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1. Association between frailty and delirium in older adult patients discharged from hospital

Author

Verloo H, Goulet C, Morin D, and von Gunten A

Subjects
delirium, frailty, hospital discharge, home-dwelling older adults, Geriatrics, RC952-954.6
Abstract

Henk Verloo,1 Céline Goulet,2 Diane Morin,3,4 Armin von Gunten51Department Nursing Sciences, University of Applied Sciences, Lausanne, Switzerland; 2Faculty of Nursing Science, University of Montreal, Montreal, QC, Canada; 3Institut Universitaire de Formation et Recherche en Soins (IUFRS), Faculty of Biology and Medicine, University of Lausanne, Lausanne University Hospital, Lausanne, Switzerland; 4Faculty of Nursing Science, Université Laval, Québec, Canada; 5Department of Psychiatry, Service Universitaire de Psychiatrie de l’Age Avancé (SUPAA), Lausanne University Hospital, Prilly, SwitzerlandBackground: Delirium and frailty – both potentially reversible geriatric syndromes – are seldom studied together, although they often occur jointly in older patients discharged from hospitals. This study aimed to explore the relationship between delirium and frailty in older adults discharged from hospitals.Methods: Of the 221 patients aged >65 years, who were invited to participate, only 114 gave their consent to participate in this study. Delirium was assessed using the confusion assessment method, in which patients were classified dichotomously as delirious or nondelirious according to its algorithm. Frailty was assessed using the Edmonton Frailty Scale, which classifies patients dichotomously as frail or nonfrail. In addition to the sociodemographic characteristics, covariates such as scores from the Mini-Mental State Examination, Instrumental Activities of Daily Living scale, and Cumulative Illness Rating Scale for Geriatrics and details regarding polymedication were collected. A multidimensional linear regression model was used for analysis.Results: Almost 20% of participants had delirium (n=22), and 76.3% were classified as frail (n=87); 31.5% of the variance in the delirium score was explained by frailty (R2=0.315). Age; polymedication; scores of the Confusion Assessment Method (CAM), instrumental activities of daily living, and Cumulative Illness Rating Scale for Geriatrics; and frailty increased the predictability of the variance of delirium by 32% to 64% (R2=0.64).Conclusion: Frailty is strongly related to delirium in older patients after discharge from the hospital.Keywords: Edmonton Frailty Scale, delirium risk factors, cognitive impairment, physical impairmentA Letter to the Editor has been received and published for this article

Published
2016

11. Biochemical dynamics during postharvest: Highlighting the interplay of stress during storage and maturation of fresh produce

Author

Lagarda-Clark Ernesto Alonso, Goulet Charles, and Duarte-Sierra Arturo

Subjects
oxidative stress, reactive oxygen species, antioxidant system, fresh products, alternative oxidase, Biology (General), QH301-705.5
Abstract

The lifecycle of fresh produce involves a sequence of biochemical events during their ontology, and these events are particularly significant for climacteric fruits. A high demand during ripening is observed in these plant products, which is reflected in a high rate of respiration and ethylene production. Increased respiratory demand triggers the activation of secondary pathways such as alternate oxidase, which do not experience critical increases in energy consumption in non-climacteric fruit. In addition, biochemical events produced by external factors lead to compensatory responses in fresh produce to counteract the oxidative stress caused by the former. The dynamics of these responses are accompanied by signaling, where reactive oxygen species play a pivotal role in fresh product cell perception. This review aims to describe the protection mechanisms of fresh produce against environmental challenges and how controlled doses of abiotic stressors can be used to improve quality and prolong their shelf-life through the interaction of stress and defense mechanisms.

Published
2024
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15. Sensorimotor adaptations to microgravity in humans

Author

Edgerton, V. R, McCall, G. E, Hodgson, J. A, Gotto, J, Goulet, C, Fleischmann, K, and Roy, R. R

