American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Oct 2001
Randomized Controlled Trial Comparative Study Clinical TrialRectal misoprostol versus intravenous oxytocin for the prevention of postpartum hemorrhage after vaginal delivery.
To compare rectally administered misoprostol to intravenously administered oxytocin for the management of third-stage labor. ⋯ Rectal misoprostol (400 microg) was no more effective than intravenous oxytocin in preventing postpartum hemorrhage.
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Am. J. Obstet. Gynecol. · Oct 2001
Randomized Controlled Trial Comparative Study Clinical TrialA randomized trial of labor analgesia in women with pregnancy-induced hypertension.
The purpose of this study was to compare the peripartum and perinatal effects of epidural with intravenous labor analgesia in women with pregnancy-induced hypertension. ⋯ Epidural labor analgesia provides superior pain relief but no additional therapeutic benefit to women with pregnancy-induced hypertension.
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Am. J. Obstet. Gynecol. · Oct 2001
Comparative StudyThe effect of sequential use of vacuum and forceps for assisted vaginal delivery on neonatal and maternal outcomes.
To determine the risk of neonatal and maternal disease associated with the sequential use of vacuum and forceps compared with spontaneous vaginal delivery. ⋯ Sequential use of vacuum and forceps is associated with increased risk of both neonatal and maternal injury.
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Am. J. Obstet. Gynecol. · Oct 2001
Comparative StudyIncreased risk of cesarean delivery with advancing maternal age: indications and associated factors in nulliparous women.
To investigate factors that contribute to the increased risk of cesarean delivery with advancing maternal age. ⋯ Older women are at higher risk for cesarean delivery in part because they are more likely to have cesarean delivery without labor. However, even among those women who labor, older women are more likely to undergo cesarean delivery, regardless of whether labor is spontaneous or induced. Part of the higher rate among older women who labor is explained by a higher rate of induction, particularly elective induction. Among women in both spontaneous and induced labor, cesarean delivery for the diagnoses of failure to progress and fetal distress was more frequent in older patients, although management of labor dystocia for these patients was similar to that for younger patients.
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Am. J. Obstet. Gynecol. · Oct 2001
Comparative StudyOutcomes of trial of labor following previous cesarean delivery among women with fetuses weighing >4000 g.
To compare outcomes at term of a trial of labor in women with previous cesarean delivery who delivered neonates weighing > 4000 g versus women with those weighing < or = 4000 g. ⋯ A trial of labor after previous cesarean delivery may be a reasonable clinical option for pregnant women with suspected birth weights of > 4000 g, given that the rate of uterine rupture associated with these weights does not appear to be substantially increased when compared to lower birth weights. However, some caution may apply when considering a trial of labor in women with infants weighing > 4250 g. In these women with infants weighing > 4000 g, the likelihood of successful vaginal delivery, although lower than for neonates weighing < or = 4000 g, is still 60%.