PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Labor Stage, First”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed1998

[Fatty acid composition of the cervical mucus obtained during ovulation and at the term of pregnancy].

BACKGROUND: Aim of this work is to evaluate the different fatty acid composition of cervical mucus obtained during ovulation and at the term of pregnancy. METHODS: The fatty acid composition in cervical mucus was determined in 14 non pregnant women during expected ovulation (cervical score > 10) and in 12 at term pregnant women. Following extraction, (acidification and transesterification), the identification and quantification of fatty acids was performed by gas-chromatographic analysis, with the aid of a specific software. RESULTS: In both groups of samples, palmitic acid, stearic acid and oleic acid were the prevalent acids comprising more than half of the total amounts. Compared to non pregnant samples, in pregnant cervical mucus, elevated levels of oleic acid were pointed out, while mean levels of miristic acid and stearic acid were lower. In the samples of cervical mucus drew at the term of pregnancy, arachidonic acid levels mean values were higher when the first period of labour was started. CONCLUSIONS: The pregnancy-induced biochemical changes in fatty acid pattern could likely be correlate to the variations of the physiochemical properties and to the physical appearance that cervical mucus undergoes during pregnancy. The elevated levels of arachidonic acid, during the first period of labour, may be correlated with prostaglandin production by intrauterine tissues (amniotic fluid, amnion, chorion, decidua, myometrium) and probably by cervical mucus.

Adult↗
PubMed1975

[Constriction ring dystocia: a special form of uterine dystocia (author's transl)].

Constriction Ring Dystocia means a rare form of uterine dystocia (0.1%--1.7%). Pathophysiologically it means a hypertonic incoordinate anomaly of labor. The paper reports two cases of constriction ring, which had been recognized first during sectio cesarean. As the measure of choose is suggested to use tocolytica, although there do not exist any experiences and there was yet no chance to utilise these medicines because of lack of early recognition.

Adult↗
PubMed1980

Clinical significance of fetal heart rate patterns during labor. VI. Early decelerations.

In a population of high-risk patients who had continuous "direct" monitoring during labor, 598 (46%) had no decelerations during the first stage, while 247 (19%) had presented early decelerations before completion of dilatation. The clinical characteristics, the fetal heart rate (FHR) baseline alterations, and neonatal outcome were compared between these two groups: there were no differences in any of the aspects evaluated, except that there was transient tachycardia more often among the early-decelerations group. The patients who had no decelerations were subdivided into vaginal deliveries and cesarean deliveries, and the same parameters were compared again: the cesarean section group had longer recordings and more contractions, lower Apgar 1 and 5 minute scores, and higher incidences of Apgar scores less than or equal to 6 at 1 minute, while all other aspects were similar. A possible explanation was that 82% of cesarean sections were done under general anesthesia and only 3% of vaginal deliveries. The implication of ruptured membranes in the etiology of early decelerations was extensively reviewed and discussed in view of these findings. It is concluded that amniotomy does not seem a maneuver deleterious to the fetal well-being.

Adult↗
PubMed1975

[The properdin titer in women with labor pathology or gynecological disease and the role of this titer in the prognosis].

Properdin-titers of 1350 women were determined to appreciate the properdin-system in obstetrics and gynaecology. At first the means of properdin of healthy pregnant women (separated to three months-terms) and blood donors were determined. Then the quantities of properdin-system of pregnant women, parturients and lying-in women with pathologic processes and extragenital diseases and of patients with gynaecologic diseases were explored. The properdin-titer of healthy women at the end of gestation was increased. With a level of 99,6 units the central properdin-titer of these women was lower than the central titer of female blood donors with a level of 109,6 units. During delivery the properdintiter of healthy women decreased, in the period after childbirth it increased again. The determination of properdin of pregnant women, parturients and lying-in women with rheumatic heart defects and gestosises is of great importance. The properdin-titer was low in cases with severe heart diseases and a long issue. The prognostic significance of the test demonstrates the good event of pregnancies, deliveries, post partum periods and late gestosises of women with high properdin-titer regardless of the severity of the pathological state. In comparison with the titer of healthy lying-in women attention is to be directed to the slow rising of the properdin-titer of lying-in women after complicated pregnancy. In cases of gynaecological diseases the determination of the properdin-titer has three purposes: The control of the severity of the disease, the control of the effectiveness of the therapy and the evidence of the prognosis. This is especially conclusive for inflammatory diseases of the genital organs. The worse the turn of the inflammatory disease, the more was the decrease of the properdin-titer and the slower was the activation of the properdin-system in the organism. In cases of septic diseases the importance of the properdin level for prognostic assertion must also be pointed out. The remaining low properdin-titer and its further decrease is characteristical for most of these patients, who show in spite of modern therapeutical methods a long turn of the disease, new septic metastases and a considerable reduction of the general state of health.

