摘要:

ABSTRACT:Over the past 30 years oxytocin has been used extensively to augment labor. The physiologic responses of the uterus to oxytocin are reviewed in relation to current practices in the augmentation of labor. The data suggest that excessive doses are being used in routine obstetric care, and that a much more cautious approach is needed, as well as clinical trials to evaluate the efficacy of high‐ and low‐dose protoc

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1988.tb01108.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1988.tb01109.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1988.tb01110.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT:Data were reviewed on first stage labor duration, as measured from onset of contractions or from hospital admission, in primiparas at three North American and three European hospitals in the past decade. Median durations were found to be over an hour longer in the North American hospitals where labor stimulation with oxytocic drugs appeared to be more frequent. It is concluded that shorter durations at the European hospitals must be attributed to factors other than the “active management of labor” with oxytocic dr

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1988.tb01111.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT:In a study of difficult labor in primiparas at two Montreal hospitals, prolonged first stage labor was significantly less frequent at a community hospital (8%) than at a high risk referral hospital (14%), even though only women admitted for uncomplicated spontaneous labor were included. Prolonged labor was defined as longer than 15 hours from admission to full dilatation of the cervix. More labors were stimulated with oxytocin at the high risk referral hospital (61%) than at the community hospital (34%), meaning that frequent stimulation did not prevent prolonged labor. Common factors may lead both to the need for stimulation and to prolonged labor.

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1988.tb01112.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT:Studies of gastric emptying time in laboring women show that delay occurs rarely, except after administration of drugs. In addition to narcotic analgesics, which cause marked delay, other drugs can also delay stomach emptying or provoke aspiration of vomitus, or aggravate its deleterious effects, including muscle relaxants, which abolish the protective cough reflex, and oxytocin in combination with large intravenous loads, which may contribute to pulmonary edema. Fasting may result in lower gastric volume within three to four hours, after which both volume and acidity of gastric juices increase. Emptying the stomach before general anesthesia by means of a nasogastric tube or giving apomorphine to induce vomiting succeeds only if done immediately before induction of anesthesia. Women prefer apomorphine, but it relaxes the gastroesophageal sphincter, making gastric reflux easier. Metoclopramide as an antiemetic has unreliable effects. Antacids can produce chalky particulate matter that is more harmful than clear fluid if aspirated. Other medications used to reduce gastric volume or raise pH have delayed action or deleterious side effects. We conclude that present approaches to preventing aspiration ofvomitus lack efficacy and entail unnecessary risks.

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1988.tb01113.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT:Concern about the incidence of maternal aspiration and its effect upon maternal morbidity and mortality has resulted in restricting oral intake of laboring women, although data show maternal death to be rare. Among many factors that can be linked to the occurrence of aspiration, the most important appears to be faulty administration of obstetric anesthesia.

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1988.tb01114.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1988.tb01115.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1988.tb01116.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT:Excessive lead exposure, not only from lead‐based paint in older homes, but also in yard soils, remains a public health problem in America despite centuries of knowledge of the poisonous nature of lead. Heightened concern about communitywide lead exposure has followed recent research findings that show lead to be toxic at levels previously thought to have no effect. Because mothers and children have been considered to be at particular risk, pregnant women and those responsible for perinatal care require greater understanding of the sources and effects of lead.In a study of 4354 women, the risk of pregnancy hypertension and of congenital anomalies doubled as umbilical cord lead levels increased from about 1 to 10 μg per dL. A subgroup of about 240 was further studied for environmental sources of lead and follow‐up of the children's development. This is a continuing longitudinal study; many of its published results are summarized here, with information from other studies. The effects of pregnancy on lead metabolism are also discu

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1988.tb01117.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY