morphine and Anemia

To determine whether there is a difference in maternal and neonatal outcomes if a sequential operative vaginal or cesarean delivery follows failed vacuum delivery.. A cross sectional study. We have analyzed maternal and neonatal outcomes of 215 vacuum extractions (group 1), 106 forceps assisted deliveries (group 2), 28 deliveries in which failed vacuum extraction were followed by forceps delivery (group 3) and 22 deliveries in which failed vacuum extraction were followed by cesarean delivery (group 4).. Compared to other groups, patients in group 4 had significantly more post partum anemia, meconium stained amniotic fluid and hospital stay (both maternal and neonatal) as well as lower pH. Apgar scores were similar in groups 3 and 4. Incidence of respiratory distress syndrome, cephalhematoma and jaundice were similar in neonates of all groups.. If an attempted vacuum delivery has failed, the risk of adverse neonatal outcome is increased with either subsequent forceps or cesarean delivery. It should remain in the judgment of the attending obstetrician to choose the method most suitable under the given circumstances.

Topics: Adult; Amniotic Fluid; Anemia; Apgar Score; Cesarean Section; Cross-Sectional Studies; Delivery, Obstetric; Dystocia; Female; Fetal Distress; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Labor Stage, Second; Length of Stay; Meconium; Obstetrical Forceps; Pregnancy; Pregnancy Outcome; Respiratory Distress Syndrome, Newborn; Shoulder; Time Factors; Treatment Failure; Vacuum Extraction, Obstetrical

We sought to compare obstetric and neonatal complications among great-grand multiparous, grand multiparous, and multiparous women.. One hundred thirty-three great-grand multiparas, 314 grand multiparas, and 2195 multiparas who were delivered of their infants between 1988 and 1998 were selected for the study. To facilitate comparison, the patients were all >35 years old and had similar socioeconomic characteristics.. The incidence of malpresentation at the time of delivery, maternal obesity, anemia, preterm delivery, and meconium-stained amniotic fluid increased with higher parity, whereas the rate of excessive weight gain and cesarean delivery decreased. Compared with grand multiparas, great-grand multiparas had significantly elevated risks for abnormal amounts of amniotic fluid, abruptio placentae, neonatal tachypnea, and malformations but lower rates of placenta previa (P <.05). The incidence of postpartum hemorrhage, preeclampsia, placenta previa, macrosomia, postdate pregnancy, and low Apgar scores was significantly higher in grand multiparas than in multiparas, whereas the proportion of induction, forceps delivery, and total labor complications was significantly lower than in the multiparous group (P <.05). Similar frequency of maternal diabetes, infection, uterine wall scar rupture, variations in fetal heart rate, fetal death, and neonatal mortality was found in the 3 groups.. Both high-parity groups have their own risk factors, but the rate of some complications decreases with higher parity. In addition, perinatal mortality remains low in these patients, and therefore, under satisfactory socioeconomic and health care conditions, high parity should not be considered dangerous.

Topics: Adult; Anemia; Cesarean Section; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor Presentation; Meconium; Obesity; Obstetric Labor, Premature; Parity; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Weight Gain

Topics: Abdomen; Adolescent; Anemia; Child; Child, Preschool; Constipation; Diagnosis, Differential; Female; Guaiac; Humans; Infant, Newborn; Male; Meconium; Megacolon; Melena; Neuromuscular Diseases; Pain; Pediatrics; Posture; Rectal Diseases; Rectum; Sigmoidoscopy; Urethral Diseases; Vaginal Diseases

Topics: Anemia; Body Weight; Chloramphenicol; Chlortetracycline; Cough; Cystic Fibrosis; Diabetes Mellitus, Type 1; Diet Therapy; Feces; Humans; Hunger; Hypoproteinemia; Infant; Infant, Newborn; Intestinal Obstruction; Meconium; Pancreatic Juice; Pancreatin; Physical Therapy Modalities; Prognosis; Rectal Prolapse; Sweat; Tooth Discoloration; Vomiting

Topics: Anemia; Erythroblastosis, Fetal; Female; Fetal Diseases; Fetal Heart; Humans; Meconium; Pre-Eclampsia; Pregnancy; Pregnancy in Diabetics; Pregnancy, Prolonged