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At least 19 recordsLinked to original sources
PubMed1977

Intrauterine pressure wave form characteristics of successful and failed first stage labor.

A retrospective study was designed to contrast the intrauterine pressure wave form characteristics of hypocontractile labor in patients with and without obstruction and before and after oxytocin therapy. No differences were observed between the patient groups (vaginal delivery vs. cesarean section), either before or after oxytocin. Problems in defining adequate contractility in patients with possible obstructed labors are discussed, and new parameters of potential value are identified.

Cesarean Section↗
PubMed1975

Intrauterine pressure wave-form characteristics of spontaneous first stage labor.

Intrauterine pressure wave-form parameters were measured in 827 contractions obtained from 26 patients in spontaneous labor. The coefficients of correlation between the maximal and minimal rates of pressure change and the maximal pressure amplitude were 0.78 and 0.63, respectively, and greater than or equal to 0.70 in 22/26 patients. Contractions partitioned into decile statistical groups of the pressure amplitude and both maximal and minimal rates. A linear relationship between these parameters has therefore been established. Contractions of greater amplitude tend to be longer, but the relationship between duration and amplitude is nonlinear with a limiting maximum contraction time. The duration of the midportion of the pressure wave appears invariate with respect to wave amplitude and only start-up and termination times increase with increasing amplitude. Mean values and standard deviations of the maximal amplitude (40.4 +/- 16.9mmHg). the maximal (2.4 +/- 0.9 mmHg/s) and minimal (-2.1+/- 0.9 mmHg/s)rates of pressure change, and the total duration of contractions (68.6 +/- 17.8s) were determined.

Female↗
PubMed1977

Respiratory movements in the fetal guinea pig in utero.

Intrauterine respiratory movements in the fetal guinea pig were detected from about 0.6 of term by the use of chronically implanted tracheal and amniotic catheters. Three distinct patterns were seen: 1) "slow" breathing recurring at a rate of 1-8/min; 2) "rapid irregular" breathing in which episodes last a few seconds to 40 min and the frequency of breathing is high (greater than 0.5 HZ) (the respiratory movements are associated with negative tracheal pressures of of 0.5-20 Torr); and 3) "rapid regular" breathing which recurs in bursts lasting 0.6-6.8 min with a maximum incidence of 3/h. Inspiratory efforts in the range of 10-20 Torr were uniform during a single episode. All three types of respiratory activity were continued into first stage labor, both during and between contractions, but were absent during second stage labor.

Animals↗
PubMed1989

The effect of pH-adjusted 2-chloroprocaine on the onset of epidural analgesia in pregnant patients in the lying and sitting position during the first stage of labor.

The purpose of this prospective, randomized, double-blind study was to compare the epidural onset time of 2% 2-chloroprocaine with pH-adjusted 2-chloroprocaine administered in either the sitting or supine position in pregnant patients during the first stage of labor. Patients in Groups I and III received the control solution in the sitting and supine position, respectively. Patients in Groups II and IV received the buffered solution in the sitting and supine position, respectively. The pH and pCO2 of the control and buffered solutions differed significantly. The pH and pCO2 of the control and buffered solutions were 4.38 +/- 0.01, 18.4 +/- 2.2 mm Hg and 7.70 +/- 0.04, 114.9 +/- 3.0 mmHg, respectively. A statistically significant reduction in the time of onset of analgesia in the pH-adjusted groups was noted. Groups I and II had onset times of 4 +/- 1.2 and 4.3 +/- 1.0, whereas Groups II and IV had onset times of 2.6 +/- 0.9 and 2.7 +/- 0.6 min., respectively. There were no intergroup differences in the cephalad spread of analgesia or duration of analgesia. Position had no effect on the onset of analgesia at the S2-3 dermatomes nor on the bilateral cephalad spread of the epidural study solutions. Our results indicate that a pregnant patient may be dosed in the lateral supine position without adversely affecting the caudad or cephalad spread of plain or pH-adjusted 2% 2-chloroprocaine, which is clinically important because the incidence of aortocaval compression is increased in the supine position when compared with the lateral supine position.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Correlation between the levels of catecholamines (noradrenaline, adrenaline) and adrenal steroids (DHA-S, cortisol) in maternal and fetal blood during pregnancy and labor].

