To clarify the effect of preceding labor on the incidence of respiratory distress, we studied 45 term neonates who were born with labor and 85 term neonates who were born without labor. Transient tachypnea of the newborns accounted for the majority of respiratory distress in term neonates. Respiratory distress occurred less frequently in term neonates delivered after the onset of labor compared to those delivered before the onset of labor (11.1% vs. 31.8%, p < 0.002). Neonatal respiratory distress syndrome (RDS) occurred in 4 of 85 (4.7%) term neonates delivered before the onset of labor. In contrast, none of the 45 term neonates born after the onset of labor developed RDS (p = 0.02). Awaiting the onset of labor appears to be beneficial in preventing neonatal RDS for term neonates delivered by elective Cesarean section.

Adult↗