oxytocin and Asphyxia-Neonatorum

Topics: Amniotic Fluid; Asphyxia Neonatorum; Extraembryonic Membranes; Female; Fetal Blood; Fetal Monitoring; Humans; Infant, Newborn; Labor Onset; Labor, Obstetric; Meconium; Oxytocin; Pregnancy

Topics: Acid-Base Equilibrium; Anesthesia, Epidural; Asphyxia Neonatorum; Blood Chemical Analysis; Blood Specimen Collection; Delivery, Obstetric; Echocardiography; Electrocardiography; Female; Fetal Death; Fetal Diseases; Fetal Heart; Heart Rate; Humans; Hydrogen-Ion Concentration; Hypotension; Infant Mortality; Infant, Newborn; Injections, Intravenous; Methods; Monitoring, Physiologic; Obstetric Labor Complications; Oxytocin; Phonocardiography; Pregnancy; Pregnancy Complications, Cardiovascular; Scalp; Uterus

The frequency of "significant" jaundice of the newborn at this hospital increased from 8-1% of all live births in 1971 to 12-1% in 1972 and 15-4% in 1973. This coincided with an increased use of oxytocic agents and epidural anaesthetics in labour, and a change in the artificial feed given to normal infants. A retrospective study of jaundiced infants born in 1972 failed to explain the increase in jaundice. Though the use of oxytocic agents was not the direct cause, since their use results in the delivery of more infants before 40 weeks of gestation it may be a contributory factor. The use of epidural anaesthetics was sastically related to the development of jaundice but the nature of the association was not clear. Mothers of infants who became jaundiced has a significantly higher frequency of poor past obstetric histories, but once again the association was not clear. The change in artificial feeds was excluded as a possible cause.

Topics: Age Factors; Anesthesia, Epidural; Anesthesia, Obstetrical; Apgar Score; Asphyxia Neonatorum; Bilirubin; Birth Weight; Clinical Trials as Topic; Contraceptives, Oral; Delivery, Obstetric; Female; Gestational Age; Humans; Infant Food; Infant Nutritional Physiological Phenomena; Infant, Newborn; Jaundice, Neonatal; Labor, Induced; Nursing Care; Oxytocics; Oxytocin; Pregnancy; Pregnancy Complications; Retrospective Studies

There is no consensus on the effects of a prolonged second stage of labor on neonatal outcomes. In this large Swedish population-based cohort study, our objective was to investigate prolonged second stage and risk of low Apgar score at 5 min. All nulliparous women (n = 32,796) delivering a live born singleton infant in cephalic presentation at ≥37 completed weeks after spontaneous onset of labor between 2008 and 2012 in the counties of Stockholm and Gotland were included. Data were obtained from computerized records. Exposure was time from fully retracted cervix until delivery. Logistic regression analyses were used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Adjustments were made for maternal age, height, BMI, smoking, sex, gestational age, sex-specific birth weight for gestational age and head circumference. Epidural analgesia was included in a second model. The primary outcome measure was Apgar score at 5 min <7 and <4. We found that the overall rates of 5 min Apgar score <7 and <4 were 7.0 and 1.3 per 1000 births, respectively. Compared to women with <1 h from retracted cervix to birth, adjusted ORs of Apgar score <7 at 5 min generally increased with length of second stage of labor: 1 to <2 h: OR 1.78 (95% CI 1.19-2.66); 2 to <3 h: OR 1.66 (1.05-2.62); 3 to <4 h: OR 2.08 (1.29-3.35); and ≥4 h: OR 2.71 (1.67-4.40). We conclude that prolonged second stage of labor is associated with an increased risk of low 5 min Apgar score.

Topics: Adult; Apgar Score; Asphyxia Neonatorum; Delivery, Obstetric; Dystocia; Female; Humans; Infant, Newborn; Labor Stage, Second; Maternal Age; Obstetric Labor Complications; Oxytocics; Oxytocin; Parity; Population Surveillance; Pregnancy; Pregnancy Outcome; Risk Factors; Sweden; Young Adult

To examine the relationship between nurse-to-patient staffing ratios and perinatal outcomes in women receiving oxytocin during labor.. A retrospective analysis of perinatal outcomes in women receiving oxytocin for induction or augmentation of labor during 2010. Outcomes examined were fetal distress, birth asphyxia, primary cesarean delivery, chorioamnionitis, endomyometritis, and a composite of adverse events. Frequency of 1:1 nurse-to-patient staffing was determined for each hospital. Outcomes were compared between hospitals categorized into quartiles of staffing ratios.. In 208,033 women delivering during 2010, there was no relation between frequency of 1:1 nurse-to-patient staffing ratio and improved perinatal outcomes. Adoption of universal 1:1 staffing in the United States would result in the need for an additional 27,000 labor nurses and a cost of $1.6 billion.. Available data do not support the imposition of mandatory 1:1 nurse-to-patient staffing ratios for women receiving oxytocin in all U.S. facilities.