Subjects
Life Sciences (General)
Abstract

Motor function is altered by microgravity, but little detail is available as to what these changes are and how changes in the individual components of the sensorimotor system affect the control of movement. Further, there is little information on whether the changes in motor performance reflect immediate or chronic adaptations to changing gravitational environments. To determine the effects of microgravity on the neural control properties of selected motor pools, four male astronauts from the NASA STS-78 mission performed motor tasks requiring the maintenance of either ankle dorsiflexor or plantarflexor torque. Torques of 10 or 50% of a maximal voluntary contraction (MVC) were requested of the subjects during 10 degrees peak-to-peak sinusoidal movements at 0.5 Hz. When 10% MVC of the plantarflexors was requested, the actual torques generated in-flight were similar to pre-flight values. Post-flight torques were higher than pre- and in-flight torques. The actual torques when 50% MVC was requested were higher in- and post-flight than pre-flight. Soleus (Sol) electromyographic (EMG) amplitudes during plantarflexion were higher in-flight than pre- or post-flight for both the 10 and 50% MVC tasks. No differences in medial gastrocnemius (MG) EMG amplitudes were observed for either the 10 or 50% MVC tasks. The EMG amplitudes of the tibialis anterior (TA), an antagonist to plantarflexion, were higher in- and post-flight than pre-flight for the 50% MVC task. During the dorsiflexion tasks, the torques generated in both the 10 and 50% MVC tasks did not differ pre-, in- and post-flight. TA EMG amplitudes were significantly higher in- than pre-flight for both the 10 or 50% MVC tasks, and remained elevated post-flight for the 50% MVC test. Both the Sol and MG EMG amplitudes were significantly higher in-flight than either pre- or post-flight for both the 10 and 50% MVC tests. These data suggest that the most consistent response to space flight was an elevation in the level of contractions of agonists and antagonists when attempting to maintain constant torques at a given level of MVC. Also, the chronic levels of EMG activity in selected ankle flexor and extensor muscles during space flight and during routine activities on Earth were recorded. Compared with pre- and post-flight values, there was a marked increase in the total EMG activity of the TA and the Sol and no change in the MG EMG activity in-flight. These data indicate that space flight, as occurs on shuttle missions, is a model of elevated activation of both flexor and extensor muscles, probably reflecting the effects of programmed work schedules in flight rather than a direct effect of microgravity.

Published
2001

17. Rhesus leg muscle EMG activity during a foot pedal pressing task on Bion 11

Author

Hodgson, J. A, Riazansky, S. N, Goulet, C, Badakva, A. M, Kozlovskaya, I. B, Recktenwald, M. R, McCall, G, Roy, R. R, Fanton, J. W, and Edgerton, V. R

Subjects
Life Sciences (General)
Abstract

Rhesus monkeys (Macaca mulatta) were trained to perform a foot lever pressing task for a food reward. EMG activity was recorded from selected lower limb muscles of 2 animals before, during, and after a 14-day spaceflight and from 3 animals during a ground-based simulation of the flight. Integrated EMG activity was calculated for each muscle during the 20-min test. Comparisons were made between data recorded before any experimental manipulations and during flight or flight simulation. Spaceflight reduced soleus (Sol) activity to 25% of preflight levels, whereas it was reduced to 50% of control in the flight simulation. During flight, medial gastrocnemius (MG) activity was reduced to 25% of preflight activity, whereas the simulation group showed normal activity levels throughout all tests. The change in MG activity was apparent in the first inflight recording, suggesting that some effect of microgravity on MG activity was immediate.

Published
2000

18. Bed rest suppresses bioassayable growth hormone release in response to muscle activity

Author

McCall, G. E, Goulet, C, Grindeland, R. E, Hodgson, J. A, Bigbee, A. J, and Edgerton, V. R

Subjects
Life Sciences (General)
Abstract

Hormonal responses to muscle activity were studied in eight men before (-13 or -12 and -8 or -7 days), during (2 or 3, 8 or 9, and 13 or 14 days) and after (+2 or +3 and +10 or +11 days) 17 days of bed rest. Muscle activity consisted of a series of unilateral isometric plantar flexions, including 4 maximal voluntary contractions (MVCs), 48 contractions at 30% MVC, and 12 contractions at 80% MVC, all performed at a 4:1-s work-to-rest ratio. Blood was collected before and immediately after muscle activity to measure plasma growth hormone by radioimmunoassay (IGH) and by bioassay (BGH) of tibia epiphyseal cartilage growth in hypophysectomized rats. Plasma IGH was unchanged by muscle activity before, during, or after bed rest. Before bed rest, muscle activity increased (P < 0.05) BGH by 66% at -13 or -12 days (2,146 +/- 192 to 3,565 +/- 197 microg/l) and by 92% at -8 or -7 days (2,162 +/- 159 to 4,161 +/- 204 microg/l). After 2 or 3 days of bed rest, there was no response of BGH to the muscle activity, a pattern that persisted through 8 or 9 days of bed rest. However, after 13 or 14 days of bed rest, plasma concentration of BGH was significantly lower after than before muscle activity (2,594 +/- 211 to 2,085 +/- 109 microg/l). After completion of bed rest, muscle activity increased BGH by 31% at 2 or 3 days (1,807 +/- 117 to 2,379 +/- 473 microg/l; P < 0.05), and by 10 or 11 days the BGH response was similar to that before bed rest (1,881 +/- 75 to 4,160 +/- 315 microg/l; P < 0.05). These data demonstrate that the ambulatory state of an individual can have a major impact on the release of BGH, but not IGH, in response to a single bout of muscle activity.

