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PubMed1996

Asymptomatic maternal shedding of herpes simplex virus at the onset of labor: relationship to preterm labor.

OBJECTIVE: To determine if fetal growth restriction and prematurity are observed with subclinical shedding of herpes simplex virus (HSV) at the onset of labor. METHODS: Within 48 hours of delivery, cultures were taken from the cervix and external genitalia of 15,923 asymptomatic pregnant women without symptoms or signs of genital HSV infection; results were positive for HSV in 57. Each of these 57 women were compared with a control group composed of the three culture-negative women delivering immediately before and the three delivering immediately after each woman shedding HSV. RESULTS: The median birth weight for infants born to the 57 women with asymptomatic shedding was 3050 g, compared with 3360 g among the 342 women without asymptomatic shedding, a statistically significant difference (P < .002). These differences were due to very low birth weight (LBW) among the five infants of women with subclinical viral shedding secondary to recently acquired primary genital herpes; these five infants had a median gestational age of 33 weeks, compared with 37 weeks for the 14 infants of mothers with nonprimary, first-episode disease and 39 weeks for the 33 infants of women with reactivation disease, also a significant difference (P = .018). CONCLUSIONS: Asymptomatic genital shedding of HSV at the onset of labor because of subclinical primary genital HSV infection is associated with preterm delivery. Women who acquire genital HSV-2 before pregnancy and are shedding subclinically at the onset of labor experience no increase in adverse outcome. Thus, prevention of the prematurity and LBW associated with genital herpes means that acquisition of the infection in late pregnancy must be prevented.

Birth Weight↗
PubMed1990

[Reflex labor induction in premature labor complicated by premature rupture of fetal membranes].

Labor induction in impending premature delivery complicated by premature rupture of the membranes is controversial. Problems arise both with choice of a mode of delivery and induction manoeuvres to be used in biologically premature delivery. The paper addresses the results with a reflex method of labor induction based on transcutaneous electroneurostimulation (TENS). An appropriate TENS regimen was found to be a highly efficient method of labor induction allowing one to reduce the incidence of perinatal complications.

Adolescent↗
PubMed1988

Labor and infection. II. Bacterial endotoxin in amniotic fluid and its relationship to the onset of preterm labor.

We have previously reported the detection of endotoxin in the amniotic fluid of patients with gram-negative intraamniotic infection. Endotoxin or lipopolysaccharide is a potent biologic product capable of inducing prostaglandin release from several cell types and, therefore, may be involved in the onset of human parturition in the presence of intraamniotic infection. This article describes a technique for the quantification of endotoxin in amniotic fluid. The method uses a computer-assisted quantification of the turbidimetric reaction between the Limulus amebocyte lysate and endotoxin. Serial dilutions of Escherichia coli endotoxin in culture-negative amniotic fluid were prepared, and the samples were run in the assay. Amniotic fluid was found to enhance the reaction, and a dilution of 1:20 was required for this biologic fluid to behave similarly to pyrogen-free water. The sensitivity of this kinetic turbidimetric technique in the detection of endotoxin in amniotic fluid was 40 pg/ml. This method was applied to the quantification of endotoxin concentration in amniotic fluid in 26 patients with intraamniotic infection and premature rupture of membranes. Patients in active labor had higher concentrations of endotoxin (median = 47,514 pg/ml) than nonlaboring patients (median = 635 pg/ml) (p less than 0.025). Therefore, women with preterm labor had a higher median concentration of endotoxin in amniotic fluid than patients who were not in labor.

Amniotic Fluid↗
PubMed1989

Infection and labor. V. Prevalence, microbiology, and clinical significance of intraamniotic infection in women with preterm labor and intact membranes.

