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At least 1,297 records · Page 72Linked to original sources
PubMed2006

Complications associated with cesarean section in the second stage of labor.

OBJECTIVE: To determine maternal and neonatal complications associated with cesarean section done in the second stage of labor. METHOD: Cohort study comparing cesarean sections done in the second stage of labor (cases) with those done for poor progress in the first stage (controls). Only singleton cephalic live pregnancies at 36 weeks or more, without previous cesarean section, were included. RESULT: There were 39 cases and 39 controls. Cesarean section in the second stage of labor took significantly longer (median 45 vs. 30 min; P<0.001), and was associated with more frequent postoperative pyrexia (10 vs. 2; P=0.012). There were more neonatal admissions in the case group (17 vs. 3; P<0.001). Hypoxic ischemic encephalopathy was more frequent in infants following second-stage cesarean section (8 vs. 1; P=0.013), as was subaponeurotic hemorrhage (6 vs. 0; P=0.012). CONCLUSION: Cesarean section in the second stage of labor is associated with significant intraoperative and neonatal morbidity.

Adolescent↗
PubMed1999

Pregnancy among women with congenitally corrected transposition of great arteries.

OBJECTIVES: The outcome of pregnancy in congenitally corrected transposition of the great vessels was studied in 22 women. BACKGROUND: Women with congenitally corrected transposition of the great vessels often reach childbearing age. Although reports on the outcome of pregnancy in these women are available, the number of patients is small. METHODS: The medical and surgical databases at the Mayo Clinic were reviewed, and 36 women >16 years old with congenitally corrected transposition of the great vessels were identified. All of them were contacted, and 22 who had pregnancies were identified and the outcome of pregnancy was evaluated. RESULTS: Twenty-two women had 60 pregnancies resulting in 50 live births (83%). Forty-four deliveries (88%) were vaginal and 6 (12%) were by cesarean section. One delivery was premature at 29 weeks. There was one successful twin pregnancy. There were 11 unsuccessful pregnancies. One patient developed congestive heart failure late in pregnancy because of systemic atrioventricular valve regurgitation and required valve replacement in the early postpartum period. One patient had a total of 12 pregnancies, including 1 twin pregnancy and 2 unsuccessful pregnancies. She had multiple pregnancy-related complications, including toxemia, congestive heart failure, endocarditis and myocardial infarction (single coronary artery). No other serious pregnancy-related maternal complications and no pregnancy-related deaths occurred. The mean birth weight of the infants (n = 32) was 3.2 +/- 0.4 kg. None of the 50 live offspring have been diagnosed with congenital heart disease. CONCLUSIONS: Successful pregnancy can be achieved in most women with congenitally corrected transposition of the great arteries. The rate of fetal loss and maternal cardiovascular morbidity is increased. Because of the small number of births, the risk of congenital heart disease in offspring of women with congenitally corrected transposition of the great arteries is uncertain.

Adult↗
PubMed1985

The outcome of pregnancy after threatened abortion.

A prospectively collected group of 93 pregnancies complicated by threatened abortion was carefully monitored throughout pregnancy, during birth and in the perinatal period, and any deviation from a completely uneventful course was registered. Comparison was made with a selected group of 282 non-risk pregnant women. A significant association was found between threatened abortion and the overall number of complications in the second half of pregnancy requiring medical intervention and/or admission to hospital, impending pre-term birth requiring betamimetics, pre-term birth, retention of the placenta, birth weight below 2000 g, light-for-dates infants in case of pre-term birth or birth weight below 2000 g, and hyperbilirubinemia in infants with birth weight below 2000 g. The incidences of perinatal mortality and congenital malformations did not differ significantly from those of the control group. Pregnancies complicated by threatened abortion constitute a risk group requiring careful obstetric and perinatal supervision and follow-up.

Abortion, Threatened↗
PubMed1994

Obstetrical implications in multiple pregnancies.

