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PubMed1996

Labor contractors: a conceptual overview.

"The purpose of this paper is to provide an overview of labor brokering or contracting that helps to explain why employers turn to foreign workers to fill certain vacant jobs, and how the presence of foreign workers brought to a country by labor contractors can affect the size and duration of migration flows. The major conclusion is that East Asian policies that aim to avoid the settlement of unskilled foreign workers also make labor brokering a prominent feature of labor migration and migrant labor markets in the region."

Asia↗
PubMed2002

Expression of matrix metalloproteinase (MMP)-2 and MMP-9 in human placenta and fetal membranes in relation to preterm and term labor.

Extensive extracellular matrix (ECM) remodeling is found in many processes during human parturition at term and preterm. These include cervical ripening, fetal membrane rupture, and placental detachment from the maternal uterus. Matrix metalloproteinases (MMPs) are the main mediators of ECM degradation. The present study was designed to investigate the expression of MMP-2 and MMP-9 in human fetal membranes (FMs) and placental (PL) tissues with or without labor at preterm and term parturition. Both zymography and Western blot analysis showed that MMP-9 was significantly (P < 0.01) increased in preterm and term labor FM, compared with nonlabor. Term labor PL also had a much higher (P < 0.05) level of MMP-9 than that of term nonlabor. No significant difference in MMP-2 expression was found between labor and nonlabor tissues. Immunolocalization studies revealed a specific distribution pattern for MMP-2 and MMP-9. MMP-2 was localized to the amnion mesenchyme, chorion laeve trophoblast, decidua parietalis, and blood vessels in PL villi. MMP-9 was localized mainly to amnion epithelia, chorion laeve trophoblast, decidua parietalis, and PL syncytiotrophoblasts. Separate cell culture from different layers of FM and culture of purified PL trophoblast cells showed that PL syncytiotrophoblast and amnion epithelial cells exclusively produced MMP-9; chorion trophoblast cells secreted both MMP-2 and MMP-9, but amnion mesenchymal cells produced only MMP-2. We concluded that MMP-2 and MMP-9 exhibited cell-specific expression in the human PL. An increase in MMP-9 expression may contribute to degradation of the ECM in the FM and PL, thereby facilitating FM rupture and PL detachment from the maternal uterus at labor, both preterm and term.

Cells, Cultured↗
PubMed2002

Identification of suppressors of cytokine signaling (SOCS) proteins in human gestational tissues: differential regulation is associated with the onset of labor.

Inflammatory cytokines secreted by the placenta and fetal membranes are believed to play an important role in the initiation of parturition. The suppressor of cytokine signaling (SOCS) proteins regulate signal transduction by several cytokines that have been reported to affect gestational tissues. The presence, distribution and roles of SOCS proteins, however, have not been described in human gestational tissues. Using reverse transcriptase (RT)-PCR and Western blot analysis we investigated the expression of SOCS1, SOCS2, and SOCS3 mRNA and protein, respectively, by human villous placenta, amnion and choriodecidua (n = 3-4). Tissues were obtained from uncomplicated pregnancies at term after either spontaneous labor and vaginal delivery or caesarean section (before labor). Messenger RNAs for SOCS1, SOCS2, and SOCS3 were expressed in all tissue types, irrespective of labor status. SOCS proteins were, however, only detectable in villous placenta and in one case in the choriodecidua. Labor was associated with abrogated expression of SOCS1 and SOCS3 proteins in villous placenta and the choriodecidua sample. Following labor the band for SOCS2 protein increased slightly in size which may indicate post-translational modification of SOCS2. Reduced expression of SOCS proteins in gestational tissues may provide a mechanism by which inflammatory cytokines enter into a positive feedback loop of inflammatory changes leading to delivery.

Blotting, Western↗
PubMed2004

High- versus low-dose oxytocin for augmentation or induction of labor.

OBJECTIVE: To compare the use of high- and low-dose oxytocin for augmentation or induction of labor. DATA SOURCES: Clinical trials were accessed through MEDLINE (1966-November 2003). Published literature relevant to the use of oxytocin for augmentation or induction of labor was evaluated. STUDY SELECTION AND DATA EXTRACTION: Articles identified from the data sources were evaluated and included if they were clinical trials comparing high-versus low-dose oxytocin for augmentation or induction of labor. DATA SYNTHESIS: Oxytocin is a treatment of choice for augmentation and induction of labor; however, no consensus exists regarding optimal dosing. Relevant studies comparing high-dose (2-6 mU/min) and low-dose (1-2 mU/min) therapy for labor augmentation and induction were evaluated. CONCLUSIONS: High-dose oxytocin decreases the time from admission to vaginal delivery, but does not appear to decrease the incidence of cesarean sections when compared with low-dose therapy.