It is known that both catecholamines (CA) and cortisol (F) levels elevate during labor. To determine the correlation between adrenal steroids and medullary function, maternal blood was collected during pregnancy, first stage of labor (MVI) and at delivery (MVII). Umbilical arterial and venous blood (UA, UV) was also obtained at delivery. Further, ACTH or dexamethasone (Dx) was given during the first stage of labor, and maternal blood was collected before and 30 minutes after the administration. Plasma levels of CA[noradrenaline (NA), adrenaline (Ad)] were extracted by trihydroxyindole method and were measured by HPLC. DHA-S and F levels were determined by specific RIA. Results are as follows: 1. No apparent change was observed in maternal NA and Ad levels throughout pregnancy. DHA-S levels were high in first trimester and decreased as pregnancy advanced, while F levels showed an increase trend as pregnancy progressed. 2. All hormone levels in maternal blood increased remarkably during labor. A significant negative correlation between F and Ad levels at delivery was noted. When F levels were elevated by ACTH administration, Ad levels decreased. Ad levels elevated when F levels were suppressed by Dx administration. 3. NA, Ad and DHA-S levels in cord blood were higher than those in MVII. Levels of F in maternal blood were higher than those in cord blood. A significant correlation of F in MVII and UA was observed. These results indicate that the suppressive effect of F may be involved in the mechanism of Ad secretion, though the secretion of Ad increased with F in the course of labor. The response of fetal adrenal to the stress of labor may be different from that of maternal adrenal since a significant correlation was not noticed between the levels of Ad and cortisol in cord blood as was found in maternal blood.

Adrenocorticotropic Hormone↗
PubMed1989

Characteristics of normal labor.

The length of the first and second stages of labor was evaluated in 6991 women with singleton gestations at 37-42 weeks with vertex presentation. All patients delivered spontaneously without the use of oxytocin. Four study groups were created based on parity and whether conduction anesthesia was used. The mean lengths and limits (95th percentile) for the first stage of labor, respectively, were as follows: nulliparas: no anesthesia--8.1 and 16.6 hours, conduction anesthesia--10.2 and 19.0 hours; multiparas: no anesthesia--5.7 and 12.5 hours, conduction anesthesia--7.4 and 14.9 hours. Similar data for the second stage were as follows: nulliparas: no anesthesia--54 and 132 minutes, conduction anesthesia--79 and 185 minutes; multiparas: no anesthesia--19 and 61 minutes, conduction anesthesia--45 and 131 minutes. These statistical parameters are useful for defining when a labor becomes abnormal and intervention should be considered.

Anesthesia, Conduction↗
PubMed1976

A reappraisal of the duration of labor.

The mean, median, and modal durations of labor have been established following a prospective study of 602 consecutive labors. The mean duration of labor for primiparae was 14.92 hours, while the median and modal durations were 13.20 and 9.66 hours, respectively. The corresponding figures for multiparae were 10.02, 9.28, and 7.80 hours, respectively. There was a statistically significant difference in the mean duration of labor in the 2 groups of patients (P less than 0.001). A significant positive correlation has been observed between the duration of the first stage of labor and the second stage of labor (P less than 0.001), and this might be of clinical importance. It has been suggested that the median and modal durations of labor may be more representative and informative than the mean or average.

Adult↗
PubMed1987

Warm tub bath during labor. Effects on plasma catecholamine and beta-endorphin-like immunoreactivity concentrations in the infants at birth.

In this study 13 women bathed in a warm tub bath during the first stage labor after a strictly normal pregnancy. The control group consisted of 9 women who did not want warm tub bath. Apgar scores at 1 and 5 minutes were recorded and plasma adrenalin, noradrenalin were measured in umbilical arterial blood at birth, together with pH, pCO2 and base excess and beta-endorphin-like immunoreactivity in umbilical venous blood. No differences were found between the groups. No beneficial effect was found on infant condition of a warm tub bath during labor.

Baths↗
PubMed1976

Dip area in fetal heart rate and its relationship to acid-base-observations of fetus and mother during labor.

The relationship between dip area (DA) of fetal heart rate (FHR) and the acid base status of fetus and mother during the first and second stage of labor were studied on 39 women at term. The observations reveal a significant correlation between the fall in fetal base excess (BE) and the measured DA: deltaBE = 0.01 - 0.143 DA (2alpha less than 0.01). There is no difference in the correlation of these parameters between the first and the second stage of labor despite the fact of a greater fall in BE and a greater DA per time compared to the first:BE meq/1/10min. 0.14 (SD 0.26) and 0.76 (SD 0.62); DA cm2/10 min. 0.99 (SD 1.19) and 4.28 (SD 3.06), respectively. With increasing DA the variance of the fall of fetal BE (S2BE) rose also: DA of 0-5 cm2: S2BE 0.66; DA greater than 15.1cm2:S2BE 3.76. With the fall in fetal BE there was also a fall in maternal BE, more pronounced during the second stage of labor:-BEF=0.38.DELTA BEM-0.70(2alphaless than 0.01). The fraction of the fall in fetal BE per DA increased with the fall in maternal BE (2alpha less than 0.05). This correlation reveals that there might be a slight influence of maternal BE on fetal BE. The present observation shows that measuring DA serves only as an approach to predict fetal condition during labor. It therefore should be combined with fetal scalp blood sampling. The influence of maternal BE on fetal BE seems to be only of less importance.

