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At least 1,189 records · Page 66Linked to original sources
PubMed2000

Maternal oxygen administration for fetal distress.

BACKGROUND: Maternal oxygen administration has been used in an attempt to lessen fetal distress by increasing the available oxygen from the mother. OBJECTIVES: The objective of this review was to assess the effects of maternal oxygenation for fetal distress during labour and to assess the effects of prophylactic oxygen therapy during the second stage of labour on perinatal outcome. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Date of last search: December 1997. SELECTION CRITERIA: Randomised trials comparing maternal oxygen therapy for fetal distress during labour and prophylactic oxygen therapy during the second stage of labour with a control group (dummy or no oxygen therapy). DATA COLLECTION AND ANALYSIS: Eligibility and trial quality were assessed by the reviewer. MAIN RESULTS: No trials addressing maternal oxygen therapy for fetal distress could be located. One trial of 85 women which addressed prophylactic oxygen therapy during labour was included. Cord blood pH values of less than 7.2 were more frequently recorded in the oxygenation group than the control group (relative risk 4.83, 95% confidence interval 1.11 to 21.04). There were no other statistically significant differences between the groups. Within the oxygenation group, those receiving oxygenation for less than 10 minutes had higher umbilical artery pH values than those receiving oxygen for longer than 10 minutes. REVIEWER'S CONCLUSIONS: There is not enough evidence to support the use of prophylactic oxygen therapy for women in labour, nor to evaluate its effectiveness for fetal distress.

Female↗
PubMed1990

Postpartum femoral neuropathy: relic of an earlier era?

Femoral neuropathy after childbirth is rarely encountered today, although around 1900 an incidence of up to 4.7% was found. A case of postpartum unilateral femoral neuropathy in a 29-year-old primigravida is described. The patient's labor was complicated by poor progression, a prolonged second stage (three hours), and midforceps delivery. The patient received both epidural anesthesia (requiring catheter manipulation) and spinal anesthesia. Total time in the dorsal lithotomy position was four hours; total duration of labor was 27 hours. After delivery, the patient experienced buckling at the right knee and numbness down the leg anteriorly. The electromyogram at one month was consistent with an acute femoral neuropathy. Information about other cases of postpartum lower extremity neuropathy was obtained by a retrospective review of all deliveries at a large maternity hospital between 1971 and 1987. Of 143,019 live births, there were three other cases of postpartum knee extensor weakness (2.8/100,000), five cases of postpartum footdrop (3.5/100,000), and two cases of meralgia paresthetica (1.4/100,000). Although the precise mechanism of injury remains unclear, the declining incidence of femoral neuropathy may reflect decreased duration of labor with modern obstetric practices, particularly more frequent Cesarean delivery.

Adult↗
PubMed2000

Amnioinfusion for meconium-stained liquor in labour.

BACKGROUND: Amnioinfusion aims to prevent or relieve umbilical cord compression during labour by infusing a solution into the uterine cavity. It is also thought to dilute meconium when present in the amniotic fluid and so reduce the risk of meconium aspiration. However it may be that the mechanism of effect is that it corrects oligohydramnios (reduced amniotic fluid), for which thick meconium staining is a marker. OBJECTIVES: The objective of this review was to assess the effects of amnioinfusion for meconium-stained liquor on perinatal outcome. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. SELECTION CRITERIA: Randomised trials comparing amnioinfusion with no amnioinfusion for women in labour with moderate or thick meconium-staining of the amniotic fluid. DATA COLLECTION AND ANALYSIS: Eligibility and trial quality were assessed by one reviewer. MAIN RESULTS: Ten studies, most involving small numbers of participants, were included. Under standard perinatal surveillance, amnioinfusion was associated with a reduction in the following: heavy meconium staining of the liquor (relative risk 0.03, 95% confidence interval 0.01 to 0.15); variable fetal heart rate deceleration (relative risk 0.47, 95% confidence interval 0.24 to 0. 90); and a trend to reduced caesarean section overall (relative risk 0.83, 95% confidence interval 0.69 to 1.00). No perinatal deaths were reported. Under limited perinatal surveillance, amnioinfusion was associated with a reduction in the following: meconium aspiration syndrome (relative risk 0.24, 95% confidence interval 0. 12 to 0.48); neonatal hypoxic ischaemic encephalopathy (relative risk 0.07, 95% confidence interval 0.01 to 0.56) and neonatal ventilation or intensive care unit admission (relative risk 0.56, 95% confidence interval 0.39 to 0.79); there was a trend towards reduced perinatal mortality (relative risk 0.34, 95% confidence interval 0.11 to 1.06). REVIEWER'S CONCLUSIONS: Amnioinfusion is associated with improvements in perinatal outcome, particularly in settings where facilities for perinatal surveillance are limited. The trials reviewed are too small to address the possibility of rare but serious maternal adverse effects of amnioinfusion.

Amnion↗