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At least 271 records · Page 15Linked to original sources
PubMed1981

Combined decelerations--clinical significance and relation to uterine activity.

A combined fetal heart rate deceleration consists of a first (either early or variable) component and a second (late) component. All patients with combined decelerations during a 2-year period of routine fetal monitoring were studied. The incidence was 1.1% (70 patients). Most patient were at low risk, and the combined decelerations appeared predominantly late in the first stage of labor. In all but 5, labor was stimulated by oxytocin infusion. In two thirds of patients, intrauterine pressure was recorded; uterine hyperactivity was found in 78.7%. Combined decelerations with a total loss of at least 90 beats and lasting for at least 60 seconds were associated with low fetal scalp pH. Ten percent of infants were born in the occiput posterior position. The results indicate a relation between abnormal uterine activity and combined fetal heart decelerations. This type of deceleration could serve as a warning signal of excessive oxytocin administration.

Electrodes↗
PubMed1978

The duration of normal labour in Cape Town whites.

The durations of the various stages of normal labour in White patients delivered at Mowbray Maternity Hospital, Cape Town, have been estimated for parity groups 1, 2, 3 and 4 and over. A significant correlation between age and the duration of the second stage was found in the para 2 group (r = 0,23, P less than 0,05). Previous abortions, marital status and oxytocic augmentation had no significant effect. The mean durations of the 1st and 2nd stages in primigravidas were significantly longer than in multigravidas. The upper limits of normal for the durations of the 1st and 2nd stages and the duration of the active phase were calculated. The mean duration of the 3rd stage was approximately 5 minutes.

Adolescent↗
PubMed1993

Squatting position for delivery.

The study was conducted on 200 normal pregnant women who were randomly classified into 2 groups of 100 cases each. The control group comprised mothers in supine position throughout labour and delivery (46 primigravidae and 54 multigravidae). The squatting group consisted of cases who were kept ambulatory during the 1st stage and were asked to squat on ordinary delivery cots during the 2nd stage of labour. Third stage of labour was conducted in supine position. The squatting group comprised 42 primigravidae and 58 multigravidae. There was a mean difference (shortening) of 3 hours in primigravidae and 2 hours in multigravidae in the duration of 1st stage of labour between the squatting and control groups. In the duration of 2nd stage of labour the mean differences in primigravidae and multigravidae of the squatting and control groups were 20 and 13.5 minutes respectively. In the squatting group there were 79 normal vaginal delivery, 16 forceps delivery and 5 caesarean sections whereas in the control group there were 80, 18 and 2 cases respectively. Although foetal complications were comparable in both the groups, the incidence of maternal injuries was observed in 14 cases in control group and 38 cases in squatting group. It was concluded that without proper birthing chairs which can give good perineal support, the usual supine position is preferable.

Adult↗
PubMed1997

Pattern of cervical dilatation in previous lower segment caesarean section patients.

The pattern of cervical dilatation during labour in 100 patients with previous lower segment caesarean section (LSCS) was determined in a prospective partographic study. Eighty-four subjects delivered successfully by vaginal route. The mean initial dilatation rate (IDR) and average dilatation rate (ADR) were 0.884 cm/hour and 1.255 cm/hour respectively. The mean IDR and ADR of the patients who delivered vaginally were 0.96 cm/hour and 1.41 cm/hour respectively, while of those who required repeat LSCS mean IDR was 0.44 cm/hour and mean ADR was 0.42 cm/hour. Hence ADR in cases who required repeat LSCS was significantly slower as compared to those who delivered vaginally (p < 0.01). Most (87.5%) of the cases who required repeat LSCS crossed the alert line as compared to 34.5% of patients who delivered vaginally. The mean admission delivery interval (ADI) was 9.45 +/- 4.29 hours in patients with no previous vaginal delivery and 8.02 +/- 4.83 hours in patients with previous vaginal delivery. The mean durations of 1st and 2nd stages of labour were 11.8 +/- 5.35 hours and 29.4 +/- 27.3 minutes respectively. It is concluded that partographic evaluation is an important aspect in management of labour of such patients.

Adult↗
PubMed1998

Arrival in the labour ward in second stage of labour--any prognostic significance?

A comparative descriptive study was carried out to determine whether, in uncomplicated term pregnancies with the foetus in vertex presentation, there were any differences in maternal or foetal outcome between women who arrived in the labour ward in second stage of labour and those who arrived in early active phase. There were two hundred and seventeen women each in the study and comparison groups. There were no significant differences between the two groups as regards age, parity, marital status and level of education. Women in the comparison group were better antenatal clinic attendants. Those in the study group were more likely to have indicated that they had problems with transportation. They also had considerably shorter labours and all achieved spontaneous vaginal deliveries; a significant proportion (10.6%) of the comparison group had interventional deliveries. The incidence of episiotomies, lower genital tract injuries, manual removal of placenta and postpartum haemorrhage after vaginal delivery were not different between the two groups. Babies born to mothers in the study group were significantly lighter, by about 170 gms, and had a lower incidence of low one-minute Apgar scores. There were no significant differences in the rates of admission to the neonatal intensive care unit or in early neonatal deaths. Arrival in the labour ward in second stage of labour prognosticates non-interventional delivery without any increased risk of adverse outcome to the mother or her baby.

Adult↗