Topics: Asphyxia Neonatorum; Costs and Cost Analysis; Female; Humans; Labor, Induced; Labor, Obstetric; Nursing Staff, Hospital; Obstetrics and Gynecology Department, Hospital; Oxytocin; Personnel Staffing and Scheduling; Pregnancy; Pregnancy Outcome; Retrospective Studies; United States; Workforce; Workload

Intrapartum rupture of the unscarred uterus is an uncommon event, usually associated with such risk factors as grand multiparity, malpresentation, history of gestational trophoblastic disease, or instrumented delivery. Rupture during first pregnancy is extremely rare.. A 30-year-old primigravid woman was admitted for labor augmentation with oxytocin at 40.5 weeks of gestation. The oxytocin infusion rate was increased during the first and second stages of labor despite contractions occurring at a rate of 4-5 per 10 minutes. The uterus ruptured during second stage. Despite emergency cesarean delivery, the baby had evidence of severe asphyxia.. This case of uterine rupture in a primigravida with no prior uterine surgery and a structurally normal uterus underscores the importance of careful contraction monitoring and judicious control of oxytocin infusion rates.

Topics: Adult; Asphyxia Neonatorum; Cerebral Palsy; Cesarean Section; Emergency Treatment; Female; Gravidity; Humans; Infant, Newborn; Labor Stage, Second; Oxytocin; Pregnancy; Uterine Contraction; Uterine Rupture

To assess the influence of high-dose oxytocin augmentation of spontaneous labor, a consecutive series of 30,874 primigravid term deliveries were analyzed for adverse perinatal outcome. In spite of a longer mean duration of labor, the frequencies of asphyxial perinatal death, neonatal seizures, and abnormal neonatal neurologic behavior were not significantly increased in 14,119 (45%) oxytocin-treated patients. There was no case of uterine rupture in any primigravid labor during the study. These results from 13 years of clinical practice provide reassurance about maternal and fetal safety if oxytocin is used as part of a protocol of active management to correct dystocia when spontaneous primigravid labor with vertex presentation fails to progress.

Topics: Asphyxia Neonatorum; Female; Fetal Blood; Hospital Mortality; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Oxytocin; Parity; Pregnancy; Pregnancy Outcome; Risk Factors

Topics: Amnion; Asphyxia Neonatorum; Female; Humans; Infant, Newborn; Labor, Induced; Oxytocin; Postpartum Hemorrhage; Pregnancy; Time Factors

This study was designed to address the effect of induced labor using pitocin iv drip in decreasing the incidence of perinatal complications and perinatal mortality of prolonged pregnancy. Induced labor was used in a study group which included 126 prolonged pregnant nullipara without complication. One hundred and twenty-eight prolonged pregnant nullipara in natural labor were defined as the control group. The perinatal mortality was 0 in the study group and 3.125% in the control. Also, the asphyxia rate was 8.7% in the study group and 13.3% in the control. The percentage of caesarean deliveries was the same in the both groups. The results of this study suggest that induced labor is safe, effective and practical in the management of prolonged pregnancies.

Topics: Asphyxia Neonatorum; Female; Fetal Distress; Humans; Infant Mortality; Infant, Newborn; Infusions, Intravenous; Labor, Induced; Oxytocin; Pregnancy; Pregnancy, Prolonged

In 77 women (phi 41 week, less than 7 days before delivery) we compared the resistance index (RI) in the umbilical artery (UA), descending aorta (DA) and intracranial artery (ICA) with an oxytocin challenge test (OCT) and a non stress test (NST). Proof criterias were asphyxia resulting in operative deliveries and metabolic acidosis. The sensitivity in predicting metabolic acidosis was low in all tests, but a high and comparable specificity could be achieved in both the RI and OCT. In predicting fetal asphyxia the RI in the ICA had a high sensitivity, the RI in the UA and DA had the highest specificity of all tests. Centralisation and increased brain perfusion seem to detect fetal asphyxia as a result of placental insufficiency.

Topics: Acidosis; Asphyxia Neonatorum; Cerebrovascular Circulation; Cesarean Section; Female; Humans; Infant, Newborn; Muscle, Smooth, Vascular; Oxytocin; Pregnancy; Prenatal Diagnosis; Prospective Studies; Risk Factors; Ultrasonography; Vascular Resistance

Fifty-two patients who had had a single previous caesarean section were submitted to a trial of scar. Labour was monitored by internal tocography and direct fetal heart rate monitoring. Oxytocin infusion was employed when uterine work proved to be inadequate. The oxytocin-augmented and unstimulated groups were compared. Oxytocin augmentation improved uterine work and did not result in significant fetal or maternal morbidity or mortality. Internal tocography was found to be of value, but fetal heart rate monitoring was essential.