Published
1997

28. Rationale, design, implementation, and baseline characteristics of patients in the dig trial: A large, simple, long-term trial to evaluate the effect of digitalis on mortality in heart failure

Author

Abernathy, GT, Abrams, J, Akhtar, S, Albitar, I, Amidi, M, Anand, IS, Arnold, JMO, Ashton, T, Aubrey, B, Auger, P, Babb, J, Baigrie, R, Baird, MG, Baitz, T, Barber, NC, Barbour, DJ, Barr, DM, Basu, AK, Baughman, KL, Beckham, V, BekheitSaad, S, Berkson, DM, Bertoglio, M, Bessoudo, R, Beaudoin, J, Bhaskar, G, Binder, A, Bloomfield, D, Bodine, K, Boehmer, JP, Borgersen, K, Borts, D, Bouchard, G, Bourassa, MG, Boutros, G, Bozek, B, Brisbin, D, Brophy, J, Brossoit, R, Brown, E, Brown, J, Bruinsma, N, Burton, G, Cameron, A, Campbell, R, Campeau, J, Campos, EE, Cardello, FP, Carter, RP, Chan, YK, Charles, FR, Chaudhry, MA, Chiaramida, A, Chiaramida, S, Chohan, A, Christie, LG, Clemson, BS, Collin, R, Cook, TH, Copen, DL, Cossett, J, Costantino, T, Crawford, MH, Croke, RP, Crowell, R, DAmours, G, Dagenais, GR, Danisa, K, Davidson, S, Davies, ML, Davies, R, Davies, RA, DeLarochelliere, R, DeLeon, AC, Delage, F, Denes, P, Dennish, GW, Denny, DM, DeVilla, MA, DeYoung, JP, Dhurandhar, RW, DibnerDunlap, M, Dodek, A, Doherty, JE, Dominguez, J, Dubbin, J, Dufton, J, Effron, MB, ElSherif, N, Eladasari, B, Fly, D, Ericson, K, Fahrenholtz, D, Fast, A, Fell, DA, Fishman, S, Fitchett, D, Fleg, JL, Flint, E, Folger, JS, Folkins, D, Forker, AD, Fowles, RE, Fraker, TD, Francis, G, Frerking, TR, Friesinger, GC, Fulop, JC, Gagnon, J, Gamble, L, Ganjavi, F, Garrou, BW, Gervais, PB, Gheorghiade, M, Gilbert, L, Gillie, E, Glatter, TR, Godley, ML, Goeres, M, Goldberger, MH, Gollapudi, A, Goode, JE, Goodman, LS, Gordon, R, Gossard, D, Gosselin, G, Goulet, C, Grant, C, Graettinger, WF, Greene, JG, Greenwood, PV, Gregoratos, G, Gregory, JJ, Groden, DL, Grover, J, Gudapati, R, Guess, MA, Gupta, SC, Habib, N, Hack, I, Hamilton, WP, Hankey, TL, Hanna, M, Harper, D, Harris, DE, Hassapoyannes, CA, Hatheway, RJ, Heinsimer, J, Pequignot, MH, Heiselman, DE, Hess, AR, Hickner, J, Hickey, JE, Higgins, T, Higginson, L, Hill, L, Hobbs, RE, Honos, G, Horner, BA, Horwitz, L, Hsieh, A, Hsueh, JT, Hubbard, J, Hughes, DF, Hui, W, Imrie, JR, Jacobs, MH, Jarmukli, N, Johnson, TH, Johnstone, D, Jutila, CK, Kadri, N, Kahl, FR, Kaimal, PK, Karnegis, J, Kay, R, Kelly, KJ, Kenefick, G, Kennelly, BM, Kent, E, Khan, AH, Khanijo, V, Khouri, M, Kinloch, D, Kirlin, PC, Kiwan, GS, Kline, MD, Kohn, RM, Koilpillai, C, Kornder, JM, Kouz, S, Kumar, VA, Kumar, U, Kuntz, A, Kuritzky, RA, Kuruvilla, G, Kwok, KK, Lader, E, Laforest, M, LaForge, D, Lalonde, G, Lalonde, L, Lang, RM, Latour, Y, Lawal, O, LeBlanc, MH, Lee, AB, Lee, RW, Legault, C, Lemay, M, Lenis, JHF, Lepage, S, Letarte, P, Levesque, C, LevinoffRoth, SN, Lewis, BK, Lipshutz, H, Loungani, RR, Lowery, ML, Lubell, DL, Lucariello, R, LugoRodriguez, JE, Lui, C, Lutterodt, AT, Lutz, L, Machel, T, Macina, G, MacLellan, K, Magnan, O, Mansuri, M, Manyari, DE, Mallis, GI, Marr, D, Mast, DJ, Mathew, J, McBarron, FD, McIntyre, KM, McLean, RW, McMahon, DP, Mercier, M, Methe, M, Miller, AB, Minkowitz, J, Milton, JR, Mizgala, HF, Mohanty, PK, Mohiuddin, S, Montero, A, Mookherjee, S, Morris, A, Morris, L, Morrison, J, Moten, M, Nafziger, A, Nair, PH, Nawaz, S, Neiman, JC, Nutting, P, NguyenPho, HT, OBrien, TK, OKelly, RL, OReilly, MV, Okerson, D, Patel, G, Pande, PN, Papa, LA, Patrick, L, Payne, RM, Perry, G, Philbin, EF, Pierpont, G, Pitt, WA, Poirier, C, Pollak, EM, Popio, K, Poulin, JF, Probst, PA, Pruneau, G, Pu, C, Puram, BS, Putatunda, B, Quinn, B, Rabkin, SW, Racine, N, Raco, DL, Radant, L, Radford, MJ, Radwany, S, Rajachar, M, Ramanathan, KB, Rashkow, A, Rausch, DC, Read, L, Reddy, KR, Reid, R, Rich, MW, Ricci, AJ, Richman, HG, Riley, A, Rim, DA, Rinne, C, Roberge, G, Roberts, DK, Robinson, V, Rodeheffer, RT, Rosenstein, R, Roth, DL, Rothbart, R, Rouleau, JL, Ruble, P, Sacco, J, Safford, RE, Salmon, D, Sahay, BM, Sarma, RJ, Sayeed, MAR, Schick, EC, Schroeder, GS, Seifert, M, Senaratne, MPJ, Sestier, F, Shah, A, Shanes, JG, Sheesley, K, Silverman, A, Shiva, T, Shrestha, DD, Silver, MA, Silverberg, L, Simard, L, Singh, BN, Small, RS, Smith, MR, Smith, S, Sochowski, RA, Southern, RF, Sridharan, MR, StHilaire, R, Stein, M, Stewart, JW, Stillabower, ME, Sullivan, BHM, Sturrock, WA, Sussex, BA, Swan, J, Swenson, L, Talbot, P, Talibi, T, Tamilia, M, Tan, A, Tanser, PH, Tarry, L, Teo, KK, Thadani, U, Thagirisa, S, Thompson, B, Thornton, R, Timmis, GC, Tobin, M, Tommaso, C, Toren, M, Tsuyuki, R, Turek, M, Utley, K, Vanderbush, EJ, VanVoorhees, L, Ventura, H, Vertes, G, Vizel, S, Wagner, KR, Wagner, S, Weeks, A, Weingert, ME, Weinstein, C, Weiss, MM, Weiss, R, Wickemeyer, W, Wielgoz, A, Willens, HJ, Williams, WL, Wong, D, Yarows, SA, Yao, L, Shalev, Y, Young, JB, Yousefian, M, Zajac, EJ, Zatuchni, J, Ziperman, DB, Zoble, RG, Zoneraich, S, Gorlin, R, Sleight, P, Cohn, JN, Collins, R, Deykin, D, Hennekens, C, Kjekshus, J, Smith, TW, Tognoni, G, Collins, JF, Williford, WO, Fye, C, Sather, R, Jolly, MK, Held, CP, Verter, J, Yusuf, S, Egan, D, Garg, R, Johnstone, DE, Montague, T, Bristow, D, Engelhardt, HT, Gent, M, Hood, WB, Jones, S, Meier, P, Pitt, B, Waters, D, Baker, A, Barnhill, S, Carew, B, Hagar, S, Liuni, C, Martin, S, Miles, R, Arthur, MM, Feldbush, MW, Highfield, DA, Hobbins, TE, Kurz, R, Leviton, SP, Libonati, JP, Moore, M, Perez, E, Mills, P, Geller, N, Hunsberger, S, Gold, J, Huang, PC, Burns, A, Caleb, H, Cline, DR, Harris, S, Hockenbrock, R, Horney, RA, Jadwin, LM, King, J, Sexton, P, Spence, ME, Chacon, F, Gagne, W, Maple, S, and Martinez, G

