Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “LABOR”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 919 records · Page 51Linked to original sources
PubMed2005

Three-dimensional power Doppler ultrasound assessment of the cervix for the prediction of successful induction of labor with prostaglandin in prolonged pregnancy.

OBJECTIVE: The purpose of this study was to determine whether 3-dimensional (3D) power Doppler ultrasound examination of the cervix can predict the success of labor induction with prostaglandin in prolonged pregnancy. METHODS: A prospective study was conducted with 36 women undergoing labor induction with prostaglandin at 41 gestational weeks 5 days and later. All 36 women underwent a transvaginal 2-dimensional gray scale ultrasound examination and a 3D power Doppler ultrasound examination of the cervix immediately before a planned post-term checkup. The analyzed variables were length, anterior-posterior diameter, and width of the cervix and any cervical funneling, cervical volume (in cubic centimeters), vascularization index, flow index, vascularization flow index, parity, and Bishop score. Results were compared among women with start of labor at 12 hours or less and more than 12 hours after application of the first prostaglandin suppository and among women who had delivery at 24 hours or less and more than 24 hours after the start of induction. RESULTS: Sonographically measured cervical length was shorter (mean, 1.8 versus 2.4 cm; P = .04), the Bishop score was higher (median, 5 versus 3; P = .02), and more women were parous (70% versus 37%; P = .05) among women who were in labor within 12 hours than in those who were not. The Bishop score was higher (median, 4 versus 2; P = .03) and more women were parous (69% versus 23%; P = .01) among women who had delivery at 24 hours or less than among those who did not. Cervical volume and the results of the 3D power Doppler ultrasound examination did not differ among women with different outcomes of labor induction. CONCLUSIONS: In women undergoing induction of labor with prostaglandin at 41 gestational weeks 5 days or later, sonographic cervical length, Bishop score, and parity are related to the success of labor induction, whereas cervical volume and the results of the 3D power Doppler examination are not.

Adult↗
PubMed1999

[Evolution and quality of care during labor and delivery in primiparous patients who underwent early obstetrical analgesia].

Evaluations of labor and delivery progress and care quality in primiparous patients that receive obstetric analgesia by peridural way at the beginning of the active phase, was done. One-hundred-twenty-nine patients at the beginning of the active phase of the labor were randomized into two groups: Group I: Sixty-six patients that received obstetric analgesia by peridural way and Group II: Sixty-three patients did not receive analgesia by any way. Length of the cervical dilation and effacement, and expulsive period, cervical dilation rate per hour, delivery type, labor experience and perinatal outcomes were measured. The length means of the cervical dilation and effacement was 177.7 (SD +/- 89.0) and 296.0 (SD +/- 114.5) minutes to Group I and II respectively (p < 0.005). Cervical dilation rate was 2.74 and 1.6 centimeters per hour to Group I and II respectively (p < 0.05). The length of the expulsive period was 36.54 minutes (SD +/- 21.7) to Group I and 42.57 minutes (SD +/- 16.15) to Group II (p > 0.05). Labor experience was referred like very painful in the 9% and 100% to Group I and II respectively (p < 0.05). The perinatal outcomes and method of delivery were similar between two groups. Obstetric analgesia administered by peridural way at the beginning of the active phase of the labor significantly reduce the dilation and effacement period and whole labor, without modify the expulsive period length. It does not inhibit the uterine activity and improvement the care quality of the labor.

Adult↗
PubMed2000

Benefits of massage therapy and use of a doula during labor and childbirth.

This article reviews the most recent literature on touch support and one-to-one support during labor and childbirth. The positive and negative aspects of the traditional birth attendant are presented. Research in one-to-one care and touch support during labor is examined with respect to husband/partner, nurses, nurse-midwives, and doulas (trained labor attendants). According to recent studies, women supported by doulas or midwives benefit by experiencing shorter labors and lower rates of epidural anesthesia and cesarean section deliveries. Also, a smaller percentage of their newborns experience fetal distress and/or are admitted to neonatal intensive care units. Women whose husbands or partners massage them during labor experience shorter labors. Nursing one-to-one support results in no significant obstetric outcomes. Antenatal perineal massage was found to reduce the rates of tears, cesarean section, and instrumental deliveries. Research in perineal massage during labor has shown no benefit.

Female↗
PubMed1998

[Clinical study on relieving labor pain used combined spinal and epidural anesthesia].

