Assuntos
Legislação Hospitalar , Legislação Médica , Legislação de Enfermagem , Humanos , Estados UnidosAssuntos
Atenção à Saúde/economia , Organização do Financiamento , Pobreza , Idoso , Humanos , Medicaid , Medicare , Estados UnidosRESUMO
The influence of maternal position during labor on comfort and uterine efficiency was studied by contrasting the influence of sitting in a chair with lying on the side during the first stage of labor. Nineteen primigravidas alternated between these two positions at 30 minute intervals for as long as this was possible during their labors. There was a significant difference in their preference to sit up during early labor (less than 6 cm dilation) and lie on their side during late labor (greater than 6 cm dilation). Uterine efficiency, however, was significantly less (p less than 0.05) in early labor in the sitting position than on the side. After labor was well established, ie after 6 cm dilation, the efficiency of uterine contractions to dilate the cervix was not significantly different between the 2 positions although it was less in the sitting position. The lateral recumbent position was accompanied by more efficient labor and was preferred by most women in late labor. Localization of pain and fetal position also seem to be associated with maternal position preference, and both factors require further investigation.
Assuntos
Trabalho de Parto , Postura , Adolescente , Adulto , Eficiência , Feminino , Humanos , Apresentação no Trabalho de Parto , Primeira Fase do Trabalho de Parto , Dor , Gravidez , Contração Uterina , Útero/fisiologiaRESUMO
Male rats were placed on choline (Ch) deficient diets for 3 to 14 days, without and with Ch (normal and large doses) supplemented in the drinking water, to determine whether altering the availability of Ch would affect the cholinergic system in relation to the latter's role in modulating the hypothalamic-pituitary-adrenocortical (HPA) system of non-stressed and stressed animals. The results indicate that the basal nonstressed activity of the HPA system, as assessed by adrenal and plasma corticosterone concentrations, was not affected by placing the animals on these diets for as long as 14 days. Furthermore, the in vitro production of corticosterone by these adrenal glands, in the presence or absence of adrenocorticotrophin, was similar to those observed in animals on the regular rat diet; however, the HPA responses to auditory (100 db) stress, and to a lesser extent hypercapnic (9% CO2) stress, were impaired on the Ch deficient diet (14 days), and these responses were partially corrected by supplementing the diet with Ch in the drinking water. Thus, the data suggest that altering the dietary intake of Ch may affect cholinergic activity, which in turn affects the HPA response to stressors.