Cesarean Section↗
PubMed2004

Does fetal head position at the term plus 12 scan influence induction, labor and delivery outcome?

AIMS: To assess the influence that fetal head position has on induction, labor and delivery outcome for both mother and baby. METHODS: During a one month period, in November 1999, all women attending for a post-dates scan were enrolled as the study population. In total, 91 women formed our study population for analysis of data. The sonographic, induction and labor details of all women were recorded on a dedicated data sheet. As well as documenting the maternal age, parity, liquor volume (mm) and BPS, the position of the fetal head was noted by the sonographer as occipitoanterior, occipitotransverse or occipitoposterior. All women had gestation confirmed by ultrasound early during the course of their pregnancy. Maternal, ultrasonographic, induction and labor variables were correlated with fetal head presentation at scan. RESULTS: There was no positive correlation found between fetal head position at the term plus 12 scan and associated induction, labor or delivery complications in the 91 women studied. CONCLUSIONS: Our study shows no positive correlation between fetal head position and induction, labor or delivery complications.

Adult↗
PubMed1987

Effects of induced abortion on the third stage of labor in subsequent pregnancy.

The aim of the study was to investigate whether the expulsion of the placenta was delayed among women who had previously undergone induced abortion by suction curettage. We studied the duration of the third stage of labor retrospectively by comparing the third stage of labor, recorded in minutes, between 76 second gravida women with previously induced abortions and 95 second para women with previously uncomplicated pregnancies. The duration of the third stage of labor was also compared among a group of primigravidas and a group of second gravidas with previously induced abortions. We excluded women with previous gynecological disorders (e.g. resulting in curettage of the uterine cavity). All patients included presented normal pregnancies and deliveries resulting in full term (greater than 37 weeks), liveborn infants. By the statistical analysis (analysis of variance and Duncan's test), it could be shown that the 3rd stage of labor lasted significantly longer among women with previously induced abortions (mean: 12 minutes), than among the other groups included in the study (mean: 9 minutes). This discrete difference in length of the third stage of labor need not indicate an altered routine for women, who give birth subsequent to an induced abortion.

Abortion, Induced↗
PubMedDate not supplied

Maternal plasma calcitonin gene-related peptide levels do not change during labor and are not influenced by delivery route.

OBJECTIVE: Calcitonin gene-related peptide (CGRP) circulates in maternal circulation throughout pregnancy, and specific receptors for CGRP (CGRPrs) are expressed by human myometrium. Because CGRP induces a dose-dependent relaxation of human myometrium, we examined a role for CGRP in modulation of myometrial smooth muscle contractility during pregnancy and labor. The aim of the present study was to evaluate the changes of maternal serum CGRP levels during parturition, according to the mode of delivery and in relation to cervical dilatation. METHODS: Circulating CGRP levels were measured in the following groups of healthy women: nonpregnant women, during the follicular phase of the menstrual cycle (n = 19); at term pregnancy (39-40 weeks; n = 24); after elective cesarean delivery (39-40 weeks; n = 20); and at spontaneous vaginal delivery (39-40 weeks; n = 16). In a subgroup of women, blood samples were collected longitudinally throughout labor at various cervical dilatations in the progress of labor (n = 8). RESULTS: Pregnant women at term not in labor had significantly higher CGRP levels than nonpregnant women (P =.021). No significant difference was found between women who delivered vaginally and those who had elective cesarean, and there were no correlations between CGRP plasma levels and cervical dilatation. CONCLUSIONS: Parturition is characterized by no significant changes in maternal serum CGRP levels, and no significant correlation exists between plasma CGRP levels and cervical dilatation during labor.

Adult↗
PubMed1975

Human placental lactogen levels during and after labor.