Topics: Asphyxia Neonatorum; Cesarean Section; Cicatrix; Female; Fetal Distress; Humans; Infant, Newborn; Labor, Obstetric; Oxytocin; Pregnancy; Uterine Contraction

Topics: Asphyxia Neonatorum; Breast Feeding; Female; Humans; Infant, Newborn; Midwifery; Obstetric Labor Complications; Oxytocin; Pregnancy; Sucking Behavior

Epidural block for vaginal delivery was given to 242 women during a 6-month period. Of these, 178 with a spontaneous start of labour and vaginal delivery were studied with respect to the effect of epidural block with bupivacaine-adrenaline on the course of labour and the condition of the infant in women with normal uterine activity and women with primary uterine inertia treated with oxytocin infusion. On average, the 178 women had already had a longer course of labour before the block was applied than women in control groups. The block per se had only a slight effect on the first stage of labour, but the effect on the second stage was more obvious, leading to outlet extraction in 50% of the primiparous women, compared to 12% of the controls. Transitory asphyxia at birth was observed in 4.5% of the infants of mothers with epidural block, but after 5 min, only 1% had an Apgar score of less than 7. Infants of mothers with epidural block were more often placed under observation or treated in the neonatal ward than infants in control groups.

Topics: Anesthesia, Epidural; Anesthesia, Obstetrical; Apgar Score; Asphyxia Neonatorum; Bupivacaine; Epinephrine; Female; Fetal Hypoxia; Humans; Infant, Newborn; Labor, Induced; Labor, Obstetric; Oxytocin; Parity; Pregnancy; Retrospective Studies

Topics: Adult; Asphyxia Neonatorum; Female; Humans; Hyponatremia; Infant, Newborn; Infant, Newborn, Diseases; Labor, Induced; Maternal-Fetal Exchange; Oxytocin; Pregnancy

The contraction stress test (CST) was used to attempt determination of fetal reserve prior to labor by evaluating the response of the fetal heart rate to spontaneous or induced uterine contractions. Testing was performed by using an external fetal heart rate monitor and tocograph. The CST was employed 189 times in 120 high-risk patients who either had hypertensive disorder of pregnancy or had completed at least 42 weeks of gestation. Testing was begun as early as 34 weeks' gestation and repeated at weekly intervals; it was not used in the clinical management of the patient. The maximum number of tests performed on one patient was 8. A negative CST appears to be a most reliable guide to the ability of the fetus to tolerate labor if it ensues within 1 week. A positive test suggests that the fetus is at increased risk, but death is not necessarily imminent. Results of the present study warrant use of the CST in controlled studies to determine its effect in improving perinatal outcome.

Topics: Apgar Score; Asphyxia Neonatorum; Female; Fetal Death; Fetal Diseases; Fetal Heart; Fetus; Heart Rate; Humans; Infant, Newborn; Monitoring, Physiologic; Oxytocin; Pregnancy; Pregnancy Complications; Prenatal Diagnosis; Stress, Physiological; Uterus

Topics: Asphyxia Neonatorum; Birth Weight; Female; Humans; Hydrogen-Ion Concentration; Hyperbilirubinemia; Infant, Newborn; Infant, Premature, Diseases; Jaundice, Neonatal; Labor, Induced; Oxytocin; Pregnancy

Topics: Asphyxia Neonatorum; Female; Humans; Infant, Newborn; Labor, Induced; Obstetric Labor Complications; Oxytocin; Pregnancy; Thiopental

Topics: Administration, Oral; Adult; Amniotic Fluid; Asphyxia Neonatorum; Cesarean Section; Female; Heart Rate; Humans; Infant, Newborn; Labor, Induced; Organ Size; Oxytocin; Placenta; Pregnancy; Pregnancy Complications; Umbilical Cord

Topics: Amnion; Asphyxia Neonatorum; Cesarean Section; Delivery, Obstetric; Female; Fever; Humans; Infant, Newborn; Labor Presentation; Labor, Induced; Obstetric Labor Complications; Oxytocin; Postpartum Hemorrhage; Pregnancy

Topics: Asphyxia Neonatorum; Female; Fetal Death; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor, Induced; Oxytocin; Pregnancy

Topics: Asphyxia Neonatorum; Female; Humans; Infant, Newborn; Labor, Induced; Oxytocin; Pregnancy

Topics: Administration, Oral; Adult; Age Factors; Asphyxia Neonatorum; Birth Weight; Delivery, Obstetric; Extraembryonic Membranes; Female; Fetal Diseases; Humans; Infant Mortality; Infant, Newborn; Injections, Intravenous; Labor Presentation; Labor, Induced; Maternal Age; Nose; Oxytocin; Parity; Pregnancy; Rupture

Topics: Adult; Asphyxia Neonatorum; Female; Fetal Death; Humans; Infant, Newborn; Labor, Induced; Oxytocin; Pregnancy; Thiopental

Topics: Abnormalities, Drug-Induced; Asphyxia Neonatorum; Cesarean Section; Female; Fetal Death; Fetal Distress; Fetal Heart; Humans; Incidence; Infant, Newborn; Oxytocin; Pregnancy; Toxicology

Topics: Asphyxia Neonatorum; Birth Weight; Female; Fetal Death; Follicle Stimulating Hormone; Humans; Infant, Newborn; Labor, Induced; Labor, Obstetric; Oxytocin; Pharmacology; Pregnancy; Puerperal Disorders; Puerperal Infection; Statistics as Topic

Topics: Asphyxia Neonatorum; Female; Fetal Diseases; Humans; Infant, Newborn; Labor, Induced; Labor, Obstetric; Oxytocin; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Puerperal Disorders; Toxicology