In the present study 90 multiple pregnancies were examined. These were subdivided on the basis of the number of embryos involved (74 twins, 10 triplets, 6 quintuplets) and on whether they were followed at our clinic for the entire pregnancy or not. In each group we analysed certain variables, calculating the respective mean values and standard deviations. We used the ANOVA test to discriminate the eventual differences in the means of the variables analysed, operating a p < 0.05 significance value. In addition, significant differences were analysed by the test of Contrasts (Scheffe F-test). The concept that emerged from the data investigated is that careful management of these pregnancies, carried out in high-level structures, can reduce the incidence of complications on both the maternal and fetal side and thus prevent "minimal brain damage" in the newborn.

Abortion, Spontaneous↗
PubMed1988

Risk factors for Erb-Duchenne palsy.

The risk factors associated with the occurrence of Erb-Duchenne palsy were examined. Of 22 palsies, 18 were noted among 32,088 nondiabetic gravidas (0.56 per 1000) compared with four among 380 diabetic gravidas (10.5 per 1000), a statistically significant difference. One in six infants of diabetic gravidas who sustained shoulder dystocia experienced an Erb-Duchenne palsy. The incidence of precipitate second-stage labors was high (31.8%) among those infants who experienced the neurologic complication. This labor abnormality is not preventable and may contribute, in many ways, to the neurologic complication. Although recently graduated (less than four years' postresidency training) obstetricians, especially if placed in a high-volume practice, were more likely to experience this adverse outcome than more experienced physicians, even the most senior clinicians delivered infants who were affected.

Dystocia↗
PubMed1979

Delayed reproductive complications after induced abortion.

An investigation was undertaken regarding subsequent pregnancy in 619 women who had their preceding pregnancy terminated by legal abortion, compared with an age- and parity-matched group of 619 women who continued with the pregnancy to delivery. The groups were compared for complications such as first and second trimester abortion, cervical incompetence, pre-term delivery, ectopic pregnancy and sterility. The total complication rate was 24.3 per cent in the abortion group, and 20.2 per cent in the controls. No significant difference was found between the two groups for any of the parameters examined, except for a significantly higher rate of complications amongst women who had not had a previous delivery: 25.5 per cent as opposed to 13.2 per cent in the control group.

Abortion, Induced↗
PubMed1986

Group B streptococcal colonisation and the outcome of pregnancy.

Vaginal colonisation of pregnant women with group B streptococci (GBS) was not related to age, parity or blood group. There were marked differences between racial groups, Asians having a low colonisation rate and Negroes a high rate. Vaginal GBS colonisation was associated with intrapartum pyrexia, but not with preterm labour, premature rupture of membranes or other complications in labour. Group B streptococci may be an important cause of bacteriuria in pregnancy and their effect on the outcome of pregnancy as urinary pathogens needs further evaluation.

Abortion, Spontaneous↗
PubMed2003

[Pregnancy and delivery in women with congenital heart disease].

OBJECTIVES: Perinatal care of women with congenital heart disease is very important for obstetrician. DESIGN: The purpose of this study was to analyse the course of pregnancy, delivery and after birth period of women with congenital heart disease. MATERIAL AND METHODS: A group of 35 pregnancies and deliveries in patients with congenital heart disease cured in 1998-2003 in the Department of Obstetrics and of Medical University in Gdansk were analysed. The control group was a total of 1657 deliveries in the Department of Obstetrics in the 1998. For statistical analysis of the results the T-Student test was used with the significance level p = 0.05. RESULTS: Time of pregnancy, birth weight and length were statistically different to the control group. CONCLUSIONS: We found no cardiological complications during pregnancy in patients with congenital heart disease at I and II stage NYHA. Time of pregnancy, birth weight and length were statistically different to the control group.

Adult↗
PubMedDate not supplied

Baby bottle tooth decay and complications during pregnancy and delivery.

