PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “LABOR”

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 55 records · Page 3Linked to original sources
PubMed1986

Immunologic factors contributing to the initiation of labor--lymphocyte reactivity in term labor and threatened preterm delivery.

To obtain data on the immunologic events during labor, we investigated cytotoxic activity, progesterone-prostaglandin F2 alpha and prostaglandin E2 sensitivity of the lymphocytes in late pregnancy at early and late stages of labor and in the puerperium. In an attempt to investigate common determinants between the behavior of lymphocytes during labor and threatened preterm delivery, the same parameters of lymphocytes obtained from women with threatened preterm delivery were tested in parallel. At the beginning of labor, cytotoxic activity of the lymphocytes significantly increased and remained at a high level till the end of labor. A negative correlation (r = -0.803) was found between the increase of cytotoxicity and the duration of labor. High progesterone sensitivity of pregnancy lymphocytes decreased while low sensitivity to prostaglandin E2 increased during labor. Sensitivity of the lymphocytes to prostaglandin F2 alpha was similar in all of the groups examined. Except for prostaglandin E2 sensitivity all parameters of the lymphocytes obtained from women with threatened preterm delivery were similar to those of lymphocytes obtained during labor.

Cytotoxicity, Immunologic↗
PubMed1993

Social support during labor and duration of labor: a community-based study.

The effect of a birth companion on duration of labor was examined in a sample of 66 nulliparous women in Michigan. Two-thirds of the sample were single, 66% received Medicaid, and 88% were white. Using simple linear regression, support during labor explained a significant amount of variance in duration of labor. Duration of labor for 8 unsupported mothers was significantly longer (965 +/- 206 min) than that for 58 supported mothers. Using hierarchic regression and including maternal education, marital status, race, amniotomy, and labor induction in the model before support, support during labor continued to explain a significant amount of variance in duration of labor. These findings are similar to those reported from earlier randomized trials of social support during labor. Evidence continues to accumulate that confirms the proposition that labor duration is affected by environmental as well as biologic factors.

Adult↗
PubMed1999

Epidural analgesia and active management of labor: effects on length of labor and mode of delivery.

OBJECTIVE: To determine whether cervical dilatation at the time of placement of patient-requested epidural affects cesarean rates or lengths of labors in actively managed parturients. METHODS: The charts of 255 women randomized to active management of labor (n = 125) or control protocols (n = 130) were reviewed and stratified to early epidural placement (up to 4 cm cervical dilatation) versus late placement (more than 4 cm). RESULTS: Women with early epidural placement had shorter labors than those with late placement (11.6 +/- 4.6 versus 13.2 +/- 5.6 hours; P = .02). Active management reduced the length of labor compared with controls regardless of epidural timing, with a reduction of 1.4 hours in early epidural placement (10.9 +/- 4.7 versus 12.3 +/- 4.3 hours; P = .04) and 3.6 hours in those with later placement (11.0 +/- 3.6 versus 14.6 +/- 6.2 hours; P = .004). Cesarean rates did not vary significantly (early 14.5% versus late 7.9%; P = .21). Early epidural placement did not lengthen the second stage of labor or increase operative vaginal delivery rates. CONCLUSION: Early epidural placement did not affect lengths of labor or cesarean rates and was actually associated with shorter labor compared with late epidural placement. Women managed actively in labor, regardless of timing of epidural placement, had shorter labors than controls.

Adult↗
PubMed1995

Sleep during the week before labor: relationships to labor outcomes.

This correlational study was conducted to examine the relationship between maternal sleep during the nights prior to the onset of labor and labor outcomes of length, type of delivery, and maternal perceptions of labor. Subjects (N = 99) were drawn from childbirth education classes at a women's hospital in the southeastern United States. Subjects completed the Visual Analog Sleep Scale each morning, beginning two weeks prior to their due dates. Following delivery, subjects completed the Perception of Labor and Delivery Scale, and researchers gathered data about their labors. These women reported poor sleep effectiveness coupled with high sleep disturbance; however, there were no significant correlations between sleep quality and length of labor or maternal perceptions of labor for either the night, or the week, prior to the onset of labor. This finding leads us to question the view that disturbed prenatal sleep will interfere with the progress of labor and lead to more cesarean sections.

