American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Nov 2000
Randomized Controlled Trial Multicenter Study Clinical TrialA multicenter controlled trial of fetal pulse oximetry in the intrapartum management of nonreassuring fetal heart rate patterns.
Recent developments permit the use of pulse oximetry to evaluate fetal oxygenation in labor. We tested the hypothesis that the addition of fetal pulse oximetry in the evaluation of abnormal fetal heart rate patterns in labor improves the accuracy of fetal assessment and allows safe reduction of cesarean deliveries performed because of nonreassuring fetal status. ⋯ The study confirmed its primary hypothesis of a safe reduction in cesarean deliveries performed because of nonreassuring fetal status. However, the addition of fetal pulse oximetry did not result in an overall reduction in cesarean deliveries. The increase in cesarean deliveries because of dystocia in the study group did appear to result from a well-documented arrest of labor. Fetal pulse oximetry improved the obstetrician's ability to more appropriately intervene by cesarean or operative vaginal delivery for fetuses who were actually depressed and acidotic. The unexpected increase in operative delivery for dystocia in the study group is of concern and remains to be explained.
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Am. J. Obstet. Gynecol. · Nov 2000
The effect of pregnancy on the compliance of large arteries and veins in healthy parous control subjects and women with a history of preeclampsia.
Early pregnancy is characterized by a fall in total peripheral vascular resistance. In this study we tested the hypothesis that this phenomenon is accompanied by rising compliances of the large arteries and veins. ⋯ These data support the concept that during normal pregnancy the fall in total peripheral vascular resistance is paralleled by improved macrovascular compliance. The latter adaptive change did not occur in women with a history of preeclampsia with hypertension or without an underlying disorder.