In order to estimate the human placental lactogen (HPL) level and its value as an indicator of fetoplacental function during labor, we determined HPL levels (N equals 225) before, during, and after labor in normal (N equals 16) and preeclamptic (N equals 14) subjects or in patients with benign intrahepatic cholestasis of pregnancy (N equals 5). During labor, greater decreases in this value were found in preeclamptic than in normal subjects and similarly in mothers with fetoplacental dysfunction than with normal fetoplacental function. The rupture of the membranes had no effect on the level of HPL, which was not related to parity, oxytocin infusion, time interval from rupture of the membranes to delivery, nor to relative placental weight. The half-life of HPL varied in the range of 20-23 minutes immediately after delivery and in the range of 30-39 minutes some time later. During labor, greater decreases in HPL level in cases of preeclampsia or fetoplacental dysfunction may be caused by relative uteroplacental ischemia during uterine contractions, but from this finding it is hard to expect any advantage of HPL as a monitor of fetoplacental function during labor.

Apgar Score↗
PubMed1990

The reorganization of mine labor recruitment in Southern Africa: evidence from Botswana.

"The past decade has been one of unprecedented change in the pattern and organization of mine labor recruitment in Southern Africa. Using detailed data on recruitment patterns in Botswana, this article supports the view that recent changes have initiated a self-sustaining trend whereby certain flows of foreign labor into South Africa will decline unabated into the foreseeable future. This results from a shift in general recruiting policy from one of encouraging external migrant labor flows--by expanding recruitment networks and employing a variable and transient workforce--to one of retrenchment and labor stabilization biased in favor of internalized labor supplies."

Africa↗
PubMed1996

Labor migration as a prelude to World War I.

"At the same time as the political tensions increased in Europe around 1900, an international labor market was developing. More and more proletarians from different parts of the continent searched for labor opportunities in the center of the agrarian and industrial capitalism. In several countries, including Russia, capitalists more and more actively recruited labor migrants for seasonal work. The labor migrants became a political issue as a part of the trade negotiations between Germany and Russia. Also, the Austrian colonization and political expansion in the Balkans can be looked upon in a perspective of (labor) migration. Class and ethnic conflicts coincided and escalated into an international conflict."

Demography↗
PubMed2003

Obstructed labor in a teaching hospital in Sudan.

OBJECTIVE: This study was aimed to deal with a serious obstetrical problem in Wad Medani Teaching Hospital, Medani, Sudan. The study reviewed the incidence of obstructed labor, its clinical presentation and methods of diagnosis. The study also includes the methods of treatment and its complications. METHODS: A prospective and descriptive study was carried out in Wad Medani Teaching Hospital, Medani, Sudan. Case notes were studied for all cases with obstructed labor received during the period 1 January 1997 to 31 December 1999. The data was analyzed. The literature was reviewed for similar studies. RESULTS: During the period 207 cases of obstructed labor were diagnosed. The total number of deliveries during the same period was 16221, giving an incidence of 1.27%. The most striking symptoms are tachycardia and low blood pressure, while the common sign is the non-engagement of the presenting part. The most common complication is septicemia. CONCLUSION: Obstructed labor remains a major obstetrical problem. Adequate antenatal care and proper care at delivery could prevent it. The obstructed labor should always be anticipated and the attendant should not wait for the advanced classical signs to make the diagnosis. Early intervention is associated with an excellent outcome.

Adult↗
PubMed2005

[Effect of different analgesia on pain relief during labor].