Adolescent↗
PubMed1999

[National survey on the use of induced labor by obstetricians. Study Group on Induced Labor].

INTRODUCTION: A strong rise in the use of induced labor has been observed in France. The aim of this work was to analyze the different methods used for achieving induction of labor and their implications. METHODS: One out of four French obstetricians were randomly selected to answer a questionnaire on their practice for achieving induction of labor. Four hundred of the 997 obstetricians answered the questionnaire. Univariate and multivariate analysis was applied. RESULTS: A high rate of induced labor was correlated with some areas of the country and with private practice. Certain methods were used in spite of opposing advice by experts in the field: elective induction of labor with unfavorable cervix, use of prostaglandins in elective induction of labor, induction of labor in cases of scarred uterus or breech presentation, use of misoprostol. Some methods were still used in spite of their poor efficacy: intravenous oxytocin used with unfavorable cervix, use of intravensou PGE2. CONCLUSION: This study would show that theory and practice are often distinctly different. Induction of labor is currently used on a far wider scale than ever before. We obviously need studies for careful assessment of the circumstances in which induction of labor is used in order to improve methods and indications of such a clinical practice.

Analysis of Variance↗
PubMed1995

Trial of labor: a disciplined approach to labor management resulting in a high rate of vaginal delivery.

A disciplined approach to labor management has resulted in a low cesarean rate (9%) in our population. We wondered if this management scheme was applicable and safe applied to women with previous cesareans. Women with a previous cesarean delivering in a 5-year period were included. Labor management included encouragement of trial of labor, labor stimulation with oxytocin when indicated, epidural analgesia only after entering the active phase, and continuous monitoring. Demographic, labor and delivery, and neonatal data were electronically stored and analysis performed using SPSS release 4.1 for VAX/VMS. Statistical analysis was performed using chi-square and Fisher's exact test where appropriate. Multiple logistic regression was performed to control for potentially confounding variables. A previous cesarean had been performed in 713 (11%) gravidas who met the inclusion criteria. Vaginal delivery was attempted in 588 (82%) and 517 (88%) achieved vaginal birth. Older women (14 versus 1 versus 8%, p = 0.04), of higher parity (63 versus 35 versus 17%, p = 0.0001), requiring preterm delivery (14 versus 8 versus 4%) were more likely to have an elective repeat cesarean than a successful or failed trial of labor. Pregnancies requiring oxytocin (90 versus 53%, p = 0.02), receiving epidural analgesia (62 versus 49%, p = 0.05), developing chorioamnionitis (20 versus 4%, p < 0.0001) were more likely to fail a trial of labor. Four uterine ruptures occurred and only one patient was receiving oxytocin. There were no differences in umbilical artery blood acidemia among elective repeat cesarean sections and successful or failed trial of labor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2000

Lack of utility of standard labor curves in the prediction of progression during labor induction.

OBJECTIVE: This study was undertaken to determine whether patients undergoing labor induction can be reliably evaluated by means of standard labor assessment curves. STUDY DESIGN: In this retrospective chart review of 123 patients who underwent cervical ripening and induction of labor, Friedman's standard labor curves were used for comparison. Statistical analysis was performed with the Student t test. RESULTS: Nulliparous and parous patients undergoing cervical ripening spent more time in active-phase labor than standard expectations of labor progression would indicate (12.7 +/- 7.8 vs 5. 9 +/- 3.4 hours for nulliparous women, P <.001; 7.9 +/- 6.4 vs 2.5 +/- 1.5 hours for parous women, P <.001). Nulliparous and parous patients who were delivered vaginally spent more time in active labor than did their respective standard historical control populations (10.3 +/- 8.0 vs 5.9 +/- 3.4 hours for nulliparous women, P <.001; 7.0 +/- 6.0 vs 2.5 +/- 1.5 hours for parous women, P <. 001). CONCLUSION: Standard methods for the evaluation of labor adequacy and prediction of the likelihood of vaginal delivery may not apply to patients undergoing cervical ripening.

