Journal of midwifery & women's health
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J Midwifery Womens Health · May 2007
ReviewBorn too soon: the continuing challenge of preterm labor and birth in the United States.
Prematurity is the single greatest cause of morbidity and mortality in obstetrics. Families, health care services, and education systems experience the impact of prematurity for the lifetime of the preterm-born child. ⋯ To further complicate the situation, new data shows that infants born between 34 and 37 weeks' gestation who were thought to have minimal long-term effects of preterm birth may be more at risk than previously appreciated. This article reviews evidence-based risk identification, prevention, and management of women experiencing preterm labor and birth.
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J Midwifery Womens Health · Jan 2007
Does epidural analgesia affect the rate of spontaneous obstetric lacerations in normal births?
The precise relationship between epidural use and genital tract lacerations in normal childbirth is unclear. Data from a clinical trial on measures to lower genital tract trauma in vaginal birth were used for a secondary analysis. The goal was to assess whether epidurals affect the rate of spontaneous obstetric lacerations in normal vaginal births. ⋯ Epidural use was not an independent predictor of sutured lacerations. Predictors of sutured lacerations included nulliparity, a prolonged second stage, being non-Hispanic white, and an infant birthweight greater than 4000 grams. Elements of midwifery management need further research.
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J Midwifery Womens Health · Jul 2006
Case ReportsA surprising case of sustained antenatal fetal bradycardia.
Persistent fetal bradycardia noted in the antenatal period can occur secondary to maternal conditions, fetal cardiac structural defects, or from congenital heart block. Fetal bradycardia can be mistaken for maternal pulse and should be confirmed with ultrasound whenever possible. Prompt evaluation of the fetus with bradycardia can lead to early interventions designed to prevent cardiac damage and/or hydrops.