OBJECTIVE: To investigate the effect of combined spinal and epidural anesthesia (CSEA) on relieving and eliminating labor pain and the effect on newborns, labor process and delivery mode. METHODS: 80 cases without any obstetric complications and anesthetic contraindications were selected for the study group. CSEA was applied when cervix dilated for about 2-3 cm, 80 pregnant women with similar obstetric condition as control group without any anesthesia. We compared the labor pain, duration, delivery mode and fetal status of two groups. RESULTS: In study group CSEA showed good effect on relief of labor pain, shortening the active phase of labor course and acceleration of cervical dilation. There are no different in the incidence of fetal distress, neonatal asphyxia and postpartum hemorrhage between two groups. CONCLUSION: Apllication of CSEA is useful in relieving labor pain, accelerating labor course, lowering cesarean section rate without any side effect on fetus.

Analgesia, Obstetrical↗
PubMed1998

[The effect of 25 micrograms misoprostol on induction of labor in late pregnancy].

OBJECTIVE: To determine the efficacy and safety of 25 micrograms misoprostol for labor induction in the third trimester of pregnancy. METHODS: 48 term pregnant women with single pregnant vertex present intact membrane were selected in study group. All case in study group indications for labor induction, without contra-indication of labor induction and misoprostol. The 48 women were randomly assigned A(25 micrograms) and B(50 micrograms) misoprostol groups. Misoprostol was placed in the posterior vaginal fornix every 4 to 6 hours. The maximum dose in 24 hours is 200 micrograms. Misoprostol was not given after either spontaneous rupture of membrane or beginning of active labor. RESULT: The sucesess rate of induction labor was groups 77.8%, 81.0% in group A and B, respectively. The average duration from administration of misoprostol to start of labor in two groups was 796.9 +/- 359.9 minutes and 807.4 +/- 405.2 minutes, respectively; the average duration from start of misoprostol use to vaginal delivery was 978.6 +/- 464.4 minutes, 977.5 +/- 421.4 minutes, respectively. The incidence of vaginal delivery had no statistics significant difference between two groups (P > 0.05). The incidence of hypertonic uterine contraction or hypertonic contractionchysystole with abnormal pattern of fetal monitoring in group A was lower than that of group B, but there was no significant difference (P > 0.05). CONCLUSION: 25 micrograms misoprostol is an efficient and safe dosage for labor induction in term pregnancy.

Adult↗
PubMed1999

The convergence of labor and public health: a natural and critical alliance.

The reorganization of a Labor Caucus in APHA provides an opportunity to reflect on the community of methods and interests between the public health and labor communities. The nature of both movements is examined and the factors (knowledge base, political will, and social strategy) that define the actions of both movements are addressed. The antagonism between the prevailing political dogma of market individualism and the two movements is also discussed, with special emphasis of the need for strong government involvement to support the functioning of both labor and public health. Important issues that currently affect labor and public health are discussed. Constructive disagreements on policy choices of labor on national health insurance and occupational safety and health are examined. A warm endorsement of a critical alliance of labor and public health is made, and the revitalization of a labor caucus is cordially welcomed.

Cooperative Behavior↗
PubMed2000

Indications for labor induction. Differences between university and community hospitals.

OBJECTIVE: To compare the rates of and indications for labor induction between a university hospital and two community hospitals and to examine the risk of cesarean delivery among labor induction cases. STUDY DESIGN: Labor induction cases over a six-month period were included (N = 536). Medical records were reviewed by a trained abstractor using a standardized form to determine maternal characteristics, reason for induction and perinatal outcomes. RESULTS: Rates of labor induction were significantly different between the three hospitals: university, 18.2%; community hospital A, 21.4%; community hospital B, 33.7% (P < .001). At the university hospital, 95% of labor inductions were medically indicated using American College of Obstetricians and Gynecologists (ACOG) criteria. Forty-four percent of labor inductions at community hospital A and 57% at community hospital B were for elective reasons. Cesarean rates among induction cases were highest at the university hospital (19%) as compared to community hospital A (15%) and community hospital B (11%), although the difference was not statistically significant. Parity, race and cervical status, but not elective induction, were significantly associated with cesarean delivery. CONCLUSION: Labor induction was more frequent in community hospitals but more likely to meet ACOG-approved indications at the university hospital. The more-frequent inductions at the community hospitals did not result in higher cesarean rates.

