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At least 19 recordsLinked to original sources
PubMed1977

Intrauterine pressure wave form characteristics of successful and failed first stage labor.

A retrospective study was designed to contrast the intrauterine pressure wave form characteristics of hypocontractile labor in patients with and without obstruction and before and after oxytocin therapy. No differences were observed between the patient groups (vaginal delivery vs. cesarean section), either before or after oxytocin. Problems in defining adequate contractility in patients with possible obstructed labors are discussed, and new parameters of potential value are identified.

Cesarean Section↗
PubMed1984

Effects of lateral recumbency and sitting on the first stage of labor.

We compared uterine activity in lateral recumbency and the sitting position during the first stage of labor in a group of nulliparas. Lateral recumbency was accompanied by more intense, less frequent and more efficient uterine contractions than sitting. Patients preferred sitting for the first half of labor and lateral recumbency for the second. No adverse fetal reaction was noticed in either position, judging from the fetal heart rate. An increase in maternal pulse rate during sitting could have indirectly indicated some compression of the prevertebral vessels. Maternal position clearly affects several parameters of labor, and its selection should be based upon maternal comfort, uterine contractility and efficiency, and hemodynamic repercussions.

Female↗
PubMedDate not supplied

Neuromuscular control of childbirth-prepared women during the first stage of labor.

To evaluate the neuromuscular control of Lamaze-prepared women during the first stage of labor and to identify the factors which influenced control, 94 women were studied. The women were categorized into two groups: class-taught and self-taught. A tool was devised to evaluate neuromuscular control. The study revealed that class-taught women exhibited a significantly higher degree of neuromuscular control, more frequent practice patterns, and a greater ability to make goal-directed statements about their labor than the self-taught women. The data also demonstrated an association between practice and control and goal directedness and control.

Adult↗
PubMed1983

Ambulation and delayed amniotomy in the first stage of labor.

Our purpose was to study the feasibility and results of encouraging ambulation during the first stage of labor in routine obstetric practice. Six-hundred and thirty low risk mothers with intact membranes were randomized into an ambulant and a control group. The results in the ambulant group were not better than in the control group. Our study suggests that, in principle ambulation may be beneficial, but that the concomitant changes in practice should be different from those in our study.

Adult↗
PubMed1975

Intrauterine pressure wave-form characteristics of spontaneous first stage labor.

Intrauterine pressure wave-form parameters were measured in 827 contractions obtained from 26 patients in spontaneous labor. The coefficients of correlation between the maximal and minimal rates of pressure change and the maximal pressure amplitude were 0.78 and 0.63, respectively, and greater than or equal to 0.70 in 22/26 patients. Contractions partitioned into decile statistical groups of the pressure amplitude and both maximal and minimal rates. A linear relationship between these parameters has therefore been established. Contractions of greater amplitude tend to be longer, but the relationship between duration and amplitude is nonlinear with a limiting maximum contraction time. The duration of the midportion of the pressure wave appears invariate with respect to wave amplitude and only start-up and termination times increase with increasing amplitude. Mean values and standard deviations of the maximal amplitude (40.4 +/- 16.9mmHg). the maximal (2.4 +/- 0.9 mmHg/s) and minimal (-2.1+/- 0.9 mmHg/s)rates of pressure change, and the total duration of contractions (68.6 +/- 17.8s) were determined.

Female↗
PubMed1977

Respiratory movements in the fetal guinea pig in utero.

Intrauterine respiratory movements in the fetal guinea pig were detected from about 0.6 of term by the use of chronically implanted tracheal and amniotic catheters. Three distinct patterns were seen: 1) "slow" breathing recurring at a rate of 1-8/min; 2) "rapid irregular" breathing in which episodes last a few seconds to 40 min and the frequency of breathing is high (greater than 0.5 HZ) (the respiratory movements are associated with negative tracheal pressures of of 0.5-20 Torr); and 3) "rapid regular" breathing which recurs in bursts lasting 0.6-6.8 min with a maximum incidence of 3/h. Inspiratory efforts in the range of 10-20 Torr were uniform during a single episode. All three types of respiratory activity were continued into first stage labor, both during and between contractions, but were absent during second stage labor.

Animals↗
PubMed1983

Insulin and glucose requirements during the first stage of labor in insulin-dependent diabetic women.