Amniotic fluid was retrieved by amniocentesis from 264 patients with preterm labor and intact membranes admitted to Yale-New Haven Hospital from Jan. 1, 1985, to July 31, 1988. The prevalence of a positive amniotic fluid culture was 9.1% (24/264). A total of 111 patients (42%) delivered preterm neonates, and 24 (21.6%) of those had positive amniotic fluid cultures. The diagnostic indexes of the Gram stain of amniotic fluid in the prediction of a positive amniotic fluid culture were as follows: sensitivity, 79.1%; specificity, 99.6%; positive predictive value, 95%; and negative predictive value, 98%. Endotoxin was detected with the limulus amebocyte lysate assay in 4.9% (13/264) of patients with preterm labor. All patients with endotoxin in the amniotic fluid delivered preterm neonates. The three most frequently isolated organisms were Ureaplasma urealyticum (n = 6), Fusobacterium species (n = 5), and Mycoplasma hominis (n = 4). Clinical chorioamnionitis was present in only 12.5% of the patients with positive amniotic fluid cultures. Women with positive amniotic fluid cultures had lower gestational ages and more advanced cervical dilatation on admission than women with negative cultures. Preterm infants born to mothers with positive amniotic fluid cultures had a higher incidence of respiratory distress syndrome and infectious complications than preterm neonates born after negative amniotic fluid cultures. These data underscore the frequency and importance of intraamniotic infections in women with preterm labor.

Amniocentesis↗
PubMed2000

Expression of myometrial activation and stimulation genes in a mouse model of preterm labor: myometrial activation, stimulation, and preterm labor.

Myometrial contractions of labor result from an increase in myometrial activation and stimulation. Activation develops through the expression of contraction associated proteins (CAPs), including oxytocin receptors (OTR), connexin-43 (Cx-43), and prostaglandin F2 alpha, receptors (FP). Stimulation involves increases in contractile agonists including prostaglandin E2 (PGE2) and prostaglandin F2 alpha. (PGF2 alpha) that may result from increases in prostaglandin endoperoxide H synthase (PGHS)-2. A mouse model of preterm birth was used to study gene expression involved in myometrial activation and stimulation. To induce preterm birth, pregnant C57BL/6J mice were intubated with 6 g/kg ethanol on gestational day 16 and were killed every 6 h from treatment until birth. RIA was used to measure uterine PGE2 and PGF2 alpha, while PGHS-2, OTR, Cx-43, and FP messenger RNA levels were measured by ribonuclease protection assay. Increases in CAP mRNA were associated with term and preterm birth. There were differences in stimulation effectors associated with preterm and term birth. Uterine PGF2 alpha values were increased only at the time of term birth, but PGE2 was elevated during both preterm and term labor. These data suggest that existing levels of PGF2 alpha are sufficient for preterm birth when CAP expression is increased, but term labor requires increases in PGE2, PGF2alpha, and CAPs. The PGHS-2 messenger RNA expression pattern suggests that it is a CAP.

Animals↗
PubMedDate not supplied

Lactation and the labor market: breastfeeding, labor market changes, and public policy in the United States.

Public health authorities in the United States actively promote breast-feeding, with target goals for increased beast-feeding rates by the year 2000. In recent decades, however, there has been an increase in the number of American mothers with infants who are in the labor market. Drawing together research examining the intersection of breast-feeding and women's involvement in paid employment, as well as various labor market analyses, this study explores how national recommendations advocating increased breast-feeding among new mothers in paid work are reconciled with economic pressures to return to the labor force in the early postpartum period. This analysis highlights those employment-related factors that constrain the practice of breast-feeding, thereby impeding "choice" over infant feeding method for many mothers. Finally, there is an attempt to explore various employer and public policies and strategies potentially supportive of breast-feeding among mothers in paid employment.

Adult↗
PubMed2004

[Time study of nurse's shift work the influence of domestic labor on fatigue after ordinary labor].

