Childbirth Challenges Research
Freidman, E. (1978). Labor: Clinical evaluation and management (2nd ed). New York: Appleton-Century-Crofts.
A long pre-labor is borth normal and not unusual when the cervix has undergone little prior change. Most long prelabors continue normally once dilation begins.
Valerie El Halta. Posterior Labor - A Pain In The Back! Its Prevention and Cure Midwifery Today, 36, 19-21. You can read a copy here .
What is says: Pitocin and AROM for a slow labor are the WORST thing to do because they cause the baby's head to go deeper into the pelvis making the bad position worse and more difficult to correct.
Dr.'s misdiagnose an ill-fitting head from a poorly positioned baby as "false labor." The mother is uncomfortable and laboring, but because the head is not able to open the cervix it is not called labor.
King, J (1993). Back Labor No More! Dallas: Plenary Systems.
an alternative to the knee-chest position for turning a posterior would be the lift
Diaz AG, Schwarcz R, Fescina R, Caldeyro-Barcia R. Vertical position during the first stage of the course of labor, and neonatal outcome. Eur J Obstet Gynecol Reprod Biol. 1980 Sep;11(1):1-7.
This study included 369 normal term labors. In 145 cases the women were sitting, standing or walking at will during the first stage, whereas 224 remained lying in bed during the whole labor. When the mother remains in the 'vertical position during the first stage of labor (1) the physiological timing of the spontaneous rupture of membranes is not altered, (2) duration of the first stage is shortened in 25%--this shortening may reach 34% in the nulliparas, (3) cephalic molding is not increased, (4) the incidence of forceps delivery diminishes and (5) perinatal morbimortality is not increased.
Citation: Fawole B, Hofmeyr GJ. Maternal oxygen administration for fetal distress (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.
Reviewers' conclusions: There is not enough evidence to support the use of prophylactic oxygen therapy for women in labor, nor to evaluate its effectiveness for fetal distress. In view of the widespread use of oxygen administration during labor and the possibility that it may be ineffective or harmful, there is an urgent need for randomized trials to assess its effects.
Postmaturity / Overdue
Carlomagno G, Candussi G, Zavino S, Primerano MR. Postmaturity: how far is it a clinical entity in its own right?
In 1990 we adopted a protocol of antepartum testing for all booked pregnant patients, permitting healthy pregnancies to go beyond 42 completed weeks of gestation. This retrospective study regards 84 patients delivering after 42 completed weeks of pregnancy and a control group of 1351 patients delivering after 37 completed and before 41 completed weeks of pregnancy. Records were revised for maternal age and parity, previous obstetric history, managing and complications of the actual pregnancy, labour and mode of delivery, neonatal biometric data and outcome. Only 4 patients delivered after 43 completed weeks of gestation, while none in the series delivered later than 44 completed weeks after the beginning of the last menstrual period. The overall frequency of cesarean birth was higher, but not significantly, in study group. Average neonatal birthweight and length were significantly greater in the study group. No significant difference in neonatal outcome was observed between study and control groups in terms of perinatal mortality. Low 1' Apgar score was significantly more frequent in the study group, but a similar frequency of 5' Apgar score and need for intensive care was observed in the two groups.
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