American journal of obstetrics and gynecology
-
Am. J. Obstet. Gynecol. · May 2000
Is the management of epidural analgesia associated with an increased risk of cesarean delivery?
The aim of this study was to quantify the association of cesarean delivery with epidural analgesia management, specifically with the timing of epidural catheter placement in relation to labor, the type of epidural analgesia, and the use of bolus dosing. ⋯ The management of epidural analgesia during labor was associated with the potential for increased risk of cesarean delivery. This risk increased with higher stations of the fetal head at the time of epidural catheter placement and with more frequent epidural boluses of local anesthetic during the first stage of labor.
-
Am. J. Obstet. Gynecol. · May 2000
Effect of single versus multiple courses of antenatal corticosteroids on maternal and neonatal outcome.
Treatment of pregnant mothers with a single course of antenatal corticosteroids significantly reduces neonatal mortality and morbidity. Multiple weekly courses are often given. However, the safety and efficacy of repeated courses of antenatal corticosteroids have not been adequately studied. ⋯ Exposure to multiple courses of antenatal corticosteroids compared with a single course resulted in a significant reduction in the incidence of respiratory distress syndrome in singleton preterm infants delivered within a week of the last corticosteroid dose. This was associated with a reduction in birth head circumference and an increased incidence of maternal endometritis. Whether the potential benefits of repeated therapy clearly outweigh the risks will ultimately be determined in randomized prospective controlled trials.
-
Am. J. Obstet. Gynecol. · Apr 2000
Increased concentrations of plasma neuropeptide Y in patients with eclampsia and preeclampsia.
Epinephrine and norepinephrine are associated with the hyperstimulation of the sympathetic nervous system. Neuropeptide Y is a potent vasoconstrictive substance that is released in response to sympathetic nerve stimulation. ⋯ We have concluded that the level of neuropeptide Y in plasma is increased in women with eclampsia and preeclampsia. Elevated plasma neuropeptide Y levels may play a key role in the development of eclampsia and preeclampsia.
-
Am. J. Obstet. Gynecol. · Apr 2000
Hypertensive disorders in twin versus singleton gestations. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units.
This study was undertaken to compare rates and severity of gestational hypertension and preeclampsia, as well as perinatal outcomes when these complications develop, between women with twin gestations and those with singleton gestations. ⋯ Rates for both gestational hypertension and preeclampsia are significantly higher among women with twin gestations than among those with singleton gestations. Moreover, women with twin pregnancies and hypertensive complications have higher rates of adverse neonatal outcomes than do those with singleton pregnancies.