Abortion, Illegal↗
PubMed2002

The effects of epidural analgesia on labor, maternal, and neonatal outcomes: a systematic review.

Mothers given an epidural rather than parenteral opioid labor analgesia report less pain and are more satisfied with their pain relief. Analgesic method does not affect fetal oxygenation, neonatal pH, or 5-minute Apgar scores; however, neonates whose mothers received parenteral opioids require naloxone and have low 1-minute Apgar scores more frequently than do neonates whose mothers received epidural analgesia. Epidural labor analgesia does not affect the incidence of cesarean delivery, instrumented vaginal delivery for dystocia, or new-onset long-term back pain. Epidural analgesia is associated with longer second-stage labor, more frequent oxytocin augmentation, hypotension, and maternal fever (particularly among women who shiver) but not with longer first-stage labor. Analgesic method does not affect lactation success. Epidural use and urinary incontinence are associated immediately postpartum but not at 3 or 12 months. The mechanisms of these unintended effects need to be determined to improve epidural labor analgesia.

Analgesia, Epidural↗
PubMed2002

Epidural analgesia: effects on labor progress and maternal and neonatal outcome.

The intended and unintended effects of epidural labor analgesia are reviewed. Mothers randomized to epidural rather than parenteral opioid analgesia have better pain relief. Fetal oxygenation is not affected by analgesic method; however, neonates whose mothers received intravenous or intramuscular opioids rather than epidural analgesia require more naloxone and have lower Apgar scores. Epidural analgesia does not affect the rates of cesarean delivery, obstetrically indicated instrumented vaginal delivery, neonatal sepsis, or new-onset back pain. Epidural analgesia is associated with longer second labor stages, more frequent oxytocin augmentation, and maternal fever (particularly among women who shiver and women receiving epidural analgesia for > 5 hours) but not with longer first labor stages. Epidural analgesia has no affect but intrapartum opioids decrease lactation success. Epidural use and urinary incontinence are weakly, but probably not causally, associated. Epidural labor analgesia would improve if the mechanisms of these unintended effects could be determined.

Analgesia, Epidural↗
PubMedDate not supplied

The National Birth Center Study. Part II--Intrapartum and immediate postpartum and neonatal care.

Part II of a three-part report of the National Birth Center Study describes care provided to 11,814 women and their newborns during and after labor and delivery until they were transferred or discharged from the birth centers. There were few low birth weight or preterm or postterm births, but more macrosomic babies than among all U.S. births during the same time period. Certified nurse-midwives provided most of the intrapartum care, which is described in the context of medically recommended standards and data that describe care provided to low-risk women giving birth in U.S. hospitals. Birth center care deviated from typical hospital care in several ways. Birth center clients were much less likely to receive central nervous system depressants, anesthesia, continuous electronic fetal monitoring, induction and/or augmentation of labor, intravenous infusions, amniotomies, or episiotomies, and they had relatively few vaginal examinations. They were more likely to eat solid food during labor and to take showers and/or baths. Nulliparity was strongly associated with longer first stage labors and longer labor was associated with more frequent use of many kinds of interventions. Infant birth weight, mother's position during delivery, and forceps- or vacuum-assisted deliveries are examined in relation to episiotomies and lacerations and tears.

Birth Weight↗
PubMed2004

Subarachnoid analgesia in advanced labor: a comparison of subarachnoid analgesia and pudendal block in advanced labor: analgesic quality and obstetric outcome.

Pain control during labor is a primary objective of antalgic therapy. The use of the peridural as an elective procedure for labor analgesia is now corroborated by the international scientific community. Sometimes a combined spinal-peridural procedure is used together with the intrathecal administration of opioids to also cover the first stage of labor. Unfortunately, patients and/or gynecologists often request analgesia in a late stage of labor. The aim of our study was to evaluate the possibility of using a subarachnoid block alone for labor analgesia when this is requested at a late stage, that is, in advanced labor with cervical dilation greater than 7 cm. After approval by our ethics committee and the written and informed consent of the patients, 111 women were enrolled in this study and randomly divided into two groups. The first group (Group S: 55 patients) received a subarachnoid block with 2.5 mg hyperbaric bupivacaine + 25 mug fentanyl + 1 mL 10% glucose. A pudendal nerve block with 7 mL 2% mepivacaine in each side was administered to the second group (Group P: 56 patients). In both groups, careful maternal-fetal monitoring was conducted, and pain was scored on a numerical scale from 0 to 4, 10 minutes after placement of the block (time [T] 0), at delivery (T1), and at episiorrhaphy (T2). In all patients, we recorded any side effects, the Apgar score at birth and after 5 minutes, the administration of other analgesic and/or sedative drugs, the degree of satisfaction, and the time of hospitalization after delivery. Evaluations were performed by anesthesiologists unaware of patients' treatment group. The duration of spinal analgesia was considered to be the time from injection of study drugs to the time of the patient's first request for additional analgesia. In no cases were there any side effects worthy of note, and hospitalization never exceeded 72 hours. The Apgar score was always between 7 and 10. All except one of the women in Group S were satisfied or more than satisfied with their pain management, whereas 50 women in Group P expressed only moderate satisfaction or dissatisfaction (P < 0.0001). In most patients in Group S, complete analgesia was obtained. In Group P, however, 10 minutes after placement of the pudendal nerve block, 40 patients reported no improvement in pain symptomatology during contractions and only 16 reported less painful contractions (P < 0.0001). The duration of spinal analgesia (128 +/- 38 minutes) was enough in most cases for delivery to be completed. These results suggest that low-dose bupivacaine-fentanyl spinal analgesia represents an important option for pain relief in late labor, not the least because the procedure does not upset the dynamics of delivery or alter vital parameters and is welcomed by women in labor who are still able to collaborate actively in the birth of their baby.

