American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Dec 1998
Randomized Controlled Trial Clinical TrialThe influence of epidural analgesia on cesarean delivery rates: a randomized, prospective clinical trial.
The effects of epidural analgesia on the progress of labor are controversial. The objective of this study was to determine the effect of epidural analgesia on cesarean delivery rates in a population of patients randomly assigned to receive either epidural analgesia or intravenous opioids for intrapartum pain relief. ⋯ Epidural analgesia provides safe and effective intrapartum pain control and may be administered without undesirable effects on labor outcome.
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Am. J. Obstet. Gynecol. · Dec 1998
Vasoactive mediators in pregnancy-induced hypertensive disorders: a longitudinal study.
The objective of this study was to evaluate the extent to which endothelin and the eicosanoids prostacyclin and thromboxane A2 are involved in the pathophysiology of gestational hypertension and preeclampsia. ⋯ In this longitudinal study we found no evidence for prostacyclin deficiency or increased endothelin levels in preeclampsia. Only women with severe preeclampsia and severe gestational hypertension expressed increased endothelin levels and thromboxane dominance over prostacyclin.
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Am. J. Obstet. Gynecol. · Nov 1998
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of lumbar epidural anesthesia on maternal middle cerebral artery blood flow in normal pregnancy: a prospective, randomized, double-blind comparison study.
Lumbar epidural anesthesia is associated with a transient elevation in intracranial pressure in both animals and humans and decreased cerebral blood flow in animals. We sought to determine the effect of medium-onset and slow-onset local anesthetic lumbar epidural anesthesia on maternal cerebral blood flow in normal human pregnancy. ⋯ Maternal middle cerebral artery blood flow velocity, as measured by transcranial Doppler ultrasonography, is maintained in normotensive, nonlaboring term gravida women receiving either lidocaine or bupivacaine lumbar epidural anesthesia, which supports intact cerebrovascular autoregulation in normal pregnancy.
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Am. J. Obstet. Gynecol. · Nov 1998
Case ReportsPreliminary experience with a prospective protocol for planned vaginal delivery of triplet gestations.
The objective of the study was to evaluate a protocol for vaginal delivery of triplet gestations. ⋯ In selected cases vaginal delivery of triplet gestations can be accomplished without increased maternal or neonatal morbidity and mortality and may significantly decrease maternal hospital stay and postoperative morbidity.