Impending Labor Research Articles

Preterm labor: Its diagnosis and management

Preterm labor and delivery remain a significant problem in contemporary obstetric practice. Although the exact cause remains unclear, it is most likely to be multifactorial in nature. No satisfactory screening tool or marker currently exists to firmly establish the diagnosis of impending labor. However, epidemiologic and historical variables associated with preterm delivery show some promise in this regard and are currently being evaluated in preterm prevention programs. Appropriate management of preterm labor mandates early recognition of subtle signs and symptoms; successful therapy is dependent on this issue. The approach to the clinical management of the patient in preterm labor used at our institution is described. Therapy with β-adrenergic receptor agonists is currently the recommended pharmacologic treatment of this disorder. A review of other tocolytic agents and their usefulness in the management of preterm labor are presented.

Observation of delivery behavior in the rhesus monkey

Seven deliveries of rhesus monkeys maintained in the laboratory were recorded by a video recorder system to determine the signs of impending labor. The characteristic postures; i.e., standing, squatting and crouching, were demonstrated in all cases with cyclic regularity (about 2–4 min) 35–210 min prior to the actual parturition, although prediction of the delivery date several days beforehand failed. The four stages of the delivery process are also presented in this report.

Factors associated with preterm labour and changes in the cervix before labour in twin pregnancy.

A total of 132 twin pregnancies in black African women were studied prospectively after 30 weeks gestation. Delivery occurred before 37 weeks in 32%. There was a trend (0.1 greater than P greater than 0.05) towards a higher preterm delivery rate in nullipara (57%), in women under the age of 20 years (60%) and in those with a height/weight ratio of greater than 2.5 (50%). The cervix was assessed with a score based on the length of the canal minus the dilatation of the internal os. In both term and preterm labour there was a significant relation between a cervical score of 0 or a decrease in cervical score and the onset of labour within the subsequent 14 days (P less than 0.001). By these criteria to predict impending labour, 60% of all labours that ensured within 14 days of the assessment would have been predicted with a 20% false positive rate. When nulliparae were excluded the predictive value of cervical assessment for preterm labour was 80% with a false positive rate of less than 5%. Plasma oestriol levels were significantly higher in the preterm labour group but had no clinical prognostic value.

Managing the legislative flood

The present wave of new and impending labour laws poses major problems for ill‐prepared managers. Here, David Wainwright — a management consultant with Binder Hamlyn Fry — provides a plan of action which can be adapted to suit the needs of individual companies.

Controversy in Obstetrics and Gynecology II

This is the second edition of this compendium of controversial topics in obstetrics and gynecology. It comprises 25 subjects authored by 102 nationally known experts. The format for each controversy is arranged to present three or four alternative points of view followed by terse editorial comment. Ten subjects cover basic obstetrical problems such as management of premature rupture of the fetal membranes, impending labor prior to the 35th week, placenta praevia, fetal monitoring, pain relief, trophoblastic disease, and cesarean hysterectomy. A discussion of medical and surgical methods of conception control is an outstanding contribution since it concentrates on the ever-present controversy of vaginal hysterectomy vs tubal ligation for permanent sterilization. The authors favoring hysterectomy emphasize the fact that abnormal uterine bleeding, pelvic pain, and symptoms of descensus occur in 15% of posttubal ligation patients within three years and that 24% of these patients underwent hysterectomy within five years, 34% within

The induction of premature labor by means of pitocin in patients with toxemia of pregnancy

All obstetricians are faced at some time with the necessity for interrupting a pregnancy complicated by toxemia between the twenty-eighth and the thirty-fourth week. When the toxemia fails to respond to treatment, termination of the pregnancy is advisable for the sake of both mother and child. Once the decision has been made, with full knowledge that prematurity is a factor to be considered, the next question is what method to use. The majority of these mothers show no sign of impending labor such as engagement of the head or effacement and dilatation of the cervix. They have what is described so often in the literature as the “long, closed cervix.” It is this type of patient, primigravida or multigravida, who is usually subjected to cesarean section.The purpose of this paper is to describe a method of induction which permits vaginal delivery in such cases. We believe that the technique, because it achieves a normal birth, is preferable to the surgical approach, as it not only increases the infant's chances for survival, but also improves the outlook for future childbearing on the part of the mother.

Is the loss of weight at the end of pregnancy a sign of impending labor?: Biehle, H.: Monatsschrift für Geburtshülfe und Gynäkologie, 1927, lxxvi, 107

Is the loss of weight at the end of pregnancy a sign of impending labor?: Biehle, H.: Monatsschrift für Geburtshülfe und Gynäkologie, 1927, lxxvi, 107