American journal of obstetrics and gynecology
-
Am. J. Obstet. Gynecol. · May 2002
ReviewNonpharmacologic relief of pain during labor: systematic reviews of five methods.
Nonpharmacologic measures to reduce labor pain have been used throughout history. Despite reports that some of these methods reduce pain, increase maternal satisfaction, and improve other obstetric outcomes, they have received limited attention in the medical literature and are not commonly available to women in North America. The controlled studies of nonpharmacologic methods are limited in number and sometimes provide conflicting results. ⋯ An extensive search of electronic databases and other sources identified studies for consideration. Critical evaluation of controlled studies of these 5 methods suggests that all 5 may be effective in reducing labor pain and improving other obstetric outcomes, and they are safe when used appropriately. Additional well-designed studies are warranted to further clarify their effect and to evaluate their cost effectiveness.
-
Am. J. Obstet. Gynecol. · May 2002
ReviewThe effects of epidural analgesia on labor, maternal, and neonatal outcomes: a systematic review.
Mothers given an epidural rather than parenteral opioid labor analgesia report less pain and are more satisfied with their pain relief. Analgesic method does not affect fetal oxygenation, neonatal pH, or 5-minute Apgar scores; however, neonates whose mothers received parenteral opioids require naloxone and have low 1-minute Apgar scores more frequently than do neonates whose mothers received epidural analgesia. Epidural labor analgesia does not affect the incidence of cesarean delivery, instrumented vaginal delivery for dystocia, or new-onset long-term back pain. ⋯ Analgesic method does not affect lactation success. Epidural use and urinary incontinence are associated immediately postpartum but not at 3 or 12 months. The mechanisms of these unintended effects need to be determined to improve epidural labor analgesia.
-
Am. J. Obstet. Gynecol. · May 2002
ReviewThe role of behavioral conditioning in the development of nausea.
Literature related to the prevalence and etiology of anticipatory nausea and vomiting associated with chemotherapy is reviewed. Physiologic causes and psychological factors, including expectations, beliefs, and conditioning, are examined to help explain these phenomena. The efficacy of pharmacologic and behavioral treatments is discussed. Similarities between the experience of anticipatory nausea and vomiting and morning sickness suggest that the conditioning model may be relevant to understanding the development of pregnancy-related nausea.
-
Am. J. Obstet. Gynecol. · May 2002
Selection of obstetrics and gynecology residents on the basis of medical school performance.
The purpose of this study was to determine whether United States Medical Licensing Examination scores during medical school predict resident-in-training examination scores and whether other criteria of medical student performance correlate with the faculty's subjective evaluation of resident performance. ⋯ Standardized tests of medical student cognitive function predict the resident's performance on standardized tests. Selection criteria that are based on other medical school achievements do not necessarily correlate with overall performance as residents in obstetrics and gynecology.