OBJECTIVE: To evaluate the effect of spinal-epidural and epidural anesthesia for pain relief in labor. METHODS: Totally 6671 cases selected from pregnant women delivered from Aug. 2001 to Oct. 2004 in our hospital were reviewed retrospectively. All cases were divided into three groups, 1482 cases in spinal-epidural group (combined epidural) and 1111 in epidural group (epidural) who received pain relief during labor; 4078 as control group without any pain relief during labor. Delivery method and maternal, fetal complications among three groups were compared. RESULTS: (1) Delivery methods were significantly different (P < 0.01) among the three groups. The cesarean section (CS) rate in combined epidural was 423 (28.5%); in epidural: 351 (31.6%); and in control, 1847 (45.3%). The forceps delivery rate was 231 (15.6%), 207 (18.9%) and 357 (8.8%) in combined epidural, epidural and control, respectively, demonstrating significant difference (P < 0.01) among three groups. There was significant difference among spinal epidural 828 (55.9%) vs epidural 553 (49.8%) vs control 1874 (46.0%) in the rate of normal delivery. (2) Maternal and fetal complication existed significant difference (P < 0.01) among combined epidural, epidural vs control in the rate of fetal distress 33.7% (499/1482), 29.8% (331/1111), 28.5% (1163/4078), arrested active phase 17.3% (256/1482), 18.1% (201/1111), 8.3% (337/4078), prolonged active phase 1.8% (27/1482), 1.7% (19/1111), 0.8% (34/4078), and prolonged second stage 6.1% (91/1482), 5.4% (60/1111), 3.0% (124/4078). While no difference (P > 0.05) in postpartum hemorrhage and neonatal asphyxia between spinal epidural 4.3% (63/1482) 1.0% (15/1482), epidural 4.1% (45/1111), 0.8% (9/1111), and control 3.9% (159/4078), 1.4% (56/4078). CONCLUSIONS: Anesthetic pain relief in labor may reduce the CS rate, but increase the rate of forceps delivery. Pain relief is associated with arrested and prolonged active phase, prolonged second stage. However, pain relief in labor does not enhance the rate of postpartum hemorrhage and neonatal asphyxia.

Analgesia, Epidural↗
PubMed1989

[Analysis of plasma levels of dehydroepiandrosterone and 17-hydroxyprogesterone in physiologic and pathologic pregnancy and labor].

Plasma levels of dehydroepiandrosterone (DEA) and 17-hydroxyprogesterone (17-HP) were studied in 43 pregnant females 11 with normal pregnancy and labor and 32 at high risk of obstetric complications (primary powerless labor, prematurity, postmaturity, rapid parturition). Hormonal investigation was performed in each particular female in the time-course of her pregnancy and labor as well as in the mixed blood plasma from the umbilical cord. Concentrations of hormones observed in the females with normal pregnancies and labors differed from those in the patients whose pregnancy was complicated as well as their labor. It has been concluded that the results of DEA and 17-HP variation assessment in the blood plasma are essential additional indicators of adrenal performance both in mother and fetus.

17-alpha-Hydroxyprogesterone↗
PubMed1988

Oxytocin for the induction of labor.

The obstetric benefits and dangers of using oxytocin to promote uterine activity have long been appreciated. The induction of labor should be undertaken when the positive reasons for delivery outweigh the risks of allowing the pregnancy to continue. Over the years, recognition of the pharmacokinetics of oxytocin has led to modifications in how it is administered for the induction of labor. Most would agree that it should be used in the lowest possible dose that will provide a safe as well as efficacious process of labor for both patients: the woman and her fetus. The sensitivity of the uterus to oxytocin varies with gestational age and from individual to individual. Likewise, each fetus exhibits its own tolerance to the effects of this drug. Close surveillance of each patient's uterine activity response and labor curve and of her fetus's heart rate response is an essential part of the induction of labor.

Female↗
PubMed1986

Cervical collagen: an important regulator of cervical function in term labor.

This study provides the first clear evidence of a close correlation between the biochemical composition of the cervix and the clinical course of delivery in terms of cervical dilatation. Cervical biopsy specimens were obtained from three groups of patients: Group A, ten women with favorable cervix and spontaneous labor; group B, 12 women with unfavorable cervix given 0.5 mg prostaglandin E2 in gel intracervically for cervical priming and induction of labor; and group C, five women with unfavorable cervix and spontaneous labor. Cervical dilatation time was significantly longer (18 hours) for women in group C compared with women in group A (6.7 hours) and in group B (5.0 hours; P less than .001). The total amount of cervical collagen was significantly higher in women in group C at 8.58 micrograms/mg compared with 6.7 micrograms/mg in women in group A and 5.47 micrograms/mg in prostaglandin E2-treated women in group B. The amount of nonextractable collagen also was significantly higher in women in group C, 23.6% compared with 11.3% in group A, and 12.4% in group B (P less than .01). The collagenolytic activity was significantly increased in cervical biopsy specimens from prostaglandin E2 gel-treated patients--520 U/100 mg wet weight compared with 380 U/100 mg wet weight in untreated patients in group A (P less than .05). From these results it is concluded that cervical collagen is an important regulator of cervical function in late pregnancy and term labor; that prostaglandin E2 is involved in cervical priming, initiation, and progress of term labor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Maternal C-reactive protein and preterm labor.

