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A study was undertaken to determine whether women with recurrent spontaneous preterm births (rSPBs) having different clinical characteristics or systemic markers than those with isolated preterm (iSPBs) or recurrent term births (rTBs), when assessed remote from delivery. Women with rSPBs are leaner, contract more, have shorter cervixes, and have more advanced Bishop scores than women with iSPBs or rTBs.

The study determines risk assessments for a spectrum of neonatal outcomes with elective cesarean delivery versus a trial of labor for previous cesarean section and otherwise healthy patients who deliver at term. The risk of adverse neonatal outcomes is low, with the choice between elective cesarean delivery and trial of labor in general balancing the low risk of increased respiratory morbidity and thereby neonatal intensive care unit triage/admission against the extremely low risk of labor-related infant death and severe morbidity.

The study compares the umbilical arterial 8-iso-prostaglandin F2-alpha, concentrations between pregnancies that were complicated by moderate or thick meconium stained liquor and those with clear liquor. Moderate of thick meconium-stained liquor is an independent factor for increased oxidative stress in pregnancy.

Two single-base polymorphisms of tumor necrosis at positions -863 and -308 were tested for association with adverse outcomes in mother-infant pairs with preterm labor. In women with preterm labor before 34 weeks' gestation, maternal homozygous carriage of the -863 polymorphism could be associated with preterm delivery.

Assessment of the safety of trial of labor after previous cesarean delivery is undertaken. Findings indicate that trial of labor is associated with increased risk of uterine rupture, however elective cesarean section is likely to increase the risk of maternal death.

The purpose of this study was to determine the continuing effectiveness of active management of labor, a protocol that involves early detection and correction of dystocia with oxytocin in spontaneous cephalic nulliparous labor. The results of this study show that the protocol of active management of labor remains effective in nulliparous women in spontaneous labor in a setting in which the total nulliparous cesarean birth rate has doubled in 12 years.

A study was conducted to develop an easily usable Web page-based calculator to estimate any womanEs probability of cephalopelvic disproportion (CPD) and cesarean delivery (CS) and also to evaluate risk factor for CS in a low-risk primiparous population. It was found that the probability of CS and CS performed for CPD was higher for shorter, older, more obese women with large pregnancy weight gains, larger fetal birth weights and longer gestation ages.

A total of 151 patients were enrolled to compare the efficacy of two protocols for active management of labor at term in the presence of an unfavorable cervix. The conclusion was that sustained-release dinoprostone with concurrent low-dose oxytocin and intermittent misoprostol with delayed high-dose oxytocin are effective alternatives for the said active management of labor.

Background. The effect of a nuchal cord on the outcome of delivery is controversial. The purposes of this study were to investigate the frequency of nuchal cords and determine the effect that nuchal cords have on the neonate. Methods. In a retrospective, case-control study, 706 consecutive infant deliveries in a community hospital were evaluated. Sixteen deliveries that were complicated by the umbilical cord entangled around an extremity or by a prolapsed cord were excluded from further analysis. The study group consisted of the 167 deliveries (23.7%) complicated by a nuchal cord. The remaining 523 deliveries were used as the control group. Results. There were no significant differences found in maternal age, race, parity, prepregnancy weight, or amount of weight gain between the mothers of the infants in the two groups. Fetal bradycardia and variable decelerations in fetal heart rate occurred almost twice as often in the nuchal cord group (18.6% as compared with 9.6%, P < .01). Despite this finding, there was no significant difference in the number of operative deliveries or in Apgar scores at 1 and 5 minutes between the two groups. There were no perinatal deaths associated with nuchal cords. Infants born with nuchal cords weighed less than those in the control group (3345 g compared with 3468 g, P < .01). There were also significantly fewer large-for-gestational-age and macrosomic infants born in the nuchal cord group. Complications such as jaundice, hypoglycemia, sepsis, and respiratory problems were not increased in the postnatal period because of a nuchal cord. Conclusions. This study suggests that nuchal cords are common and are rarely associated with significant morbidity or mortality in neonates., As Baden so eloquently wrote in 1955, "intrauterine life, sustained only by two small arteries an a tortuous vein coursing through a long flexible cord, hangs by a very delicate [...]

OBJECTIVE: The purpose of study was to determine the frequency, microbiologic characteristics, and clinical significance of microbial invasion of the amniotic cavity in women with premature rupture of membranes at term. STUDY DESIGN: Aminocentesis was performed in 32 women with term premature rupture of membranes and amniotic fluid cultured for aerobic and anaerobic bacteria and Mycoplasmas. RESULTS: The prevalence of positive amniotic fluid cultures was 34.3% (11/32). The most common isolates were Ureaplasma urealyticum, Peptostreptococcus sp., Lactobacillus sp., Bacteroides fragilis, and Fusobacterium had ophthalmitis. Three patients (9.4%) had endometritis. Among women who were delivered vaginally, those with a positive amniotic fluid culture had a significantly higher rate of endometritis than those with a negative culture (33% [3/9] vs 0% [0/20], respectively, p = 0.023). CONCLUSIONS: These data indicate that microbial invasion of the amniotic cavity occurs in approximately one third of patients with preterm premature rupture of membranes. Microbial invasion of the amniotic cavity is a risk factor for endometritis in women with term premature rupture of membranes. (Am J Obstet Gynecol 1992;166:129-33.)

Objective: Increased obstetrical complications have been reported in individuals with adult-onset schizophrenia, with several studies finding an association between such complications and an earlier age at onset. Consequently, obstetrical records were examined for individuals with childhood-onset schizophrenia to determine if birth complications were more prevalent. Method: The birth records of 36 patients with childhood-onset schizophrenia and 35 sibling comparison subjects were rated for birth complications by two psychiatrists who were unaware of group membership. Results: There were no significant differences between the groups in rates of obstetrical complications. Patients with such complications did not have a relatively earlier age at onset of schizophrenia. Conclusions: A very early age at onset of schizophrenia is probably not due to birth complications.

Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Hannah, M.E. et al. for the Term Breech Trial Collaborative Group. The Lancet Vol. [...]

ABSTRACT & COMMENTARY Synopsis: Cesarean delivery for early preterm breech delivery at 26-31 weeks does not improve survival without disability or handicap. Source: Wolf H, et al. Br J Obstet [...]

A Colorado State University study shows that a delay in delivery of just 40 minutes can mean the difference between life or death for the foal. The researchers examined the [...]

Cervical ripening that instigates preterm labor is distinct from what happens at the onset of normal term labor, researchers at the University of Texas Southwestern Medical Center, Dallas, have found. [...]

Midwife Elizabeth Cluett and multidisciplinary colleagues in Southampton, UK, have published the results of a randomised control trial showing that water immersion to address slow labour in nulliparous women reduced [...]