Studies utilizing glucose-controlled insulin infusion systems were undertaken to more accurately define the glucose and insulin requirements during the first stage of labor induced by oxytocin in 12 insulin-dependent diabetic women in whom normoglycemia had been maintained before delivery. Insulin requirements decreased to zero during active stage 1 labor, while the glucose infusion rate necessary to maintain a blood glucose level of 70 to 90 mg/dl (or 3.9 to 5.0 mmol/liter) was constant at 2.55 mg/kg per minute. The findings were confirmed in 40 additional studies of oxytocin-induced labor. Studies of six women undergoing spontaneous labor and one nonpregnant woman receiving oxytocin confirmed that the decrement in the insulin requirement during stage 1 labor was not influenced by oxytocin infusion. The changes occurred regardless of whether epidural anesthesia was employed. Insulin requirements returned during the second stage of labor. Active stage 1 labor in diabetic women thus appears to be associated with a predictable decrease in the need for insulin and a constant glucose requirement.

Blood Glucose↗
PubMed1989

The effect of pH-adjusted 2-chloroprocaine on the onset of epidural analgesia in pregnant patients in the lying and sitting position during the first stage of labor.

The purpose of this prospective, randomized, double-blind study was to compare the epidural onset time of 2% 2-chloroprocaine with pH-adjusted 2-chloroprocaine administered in either the sitting or supine position in pregnant patients during the first stage of labor. Patients in Groups I and III received the control solution in the sitting and supine position, respectively. Patients in Groups II and IV received the buffered solution in the sitting and supine position, respectively. The pH and pCO2 of the control and buffered solutions differed significantly. The pH and pCO2 of the control and buffered solutions were 4.38 +/- 0.01, 18.4 +/- 2.2 mm Hg and 7.70 +/- 0.04, 114.9 +/- 3.0 mmHg, respectively. A statistically significant reduction in the time of onset of analgesia in the pH-adjusted groups was noted. Groups I and II had onset times of 4 +/- 1.2 and 4.3 +/- 1.0, whereas Groups II and IV had onset times of 2.6 +/- 0.9 and 2.7 +/- 0.6 min., respectively. There were no intergroup differences in the cephalad spread of analgesia or duration of analgesia. Position had no effect on the onset of analgesia at the S2-3 dermatomes nor on the bilateral cephalad spread of the epidural study solutions. Our results indicate that a pregnant patient may be dosed in the lateral supine position without adversely affecting the caudad or cephalad spread of plain or pH-adjusted 2% 2-chloroprocaine, which is clinically important because the incidence of aortocaval compression is increased in the supine position when compared with the lateral supine position.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

The management of functional dystocia in the first stage of labor.

To summarize: Functional dystocia is easily diagnosed in laboring patients by lack of cervical dilatation for 2 hours in association with weak uterine contractions. If the membranes are intact, amniotomy should be performed. If cervical dilatation at a rate of at least 1 cm/h does not occur promptly, oxytocin should be begun. Efficient and safe use of oxytocin requires knowledge of its clinical pharmacologic characteristics: that the maximum level of a dose is not reached for approximately 40 minutes, that the blood level needed is a reflection of the sensitivity of the myometrium, and the blood level produced by a specific dose is a manifestation of the plasma clearance rate. While it has never been demonstrated that continuous electronic monitoring of the uterus and fetus with intermittent visits from professional personnel is better than palpation and auscultation performed by an educated attendant present continuously, the former practice is more common in the United States than the latter. If maximum use is to be made of the information provided by the uterine monitor, the data must be quantitated. When the patient's inadequate contractility fails to improve in response to the initial dose of 1 mU/m, the dose must be increased until some improvement is noted. Geometric incrementation should be limited to nulliparas in whom each dose of oxytocin is evaluated after a 40-minute infusion period.(ABSTRACT TRUNCATED AT 250 WORDS)

Amnion↗
PubMed1986

[Prognostic significance of heart rate accelerations of the fetus in the first stage of labor].

The clinical data and the cardiotocograms of 232 low-risk-deliveries and that of 344 cases of high risk deliveries (98 premature deliveries, 102 cases with meconium stained amniotic fluid, 86 cases with EPH gestosis and 58 cases of fetal distress necessitating emergency cesarean section) have been studied. It is concluded that the fetal heart rate accelerations even in cases of high risk pregnancies and deliveries indicate a good fetal state and a good neonatal outcome. In the presence of both of decelerations and accelerations the fetal state is still good. In the presence of accelerations the low- and high risk deliveries (except the premature deliveries) have a similarly good prognosis. In the lack of accelerations the neonatal mortality, the frequency of resuscitations is higher, and the low Apgar-scores are commoner.

Asphyxia Neonatorum↗