American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Aug 1997
Randomized Controlled Trial Clinical TrialRandomized trial of two doses of the prostaglandin E1 analog misoprostol for labor induction.
Our purpose was to compare the safety and effectiveness of intravaginally administered misoprostol at doses of 25 micrograms and 50 micrograms for indicated labor induction in patients with an unfavorable cervix. ⋯ Although a dose of 50 micrograms is associated with a shorter start-to-delivery interval and a higher incidence of vaginal delivery after one dose, 25 micrograms of intravaginal misoprostol is effective and associated with a lower incidence of tachysystole and cord pH values < 7.16.
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Am. J. Obstet. Gynecol. · Jul 1997
The labor-adjusted cesarean section rate--a more informative method than the cesarean section "rate" for assessing a practitioner's labor and delivery skills.
Our purpose was to determine the benefits of an acuity-adjusted labor management tool. ⋯ A labor-adjusted cesarean section rate is more appropriate than just "raw" data. Medical, obstetric, and fetal factors affect a "raw" rate that is out of the control of the obstetrician. This method of assessing the labor and delivery skills of each practitioner and hospital would allow meaningful comparison with others.
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Am. J. Obstet. Gynecol. · Jul 1997
Multicenter Study Clinical TrialThe preterm prediction study: patterns of cervicovaginal fetal fibronectin as predictors of spontaneous preterm delivery. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.
Our purpose was to determine how various temporal patterns of fetal fibronectin positivity from 24 to 30 weeks predict subsequent fetal fibronectin test results and spontaneous preterm delivery. ⋯ The presence of a positive cervical or vaginal fetal fibronectin test result predicts subsequent positive fetal fibronectin positivity and subsequent spontaneous preterm birth. The greater the percent of positive results, the higher is the risk of spontaneous preterm birth. After a positive test result, two negative results are required before the risk of spontaneous preterm birth returns to baseline.
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Am. J. Obstet. Gynecol. · Jul 1997
Multicenter Study Clinical TrialFetal fibronectin as a predictor of preterm birth in patients with symptoms: a multicenter trial.
Our aim was to determine whether the presence of fetal fibronectin in vaginal secretions of patients with symptoms suggestive of preterm labor predicts preterm delivery. ⋯ In a population of patients with symptoms, the presence of fetal fibronectin in vaginal secretions best defines a subgroup at increased risk for delivery within 7 days; the high negative predictive value of fetal fibronectin sampling supports less intervention for patients with this result.
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Am. J. Obstet. Gynecol. · Jul 1997
Comparative StudyAmniotic fluid inflammatory cytokines (interleukin-6, interleukin-1beta, and tumor necrosis factor-alpha), neonatal brain white matter lesions, and cerebral palsy.
Ultrasonographically detectable neonatal brain white matter lesions are the most important identifiable risk factor for cerebral palsy. Inflammatory cytokines released during the course of intrauterine infections have been implicated in the genesis of brain white matter lesions and subsequent cerebral palsy. This study was undertaken to determine whether fetuses who subsequently were diagnosed to have periventricular brain white matter lesions could be identified by determining the concentrations of inflammatory cytokines in the amniotic fluid. ⋯ Infants at risk for development of brain white matter lesions can be identified by the concentrations of interleukin-6 and interleukin-1beta in amniotic fluid. Our findings support the hypothesis that inflammatory cytokines released during the course of intrauterine infection play a role in the genesis of brain white matter lesions.