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Results for “Labor Onset”

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At least 19 recordsLinked to original sources
PubMed1990

Pregnancy outcome in women with labor-onset hypertension. Similar outcome between labor-onset hypertension and preeclampsia.

Labor-onset hypertension is a poorly documented category, and there is scanty information concerning the outcome of pregnancy in this condition. A retrospective study was performed to compare the pregnancy outcome of 36 patients with labor-onset hypertension (group A) with 36 patients with classical preeclampsia diagnosed before labor (group B) who were matched for parity and age. There was no difference in age, past history of hypertensive pregnancies or family history of hypertension between the two groups. The need for intrapartum hypertensive and anticonvulsant treatment as well as the outcome of pregnancy were similar in both groups. The only significant difference was that group A patients had lower maximum and booking systolic and diastolic pressures. The results indicate that labor-onset hypertension represents a late manifestation of the preeclampsia process, because these patients had lower blood pressure in pregnancy and would not be identified until intrapartum elevation of blood pressure satisfied the diagnostic criteria of preeclampsia.

Apgar Score↗
PubMed1990

Objective tocodynamometry identifies labor onset earlier than subjective maternal perception.

The ability of women instructed in self-detection of uterine contractions to identify the abrupt rise in uterine activity known to precede the onset of labor has not been evaluated. This study was designed to assess the temporal relationship between objective uterine activity monitoring, subjective maternal perception of uterine activity above a commonly used threshold value (four or more contractions per hour), and progressive cervical change. Daily tocodynamometry (7-9 AM) was recorded in 79 women with preterm premature rupture of the membranes from admission until the onset of spontaneous labor (5.3 +/- 6.3 days). The subjects were at bed rest, received no tocolytic therapy, and were instructed in the signs of labor and uterine self-palpation. Patients simultaneously provided a subjective assessment of uterine activity (four or more contractions per hour). The majority of uterine activity recordings (78%) revealed fewer than four contractions per hour, and the patients' subjective reports agreed in almost all instances (97.6%). On 91 days, four or more contractions per hour were recorded objectively, but the patients' subjective reports agreed in only 25 instances (27%). On the day of labor onset, significantly more women had an objective assessment (32%) (P less than or equal to .01). Patients subjectively identified labor onset 10.6 +/- 6.7 hours after objective monitoring indicated increased uterine activity, and when subjectively identified, both cervical dilatation (4.9 +/- 2.5 cm) and effacement (85 +/- 30%) were significantly advanced (P less than or equal to .001) compared with the admission examination (1.1 +/- 1.2 cm; 20 +/- 30%).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiotocography↗
PubMed1991

An evaluation of the pelvic score by the quantification theory for categorical data.

The scoring system for pelvic examination used in Tsukuba University Hospital was evaluated by the quantification theory to investigate the precision in predicting the date of labor onset. The objects of this study were 137 nulliparous gravidae and 142 multiparous gravidae who had spontaneous onset of labor at full-term. In this analysis, we used 15 categories of findings in the examination as independent variables, and as the objective variable we used the interval from the examination to the labor onset. The multiple correlation coefficients in nulliparae was 0.593 and in multiparae 0.598. The following conclusions were reached concerning the assessment of labor onset: (1) The consistency of the cervix and the engagement of the vertex in nulliparous gravidae should be given more consideration. (2) In multiparous gravidae the dilatation of the cervix and the engagement of the vertex are important factors. (3) A different scoring system should be employed for both nulliparae and multiparae.

Evaluation Studies as Topic↗
PubMedDate not supplied

Theories regarding endocrine contributions to the onset of labor.

A review of the literature on endocrine factors influencing labor is presented. Treated separately are oxytocin, the prostaglandins, the fetus, and estrogen/progesterone. Implications for nursing practice and theory are discussed where appropriate, and the reader is encouraged to think of parturition as a complex interplay of factors.

Coitus↗
PubMed1991

An enzyme (beta-D-N-acetylglucosaminidase) released from the decidua to maternal plasma prior to the onset of labor.

Changes in the activity of beta-N-acetylglucosaminidase (E.C. 3.2.1.30; NAG), a lysosomal marker enzyme, in the maternal plasma and utero-placental tissues during late pregnancy and parturition were examined in order to determine if lysosomal enzymes participate in the cervical ripening. NAG activity in the plasma gradually increased as gestation advanced, to reach a maximum 3-4 days before the spontaneous onset of labor, and remaining at this level until the second stage. The activity measured in decidua and amnion obtained from the women who had undergone routine repeat cesarean section after labor onset was lower than in those before the onset. Since the decidua was much heavier than the amnion, it was concluded that NAG was released to the maternal circulation mainly from the decidua and only partly from the amnion. Our data revealed that lysosomal enzyme release occurs prior to the onset of labor, and that NAG may play a role primarily in the ripening of the cervix rather than in the onset of labor, by hydrolysing GAGs in the uterine cervix.

Acetylglucosaminidase↗
PubMed1990

[Weather front sensitivity as an influencing factor in the onset of labor].

The connection between meteorological stimuli and the onset of labor was examined on the basis of the patients' front-sensitivity. Front-sensitivity was tested by a questionary containing 60 questions. Converse relation was observed between the degree of sensitivity and the gestational age. A sudden rise of onsets of labors could be shown during frontal changes, occurred after meteorologically quiet periods. During frontal changes the ratio of onsets of labors rose significantly among those patients who were sensitive tho the given front. This effect could be observed during a longer period of frontal influence. By the authors opinion also meteorological stimuli can be regarded as one of the factors, determining the actual date of onset of labor among front-sensitive women.