Maternal C-reactive protein (CRP) was measured in 109 pregnant women: 34 who were in labor before 35 weeks, 25 who were in labor at term and 50 who were not in labor. CRP values were correlated with outcome of tocolysis and with gestational age. Among 34 women in preterm labor, a CRP of greater than of equal to 0.8 mg/dL had a sensitivity of 85% (17/20) and a value of 81% (17/21) in predicting delivery within one week. Ten of the 14 who delivered more than one week following tocolysis had a CRP less than 0.8 mg/dL (71% specificity). Maternal CRP of greater than or equal to 0.8 mg/dL identifies a subgroup of women in preterm labor at highest risk of preterm delivery.

C-Reactive Protein↗
PubMedDate not supplied

Effect of the birth chair on duration of second stage labor, fetal outcome, and maternal blood loss.

The effect of delivering in a birth chair on duration of second stage labor, fetal outcome, and maternal blood loss was examined in a retrospective study. The sample consisted of 60 primiparous women, 37 to 41 weeks gestation with a normal pregnancy and labor, 30 delivering on a traditional delivery table and 30 delivering in a birth chair. Comparisons were made between groups for mean duration of second stage labor, mean Apgar scores at one and five minutes, and mean maternal hemoglobin and hematocrit values during the pre- and post-partum periods. No significant difference was found between delivery table and birth chair groups for mean duration of second stage labor (birth chair, X = 60 minutes versus delivery table, X = 43 minutes, t = 1.66, p = .10). Mean Apgar scores at one and five minutes were nearly identical. Statistically significant differences existed between groups in mean maternal hemoglobin and hematocrit values. Both the mean hemoglobin and the mean hematocrit upon admission were significantly higher in the birth chair group (p less than .027). However, postpartally the birth chair group had significantly lower mean hemoglobin and hematocrit values (p less than .025). These findings suggest that the birth chair, as an alternate delivery method, is safe in terms of fetal outcome but presents no advantage to the mother in terms of shorter second stage labor. Further investigation of maternal blood loss is recommended to rule out possible untoward effects.

Apgar Score↗
PubMed1985

[Studies on the tocogram with bearing-down efforts during labor--analysis of the waveform and its clinical significance].

Together with a recording of external tocogram (Ex. toc.), intra-uterine pressure (IUP) and pressure between fetus and birth canal (PFB) were measured simultaneously and continuously, in 77 women during labor who were showing uterine contraction (UC) with bearing-down efforts (BDE). UC curves with BDE were analyzed to detect characteristic features and the sequence of their change in the second stage of labor. The following results were obtained. IUP curves were able to be classified into three types (Type A, B and C) according to the characteristics of the BDE waveform. This means of categorization was also able to be applied to the waveforms of PFB and Ex. toc., because those two pressure curves were essentially the same as that of IUP. Most of the type A contractions were observed early in the second stage of labor, and type B and C made their appearance successively. During the period of labor, from the first appearance of BDE on UC until the termination of the delivery, the mean frequency of UC with BDE was estimated to be 43 times in premiparae (Type A 5.8, Type B 19.7 and Type C 15.5 times) and 13 times in multiparae (Type A 2.0, Type B 2.7 and Type C 7.6 times). 3) Clinical significance from the point of view of parameters was as follows. The peak pressure of IUP increased slightly as labor progressed and the mean levels were 14.4kPa in Type A, 17.7kPa in Type B and 23.5kPa in Type C, respectively. PFB peak pressure, however, remained close to 50kPa in all cases irrespective of the type of curve. The mean BDE pressure was about a half the mean peak pressure for IUP and PFB respectively. The ratio of the levels of peak pressure of PFB and IUP (PFB/IUP ratio) were found to be approximately from 2.04 to 3.12. By a power spectrum analysis, the maximum levels of power in Type B curves were found at both 0.01 Hz and 0.2 Hz. The differential calculus curves estimated from IUP with BDE were able to be divided into three types, and the maximum value in Type B curves of IUP was 12.8kPa/sec. The IUP levels were plotted against those of PFB estimated from UC curves and the curve obtained indicated a straight line relationship. The levels of PFB were consistently two or three times higher than those of IUP.(ABSTRACT TRUNCATED AT 400 WORDS)

Cervix Uteri↗