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PubMed1987

Urban unemployment and labor force participation in Korea.

"This paper examines urban unemployment patterns in [the Republic of] Korea using a simultaneous model of unemployment and labor force participation. Urban demographic characteristics and economic conditions are put forward to explain inter-urban variations in the rates of unemployment and labor force participation. The estimation results indicate the importance of local demographic characteristics and economic conditions in determining labor force participation rates and unemployment rates. The results clearly indicate that 'sexual dualism' is pervasive in the urban labor market in Korea. Market discrimination against women is quite evident. "The analysis is based on data from the 1980 Population and Housing Census of Korea and the 1974 Special Labor Force Survey.

Asia↗
PubMed1996

Maternal plasma and amniotic fluid dehydroepiandrosterone-sulfate concentrations in preterm labor and delivery.

The purpose of this study was to determine whether preterm parturition is associated with changes in maternal plasma and amniotic fluid dehydroepian-drosterone-sulfate concentrations. A cross sectional study was constructed according to the gestational age at admission and response to tocolysis. Group 1 consisted of women admitted with preterm labor and intact membranes between 28 and 31 weeks and 6 days gestational age (n = 40). Group 2 included 40 patients with preterm labor between 32 and 36 weeks gestational age. Both groups were classified into two subgroups: preterm delivery within seven days of admission and term delivery. Commercially available immunoassay kits validated for amniotic fluid analysis of DHEA-S, were used to measure maternal plasma and amniotic fluid DHEA-S concentrations. Maternal plasma DHEA-S concentrations were significantly higher in women with preterm labor who delivered preterm than in those who delivered at term. (Group 1: median 800 ng/ml [range 100-1100] vs. median 200 ng/ml [70-800], P < 0.001; Group 2: median 850 ng/ml [300-1700] vs. median 300 ng/ml [90-1100], P < 0.001). In contrast, no significant differences were detected in amniotic fluid DHEA-S concentrations. Our data suggest that the rise in maternal plasma DHEA-S concentrations observed in patients with preterm labor may be related to the effects of stress during labor.

Adult↗
PubMed1999

Clinical effects and mechanism of chanlibao in accelerating second stage of labor.

To observe the clinical effects and the mechanism of Chanlibao (CLB, a preparation of Chinese herbal medicine) in accelerating second stage of labor, primiparae were divided into 3 groups at random. CLB or oxytocin (OTC) was given to the CLB group (n = 80) and the OTC group (n = 52) respectively. The third group served as controls (n = 29). The control group consisted of women experiencing natural labor and to whom no drug was given. The time of second stage of labor and prognosis of mother and newborn of different groups were observed and compared. And intrauterine pressure and fetal heart rate were monitored by means of electronic monitoring. Isolated uterine muscular tissue was used to observe the reactivity to CLB. The results showed that the time of second stage of labor and postpartum hemorrhage in the CLB group were less than those in the control group and the average intrauterine pressure in the former was higher than that in latter, so was the contraction strength of isolated uterine muscle, but with no difference as compared with the OTC group. No side effect of CLB was found. It is concluded that CLB could obviously strengthen uterine contraction and accelerate second stage of labor. Moreover, it is inexpensive, convenient and free of side effect. It can be used as a new, safe and effective alternative for improving prognosis of mother and newborn, especially those not indicated for oxytocin or profuse infusion.

Adult↗
PubMed2006

A randomized comparison between intravaginal misoprostol and prostaglandin E2 for labor induction.

OBJECTIVE: The aim of this randomized study was to compare the effectiveness, safety, and side effects of 6 h vaginal misoprostol versus vaginal prostaglandin E(2) (PGE(2)) for labor induction. STUDY DESIGN: Fifty microgram of misoprostol was given intravaginally in the misoprostol group (204 women), and 3 mg PGE(2) was given intravaginally in the PGE(2) group (211 women). In both groups, the dose was repeated every 6 h for a maximum of three doses, until active labor was achieved. Artificial rupture of membranes and oxytocin infusion was used during labor in both groups where it was indicated. RESULTS: The mean interval from the institution of labor induction to delivery was 11.3 +/- 8.6 h for the misoprostol group, and 15.7 +/- 9.3 h for PGE(2 )group (P < 0.05). In the misoprostol group, oxytocin was used less frequently, but there was a higher prevalence of tachysystole. No statistically significant differences were observed between the two groups as regard abnormal patterns of fetal heart rate, the mode of delivery, and the need for neonatal intervention. CONCLUSION: In conclusion, the intravaginal administration of 50 mug misoprostol at 6 h interval (maximum three doses) is comparable in safety, but more effective for induction of labor than 3 mg intravaginal PGE(2).

Administration, Intravaginal↗
PubMed1978

Induction of labor with oral prostaglandin E2 in normal and high-risk pregnancies.