INTRODUCTION: The relationship between domestic labor and fatigue following night shift work by nurses was examined. Differences due to the age of the youngest child, which apparently influences housework time, were analyzed. METHODS: A time survey was conducted with 159 shift work nurses at a public general hospital. Participants were divided into three groups based on the age of the youngest child, i.e., those whose youngest child was in school were placed in the "school age" group, those whose youngest child was preschool age were placed in the "preschool age" group, and nurses without children were placed in the "childless" group. Using four categories of daily living, time use was set as labor hours, physiological hours, house work hours, and social and cultural activity hours, and daily living time was described with reference to seventeen items. A subjective symptoms index (SSI) was applied after both day and night shifts. Comparison of the degree of recovery from physical fatigue and loss of mental concentration were also investigated between the end of day work and the start of night work. RESULTS: Sleeping and napping time was 7 hours and 53 minutes in the "preschool age" group, 8 hours and 18 minutes in the "school age" group, and 9 hours and 11 minutes in the "childless" group. Housework time was 3 hours and 9 minutes in the "preschool age" group, 2 hours and 1 minute in the "school age" group, and 48 minutes in the "childless" group, with the majority of time spent doing cooking and childcare chores. Social and cultural activity time was 36 minutes in the "preschool age" group, 57 minutes in the "school age" group, and 1 hour and 19 minutes in the "childless" group. Fireside time with family was a mere 7 minutes in the "preschool age" group. The subjective symptoms index (SSI) after night work showed severe fatigue in all groups. All groups showed greater fatigue and loss of concentration at the time of night work than when finishing day work. DISCUSSION: The results showed greater fatigue in the "preschool age" group, which suggests an inverse correlation with sleeping and napping and a positive link to labor in the home. The "preschool age" group had longer housework hours, and shorter sleeping and social and cultural activity hours, which are presumed to influence fatigue.

Fatigue↗
PubMed1997

Child labor and the division of labor in the early English cotton mills.

"The share of children employed in English cotton factories fell significantly before the introduction of effective child labor legislation in the early 1830s. The early factories employed predominantly children because adults without factory experience were relatively unproductive factory workers. The subsequent growth of the cotton industry fostered the development of a labor market for productive adult factory workers. This effect helps account for the shift toward adults in the cotton factory workforce."

Age Factors↗
PubMed1975

[Influence of labor induced by prostaglandins on the metabolism and blood coagulation system of the mother and child during labor].

22 pregnancies at term were terminated by dilatation of the uterine cervix, low amniotomy, and by intravenous administration of PGF2alpha or PGE2. The average infusion time was 4 hours 10 minutes, and the average total dose of PGF2alpha amounted to 2,0 mg and of PGE2 0,2 mg. Parameters of acid-base changes, carbohydrate and energic state changes, gas metabolism, and changes in coagulation and fibrinolysis in mother and in fetus were analyzed during labor and after birth. Labor activity and fetal cardiac action were monitored cardiotocographically. Checked against 50, and for the coagulation 12 uncomplicated spontaneous deliveries, we have found no disadvantageous changes in the parameters investigated.

Acid-Base Equilibrium↗
PubMed1989

Management of the second stage of labor: a review (Part II). Maternal positioning as it relates to the management of the second stage of labor is reviewed.

In the previous article, the rigid use of the Friedman Curve, breathing techniques, and other management options for the second stage of labor were examined. This article concentrates on the affect of maternal positioning, on the length of the second stage of labor, and summarizes the contents of that former article and this one.

Female↗
PubMed1980

Determinants of postpartum morbidity in laboring monitored patients: a reassessment of the bacteriology of the amniotic fluid during labor.

Identification of the type and concentration of bacterial organisms in the amniotic fluid (AF) during labor might allow for earlier and more effective treatment of postpartum infections. Previous studies have identified organisms typically associated with postpartum endometritis, but the relationship to intrapartum findings has been disappointing. The purpose of this prospective study was to reassess any relationships between the bacteriology of the AF during labor and the postpartum course in the high-risk, noninfected, monitored gravid patient. The intrapartum AF bacterial flora was similar in 70 patients delivered vaginally and 80 patients delivered abdominally. In patients who did not receive prophylactic antibiotics, a total AF organism count of greater than or equal to 10(4) colonies/ml and the presence of any streptococcal or Bacteroides organism, gram-negative bacillus, or Staphylococcus aureus were significantly related to postpartum morbidity. Under these conditions, cesarean section considerably increased the risk of clinical endometritis. These results suggest that semiquantitative culture of AF obtained through the intrauterine pressure catheter prior to delivery may be of value in the postpartum management of patients delivered by cesarean section.

Amniotic Fluid↗
PubMed1977

Elective induction of labor conducted under lumbar epidural block. II. Labor induction by amniotomy and intravenous prostaglandin.

