ABSTRACT
Our results demonstrate that free mobility in labor has many advantages. Because of the accelerated uterine contractility, the induction-delivery interval is shortened. No unphysiologic baseline pressure alterations were found. The maximal labor amplitudes did not differ from bedside-monitored labor. No FHR-changes occurred and the fetal outcome was excellent. Being able to move about, women are not influenced by the unfamiliar surroundings of modern labor wards. Pain relief and breathing are better than in the recumbent position. The ideal compound to support labor is oral PGE2.
Subject(s)
Labor, Induced/methods , Labor, Obstetric , Prostaglandins E/administration & dosage , Administration, Oral , Female , Humans , Posture , Pregnancy , Telemetry , Uterine ContractionABSTRACT
Report on 27 cases on emergency cerclage. Six infants survived. Among these were four with birth weights over 2500 grams. The high abortion rate of 59% and the high perinatal mortality of the live born infants (5 of 11) make it imperative to be highly selective in this procedure. In emergency cerclage during labor or maternal pyrexia is contraindicated. Local and systemic antibiotic profolaxsis is recommended. Proposals for the definition technique and post-operative care in cases of emergency cerclage are discussed.
Subject(s)
Uterine Cervical Incompetence/surgery , Abortion, Spontaneous/epidemiology , Birth Weight , Emergencies , Female , Germany, West , Humans , Infant Mortality , Infant, Newborn , Methods , Pregnancy , Retrospective StudiesABSTRACT
In a comparative study of the course of pregnancy and delivery of 357 patients who delivered live infants between 1966-1976 following cerclage operation were compared to a control group of 380 without cerclage who were matched in age, parity and delivery time to the group under study. The high prematurity rate in the pregnancies preceeding the cerclage of 28.4% decreased following the cerclage to 16.8% (p less than 0.001). The perinatal mortality was reduced from 21.5% to 5.6% (p less than 0.001). This effect was especially achieved by the lower incidence of deliveries of infants with a birth weight of less than 1500 grams (p less than 0.05). The difference to the controls regarding prematurity (8.2%) and perinatal mortality (1.6%) remained significant (p less than 0.001). An increased rate of malformations in the cerclage children was not noticed. The maternal risk is low and consists mainly of a increase of cervical lacerations (4.9%) and problems of wound healing (2.2%). The duration of labor and type of delivery, the type of third stage of labor, and the post-partum course were not different from the control group.
Subject(s)
Obstetric Labor Complications/mortality , Pregnancy Complications/mortality , Uterine Cervical Incompetence/surgery , Birth Weight , Congenital Abnormalities/epidemiology , Female , Germany, West , Humans , Infant Mortality , Infant, Newborn , Maternal Mortality , Obstetric Labor, Premature/complications , Pregnancy , Surgical Wound Dehiscence/complicationsABSTRACT
The previous history and course of pregnancy in 357 women with variable births, in whom cerclage had been performed during 1966-1976 at the Freiburg University Gynaecological Hospital, were compared with a group of 380 women without cerclage, the age, parity and period during which birth had occurred, being identical. The high average of the patients with cerclage (29.3 years), the low percentage of primigravidae (17.1%), the threefold increased rate of abortions and early births (28.4%) as well as the high perinatal mortality (21.5%) during the preceding pregnancies, confirmed these women as a "risk" group. After cerclage, births before the 38th week were reduced from 41.1% to 24.6% (p less than 0.001.) 52.3% of the premature births occurred between the 36th and completed 37th week. Perinatal mortality dropped to 5.6% (p less than 0.00l.). A clinically relevant gestosis was less frequent (0.8%;p less than 0.00l.). The fact that the rate of premature births in the cerclage group (p less than 0.001) continued to be elevated, is mainly attributed to the frequency of rupture of the amnion before the 38th week (21.0%).