Subjects
Heart Failure, Male, Pharmacology, Digoxin, Treatment Outcome, Patient Selection, Digitalis Glycosides, Humans, Multicenter Studies as Topic, Female, Middle Aged, Aged, Randomized Controlled Trials as Topic
Abstract

This article provides a detailed overview of the rationale for key aspects of the protocol of the Digitalis Investigation Group (DIG) trial. It also highlights unusual aspects of the study implementation and the baseline characteristics. The DIG trial is a large, simple, international placebo-controlled trial whose primary objective is to determine the effect of digoxin on all cause mortality in patients with clinical heart failure who are in sinus rhythm and whose ejection fraction isor = 0.45. An ancillary study examines the effect in those with an ejection fraction0.45. Key aspects of the trial include the simplicity of the design, broad eligibility criteria, essential data collection, and inclusion of various types of centers. A total of 302 centers in the United States and Canada enrolled 7788 patients between February 1991 and September 1993. Follow-up continued until December 1995 with the results available in Spring 1996.

Published
1996

30. SlCCD7 controls strigolactone biosynthesis, shoot branching and mycorrhiza-induced apocarotenoid formation in tomato

Author

Vogel, J.T., Walter, M.H., Giavalisco, P., Lytovchenko, A., Kohlen, W., Charnikhova, T., Simkin, A.J., Goulet, C., Strack, D., Bouwmeester, H.J., Fernie, A.R., and Klee, H.J.

Subjects
germination stimulants, plant architecture, food and beverages, arabidopsis, striga-lutea lour, carotenoid cleavage dioxygenase, orobanche spp, root-derived signal, Bioscience, liquid-chromatography, Laboratorium voor Plantenfysiologie, EPS, genes, Laboratory of Plant Physiology, yellow pigment
Abstract

The regulation of shoot branching is an essential determinant of plant architecture, integrating multiple external and internal signals. One of the signaling pathways regulating branching involves the MAX (more axillary branches) genes. Two of the genes within this pathway, MAX3/CCD7 and MAX4/CCD8, encode carotenoid cleavage enzymes involved in generating a branch-inhibiting hormone, recently identified as strigolactone. Here, we report the cloning of SlCCD7 from tomato. As in other species, SlCCD7 encodes an enzyme capable of cleaving cyclic and acyclic carotenoids. However, the SlCCD7 protein has 30 additional amino acids of unknown function at its C terminus. Tomato plants expressing a SlCCD7 antisense construct display greatly increased branching. To reveal the underlying changes of this strong physiological phenotype, a metabolomic screen was conducted. With the exception of a reduction of stem amino acid content in the transgenic lines, no major changes were observed. In contrast, targeted analysis of the same plants revealed significantly decreased levels of strigolactone. There were no significant changes in root carotenoids, indicating that relatively little substrate is required to produce the bioactive strigolactones. The germination rate of Orobanche ramosa seeds was reduced by up to 90% on application of extract from the SlCCD7 antisense lines, compared with the wild type. Additionally, upon mycorrhizal colonization, C13 cyclohexenone and C14 mycorradicin apocarotenoid levels were greatly reduced in the roots of the antisense lines, implicating SlCCD7 in their biosynthesis. This work demonstrates the diverse roles of MAX3/CCD7 in strigolactone production, shoot branching, source–sink interactions and production of arbuscular mycorrhiza-induced apocarotenoids.

