morphine and Placenta-Previa

The association of grand multiparity and poor pregnancy outcome has not been consistent for decades. Classifying grand multiparous women as a high-risk group without clear evidence of a consistent association with adverse outcomes can lead to socioeconomic burdens to the mother, family and health systems. We compared the maternal and perinatal complications among grand multiparous and other multiparous women in Dar es Salaam in Tanzania.. A cross-sectional study was undertaken at Muhimbili National Hospital (MNH). A standard questionnaire enquired the following variables: demographic characteristics, antenatal profile and detected obstetric risk factors as well as maternal and neonatal risk factors. Predictors of adverse outcomes in relation to grand multiparous women were assessed at p = 0.05.. Grand multiparas had twice the likelihood of malpresentation and a threefold higher prevalence of meconium-stained liquor and placenta previa compared with lower-parity women even when adjusted for age. Neonates delivered by grand multiparous women (12.1%) were at three-time greater risk of a low Apgar score compared with lower-parity women (5.4%) (odds ratio (OR), 2.9; 95% confidence interval (CI), 1.5-5.0). Grand multiparity and low birth weight were independently associated with a low Apgar score (OR, 2.4; 95%, CI 1.4-4.2 for GM; OR, 4.2; 95% CI, 2.3-7.8) for low birth weight.. Grand multiparity remains a risk in pregnancy and is associated with an increased prevalence of maternal and neonatal complications (malpresentation, meconium-stained liquor, placenta previa and a low Apgar score) compared with other multiparous women who delivered at Muhimbili National Hospital.

Topics: Adult; Amniotic Fluid; Apgar Score; Cross-Sectional Studies; Delivery, Obstetric; Female; Humans; Infant, Low Birth Weight; Infant, Newborn; Labor Presentation; Maternal Age; Meconium; Parity; Placenta Previa; Pregnancy; Prevalence; Prospective Studies; Risk Factors; Tanzania; Young Adult

Over the last 4 years at Los Angeles County-University of Southern California Medical Center, Women's Hospital, clinical interest in antepartum fetal monitoring has increased considerably. As a result of approximately 1,500 tests in some 600 patients at high risk for placental insufficiency, we have reached several conclusions regarding the methods for antepartum fetal monitoring, criteria for interpretation of the results obtained, and the role of antepartum monitoring information in clinical management. In this paper, the results of "stress" monitoring (monitoring in the presence of uterine contractions) are presented. The term "oxytocin challenge test" is used in reference to "stressed" monitoring even though sometimes the contractions were spontaneous, or without oxytocin stimulation.

Topics: Cesarean Section; Electrocardiography; Estriol; Female; Fetal Death; Fetal Heart; Heart Rate; Hemoglobinopathies; Humans; Labor, Obstetric; Meconium; Monitoring, Physiologic; Obstetric Labor, Premature; Oxytocin; Phonocardiography; Placenta Diseases; Placenta Previa; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics; Pregnancy, Prolonged; Prenatal Diagnosis; Ultrasonography; Uterus

Topics: Amniotic Fluid; Female; Fetal Death; Humans; Meconium; Placenta Previa; Pregnancy

Topics: Abruptio Placentae; Amnion; Amniotic Fluid; Apgar Score; Endoscopy; Erythroblastosis, Fetal; Female; Fetal Death; Fetal Diseases; Fetoscopy; Humans; Hypoxia; Meconium; Placenta Previa; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy, Prolonged