Labor Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(8):519-523
DOI 10.1590/S0100-72032000000800008
Purpose: to evaluate the results of assistance to breech deliveries. Methods: this was a descriptive study where 160 pregnant women with breech presentation and live newborns were analyzed. They were divided into two groups according to the route of delivery. Clinical data concerning labor, delivery and newborns were studied. For statistical analysis vaginal deliveries were compared with cesarean sections using mean and standard deviation estimates, Student's t, Mann-Whitney and chi² tests. Results: the global cesarean section rate was 81.2%. The gestational age and the weight of the newborns were significantly lower in the vaginal delivery group. Prematurity and low birth weight were significantly associated with vaginal delivery. Only 14 newborns had an Apgar score below 7 at the fifth minute, almost 60% of them in the vaginal delivery group. Conclusions: this population presented a high cesarean section rate and also high perinatal morbidity, prematurity and low birth weight in the vaginal delivery group. These findings do not allow conclusions regarding the real relationships among breech presentation, route of delivery and perinatal outcomes. The control regarding gestational age and parity, besides a random decision on the route of delivery, is necessary for future conclusions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(8):519-523
DOI 10.1590/S0100-72032000000800008
Purpose: to evaluate the results of assistance to breech deliveries. Methods: this was a descriptive study where 160 pregnant women with breech presentation and live newborns were analyzed. They were divided into two groups according to the route of delivery. Clinical data concerning labor, delivery and newborns were studied. For statistical analysis vaginal deliveries were compared with cesarean sections using mean and standard deviation estimates, Student's t, Mann-Whitney and chi² tests. Results: the global cesarean section rate was 81.2%. The gestational age and the weight of the newborns were significantly lower in the vaginal delivery group. Prematurity and low birth weight were significantly associated with vaginal delivery. Only 14 newborns had an Apgar score below 7 at the fifth minute, almost 60% of them in the vaginal delivery group. Conclusions: this population presented a high cesarean section rate and also high perinatal morbidity, prematurity and low birth weight in the vaginal delivery group. These findings do not allow conclusions regarding the real relationships among breech presentation, route of delivery and perinatal outcomes. The control regarding gestational age and parity, besides a random decision on the route of delivery, is necessary for future conclusions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(1):45-52
DOI 10.1590/S0100-72032003000100007
PURPOSE: to determine maternal and neonatal outcome according to the application or not of transcutaneous electrical nerve stimulation (TENS) for relief of labor pain before installation of combined spinal epidural (CSE) block. METHODS: a randomized open clinical trial was conducted involving 22 parturients with a singleton, vertex, term fetus, managed in a tertiary-care academic medical center in Recife, Brazil. These patients were randomly assigned to receive or not TENS before CSE block for labor analgesia. Outcome analysis included pain intensity as measured by visual analog scale (VAS), interval between initial evaluation and CSE installation, labor duration, cesarian section and instrumental delivery rate, Apgar scores and frequency of neonatal hypoxia. Statistical analysis was performed using Mann-Whitney and Fisher's exact tests with a 5% level of significance. RESULTS: a significantly prolonged interval between initial evaluation and CSE block was observed in the TENS group (median of 90 min) when compared with the control group (median of 30 min). Duration of labor was similar (about 6 h). No significant difference was found in VAS scores. Cesarian section rate was 18.2% in both groups. There was only one forceps delivery (in the control group). The median of Apgar scores at the 5th minute was 10 and no case of neonatal hypoxia was found. CONCLUSONS: TENS was effective in delaying CSE analgesia installation without affecting pain intensity and duration of labor. There were no adverse effects on mothers or newborns.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(1):45-52
DOI 10.1590/S0100-72032003000100007