There were 153 oral prostaglandin (PG) E2 inductions attempted in 149 patients. For various reasons nine cases were dropped from the study. Of the remaining 144 induction attempts, 96 were judged successful, with a success rate of 67 per cent. Details of these inductions are presented, including summaries of three patients with uterine hypertonus and three with uterine hyperstimulation. As a rule, the labor pattern established with oral PGE2 was effective and indistinguishable from normal spontaneous labor. After review of the data we feel that induction of labor with oral PGE2 is no more hazardous to mother or infant than with other oxytocic agents. In our opinion oral PGE2 offers the obstetrician an additional means for induction of labor in normal and high-risk pregnancies. The need for close observation of the progress of labor during PGE2 inductions is emphasized.

Administration, Oral↗
PubMed1979

Pharmacologic inhibition of preterm labor.

Preterm labor is responsible for a majority of cases of perinatal morbidity and deaths. Prevention of preterm labor is not usually possible; thus pharmacologic treatment is the only recourse available. Numerous agents have been used to treat preterm labor, but none has proved to be superior. This report reviews the current information available about the pharmacology of labor-inhibiting drugs and discusses the clinical approach to the management of preterm labor.

Adrenergic beta-Agonists↗
PubMed1979

Labor decreases the lung water content of newborn rabbits.

To test the prevailing concept that drainage of fetal lung liquid begins after birth, we measured extravascular lung water content of 47 fetal rabbits born at term gestation, with or without prior labor. Rabbits born after labor, either vaginally or operatively, had less water in their lungs than those delivered by cesarean section without preceding labor; there was no difference in lung water content between rabbits born vaginally or operatively after labor. These results suggest that reduction in the volume of fetal lung liquid in rabbits normally begins before birth and depends on the experience of labor, not the mode of delivery.

Animals↗
PubMed1979

Induction of preterm labor in the rat by antiprogesterone.

The validity of a new concept, predicting that preterm labor can be induced without oxytocic stimulation by a regulatory imbalance, generated by antiprogesterone (A-P)-provoked P withdrawal (Pw), has been examined in the rat model. At day 19 of pregnancy a single oral dose of the steroidal A-O isoxazol, which inhibits P synthesis, significantly reduced uterine P levels, increased uterine estradiol and prostaglandin F levels, and induced preterm labor. This precocious regulatory imbalance and preterm labor were prevented, by blocking the A-P-induced Pw with P treatment. The regulatory imbalance which triggered the onset of spontaneous labor in the control animals was similar, but it occurred at term rather than before term. The potential of this method in improving the management of medically indicated induction of preterm labor is discussed.

Administration, Oral↗
PubMed1980

Progesterone, 17-hydroxyprogesterone, estradiol, and estriol in late pregnancy and labor.

Levels of progesterone, 17 alpha-hydroxyprogesterone, estradiol, and estriol were measured in serial plasma samples collected from 30 uncomplicated pregnancies during the last eight weeks of gestation. From another group of 27 uncomplicated pregnancies, blood samples were collected during the second stage of labor and the same steroids were measured. Progesterone, 17-hydroxyprogesterone, and estradiol levels were highest during the last one to three weeks prior to the onset of labor, whereas estriol concentration increased progressively. The levels of these steroids during the second stage of labor were statistically not different from those just preceding labor. It is concluded that the onset of human labor is not associated with marked changes in the maternal levels of any of these steroids.

Estradiol↗
PubMed1982

Insulin requirements during labor: a reappraisal.

Continuous insulin infusion has been advocated for strict glucose control during labor in insulin-requiring diabetic patients. We studied 33 insulin-dependent diabetic patients who were at term and undergoing induction of labor with oxytocin. Each patient received a glucose infusion (6 gm/hr), and the blood glucose level was determined hourly. Blood glucose levels did not rise above 100 mg/dl in 16 patients (48.4%) despite continuous intravenous glucose infusion. No differences were found in the following parameters between these patients and those requiring insulin infusion: maternal age, weight, diabetic class, gravidity, and prior insulin requirement. Birth weights and the incidence of neonatal morbidity were similar between groups and occurred despite euglycemia during labor. We found that euglycemia during labor did not prevent infant morbidity irrespective of the use of continuous low-dose insulin infusion. Additionally, 48% of patients did not require any insulin during induction of labor despite large antenatal insulin requirements.

Blood Glucose↗
PubMed1982

Plasma levels of oxytocin and 13, 14-dihydro-15-keto prostaglandin F2 alpha in preterm labor and the effect of ethanol and ritodrine.