Adult↗
PubMed2006

Comparative study of induction of labor in nulliparous women with premature rupture of membranes at term compared to those with intact membranes: duration of labor and mode of delivery.

AIM: To evaluate the effect of premature rupture of membranes (PROM) at term on the duration of labor and mode of delivery in comparison with intact membranes in nulliparous women with an unfavorable cervix whose labor was induced. METHODS: This retrospective cohort study included all term nulliparous women with an unfavorable cervix requiring labor induction over a 2-year period. Prostaglandin E(2) (dinoprostone) and oxytocin were used for labor induction. Criteria for enrolment included (i) singleton pregnancy; (ii) term nulliparous women; or (iii) Bishop score below 6. Statistics were analyzed with Student's t-test, chi(2)-test, Fisher's exact test, and multiple logistic regression. RESULTS: Our study subjects were 82 women whose labor was induced for PROM and 219 women with intact membranes whose labor was induced for social or fetal reasons. The mean durations of active phase of labor were not significantly different between women with PROM and those with intact membranes. However, the women with PROM had a significantly longer mean duration of second stage and a higher rate of cesarean delivery for failure to progress than those with intact membranes. Multiple logistic regression demonstrated that only PROM and fetal macrosomia were significantly associated with an increased risk of cesarean delivery for failure to progress after other confounding variables were adjusted. CONCLUSIONS: Labor induction for PROM at term in nulliparous women with an unfavorable cervix is associated with longer duration of the second stage and a higher risk of cesarean delivery for failure to progress in comparison to those with intact membranes.

Adult↗
PubMed2003

Intervention rates after elective induction of labor compared to labor with a spontaneous onset. A matched cohort study.

INTRODUCTION: Elective induction of labor has become a widely used procedure in obstetrics. A number of studies have shown an increased incidence of operative deliveries. The objective of this study was to evaluate the rate of interventions in our hospital, including operative delivery. METHODS: A matched cohort study in which labor of 122 electively induced women and 122 women with labor with a spontaneous onset were analyzed retrospectively. These women were matched for parity and gestational age. RESULTS: Pain relief, fetal scalp blood sampling and operative deliveries were recorded more frequently in the electively induced labor group. Cesarean delivery was found in 15% of women with induced labor, and in 1% of labors with a spontaneous onset (relative risk 18 (95% CI 2.4-132.7)). No differences were found in neonatal outcomes. CONCLUSIONS: Elective induction of labor leads to increased intervention rates during labor. The rate of cesarean delivery is high, particular in nulliparous women and multiparous women without a previous vaginal birth.

Adult↗
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↗
PubMed1996

Continuous labor support from labor attendant for primiparous women: a meta-analysis.

OBJECTIVE: To evaluate the available literature on the effects of continuous labor support among primiparous women. DATA SOURCES: We did a Medline search using the keywords "labor support," "doula," and "monitrice." Papers published in English from 1965 to May 1995 were eligible for this review. We also cross-checked all the references in the selected reports. METHODS OF STUDY SELECTION: We identified seven randomized clinical trials published during that period; four of these were eligible for our meta-analysis. DATA EXTRACTION AND SYNTHESIS: Meta-analysis of four studies conducted among young, low-income, primiparous women who gave birth on a busy labor floor in the absence of a companion suggested that continuous labor support by a labor attendant shortens the duration of labor by 2.8 hours (95% confidence interval [CI] 2.2-3.4), doubles spontaneous vaginal birth (relative risk [RR] 2.01, 95% CI 1.5-2.7) and halves the frequency of oxytocin use (RR 0.44, 95% CI 0.4-0.7), forceps use (RR 0.46, 95% CI 0.3-0.7), and cesarean delivery rate (RR 0.54, 95% CI 0.4-0.7). Women with labor support also reported higher satisfaction and a better postpartum course. CONCLUSION: Labor support may have important positive effects on obstetric outcomes among young, disadvantaged women. Further studies on benefit relative to cost are needed before a broad-scale program is advocated.

Delivery, Obstetric↗
PubMed1987

Estrogen, progesterone, prolactin, prostaglandin E2, prostaglandin F2 alpha, 13,14-dihydro-15-keto-prostaglandin F2 alpha, and 6-keto-prostaglandin F1 alpha gradients across the uterus in women in labor and not in labor.