Labor was electively induced at term in 117 clinically normal nulliparae and parous women by combining low amniotomy with intravenous administration of prostaglandin F2 alpha (n = 64) or prostaglandin E2 (n = 53). Analgesia was obtained by continuous lumbar epidural block with bupivacaine. The procedure was very effective in producing vaginal delivery within 24 h after prostaglandin infusion (n = 115), but it was accompanied by an extremely high incidence of uterine hypertonus. Tentative explanations for the transient uterine hyperstimulation are a direct stimulatory effect of the local anesthetic on the contractility of the myometrial fiber and/or a temporarily higher amount of circulating oxytocic compound reaching the myometrium due to local vasodilatation as a result of sympathetic nerve blockade. In some cases uterine hypertonus was associated with slowing of the basal fetal heart rate and, when severe, with the appearance of late deceleration patterns and fetal acidosis. In other cases the fetal heart rate deceleration is explained by the toxic effect of bupivacaine on the myocard. Since both the myometrial hyperactivity and the FHR alterations were temporary, fetal biochemical parameters were unaffected at completion of the first stage of labor. Because with intravenous prostaglandin uterine hyperstimulation is more difficult to avoid and regional analgesia further increases the hazard of both hypertonus and fetal heart rate deceleration, the combined application of an intravenous prostaglandin and continuous epidural analgesia should not be introduced into obstetrical practice.

Adult↗
PubMed1998

Labor migration during the first phase of basque industrialization: the labor market and family motivations.

"This article analyzes the migration strategies of those social groups making up the labor supply during the first phase of industrialization in the Basque Country (1877-1910), which was one of the most industrialized regions of the northern part of Spain. Migration is estimated by sex, marital status, and origin and interpreted within the context of family decision-making. The article also deals with the expectations among potential migrants by the areas of destination. The study of the labor market, from the standpoint of job specialization, will enable us to know more about the profile of a typical migrant, and the family as a protagonist in migratory flows."

Behavior↗
PubMed2001

Developing CD-ROM based multimedia digital textbook of 'San-Yin-Jiao(SP-6) pressure for reducing the labor pain and shortening the labor time'.

The computer-based textbook is a new educational tool that promises to play a prominent role in the coming years. Classical instructional technologies, such as video, stills, audio files and computer programs with a textbook orientation, have been merged into one multimedia computer system and have created additional opportunities for learning in medical, dental and nursing education. The authors developed a hypermedia textbook of â San-Yin-Jiao pressure for reducing the labor pain and shortening the labor time' using a personal computer with hypermedia software that contains texts, images, videos, audios and literature citations. The target population of this educational CD-ROM would be nurse-midwives, clinical nurses working for the obstetric units, and faculty members who teach the Maternity and Women's Health Nursing. Valuable and practical experiences were obtained and shared.

Acupressure↗
PubMed1987

Does extra-amniotic infection cause preterm labor? Gas-liquid chromatography studies of amniotic fluid in amnionitis, preterm labor, and normal controls.

Gas-liquid chromatography (GLC) was used to identify short-chain organic acid byproducts of bacterial metabolism in amniotic fluid from seven normal control patients, six women with overt amnionitis, and six preterm labor patients. Microbiologic culture for aerobic and anaerobic bacteria was also carried out. Positive GLC findings were generally associated with positive cultures, except in five of the preterm labor patients whose GLCs were positive despite negative cultures. The origin of the short-chain organic acids found in these women is unclear; extra-amniotic bacterial growth may explain this finding.

Amniotic Fluid↗
PubMed1977

Induction of abortion and labor by extraamniotic isotonic saline, with or without addition of oxytocin, in cases of missed abortion, missed labor and antepartum fetal death.

In a group of 16 women admitted for missed abortion, missed labor or antepartum fetal death, we induced abortion or labor by means of extraamniotic infusion of isotonic saline solution, using a Foley catheter inserted through the cervix. Eight patients also required parallel intravenous administration of 5-10 U of oxytocin drip. The average time from the onset of treatment until expulsion of the macerated fetus was 9.09 hours. No complications were recorded. This method is suggested in all such cases, especially when the classical methods are contraindicated.

Abortion, Induced↗