We have measured the concentrations of circulating oxytocin and the 13, 14-dihydro, 15-keto-metabolite of prostaglandin F2 alpha (PGFM) in women during preterm labor. Twelve women were given intravenous ethanol and 11 women received intravenous ritodrine for the prevention of preterm birth. Blood samples were obtained before and 1/2, 1, 2, 4, 12, and/or 24 hours after treatment began. On admission, the plasma concentrations of both oxytocin and PGFM were raised over levels observed in women with normal pregnancies of similar gestational age, 25 to 36 weeks. The initial oxytocin level was 58.5 +/- 8.2 pg/ml (mean +/- SE, n = 23) and the mean initial PGFM level was 264 +/ 33.1 pg/ml (n = 15); both values were significantly higher than in 10 control subjects (17.4 +/- 4.8 and 156 +/- 21.8 pg/ml, respectively). During infusion of ethanol, the plasma oxytocin level fell rapidly, the levels at 1/2 and 1 hour after infusion being significantly lower than before the infusion (29.0 +/- 5.5 and 27.8 +/- 3.5 pg/ml, respectively). The plasma oxytocin level remained low in women in whom the treatment arrested labor and prevented preterm birth (n = 8) but rose 2 to 4 hours after the infusion began in women in whom the treatment failed to arrest labor (n = 4). Ritodrine, on the other hand, had no significant effect on circulating oxytocin levels. The plasma PGFM level decreased significantly during ritodrine treatment only in the successfully treated patients. Ethanol had no consistent effect on plasma PGFM levels in the four patients in whom PGFM levels were measured. In the ritodrine-treated patients, the plasma PGFM level was positively correlated with the frequency of uterine contractions whereas in the ethanol-treated patients a correlation of plasma oxytocin to the frequency of contractions was observed. Thus, oxytocin secretion is increased during preterm labor, and the release of prostaglandin F is also increased. While it is not possible to determine whether any or both of these oxytocic agents actually trigger preterm labor, both seem to play a role in its mechanism.

Dinoprost↗
PubMed1983

Improvement in perinatal mortality rate attributed to spontaneous preterm labor without use of tocolytic agents.

A retrospective study of the influence of spontaneous preterm labor on perinatal mortality rate over a period of 15 years was conducted at the National Maternity Hospital, Dublin. As the perinatal mortality rate from all causes declined from 48 to 16 per 1,000 births, the rate attributed to spontaneous preterm labor declined in the same proportion, from 10 to three per 1,000 births. Review of the circumstances of death attributed to spontaneous preterm labor in each case indicates that improvement in this area was due mainly to a natural reduction in incidence and, to a lesser degree, to better care of the neonate. Pharmacologic agents recommended for the purpose of averting spontaneous preterm labor made no contribution, because none was used. Natural improvement in the evolution of a disease may lead to exaggerated claims for the benefits of treatment; experience with perinatal death attributed to spontaneous preterm labor in this large unit suggests that current enthusiasm for tocolytic agents may well be misplaced.

Female↗
PubMed1985

Increase in cervical extensibility during labor induced after isolation of the cervix from the uterus in pregnant ewes.

Surgical transection of the cervix was done on eight ewes in late pregnancy. This procedure resulted in most of the length of the cervix being mechanically disconnected from the uterus. Labor was induced by injection of dexamethasone phosphate into a fetal hind limb during operation in four of the eight ewes. The success of the induction of labor was confirmed by observation of increased uterine activity and by measurement of the concentrations of progesterone and 17 beta-estradiol in peripheral plasma. Ewes were put to death approximately 48 hours after injection of dexamethasone and the extensibility of the isolated portion of the cervix was determined. Cervices taken from ewes in which labor had been induced were found to have softened considerably compared to control cervices taken from ewes in which the cervix had been transected without induction of labor. The results suggest that cervical softening can still occur during labor in the absence of any direct mechanical or local vascular connection between the cervix and uterus.

Animals↗
PubMed1986

Preterm labor: its diagnosis and management.

Preterm labor and delivery remain a significant problem in contemporary obstetric practice. Although the exact cause remains unclear, it is most likely to be multifactorial in nature. No satisfactory screening tool or marker currently exists to firmly establish the diagnosis of impending labor. However, epidemiologic and historical variables associated with preterm delivery show some promise in this regard and are currently being evaluated in preterm prevention programs. Appropriate management of preterm labor mandates early recognition of subtle signs and symptoms; successful therapy is dependent on this issue. The approach to the clinical management of the patient in preterm labor used at our institution is described. Therapy with beta-adrenergic receptor agonists is currently the recommended pharmacologic treatment of this disorder. A review of other tocolytic agents and their usefulness in the management of preterm labor are presented.

Adolescent↗
PubMed1987

Preterm labor: stimulation of arachidonic acid metabolism in human amnion cells by bacterial products.

