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PubMed1952

Prolonged labor.

Dystocia is usually the result of inadequate uterine contraction or slow cervical dilation or both. Some conditions causing these deficiencies are large size of the infant, multiple pregnancy, hydramnios, faulty presentation (particularly the occiput-posterior), occluding tumors, fullness of the bladder, umbilical cord impediment, concealed uterine hemorrhage, clamping of a thick anterior cervical lip by the infant's head, adhesion of the membranes to the cervix, or delay in rupture of the membranes. Dystocia is often observed in patients with hypopituitarism. A nervous, worrying temperament may seriously affect the progress of labor. Maneuvers that are helpful in many of these difficulties are described and the indications and dosages for Pitocin(R) are presented.

Dystocia↗
PubMed2004

[Effects of Spasfon on course of labor].

OBJECTIVE: To observe the effects of Spasfon on improving dilatation of cervix and promoting the progression of labor. METHODS: Ninety seven normal primiparae with cervical edema were randomly divided into Spasfon group (group A, n = 46) and atropine group (group B, n = 51) when the cervix dilated 2 - 3 cm. Group A was given 80 mg of Spasfon intravenously, and group B was injected atropine 0.5 mg into the cervix. RESULTS: (1) The mean time period from drug administration to full dilation of the cervix was (3.1 +/- 0.3) h in group A, and (4.4 +/- 0.4) h in group B (P < 0.01). (2) The disappearance ratio of cervical edema 2 h after drug administration in group A was 95.6%, while in group B it was 90.2% (P > 0.05); the mean dilatation of cervix between the 2 hours in group A was (4.3 +/- 0.2) cm, while in group B it was (2.5 +/- 0.3) cm (P < 0.01). (3) There were no obvious side effects in group A. While eight women in group B complained of thirst and 22 women had increased heart rate accompanied with elevated baseline FHR, which all recovered in about 60 minutes. (4) Vaginal delivery rate in group A was 95.7%, and 90.2% in group B (P > 0.05). (5) There was no statistically significant difference in the color of amniotic fluid, suffocation state and weight of the newborns between the two groups (P > 0.05). (6) There was no statistically significant difference in postpartum hemorrhage between the two groups, either (P > 0.05). CONCLUSION: Spasfon can effectively improve cervical dilatation during labor and it is well tolerated by both mother and newborn.

Administration, Intravaginal↗
PubMedDate not supplied

Teaching cervical dilation measurement to family medicine residents.

BACKGROUND AND OBJECTIVES: Cervical dilation measurement is difficult to teach. This pilot study's objective was to determine if residents participating in an innovative workshop improved their cervical measurement accuracy when using soft cervical models in the classroom. METHODS: Resident physicians measured cervical models before and after the workshop. We compared pre-workshop and post-workshop coefficients of variation using a standard t test. CONCLUSION: Residents reduced their measurement error from 38.2% to 15.6%.

Clinical Competence↗
PubMed2005

[Effects of ambulatory labor analgesia on fetal oxygen saturation].

OBJECTIVE: To observe the effect of ambulatory labor analgesia on fetal oxygen saturation during labor. METHODS: Sixty parturients with uncomplicated term pregnancies were equally divided, according to their personal preference, into ambulatory analgesia group receiving combined spinal-epidural labor analgesia and control group without analgesia administration. All the parturients with ambulatory labor analgesia received sufentanil and ropivacaine administration. Fetal oxygen saturation was monitored continuously during the labor by recording the values every 5 minutes and the mean value was calculated. Umbilical blood was analyzed after fetal delivery and the pH, base excess (BE) value were recorded. RESULTS: In the analgesia group and the control group, the mean values of fetal oxygen saturation was (51.92+/-5.90)% and (50.77+/-6.47)%, respectively, during the first labor stage (P=0.48), and was (44.85+/-6.27)% and (43.12+/-7.34)% during the second labor stage (P=0.32), and the lowest values during the labor was (41.63+/-7.51)% and (40.96+/-7.48)%, respectively (P=0.73), showing no significant differences in the three values between the two groups. CONCLUSION: Ambulatory labor analgesia does not significantly affect fetal oxygen saturation during the entire course of labor.

Adult↗
PubMed1991

[The value of the administration of prostaglandin E2 on the biodegradable support of the maturation of the cervix uteri and the induction of labor].

We report the results of a prospective randomized study concerning the effects of prostaglandin E2 on cervical ripening and/or induction of labour. Between August 1988 and April 1989, 100 women underwent induction of labour for medical reasons. These women were divided into 4 groups. In those with Bishop's score below 4, we compared the intracervical dinoprostone 0.5 mg gel (Gr 1, n = 24) with an intracervical administration of PGE2 1.5 mg on Surgicel Gr 2, n = 26). In women with Bishop's score between 4 and 6, we compared the intracervical dinoprostone 0.5 mg gel (Gr 3, n = 28) with administration of PGE2 2.25 mg on a Spongel introduced into the posterior vaginal fornix (Gr 4, n = 22). Induction was authorized only for women with Bishop's score above 6. If this was not the case, a second administration of PGE2 was allowed 12 hours later, depending on maternal and foetal tolerance. The 4 groups were similar in mothers' age, gestational age and parity. The results obtained showed a significant increase in Bishop's score 12 hours after cervical ripening, irrespective of the way PGE2 was administered: from 2.3 +/- 1.0 to 5.2 +/- 2.5 vs 2.2 +/- 1.2 to 5.0 +/- 2.6 for groups 1 and 2, and from 4.4 +/- 0.6 to 6.7 +/- 2.3 vs 4.2 +/- 0.4 to 6.8 +/- 2.4 for groups 3 and 4.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intravaginal↗
PubMedDate not supplied

[Cerebral blood flow during labor].

The successful results obtained using Doppler sonography for antepartal diagnosis gave cause to use the method during labor. For this purpose doppler measurements of the intern fetal carotid artery of a group of 7 patients with normal course of pregnancy were made and a continuous direct CTG was recorded simultaneously. The Doppler parameter, the S/D-ratio, for the contraction phases were compared with those of the contraction--free phases. During the contraction phase the S/D-ratio was higher than during the relaxation period of the uterus. The difference between these values were proved to be statistically significant. A comparison of the doppler parameter of the patients at onset of labor and the patients at the end of labor showed, that the S/D-ratio increased significantly at the end of labor. This result demonstrates, that the intravascular resistance in the fetal carotid artery increased due to the cephalic pressure.

Blood Flow Velocity↗
PubMed1989

[The sympathetic-adrenal system during reflex analgesia used in the treatment of a pathological preliminary period].

Effects of reflex analgesia on the activity of the sympathetic-adrenal system (SAS) were examined in pregnant females with an abnormal preliminary period. The status of SAS was judged by the results of urinary epinephrine and norepinephrine excretion tests. A session of reflex analgesia performed by electric acupuncture (3-30 Hz) in the pregnant women with an abnormal preliminary period and relative readiness of the generative passage for labor led to activation of SAS and childbirth induction. A session of combined exposure to electric acupuncture (3-7 Hz) and transcutaneous electric neurostimulation (60-80 Hz) in the pregnant women with a more prolonged preliminary period and unreadiness of the maternal passage for labor caused a decrease in SAS activity, which was followed by a therapeutic rest.

Acupuncture Analgesia↗