Search

Objective: To examine the course of labor in nulliparous women in active labor with a floating fetal head., Study Design: A prospective, cohort study of nulliparous women presenting in active labor at term with a floating fetal head (station > or = -3, n = 108) or engaged fetal head (n = 241). All patients were examined by a senior physician. Assignment to the study or control group was noted in the investigator's records. However, management of labor was at the discretion of the labor ward team on duty., Results: Cesarean section rates for failure to progress were significantly higher in the study group (17.1% versus 4.2%, P < .0001), and the second stage of labor was prolonged (65.3 +/- 27.1 versus 54.9 +/- 30.2 minutes, P < .03). None of the women who had a persistently floating fetal head at 7 cm of cervical dilation delivered vaginally. Birth weights were larger (P < .03) and Apgar scores lower (P < .0001) in the study group. The lengths of the active phase and instrumental delivery rates were similar in the two groups., Conclusion: Nulliparous women presenting in active labor at term with a floating head are at substantially increased risk of cesarean section for abnormal progress of labor. However, the majority of patients will still deliver vaginally. A persistently floating head with advanced cervical dilation (7 cm) should prompt consideration of cesarean section since little is to be gained by waiting.

Objective: To determine the role of steroid receptors in the pathogenesis of tubal pregnancy., Study Design: Twenty-two women in the reproductive-age group who had undergone salpingectomy because of ectopic pregnancy or sterilization were enrolled. The study group consisted of 12 women who underwent salpingectomy for ectopic pregnancy. The control group included 10 patients in whom the tubes had been removed for elective sterilization., Results: Estrogen receptors were detected in 1 (8.3%) tube with ectopic pregnancy and in 10 (100%) normal tubes (P = .0001). Progesterone receptors were present in 4 (33.3%) tubes in the study group and in all the tubes in the control group (P = .002)., Conclusion: Our findings indicate that a basic cellular component, the steroid receptor, is damaged in tubes harboring pregnancy.