There is a strong association between preterm labor and infection. Some potentially pathogenic bacteria have phospholipase activity, and it has been suggested that release of phospholipase from these organisms may increase prostaglandin E2 synthesis in amnion cells and hence initiate preterm labor. In this study we established monolayer amnion cell cultures from tissue collected at elective cesarean section at term before labor. Cells were prelabeled with tritiated arachidonic acid and then further incubated after addition of 2%, 5%, or 10% (vol/vol) filtered medium in which either group B beta-hemolytic streptococcus, Streptococcus viridans, Escherichia coli, Bacteroides fragilis, or Lactobacillus had been growing. Tritiated arachidonic acid and its metabolites released by the amnion cells in these or control incubates were extracted from culture medium and separated by high-performance liquid chromatography. Addition of conditioned medium from each of the organisms with the exception of Lactobacillus caused an increase in overall arachidonic acid metabolism. There was an increase in the ratio of cyclooxygenase to lipoxgenase metabolism and in prostaglandin E2 production in particular when compared to controls. The profile of arachidonic acid metabolism in amnion cells following addition of filtered bacterial medium resembled that obtained from amnion cells cultured following spontaneous labor. We suggest that abnormal bacterial colonization of the genital tract may lead to an increase in arachidonic acid metabolism in amnion cells with an increase in prostaglandin E2 production and the consequent initiation of preterm labor.

Amnion↗
PubMed1987

Major basic protein as a predictor of preterm labor: a preliminary report.

To determine the association between levels of major basic protein and onset of preterm labor, plasma levels of major basic protein were measured in 13 women from weeks 22 to 41 of gestation. Twelve of the 13 women studied experienced spontaneous onset of labor. All of these women demonstrated a late rise in serum levels of major basic protein characterized by an increase in concentration of 156% +/- 14%. A temporal association between a rise in concentrations of major basic protein and the onset of preterm labor, which was successfully treated with tocolytic agents, was observed in three patients. Increases in major basic protein began 3 to 4 weeks before delivery. The rise in levels of major basic protein was absent in one patient who was delivered of her infant at 30 weeks' gestation after induction of labor with oxytocin. Analysis of these data indicate that a protein marker is associated with the onset of human labor not only at term but also preterm.

Blood Proteins↗
PubMed1988

Active management of labor and operative delivery in nulliparous women.

There has been a fourfold increase in cesarean births in Canada in the last 20 years. The two main indications are dystocia and repeat cesarean section. Of all primary cesarean sections, about half are due to dystocia. This is largely confined to nulliparous women. Work from Ireland suggests that a policy of active management of labor may reduce dystocia. This involves a uniform policy of amniotomy once a diagnosis of labor is established, followed by oxytocin augmentation if labor is nonprogressive (less than 1 cm/hr). From October 1, 1985, to December 31, 1986, this policy was carried out on 552 consecutive normal nulliparous women in spontaneous labor at greater than or equal to 37 weeks' gestation with a single fetus in vertex presentation with no fetal distress. These results were compared with a control group of 533 similar nulliparous women delivered between January 1, 1984 and March 31, 1985. The cesarean section rate dropped to 4.3% from 13% (p less than 0.005) and the forceps delivery rate dropped to 19.4% from 29% (p less than 0.005). The duration of labor greater than 12 hours dropped to 7% from 20% (p less than 0.005). There was no increase in fetal morbidity or mortality.

Cesarean Section↗
PubMed1989

Ceramide lactoside in amniotic fluid: high concentration in chorioamnionitis and in preterm labor.

The mechanisms responsible for the onset and progression of preterm labor are poorly understood. In the present study a total of 115 amniotic fluid specimens were analyzed for a lipid that has not previously been detected in amniotic fluid. This glycolipid was identified as ceramide lactoside. It was found in two-dimensional thin-layer chromatograms for evaluation of lung maturity and quantified by gas chromatography. Ceramide lactoside concentrations in amniotic fluid were low in spontaneous labor at term (1.7 +/- 0.7 nmol/ml) and in pregnancies that were not associated with spontaneous preterm labor (1.4 +/- 0.6 nmol/ml). The concentrations were high in chorioamnionitis with signs of infection (11.8 +/- 5.8 nmol/ml) and in preterm labor without clinical signs of chorioamnionitis (5.4 +/- 4.0 nmol/ml). A high ceramide lactoside (greater than or equal to 5 nmol/ml) predicted chorioamnionitis with signs of infection at a sensitivity and a specificity of 94% and 95%, respectively. A moderately high ceramide lactoside concentration (greater than or equal to 2.5 nmol/ml) predicted spontaneous preterm labor: sensitivity, 82%; specificity, 95%. Little, if any, ceramide lactoside was present in urine, vernix, normal fetal membranes, or lung effluent, whereas this glycolipid was present in large amounts in granulocytes and in inflamed fetal membranes. We propose that phagocytosing granulocytes release ceramide lactoside into amniotic fluid.

Amniocentesis↗