Adult↗
PubMed2000

Intrathecal narcotics are associated with prolonged second-stage labor and increased oxytocin use.

BACKGROUND: Safe and effective labor analgesia is an important part of obstetric care. Intrathecally injected narcotics (ITN) are an effective alternative to epidural anesthesia, and are perceived less likely to interfere with the course and outcome of labor. Data on their effects, however, are sparse and contradictory. METHODS: Our retrospective study compared labor length, oxytocin use, delivery type, maternal side effects, and neonatal outcomes among women who received ITN (n=100) and a group who received intravenous narcotics or no analgesia during labor (n=100). We randomly sampled medical records with stratification for parity and collected data through systematic chart review. RESULTS: Women receiving ITN were more likely to be white. They experienced longer second-stage labors (73 minutes vs 40 minutes, P=.000) and used oxytocin twice as often. These differences remained significant after controlling for potential confounding factors. ITN use was also associated with a trend toward more cesarean sections (7% vs 1%, P=.06). More of the women receiving ITN required urinary catheterization (25% vs 5%, P=.000) and experienced significant pruritus (10% vs 0%, P=.001). Neonatal outcomes were similar for both groups. CONCLUSIONS: In our retrospective study, ITN use was associated with a significant prolongation of second-stage labor, which may be clinically relevant for women having their first child. ITN were also associated with increased oxytocin use and a trend toward more cesarean births. Whether these relationships are causal or a proxy for more difficult labors is a question for future prospective studies.

Adult↗
PubMed2001

[Effect of peridural analgesia on labor progress].

Epidural analgesia (EDA) is the most effective method of intrapartum pain relief. Its influence on the course of labor continues to be controversial. Although a cause-and-effect relationship has not been proven, this form of analgesia has been blamed for a host of adverse maternal/fetal events during labor, including prolonged first and second stage of labor, dystocia, malrotation of the fetal head and an increased risk of operative delivery (instrumental delivery, Caesarean section). Our own data from the Department of Obstetrics and Gynaecology at the University of Leipzig demonstrate that women with epidural analgesia had a longer duration of labor (the greater proportion taking more than 13 hours), although labor was often already protracted before the start of epidural analgesia. Early epidural analgesia with a cervical dilatation of less than 4 cm does not have any negative impact on the progress of labor. The duration of second-stage pushing and the rate of instrumental deliveries were not increased in our patients. Although the Caesarean section rate for women with an EDA was elevated, the total proportion of secondary Caesarean section remained unchanged despite increased use of EDA. Our findings suggest that women selected for intrapartal EDA already represent a population with an increased risk of an unfavourable course of labor, priming of the cervix, increased need of oxytocin and nulliparity. Pain relief in itself is sufficient indication for the use of intrapartal epidural analgesia.

Adolescent↗
PubMed2001

Acupuncture for cervical ripening and induction of labor at term--a randomized controlled trial.

OBJECTIVE: The aim of this study was to evaluate whether acupuncture at term can influence cervical ripening, induce labor and thus reduce the need for postdates induction. METHODS: On the estimated date of confinement (EDC) women were prospectively randomized to an acupuncture group (AG) or a control group (CG). Data of 45 women were evaluated (AG, n = 25; CG, n = 20). Inclusion criteria were as follows: confirmed EDC, uncomplicated course of pregnancy, singleton pregnancy in cephalic presentation. Exclusion criteria were as follows: cervical dilation > 3 cm, active labor, premature rupture of membranes, previous cesarean section, pathologies in mother or fetus. Women were examined at 2-day intervals. The cervical length was measured with vaginal ultrasonography, cervical mucus was obtained for a fetal Fibronectin test and the cervical status was assessed according to the Bishop score. In the AG, the points Hegu (Large Intestine 4) and Sanyinjiao (Spleen 6) were pierced on both sides every second day. If women were not delivered 10 days after EDC, labor was induced by administering vaginal prostaglandin tablets. RESULTS: The cervical length in the AG was shorter than that in the CG on day 6 and day 8 after EDC (P = 0.04 for both). In the AG the time period from the first positive Fibronectin test to delivery was 2.3 days, while that in the CG was 4.2 days (P = 0.08). The time period from EDC to delivery was on average 5.0 days in the AG and 7.9 days in the CG (P = 0.03). Labor was induced in 20% of women in the AG (n = 5) and in 35% in the CG (n = 7) (P = 0.3). Overall duration of labor, and first and second stage of labor were not different in the two groups. In 56% of women who underwent acupuncture (n = 14) and in 65% of controls (n = 13), Oxytocin was used to augment labor. (P = 0.54). CONCLUSION: Acupuncture at points LI4 and SP 6 supports cervical ripening at term and can shorten the time interval between the EDC and the actual time of delivery.