PURPOSE: to determine maternal and neonatal outcome according to the application or not of transcutaneous electrical nerve stimulation (TENS) for relief of labor pain before installation of combined spinal epidural (CSE) block. METHODS: a randomized open clinical trial was conducted involving 22 parturients with a singleton, vertex, term fetus, managed in a tertiary-care academic medical center in Recife, Brazil. These patients were randomly assigned to receive or not TENS before CSE block for labor analgesia. Outcome analysis included pain intensity as measured by visual analog scale (VAS), interval between initial evaluation and CSE installation, labor duration, cesarian section and instrumental delivery rate, Apgar scores and frequency of neonatal hypoxia. Statistical analysis was performed using Mann-Whitney and Fisher's exact tests with a 5% level of significance. RESULTS: a significantly prolonged interval between initial evaluation and CSE block was observed in the TENS group (median of 90 min) when compared with the control group (median of 30 min). Duration of labor was similar (about 6 h). No significant difference was found in VAS scores. Cesarian section rate was 18.2% in both groups. There was only one forceps delivery (in the control group). The median of Apgar scores at the 5th minute was 10 and no case of neonatal hypoxia was found. CONCLUSONS: TENS was effective in delaying CSE analgesia installation without affecting pain intensity and duration of labor. There were no adverse effects on mothers or newborns.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(10):641-646
DOI 10.1590/S0100-72032002001000002
PURPOSE: to compare the effectiveness and safety of two different doses of misoprostol (12.5 mug and 25 mug) administered vaginally for cervical ripening and labor induction in term pregnancies with an indication for interruption. METHODS: this was a pilot randomized controlled single blinded trial, including 40 pregnant women treated with one of the two different doses of misoprostol. The independent variable was the dose of misoprostol and the main dependent variables were the mode of delivery, time between induction and delivery, perinatal complications and maternal side effects. The main control variables were maternal age, gestational age, literacy, parity, skin color and conditions of the cervix at the beginning of induction. For data analysis Student's t test, chi2, exact Fisher, Wilcoxon and Kolmogorov-Smirnof tests were used, besides survival analysis. RESULTS: the groups using 12.5 and 25 mug were similar and did not present any significant difference regarding time for onset of uterine contractions (20.9±20.4 and 16.6±9.8 h, respectively), time between onset of uterine contractions and delivery (7.8±3.4 and 6.9±5.0 h), vaginal delivery (65 and 80%) and maternal and perinatal side effects (similar Apgar scores and hyperstimulation syndrome in both groups). CONCLUSION: the higher percentage of vaginal births and the shorter time for delivery using 25 mug, although not significant, does not allow to recommend the dose of 12.5 mug as more advantageous for cervical ripening and labor induction in term pregnancies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(10):641-646
DOI 10.1590/S0100-72032002001000002
PURPOSE: to compare the effectiveness and safety of two different doses of misoprostol (12.5 mug and 25 mug) administered vaginally for cervical ripening and labor induction in term pregnancies with an indication for interruption. METHODS: this was a pilot randomized controlled single blinded trial, including 40 pregnant women treated with one of the two different doses of misoprostol. The independent variable was the dose of misoprostol and the main dependent variables were the mode of delivery, time between induction and delivery, perinatal complications and maternal side effects. The main control variables were maternal age, gestational age, literacy, parity, skin color and conditions of the cervix at the beginning of induction. For data analysis Student's t test, chi2, exact Fisher, Wilcoxon and Kolmogorov-Smirnof tests were used, besides survival analysis. RESULTS: the groups using 12.5 and 25 mug were similar and did not present any significant difference regarding time for onset of uterine contractions (20.9±20.4 and 16.6±9.8 h, respectively), time between onset of uterine contractions and delivery (7.8±3.4 and 6.9±5.0 h), vaginal delivery (65 and 80%) and maternal and perinatal side effects (similar Apgar scores and hyperstimulation syndrome in both groups). CONCLUSION: the higher percentage of vaginal births and the shorter time for delivery using 25 mug, although not significant, does not allow to recommend the dose of 12.5 mug as more advantageous for cervical ripening and labor induction in term pregnancies.