The purpose of the study was to investigate an association between maternal and/or fetal complications during pregnancy and/or delivery and the occurrence of baby bottle tooth decay (BBTD) in the infant. The study population comprised 50 mothers of infants with BBTD (BBTD+ mothers): 50 mothers of aged-matched children with similar eating and bottle-use habits but without BBTD (BBTD-) served as comparisons. Interviews with the mothers focused on pregnancy complications (vaginal bleeding, premature uterine contractions, viral or bacterial infections, hospitalization, diabetes, or other causes of high-risk pregnancy), mode of delivery (normal or instrumental), fetal distress, gestational age, birth weight, and mother's age at delivery. Chi-square analysis and the Student's t-test were used to analyze the data. Pregnancy complications and instrument delivery/cesarean section were significantly higher in the BBTD+ group than in the controls (P = 0.0001 and P = 0.0004, respectively). In the BBTD+ group, vaginal bleeding/premature uterine contractions were most frequent (50%), while in the BBTD- group high-risk pregnancy dominated (20%). Normal deliveries were more frequent in the BBTD+ mothers (68%) than in the comparisons (40%). Gestational age and baby's birth weight did not differ between the two groups. The mean age of the BBTD+ mothers was significantly lower than that of the controls (P = 0.013). The results suggest that babies born after maternal complications during pregnancy or babies who experience a traumatic birth must be considered to be at risk of developing BBTD when exposed to excessive bottle nursing.

Adult↗
PubMed1995

[Subpartal diagnosis of umbilical cord encirclement using color-coded Doppler ultrasonography and correlation with cardiotocographic changes during labor].

Umbilical cord complications are the most common cause of pathologic fetal heart tones during delivery. The inauguration of colour-coded Doppler ultrasound in obstetrics has made the definite diagnosis of umbilical cord encirclement during delivery possible. The prospective study introduced here examines the question of how exactly an encirclement can be seen by Doppler during delivery, its influence on cardiotocographic results, delivery mode, and fetal outcome. 107 patients in labour with cervical dilatation were examined in a prospective study using colour-coded Doppler ultrasound to determine cases of umbilical cord encirclement. In 50 cases, encirclement could be visualised, 48 of which were confirmed post partum. Encirclement could be ruled out in 57 other cases. A sensitivity of 96% and specificity of 100% resulted. No significant differences could be found with regard to mode of delivery and fetal outcome. However, the umbilical cord in cases of encirclement was significantly longer than when no encirclement occurred. Assessment of fetal heart tones demonstrated a significantly higher rate of variable decelerations in the patient group with umbilical cord encirclement compared to that without. In conclusion, our results show that the early diagnosis of umbilical cord encirclement during delivery allows appropriate assessment of fetal heart tone changes,justifying temporising management under continuous monitoring with possible micro-blood analysis.

Asphyxia Neonatorum↗
PubMed1991

Demonstration of fetal habituation and patterns of fetal heart rate response to vibroacoustic stimulation in normal and high-risk pregnancies.

Habituation is the decremental response to repetitive stimulation and is a learned response. One hundred five fetuses from 26 normal and 79 high-risk pregnancies were evaluated from 28 to 43 weeks' gestation and in labor as to the fetal heart rate response from repetitive vibroacoustic stimulation. Four patterns were observed: (1) habituation (H), (2) reactive nonhabituation (R-NH), (3) accelerative nonhabituation (A-NH), and (4) nonreactive (NR). Fetuses from normal pregnancies habituated significantly more often than those at greater risk. Of the high-risk group, only 6.4% who have habituated antenatally had a labor or nursery complication compared with 67.5% who exhibited the R-NH or A-NH pattern (P less than .001). This study has demonstrated the patterns of FHR response to vibroacoustic stimulation, as well as the ability to induce fetal habituation. Habituation may differentiate high-risk fetuses on the basis of labor complications or poor neonatal outcome. Further study of habituation is being conducted to ascertain if it should be added to standard fetal surveillance modalities of fetal movement, the non-stress test, contraction stress test, and biophysical profile.

Acoustic Stimulation↗