American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Oct 2001
Comparative StudyIncreased risk of cesarean delivery with advancing maternal age: indications and associated factors in nulliparous women.
To investigate factors that contribute to the increased risk of cesarean delivery with advancing maternal age. ⋯ Older women are at higher risk for cesarean delivery in part because they are more likely to have cesarean delivery without labor. However, even among those women who labor, older women are more likely to undergo cesarean delivery, regardless of whether labor is spontaneous or induced. Part of the higher rate among older women who labor is explained by a higher rate of induction, particularly elective induction. Among women in both spontaneous and induced labor, cesarean delivery for the diagnoses of failure to progress and fetal distress was more frequent in older patients, although management of labor dystocia for these patients was similar to that for younger patients.
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Am. J. Obstet. Gynecol. · Oct 2001
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of various routes and dosages of misoprostol for cervical ripening and the induction of labor.
The purpose of this study was to compare the efficacy of different routes of misoprostol administration for cervical ripening and the induction of labor. ⋯ At the doses studied, induction of labor with vaginally administered misoprostol is more efficacious than either oral-plus-vaginal or oral-only route of administration.
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Am. J. Obstet. Gynecol. · Oct 2001
Comparative StudyAre women who are Jehovah's Witnesses at risk of maternal death?
The purpose of this study was to determine the rates of obstetric hemorrhage and maternal mortality in women who are Jehovah's Witnesses and to evaluate a protocol that uses erythropoietin to optimize the red blood cell mass before delivery. ⋯ Women who are Jehovah's Witnesses are at a 44-fold increased risk of maternal death, which is due to obstetric hemorrhage. Patients should be counseled about this risk of death, and obstetric hemorrhage should be aggressively treated, including a rapid decision to proceed to hysterectomy when indicated.
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Am. J. Obstet. Gynecol. · Oct 2001
Randomized Controlled Trial Comparative Study Clinical TrialA randomized controlled trial comparing oxytocin administration before and after placental delivery in the prevention of postpartum hemorrhage.
To determine if the timing of the administration of prophylactic oxytocin influences the incidence of postpartum hemorrhage caused by uterine atony, retained placenta, and third-stage duration. ⋯ The administration of prophylactic oxytocin before placental delivery does not reduce the incidence of postpartum hemorrhage or third-stage duration, when compared with giving oxytocin after placental delivery. Early administration, however, does not increase the incidence of retained placenta.
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Am. J. Obstet. Gynecol. · Oct 2001
Randomized Controlled Trial Comparative Study Clinical TrialA randomized trial of labor analgesia in women with pregnancy-induced hypertension.
The purpose of this study was to compare the peripartum and perinatal effects of epidural with intravenous labor analgesia in women with pregnancy-induced hypertension. ⋯ Epidural labor analgesia provides superior pain relief but no additional therapeutic benefit to women with pregnancy-induced hypertension.