Search

sThe first stage of obstetrical labor is much shorter in women carrying two fetuses than in singleton gestations. Researchers compared 163 women carrying twins and 163 women carrying single fetuses in the progression of labor. The cervical dilatation was smaller on hospital admission, and labor from 4-10 cm. of cervical dilatation was about 25% shorter, for women carrying twins. This difference did not emerge among women who had previously given birth.

Physiological variables in pregnant women effect the blood levels of magnesium sulfate when it's used to prevent premature labor, and their activity can be used to maintain proper blood levels. The variables which affect magnesium sulfate levels are blood protein levels, creatinine levels, and maternal weight. By measuring and allowing for these variables, the magnesium infusion rate can be adjusted for optimum effect.

Injection of dexamethasone through the cervix may shorten the time from induction of labor to delivery. Ninety-eight women requiring cervical ripening, softening and thinning of the cervix, and induction of labor had Foley balloon catheters inserted through the cervix and either saline or dexamethasone was injected. Intravenous oxytocin was administered to induce labor. The 50 women treated with dexamethasone experienced shorter intervals between induction and active labor and shorter times between induction and delivery than the 48 women in the group receiving saline only.

Observed growth curves of twins, based on birth weights at known gestational ages, may be useful for the clinical management of twin pregnancies in addition to expected growth curves for singleton pregnancies. The birth weights of 520 pairs of twins delivered at 28 to 41 weeks of gestational age were used to generate growth curve charts. When compared to singleton pregnancies, twins exhibited growth restriction throughout the third trimester, most pronounced in the last 4 to 6 weeks of pregnancy. Male twins were heavier on the average, compared to females.

Byline: Eyal Schiff, Steven A. Friedman, Shlomo Mashiach, Oded Hart, Gad Barkai, Baha M. Sibai Keywords: Breech; cesarean section; perinatal outcome Abstract: OBJECTIVE: Our purpose was to evaluate the maternal and neonatal outcome of 846 consecutive term singleton breech deliveries at a single center. STUDY DESIGN: We reviewed the maternal and neonatal charts of all women who delivered singleton breech fetuses between 1984 and 1990 and divided them into two groups: women who fulfilled the criteria for trial of labor (group 1, n = 613) and those who did not meet these criteria and underwent scheduled cesarean section (group 2, n = 233). RESULTS: In group I, 326 women (53.2%) were delivered vaginally. There were no maternal deaths. Febrile morbidity and length of hospitalization were significantly higher in the women who required cesarean section in labor compared with those delivered vaginally. In the total study population there were no stillbirths and eight neonatal deaths, 6 of which had major malformations incompatible with life. The remaining two deaths occurred in group I (0.33% corrected neonatal mortality in group 1). Newborns in Group 1 exhibited a higher rate of trauma with borderline statistical significance (3.0% vs 0.5%, p = 0.052). No significant differences were found in the rates of low Apgar scores, intubation, and intensive care unit admission. CONCLUSION: Although certain short-term outcome variables may appear less favorable in term singleton breech infants delivered vaginally, large randomized studies of short- and long-term outcome should be undertaken because current data are not sufficiently conclusive to warrant routine cesarean section for term breech presentation. (Am J Obstet Gynecol 1996;175:18-23.) Author Affiliation: Tel-Aviv, Israel, and Memphis, Tennessee Article History: Received 10 August 1995; Revised 21 September 1995; Accepted 27 December 1995 Article Note: (footnote) [star] From the Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Aviv University,a and the Department of Obstetrics and Gynecology, University of Tennessee, Memphis. b , [star][star] Reprint requests: Baha M. Sibai, MD, Department of Obstetrics and Gynecology, University of Tennessee, Memphis, 853 Jefferson Ave., Suite E102, Memphis, TN 38103., a 0002-9378/96 $5.00 + 0 6/1/71495

Oral ritodrine may fail to prevent recurrent premature labor because the recommended dosage is too low. Ritodrine is a drug used for tocolysis. Tocolysis is inhibition of uterine contraction in premature labor. Among 38 pregnant women, nine were treated with 60 to 120 milligrams per day of oral ritodrine, 20 with 50 to 300 micrograms per minute of intravenous (IV) ritodrine and nine with IV ritodrine followed by oral ritodrine. Blood levels of ritodrine were significantly lower during treatment with oral ritodrine than during treatment with IV ritodrine. Blood levels of ritodrine increased with dosage during treatment with both oral and IV ritodrine. Blood levels during treatment with oral ritodrine were approximately two-thirds lower than during treatment with IV ritodrine in patients treated by both routes.