American journal of obstetrics and gynecology
-
Am. J. Obstet. Gynecol. · Nov 1997
Managed care does not lower costs but may result in poorer outcomes for patients with gestational diabetes.
Our purpose was to compare the costs of prenatal care and subsequent maternal and neonatal outcomes in patients with gestational diabetes cared for in an inner-city university hospital house staff clinic versus an inner-city managed care organization. ⋯ Managed care does not decrease the cost of caring for patients with gestational diabetes but does lead to a greater rate of neonatal macrosomia, which may reflect poorer glucose control.
-
Am. J. Obstet. Gynecol. · Nov 1997
Predictive factors for neonatal morbidity in neonates with an umbilical arterial cord pH less than 7.00.
Fewer than 50% of neonates with an umbilical arterial pH < 7.00 have neonatal complications. Our objective was to identify clinical predictive factors for adverse outcomes in this group of neonates. ⋯ Neonatal morbidity in neonates with an umbilical arterial cord pH < 7.00 can be predicted by a high arterial base deficit value and low 5-minute Apgar score.
-
Am. J. Obstet. Gynecol. · Nov 1997
Fetoplacental vascular tone during fetal circuit acidosis and acidosis with hypoxia in the ex vivo perfused human placental cotyledon.
Our purpose was to determine the effects of acidosis and acidosis-hypoxia on fetoplacental perfusion pressure and its response to angiotensin II. ⋯ In the perfused placental cotyledon fetoplacental perfusion pressure and pressor response to angiotensin II are not affected by fetal circuit acidosis or acidosis-hypoxia. This suggests that neither fetal acidosis nor fetal acidosis combined with hypoxia has a direct effect on fetoplacental vascular tone.
-
Am. J. Obstet. Gynecol. · Oct 1997
Randomized Controlled Trial Clinical TrialIntrapartum maternal glucose infusion reduces umbilical cord acidemia.
Our purpose was to compare the effects of intrapartum 5% glucose in the intravenous fluid on umbilical cord acid-base and glucose status after spontaneous vaginal delivery. ⋯ Intrapartum intravenous fluid consisting of lactated Ringer's solution containing 5% glucose reduces umbilical cord acidemia and hypercarbia but does not change cord levels of glucose or base excess. Lactated Ringer's solution containing 5% glucose may be a preferable solution than without glucose as an intravenous fluid during labor.
-
Am. J. Obstet. Gynecol. · Oct 1997
Randomized Controlled Trial Clinical TrialControlled cord traction versus minimal intervention techniques in delivery of the placenta: a randomized controlled trial.
Our purpose was to compare the controlled cord traction technique with the minimal intervention technique for delivery of the placenta. The primary outcome was the incidence of postpartum hemorrhage. Secondary outcomes included duration of third stage of labor, frequency of retained placenta, hemorrhagic shock, the need for blood transfusion, and the need for uterotonic agents to control postpartum hemorrhage. ⋯ The controlled cord traction technique for delivery of the placenta results in a significantly lower incidence of postpartum hemorrhage and retained placenta, as well as less need for uterotonic agents, compared with the minimal intervention technique.