Acupuncture Points↗
PubMed2000

[Correlation between epidermal growth factor receptor messenger RNA expression and the onset of labor].

OBJECTIVE: To study the correlation between epidermal growth factor receptor messenger RNA expression and the onset of labor. METHOD: Semiquantitative reverse transcriptase polymerase chain reaction, using GAPDH as internal standard, was applied to determine the levels of epidermal growth factor receptor messenger RNA in human myometrium (n = 20) and fetal membranes (n = 20) before and during labor. RESULTS: In myometrium, epidermal growth factor receptor messenger RNA increased from 0.91 +/- 0.32 before labor to 1.33 +/- 0.23 after the onset of labor (P < 0.05). In fetal membranes, epidermal growth factor receptor messenger RNA increased from 1.05 +/- 0.30 before labor to 1.65 +/- 0.71 after the onset of labor (P < 0.05). CONCLUSION: The study indicates it is Up-regulation of epidermal growth factor receptors messenger RNA expression in myometrium and fetal membrane before and after the onset of labor.

Amnion↗
PubMed2001

Effect of lower uterine segment sweeping on progress of labor in nullipara.

Previous studies have shown that sweeping between the membranes and lower uterine segment was an effective procedure for reducing prolonged pregnancy. However, there has been no study to show the effect of lower uterine segment sweeping to the progress of the active phase of labor. This study was to determine the effect of lower uterine segment sweeping on the progress of the active phase of labor in nullipara. A total of four hundred nulliparous term pregnant women with spontaneous labor were randomized to one of two groups; the control group had routine vaginal examination while the study group had lower uterine segment sweeping at the time of each examination. Oxytocin infusion was given if there was dysfunctional labor. Progression of labor and the need for oxytocin augmentation were reviewed. Data were analyzed by chi square and Student t-test. Oxytocin was used in 67 per cent of the sweeping group and 62 per cent of the control group (p=0.3). The duration of the first stage (0.46), the second stage (0.38), and the third stage (0.28) of labor were not significantly different between the two groups. In conclusion, lower uterine segment sweeping did not reduce the need for oxytocin augmentation or lessen the duration of labor in nullipara.

Adult↗
PubMed2001

[Family labor from the father's point of view].

Family labor becomes increasingly popular in our country. The aim of the study was answering the question: what the main motive for the men attending to labor was, whether fathers were satisfied of their participation and what the main reason of their satisfaction was. The study was performed in the district and local hospitals in south-eastern Poland during 7 months. 110 fathers were in the study group, 78 (70.9%) of urban population, and 32 (29.1%) of rural. The obtained results indicate firm acceptance of such a way of labor among majority of fathers. It was supported by the fact that almost all of them were satisfied of their participation in labor, and wished to attend the next one. The main reason for inclining them for the participation in labor was the granting of the partners' request, and internal willing. The source of satisfaction from sharing of the labor was providing the safety for the partner and setting up early contact with the baby. Significant influence of the labor schools on the feeling of readiness for delivery and the level of father's satisfaction were not evident.

Adaptation, Psychological↗
PubMedDate not supplied

[Endocrine, paracrine and electrophysiologic regulation of human labor].

The problem of labor and delivery, either at term or occurring prematurely, are among the greatest problems facing physicians nowadays. The understanding of the process of preparation and initiation of active labor is of utmost importance. Currently, the clinical methods to assess the changes of the uterus and cervix are still subjective, inaccurate and crude. Fortunately, a noninvasive method of transabdominal uterine muscle electrical activity analysis (electromiography, EMG) is digitalized and standardized in recognizing uterine contractility, and biochemical changes, as well as ultrasound and fluorescent methods, are emerging to estimate cervical preparation prior to active labor. Studies in humans indicate that uterine and cervical function an be accurately monitored during pregnancy and during the preparation for labor. In the review article all aspects of uterine muscle and uterine cervix architecture, preparation for labor and control of these processes are presented. The development of new methods of diagnosis for the patient in labor will improve our ability to diagnose preterm labor early enough to undertake all kinds of scientifically based methods and strategies specifically for the management of this condition.

