American journal of obstetrics and gynecology
-
Am. J. Obstet. Gynecol. · Feb 1983
Women refused second-trimester abortion: correlates of pregnancy outcome.
Little is known of the outcome of pregnancy in women denied abortions in the United States. To address this question, we studied the pregnancy outcomes in 316 low-income women who were denied second-trimester abortion at a large, metropolitan teaching hospital in the Southeast between August, 1978, and July, 1979. ⋯ Earlier gestational age at the initial abortion request, higher education level, and higher income were the best predictors of whether a woman subsequently obtained an abortion. For the women who continued their pregnancies, neither the rate of serious maternal complications nor the neonatal death rate was increased when compared with that of the rest of the hospital's population.
-
Am. J. Obstet. Gynecol. · Jan 1983
Comparative StudyThe outcome of prolonged labor as defined by partography and the use of oxytocin: a descriptive study.
A descriptive study of 300 consecutive spontaneous labors in primigravid patients whose pregnancies were of 37 or more weeks' gestation with a singleton fetus in the vertex presentation, showed a cesarean section rate of 13%, a forceps delivery rate of 49%, and a spontaneous delivery rate of 38%. Oxytocin was used in 17% and epidural analgesia was used in 75% of the patients. The median rate for cervical dilatation for those women with spontaneous deliveries was 2 cm/hr (interquartile range = 1.5 to 3.3 cm/hr) and for those delivered with forceps, 1.2 cm/hr (interquartile range = 0.9 to 1.8 cm/hr). ⋯ Of 23 women delivered by cesarean section for dystocia/disproportion, only nine received oxytocin. From the low incidence of low Apgar scores in all labor groups from this series, there would not appear to be a fetal advantage to earlier intervention. Although the suggestion from this study is that oxytocin administration when labor is prolonged by 4 hours will reduce the need for cesarean section, the true value of such an intervention can be tested only by a randomized controlled trial.
-
Am. J. Obstet. Gynecol. · Nov 1982
Collaborative practice in obstetrics/gynecology: implications for cost, quality, and productivity.
Rising costs, concern over quality of care, and low worker productivity are some of the factors suggesting a need for revision in the organization of the health care delivery system. Reorganization of the nurse-physician working relationship through the establishment of collaborative practice can serve as the mechanism for improving cost, quality, and productivity outcomes. This analysis evaluates collaborative practice within the disciplines of obstetrics and gynecology.
-
The prevalence of dysmenorrhea was studied in a random sample of 19-year-old women from an urban Swedish population. Dysmenorrhea was reported by 72% of the women. Fifteen percent suffered from dysmenorrhea which limited daily activity and was unimproved by analgesics. ⋯ Smokers as compared to nonsmokers had significantly (p less than 0.01) less dysmenorrhea. The severity of dysmenorrhea was not affected by height, weight, or regularity of the menstrual cycle. Absenteeism as a result of dysmenorrhea was evaluated.