Adult↗
PubMed1997

Managing difficult labor: avoiding common pitfalls.

The suggestions offered in this article represent an effort to reduce the incidence of cesarean delivery for dystocia while maintaining a safe course to vaginal birth. Avoiding difficult labor induction in which a compelling indication is lacking, providing prompt and effective oxytocin therapy of arrested first stage labor, and liberalizing the use of oxytocin therapy in selected cases of second-stage arrest are emphasized. With the widening use of conduction analgesia, indicated operative vaginal delivery has an increasingly important role in tempering cesarean birth rates. Operative vaginal delivery can play an effective role only when strict conditions to insure its safety are met.

Delivery, Obstetric↗
PubMed2005

What determines the analgesic effect of paracervical block?

BACKGROUND: The objective of the study was to evaluate the analgesic effect of paracervical block (PCB) in labor pain relief and to discover the determinants associated with good analgesia. METHODS: In a prospective trial, 341 women received PCB for pain relief in the first stage of labor, with 10 ml of 0.25% levobupivacaine or racemic bupivacaine. All these pregnancies were uncomplicated and the progress of labor was normal. The analgesic effect of PCB was measured by using a visual analog scale (VAS). The factors associated with good pain relief (>50% decrease in the VAS score within 30 min) were analyzed statistically by Student's t-test or the Mann-Whitney test (continuous variables), Fisher's exact test (categorial variables) and after univariate analysis by logistic regression analysis. For pairwise comparisons, Wilcoxon's signed ranks test was used. RESULTS: Good pain relief was achieved in 47.2% of the cases. 12.3% of the parturients needed subsequent epidural or spinal analgesia. In logistic regression analysis, primiparity, a high pain score before PCB, and PCB given by a specialized obstetrician were found to affect the level of pain relief 30 min after PCB. CONCLUSIONS: The best pain relief after PCB was achieved among primiparas. Good pain relief was connected with a high pain score before PCB and an experienced obstetrician.

Adolescent↗
PubMed2003

Sonographic assessment of the cervix before, during and after a uterine contraction is effective in predicting the course of labor.

OBJECTIVE: To investigate whether the degree of change in cervical length during a uterine contraction is predictive of subsequent progression of labor. METHODS: The subjects were 73 uncomplicated parturient women at term. We observed the cervix before, during and after a uterine contraction by transvaginal ultrasound in the first stage of labor and determined the degree of cervical shortening during the contraction relative to the cervical length before contraction. We related the degree of cervical shortening to labor patterns at the time of the ultrasound examination, which were retrospectively determined by reviewing the partogram. RESULTS: The cervix was shortened in length by about 50% on average during a uterine contraction in the normal course of labor. The degree of cervical shortening was significantly greater in the normal latent and active phases than it was in the prolonged latent phase, protracted active phase and false labor, whereas there were no differences between the former two phases nor between the latter three phases. Nulliparous and parous women exhibited almost the same degree of shortening in the normal latent and active phases. CONCLUSIONS: Real-time ultrasound observation of the cervix during uterine contraction could help differentiate inefficient uterine contractions from normal ones and thus predict the subsequent course of labor.

Adolescent↗
PubMed1984

Enflurane as an analgesic in labour.

A comparison of the analgesic efficacy of enflurane 1% in air with Entonox (50% nitrous oxide in oxygen) was performed in 20 consenting women during the first stage of labour. The two drugs were given in a random sequence to each woman, who also acted as her own control. Pain scores were significantly lower with enflurane than Entonox, although drowsiness scores were higher. No untoward effects were reported with either agent. The use of enflurane as an analgesic in the first stage of labour warrants further investigation.

Adult↗
PubMedDate not supplied

Labor analgesia with paravertebral lumbar sympathetic block.

BACKGROUND AND OBJECTIVES: Provision of labor analgesia continues to be a challenge for parturients with spine pathology or history of back surgery. METHODS: We report on the use of paravertebral lumbar sympathetic block for first stage labor analgesia in two parturients with spine pathology.

Adult↗