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Labor Complication

About: Labor Complication is a research topic. Over the lifetime, 185 publications have been published within this topic receiving 1614 citations.


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Journal ArticleDOI
TL;DR: This case is described by Russell and Ellis (1g33), who are more interested in the histological and pathological studies than in the obstetrical significance.

2 citations

Journal Article

2 citations

Journal ArticleDOI
TL;DR: Higher maternal BMI at booking was associated with an increased risk of prolonged pregnancy, IOL, and CS, and increasing BMI in obese versus normal-weight women showed that IOL is a reasonable, safe management option for prolonged pregnancy in obese parturients.
Abstract: The increase in maternal obesity is having a major impact on female reproduction and maternity services in the UK. Obesity in pregnancy has been associated with many adverse outcomes, including greater risk for cesarean section (CS), postpartum hemorrhage, maternal hypertension, and gestational diabetes. Obese women have also been reported to have longer gestations, thus increasing the risks of post-term delivery and induction of labor (IOL). These factors have been associated with increased rates of CS and perinatal and maternal complications. National guidelines recommend that IOL be offered between 41 and 42 weeks’ gestation, as the alternative of conservative management has an even greater chance of perinatal mortality. Few data exists on delivery complications after IOL in obese parturients. Thus, the purpose of this retrospective cohort study was to assess the risk of prolonged pregnancy with high maternal body mass index (BMI) and the risk of delivery complications after IOL in obese versus normal-weight women. Subjects included women with singleton pregnancies, delivered at >24 weeks gestation between January 2004 and December 2008 in a large UK university maternity unit. Primary outcome measures were length of gestation, mode of delivery, and maternal and neonatal complications after IOL for prolonged pregnancy in obese compared with normal-weight parturients. Women were divided into groups based on BMI: r19.9 (underweight); 20 to 24.9 (normal); 25 to 29.9 (overweight); 30 to 34.9 (obese); 35 to 39.9 (very obese); and >40 (morbidly obese). Demographic and obstetric data were obtained from the unit’s Meditech database and labor/delivery records. Maternal variables assessed were age, race, height and weight at booking, parity, smoking status, gestation at delivery, estimated blood loss, second and third-degree tears, and episiotomy. Neonatal variables were sex, birthweight, Apgar scores, cord blood pH, and incidence of dystocia and stillbirth. Statistical analyses included Kruskal-Wallis test, w statistics, and multivariable logistic regression. After exclusions (eg, missing data, elective CS, and IOL at <41wk), 20,559 singleton deliveries were available for analysis of length of gestation by BMI category; 3076 women having IOL for prolonged pregnancies (Z290 days or Z41 weeks) were further analyzed for delivery outcomes after IOL. Increasing maternal BMI was associated with slightly longer gestations, with median gestation in underweight women being 281 days, normal-weight women 283 days, and morbidly obese women 287 days. Prolonged pregnancies occurred in 30.0% of obese women versus 22.3% and 17.1% of normal and underweight groups, respectively. Rates in very obese and morbidly obese women were 32.4% and 39.4%, respectively. Prolonged pregnancy was also associated with older maternal age and white race. Smoking greatly increased the risk of preterm delivery and decreased the rate of prolonged pregnancy. IOL was performed in 24.2% of underweight women, 26.2% of normalweight, 34.4% of obese, 40%, of very obese, and 43.6% of morbidly obese. Obese women had a significantly higher rate of IOL ending in CS compared with those of normal weight: 38.7% versus 23.8% among primiparae; 9.9%, versus 7.9% in multiparae. Rates of PPH, third-degree tear, low cord blood pH, and Apgar scores, and shoulder dystocia were similar among all BMI groups. The rate of fetal macrosomia increased with increasing BMI. The findings of this study showed that higher maternal BMI at booking was associated with an increased risk of prolonged pregnancy, IOL, and CS. However, >60% of obese primiparae and 90% of obese multiparae undergoing IOL for prolonged pregnancy achieved a vaginal delivery with similar labor complications as normal-weight women. The authors concluded that IOL is a reasonable, safe management option for prolonged pregnancy in obese women.

2 citations

Journal ArticleDOI
15 Oct 1960-BMJ
TL;DR: It has become evident that if the precise nature of the deformity is known beforehand it is possible to toretell with some degree of accuracy which complications of pregnancy and labour are apt to occur in any particular case.
Abstract: It has become evident that if the precise nature of the deformity is known beforehand it is possible to toretell with some degree of accuracy which complications of pregnancy and labour are apt to occur in any particular case. It is difficult, however, to arrive at a definite anatomical diagnosis in the non-pregnant state and still more difficult during pregnancy. The presence of a uterine deformity may be suggested by the finding of a vaginal septum; and the diagnosis is based upon the findings on vaginal examination with palpation and inspection of the cervix; uterine palpation, exploration of the cervical canal and uterine cavity with a sound; hystero-salpingography; and, when the operation is necessary for some coincident condition, laparotomy. During late pregnancy the presence of a transverse foetal lie or of an oblique lie with the head or breech in one cornu and the feet in the other suggests that there may be a single but deformed uterine cavity; and the presence of a slender extended breech in a somewhat elongated uterus inclined to one side and a high presenting part suggests that there may be two separate, non-communicating uterine cavities. Palpation of the uterine cavity during manual removal of a retained placenta may give useful information about its conformation. The terminology used in describing cases of fusion deformities of the uterus should be informative and precise. The state of the uterine fundus, of the uterine cavity, and of the cervical canal should always be indicated in the descriptive term used in the records if this term is to be sufficiently comprehensive to be of value in future attempts to foretell the outcome of any particular case (Hunter, 1950).

2 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
20211
20201
20193
20182
20172
20142