Before or during labor in humans, changes in peripheral levels of estrogen and progesterone are not evident. Local alterations of estrogen, progesterone, and prolactin concentrations may be present and be accompanied by prostaglandin changes. The purpose of this study was to investigate the differences in concentrations of these hormones across the uterus and to evaluate their interrelationships in patients at term gestation with and without labor. Blood samples were obtained from a radial artery and a uterine vein in 22 women without and in 10 with labor. The difference between levels in the two blood vessels was designated as the gradient. Neither levels nor gradients were different between the two groups for estrone, estradiol, estriol, progesterone, or prolactin. The plasma levels of prostaglandin F2 alpha, 13,14-dihydro-15-keto-prostaglandin F2 alpha, and prostaglandin E2 were significantly increased in labor. Prostacyclin levels, as indicated by the 6-keto-prostaglandin F1 alpha metabolite, were not altered. The gradients for prostaglandin F2 alpha and E2 were significantly increased in labor. The results of the study also suggested that, in gestation at term, serum prolactin is produced mainly by the pituitary and that estrone may originate from peripheral conversion of estradiol. We conclude that in humans prostaglandin gradients of the E and F groups are increased in labor. These increases are not associated with changes in sex steroids or prolactin. Prostacyclin metabolite gradients also appear not to be altered in labor, suggesting that some prostaglandins are selectively increased in early labor either by enhanced production or decreased metabolism or both.

6-Ketoprostaglandin F1 alpha↗
PubMed1995

Management of labor and labor complications.

Obstetricians assume a dual role in the provision of health care for both mother and fetus during labor. Not only do they function as consultants for medical and surgical problems peculiar to labor, but they also assume a more broad-based role in the prevention of labor complications to achieve the best possible health maintenance for both patients. This includes the provision of continuous health care throughout pregnancy, delivery, and postpartum management. A summary of the common problems of management of labor and labor complications is provided, including fetal monitoring during labor, augmentation of labor, vaginal delivery after cesarean section, epidural analgesia and its effects on delivery, and fecal incontinence after delivery.

Anesthesia, Epidural↗
PubMed2000

Pathways to retirement: patterns of labor force participation and labor market exit among the pre-retirement population by race, Hispanic origin, and sex.

OBJECTIVES: This study examines the pre-retirement labor force participation behavior of Black, White, and Hispanic men and women to determine how patterns of labor market exit differ among groups. METHODS: We combine data from the first and second waves of the Health and Retirement Study and apply multinomial logit regression techniques to model labor force status in the first wave of the HRS and change over time. RESULTS: Black, Hispanic, and female elderly persons experience more involuntary job separation in the years immediately prior to retirement, and the resulting periods of joblessness often eventuate in "retirement" or labor force withdrawal. Minority disadvantage in human capital, health, and employment characteristics accounts for a large part of racial and ethnic differences in labor force withdrawal. Nevertheless, Black men and Hispanic women experience more involuntary labor market exits than Whites with similar socioeconomic and demographic characteristics. DISCUSSION: Workers most vulnerable to labor market difficulties during their youth confront formidable obstacles maintaining their desired level of labor force attachment as they approach their golden years. This has significant policy implications for the contours of gender and race/ethnic inequality among elderly persons, particularly as life expectancy and the size of the minority elderly population continue to increase.

Black or African American↗
PubMed2002

Labor analytics software can help control labor costs.

One of the largest costs in healthcare organizations is labor. As volume of activity fluctuates, the labor supply needs to be adjusted appropriately. Having an appropriate quantity and skill mix of full- and part-time employees affects labor costs per hour and labor efficiency, two labor-cost control points that department managers need to monitor to make effective hiring decisions. Managers can use software applications for operating budgets, productivity monitoring, position control, and staffing/scheduling to manage labor expenses. Knowing the type of information each of these cost-control tools provides is critical to making effective decisions related to labor expenses. Because of their unique expertise, healthcare financial managers can serve as a resource to help the organization's department managers manage labor costs.

Cost Control↗