Female↗
PubMedDate not supplied

Recognizing the onset of labor.

An experimental study compared the use of an educational technique based on patient participation with routine instructions to prepare patients to recognize the onset of active labor. The number of visits to the labor suite that resulted in the patient being discharged undelivered was significantly lower in patients who received the educational intervention. The study revealed that, without any increase in time, nurses can prepare patients to make judgments about the need for hospitalization.

Female↗
PubMed1975

Blood in amniotic fluid following intrauterine transfusion and its effect on premature onset of labor.

The most frequent cause of perinatal death following intrauterine transfusion in cases of severe rhesus hemolytic disease remains premature onset of labor and the resulting newborn so delivered. In the present study, 70% of all perinatal deaths were directly related to immaturity. A factor of decisive importance as an initiator of labor before the intended time is the leakage of blood into the amniotic fluid at the time of the procedure. (Mostly, this blood seems to originate from the fetal abdomen into which it was injected for therapeutic reasons.) The effect of blood-contaminated amniotic fluid on uterine activity is demonstrated on the material from Lewisham Hospital of London, where between 1 and 5 intrauterine transfusions were performed on 517 patients during a period between November 1963 and the end of March 1973. The presence of blood in the amniotic fluid was proved either by means of amniocentesis performed 2 days after intrauterine transfusion, or at the time of membrane rupture in labor. Patients who received a self-retaining catheter for any length of time were excluded from the material since the additive influence of the catheter on labor could not be assessed. Out of a total of 452 cases receiving single-use catheters, there were 208 cases (46%) with premature onset of labor. In 2-thirds of the cases this happened within the first week after the last intrauterinetransfusion. Further investigation of 332 case-histories with complete records was carried out. In 61.6% of the patients with labor before the intended time within 21 days after the last intrauterine transfusion, blood contaminated amniotic fluid was found, whereas this occurred in only 34.8% of the cases without premature onset of labor (p less than 0.001). From the same material, corresponding percentages for livebirths and stillbirths were calculated. As a consequence of these results, it is recommended that patients be kept under intensive hospital care following intrauterine transfusion whenever blood can be proved to be present in the amniotic fluid. Prophylactic measures to prevent premature onset of labor should also be considered.

Amniotic Fluid↗
PubMed1990

A comparison of the ability of a sonographically measured biparietal diameter and the last menstrual period to predict the spontaneous onset of labor.

To study whether the estimated date of confinement (EDC) for women with optimal menstrual histories is predicted best from the last menstrual period (LMP) or biparietal diameter (BPD), 2320 women had the EDC estimated by both LMP and BPD measured sonographically in the second trimester. Those who delivered after the spontaneous onset of labor are reported here. Compared with the EDC calculated from the LMP, the EDC calculated from the BPD was postponed more than 1 week for 406 women (17.5%) and advanced more than 1 week for 56 (2.4%). For these women, the BPD estimate of EDC turned out to be closer to the day of delivery in 264 cases, whereas the LMP estimate was closer in 125 (P less than .001). For 73 women, the estimates were equally good. For 80.1% of the women, the two estimates of EDC differed by 1 week or less; in these cases, the estimates were equally good in predicting the day of delivery. We conclude that the BPD is a better predictor of the spontaneous onset of labor than is the LMP.

Clinical Trials as Topic↗
PubMed1991

Cesarean section before the onset of labor and subsequent motor function in infants with meningomyelocele diagnosed antenatally.

Background. Meningomyelocele can now be detected before birth. Few data are available on its natural history, however, and optimal management at the time of delivery is controversial, although it has been suggested that labor and vaginal delivery may cause pressure on exposed nerve roots, resulting in additional loss of neural function. Methods. To assess the effect of labor and the type of delivery on the level of motor function in fetuses with uncomplicated meningomyelocele, we identified 200 cases of this disorder, accounting for 95 percent of the cases that occurred in the state of Washington during our 10-year study period. We compared the outcomes of 47 infants delivered by cesarean section before labor began, 35 delivered by cesarean section after a period of labor, and 78 who were delivered vaginally (another 40 were ineligible for the study). In cases of meningomyelocele detected prenatally, cesarean section was performed before the onset of labor if isolated meningomyelocele without severe hydrocephalus was present. The infants delivered in this manner were compared with those who were delivered either vaginally or by cesarean section after labor began. Results. At two years of age, the infants who had been exposed to labor were 2.2 times more likely to have severe paralysis than those delivered by cesarean section without labor (95 percent confidence interval, 1.7 to 2.8). Infants delivered by cesarean section before the beginning of labor had a mean (+/- SD) level of paralysis 3.3 +/- 3.0 segments below the anatomical level of the spinal lesion at two years of age, as compared with 1.1 +/- 2.3 for infants delivered vaginally and 0.9 +/- 4.1 for infants delivered by cesarean section after the beginning of labor (P less than 0.001 for both comparisons). Exposure to labor did not affect the frequency of neonatal complications or later intellectual performance. Conclusions. For the fetus with uncomplicated meningomyelocele, delivery by cesarean section before the onset of labor may result in better subsequent motor function than vaginal delivery or delivery by cesarean section after a period of labor.

Cesarean Section↗