Published
2010

39. [Multicenter randomized trial of amnioinfusion]

Author

Fraser W, Marcoux S, Prendiville W, Stavros Petrou, Hofmeyr J, Reinharz D, Goulet C, and Ohlsson A

Subjects
Meconium, Meconium Aspiration Syndrome, Patient Selection, Infant, Newborn, Humans, Multicenter Studies as Topic, Amniotic Fluid, Infant, Newborn, Diseases, Randomized Controlled Trials as Topic
Abstract

Meconium staining of the amniotic fluid in labor is a frequent problem that is associated with an increase in the risk of neonatal and maternal morbidity. Amnioinfusion is a simple technique that is designed to prevent neonatal and maternal morbidity associated with meconium. Preliminary studies indicate that amnioinfusion is a promising approach to the prevention of such complications of labor. However, further research is required. The primary objective of this multi-centre randomized controlled study is to determine if amnioinfusion for thick meconium stained amniotic fluid results in a reduction in perinatal death or moderate to severe meconium aspiration syndrome. We will also assess the effects of amnioinfusion on other indicators of neonatal morbidity and on cesarean section. The study includes an evaluation of womens views on their childbirth experience and an economic evaluation of a policy of amnioinfusion The study will be achieved with the collaboration of approximately 50 obstetrical centres from across Canada, US, Europe, South America and South Africa. This multicentre trial will provide urgently needed information on the efficacy and effectiveness of amniofusion for the indication of meconium stained amniotic fluid.

Published
2000

40. [Critical review of instruments to assess pain in the non communicative brain injured persons in intensive care].

Author

Roulin, M., Goulet, C., Ramelet, Anne-Sylvie, Roulin, M., Goulet, C., and Ramelet, Anne-Sylvie

Abstract

The purpose of this review is to critically appraise the pain assessment tools for non communicative persons in intensive care available in the literature and to determine their relevance for those with brain injury. Nursing and medical electronic databases were searched to identify pain tools, with a description of psychometric proprieties, in English and French. Seven of the ten tools were considered relevant and systematically evaluated according to the criteria and the indicators in the following five areas: conceptualisation, target population, feasibility and clinical utility, reliability and validity. Results indicate a number of well designed pain tools, but additional work is necessary to establish their accuracy and adequacy for the brain injured non communicative person in intensive care. Recommendations are made to choose the best tool for clinical practice and for research.

Published
2011

44. Symposium

Author

Verhagen, E., primary, Gabbe, B., additional, Naughton, G., additional, Goulet, C., additional, and Marino, N., additional

Published
2012
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45. Multicenter, randomized, controlled trial of delayed pushing for nulliparous women in the second stage of labor with continuous epidural analgesia. The PEOPLE (Pushing Early or Pushing Late with Epidural) Study Group.

Author

Fraser WD, Marcoux S, Krauss I, Douglas J, Goulet C, Boulvain M, PEOPLE (Pushing Early or Pushing Late with Epidural) Study Group, Fraser, W D, Marcoux, S, Krauss, I, Douglas, J, Goulet, C, and Boulvain, M

Abstract

Objective: This study was undertaken to determine whether a policy of delayed pushing for nulliparous women with continuous-infusion epidural analgesia reduces the risk of difficult delivery (cesarean delivery, operative delivery from a midpelvic position, low-pelvic procedures with rotation >45 degrees ).Study Design: In this multicenter, randomized, controlled trial women in the delayed pushing group (n = 936) were advised to wait > or =2 hours after full dilatation before commencement of pushing. Women in the early pushing group (n = 926) were advised to commence pushing as soon as they had been randomly assigned.Results: Difficult delivery was reduced with delayed pushing (relative risk, 0.79; 95% confidence interval, 0.66-0.95). The greatest effect was on midpelvic procedures (relative risk, 0.72; 95% confidence interval, 0.55-0.93). Although there was little evidence for an effect on low-pelvic procedures, spontaneous delivery was more frequent among women who practiced delayed pushing (relative risk, 1.09; 95% confidence interval, 1.00-1.18). Abnormal umbilical cord blood pH (<7.15 venous value or <7.10 arterial value) was more frequent in the delayed pushing group (relative risk, 2.45, 95% confidence interval, 1.35-4. 43). However, scores for a summary indicator, the Neonatal Morbidity Index, were similarly distributed in the 2 groups.Conclusion: Delayed pushing is an effective strategy to reduce difficult deliveries among nulliparous women. [ABSTRACT FROM AUTHOR]

Published
2000
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