Cervix Uteri↗
PubMed1991

[[The effect of demographic structural change on labor utilization in Taiwan]].

"The purpose of this study is to examine the effect of demographic structural change on labor utilization in Taiwan.... Both purging method and decomposing rate differences method are used to analyze labor utilization data obtained from reports on the Manpower Utilization Survey from 1980 to 1989. The results suggest that the age-sex composition change of labor force from 1980 to 1989 pushed down the crude rate of labor underutilization in the labor market; the education-sex composition change pulled up crude rate of underutilization; and marital status-sex composition change also pushed down crude underutilization rate. In sum, the demographic structural change of labor force in Taiwan does have [an] obvious impact on labor utilization." (SUMMARY IN ENG)

Age Distribution↗
PubMed2002

[Paravertebral block for labor analgesia in a parturient with idiopathic thrombocytopenia].

A parturient with idiopathic thrombocytopenia received labor analgesia with bilateral paravertebral blocks, because epidural analgesia was contraindicated due to her low platelet count (69,000.microliter-1) even after intravenous administration of freeze-dried sulfonated human normal globulin (400 mg.kg-1.day-1) and transfusion of platelet (20 units.day-1). In spite of predonisolone (1 mg.kg-1.day-1) p.o., her platelet counts could not increase at early gestation period. Prior to the induction of the labor, two catheters were inserted into T 11 bilateral paravertebral spaces, then 0.2% ropivacaine 10 ml was administered in each side, followed by the infusion at 5 ml.hr-1 each for the management of first stage of labor pain. Labor was induced with oxytocin infusion at 2.5-5.0 mU.min-1. As she requested additional analgesia in the second stage of labor, fentanyl 50 micrograms was administered twice intravenously. The labor course was uneventful with adequate analgesia, and the neonate (2,826 g) was vigorous with Apgar scores 9/10. Complications associated with this block such as hypotension, vascular or pleural punctures and pneumothorax were not seen. Bilateral paravertebral blocks may provide adequate analgesia as an alternative method for labor analgesia in a parturient with thrombocytopenia when conventional epidural analgesia is contraindicated.

Adult↗
PubMedDate not supplied

[Sequential changes of extracellular matrix metalloproteins in pregnancy and labor in the rat chorio-allantois].

Participation of matrix metalloproteinases (MMP) and their tissue inhibitors (TIMP) in the rupture of fetal membranes (FM) during labor has been proposed. We describe and characterize sequentially the activity of the enzymes that degrade connective tissue in the FM of the rat during pregnancy and labor. Pregnant Wistar rats were sacrificed on different days of gestation and samples of amniotic fluid (AF) and MCA were collected to be analyzed for proteolytic activity, zymography, western blot and northern blot. Results showed that during labor, there is a significant increase in the proteolytic activity in the MCA and in the AF. MMP-2 was identified from day 15 of pregnancy and it increased near labor. MMP-9 was only identified two days before labor. MMP-2 and MMP-9 mRNA expression were coincident with enzymatic activity and western blot data. During labor, TIMP-1 decreased and TIMP-2 did not change. These results allow us to conclude that there exists a quantitative and qualitative differential expression of MMPs during gestation, especially during labor.

Allantois↗
PubMed2003

[Expression of cyclooxygenase-2 mRNA and identification of its spliceriant in human myometrium obtained from women in labor].

OBJECTIVE: To investigate the expression of cyclooxygenase-2 (COX-2) in human lower segments of myometrium obtained from women in labor and those not in labor and identify the splice variant of COX-2. METHODS: Reverse transcriptase-polymerase chain reaction (RT-PCR) was used for investigating the expression of COX-2. According to the sequence of rat COX-2 splice variant, the primers were designed and synthesized, then the splice variant of COX-2 in human myometrium from woman in labor was identified, cloned into vector and sequenced. RESULTS: The results showed that (1) The Expression of COX-2 mRNA was lower in human myometrium obtained from women who were not in labor than those in labor. (2) A new band of COX-2 was obtained in myometrium from a woman in labor. The fragment includes an unspliced intron, which locates between exons 7 and 8. CONCLUSION: COX-2 gene is not only expressed highly in human myometrium from women in labor, but also produced splicing variant by alternative splicing.

Adult↗