Acid-Base Equilibrium↗
PubMed1991

Epidural anesthesia shortens duration of labor in singleton vertex presentation spontaneous delivery.

Influence of epidural anesthesia on the duration of labor was studied in 1,206 parturients having spontaneous singleton vaginal delivery. In primiparous women, the mean first stage was 3.52 hr in the epidural group, and 7.68 hr in the control group (p less than 0.001), the mean second stage was 25.78 min in the epidural group, and 43.58 min in the control group (p less than 0.001). In the multiparous women, the mean first stage was 2.06 hr in the epidural group, and 3.85 hr in the control group (p less than 0.001), the mean second stage was 17.06 min in the epidural group, and 25.42 min in the control group (p less than 0.0001). The conclusion is that epidural anesthesia shortens the duration of first and second stages of labor in singleton vaginal delivery.

Anesthesia, Epidural↗
PubMed1991

Oxytocin secretion and human parturition: pulse frequency and duration increase during spontaneous labor in women.

The secretory pattern of oxytocin was determined in blood samples taken at 1-minute intervals for 30 minutes from 32 parturient women. The samples were collected in a manner that minimized degradation by plasma oxytocinase, and a highly specific antibody was used for the radioimmunoassay. The results indicated that oxytocin is secreted in discrete pulses of short duration. The frequency of the pulses was significantly higher during spontaneous labor than before the onset of labor. The mean pulse frequencies per 30 minutes were 1.2 +/- 0.54 before labor, 4.2 +/- 0.45 during the first stage, and 6.7 +/- 0.49 during the second and third stages of labor. The mean pulse durations in these three groups were 1.2 +/- 0.20, 1.9 +/- 0.28, and 2.0 +/- 0.26 minutes, respectively. The amplitude of the pulses was variable with no significant differences between the groups, the majority being around 1.0 microU/ml. The spontaneous pulses were of similar magnitude as those measured in 18 women after intravenous injections of 4 to 16 mU of oxytocin, which doses stimulated uterine contractions. We therefore conclude that the pulses of oxytocin observed at increasing frequency during spontaneous labor are of physiologic significance and provide evidence for the participation of oxytocin in the onset and maintenance of spontaneous labor.

Analysis of Variance↗
PubMed1991

Spurious labor: a high risk factor for dysfunctional labor and fetal distress.

This is a retrospective case controlled study comparing the outcome of labor and neonates in pregnancies complicated by spurious labor at term. The first stage of labor was significantly longer and the proportion of cases requiring oxytocin augmentation was higher in the study group when compared to the controls. More infants in the study group displayed intrapartum CTG abnormalities and five had a depressed Apgar score at 5 min, compared to none in the controls. Of these five neonates, three were admitted to the neonatal intensive care unit and one died from meconium aspiration syndrome and asphyxia. The findings in this study support the view that spurious labor at term constitutes a high risk factor for the ensuing labor.

Adult↗
PubMed1977

[Pharmacokinetic of piracetam during labour influence to acid-base-status in maternal and fetal blood (author's transl)].

PIRACETAM concentrations in fetal and maternal blood were measured during the first and second stage of labor and the elimination in maternal and fetal blood was studied. Fetal heart-rate, pH- and base-excess of the maternal and fetal blood were investigated to evaluate the influence of PIRACETAM on the acid-base-status of mother and child. PIRACETAM was administered intravenously to 43 patients in a dosage 2 g, 4 g and 6 g. The concentration in the maternal and fetal plasma was measured by gaschromatography. Before and after the injection of PIRACETAM and at delivery, blood was sampled from the mother's earlobe and the umbilical artery and vein, respectively. The results were compared with a control group. There was an exponential fall of PIRACETAM concentration in maternal and fetal blood. Maternal and fetal elimination half-life of PIRACETAM was about 112-98 minutes and 200 minutes, respectively. A fairly good correlation between the concentration of PIRACETAM in maternal and fetal blood was found. The fetal PIRACETAM concentration was about 50% below the maternal values. Fetal heart-rate, maternal and fetal pH- and base-excess-values were not significantly altered following PIRACETAM infusion. It may be concluded, that there exists a transfer of PIRACETAM across the placental barrier. However, the cytoprotective effect of PIRACETAM, as described in animal observations and by investigations in human, could not be verified by the methods and technology used in this study.

Acid-Base Equilibrium↗
PubMed1990

Collagenase activity in the cervix of non-pregnant and pregnant women.

Cervical biopsies were obtained from non pregnant patients and from pregnant at various stages of gestation and during labour. The tissues were extract with a Ca(++)-containing buffer, and collagenase activity was determined in these extracts using a solid phase assay in which triple helical 125I-labelled collagen was cleaved. Collagenase was detected in all samples but significantly elevated activity was only present in labour at 6-8 cm cervical dilatation. This provides direct evidence for the crucial role of specific collagen degradation during cervical ripening and dilatation.

Abortion, Induced↗