intrauterine resuscitation during labor

Subdural injection of epidural anesthesia is rare and is usually undiagnosed during epidural anesthesia causing severely delayed maternal hypotension, hypoxia, and fetal distress. A 38-year-old primiparous woman was administered epidural labor analgesia at 40(+6) weeks' gestation, and developed progressive maternal respiratory depression, bradycardia, and hypotension after accidental subdural administration of the anesthetic agent. Furthermore, fetal distress occurred soon after administration. The patient was managed with oxygen, position changes, fluid resuscitation, and ephedrine...

This case report describes the management of a patient, diagnosed with an intrauterine death at 31 weeks' gestation, who suffered a cardiorespiratory arrest during her induced labour while using a remifentanil PCA. She made a full recovery from resuscitation which included a peri-mortem caesarean section.

Cesarean section is the most commonly performed procedure all over the world. Both American and European data reveal constant and steady increase of pregnancies resolved by a cesarean section. The reasons include: growing number of medical indications or requests of the pregnant women. Regardless of the fact that elective cesarean section decreases the risk of intrauterine hypoxia, meconium aspiration and injury during labor it remains a significant risk factor for respiratory failure in the course of transient tachypnea of the newborn, infant respiratory distress syndrome and pulmonary hypertension, both for term and late preterm infants...

Intrauterine resuscitative measures are commonly initiated during labor when the fetal heart rate (FHR) pattern is indeterminate or abnormal. The most effective use of these measures is directed at the presumed underlying cause. However, some FHR patterns are nonspecific, while others are such that intrauterine resuscitation will not remedy the situation. The goals of intrauterine resuscitation during labor are, at its best, to reverse any hypoxia that might lead to further deterioration, and at the very least to avoid prolonged periods of indeterminate or abnormal FHR patterns, which may cause unnecessary concern for caregivers and patients and unnecessary operative intervention...

PURPOSE: The main goal of this study was to investigate the impact of parity and intrauterine fetal condition on vacuum extraction. MATERIAL AND METHODS: This study included 10742 newborns who were delivered during 2008 in obstetrics/gynecology clinics in Kosovo, Yugoslavia. One hundred fifty-eight of these were vacuum deliveries. Data were collected for indicators such as parity, maternal age, gestation duration, newborn vitality, and birth weight. RESULTS: Vacuum extraction was used in 158 cases (1...

Intrauterine resuscitation techniques are often used during labor when the fetal heart rate pattern is nonreassuring. These techniques have not been well studied; common practices are based on classic studies many years old. Models of intrauterine resuscitation using one (or more) technique as a first-line intervention and adding others in a specific series or clinical algorithm based on fetal response have not been tested. Maternal oxygen therapy is often used; however, recent evidence suggests potential risks to the mother and fetus or newborn...

OBJECTIVES: To determine labour management procedures associated with an increased risk of fetal heart rate anomalies and to assess the effectiveness of various intrauterine resuscitation techniques for fetal distress. METHODS: The literature search was carried out systematically on Medline and Cochrane database between 1980 and June 2007 was performed. RESULTS: Early amniotomy and/or active management of labour reduce the duration of the first stage of labour without affecting the rate of caesarean section (level of evidence 1)...

A 35-year-old multipara woman underwent intrauterine pressure catheter placement during labor. Immediately afterwards, she had severe dyspnea develop, became unresponsive, and had a prolonged fetal bradycardia. During emergency cesarean section, she required cardiopulmonary resuscitation repetitively. She then had disseminated intravascular coagulopathy develop and underwent hysterectomy. Anaphylactic reaction may be associated with intrauterine pressure catheter placement.

AIM: To determine whether fetal intrauterine resuscitation using tocolysis and delayed delivery is better for the fetus than emergency delivery when fetal hypoxia is suspected because of a non-reassuring fetal heart-rate (FHR) pattern using conventional heart rate monitoring. METHODS: This was a prospective and randomized study, conducted between 2001 and 2004 at Pereira Rossell Hospital, Montevideo, Uruguay. The population consisted of 390 fetuses, in which intrauterine distress was diagnosed using electronic FHR monitoring...

When the fetal heart rate pattern is suggestive of fetal compromise during labor, various methods to promote fetal well-being are traditionally initiated. They include maternal repositioning, reduction of uterine activity, an intravenous fluid bolus, oxygen administration, correction of maternal hypotension, amnioinfusion, and alteration of second-stage labor pushing efforts. Although these intrauterine resuscitation techniques are commonly used, and in some cases considered standard care, supportive data could be more robust...

No abstract text is available yet for this article.

OBJECTIVE: To evaluate the efficacy of 3 common intrauterine resuscitation techniques used during labor. METHODS: Intrauterine resuscitation techniques were prospectively evaluated in healthy women during labor. Forty-two women were randomized to either a 500-mL or 1,000-mL intravenous (IV) fluid bolus over 20 minutes. Fifty-one women were randomized to 1 of 6 position sequences including supine with the head elevated 30 degrees , left lateral and right lateral for 15 minutes each in succession...

OBJECTIVE: A preliminary assessment of the ability of Atosiban to alleviate uterine hyperactivity during active labor. METHODS: Fifteen consecutive women with uterine hyperactivity during active labor were included in this prospective observational study. Atosiban was given as a single or repeated intravenous bolus dose (6.75 mg in 0.9 mL NaCl solution) if hyperactivity was not alleviated within 5 minutes with "intrauterine resuscitation" measures. RESULTS: Alleviation of uterine activity was achieved in 14 out of 15 cases and was almost immediate in the responders...

In presenting the neuropathology of asphyxia neonatorum and some related conditions, as illustrated in experiments with monkeys (12), I have tried to make six principal points. (i) Newborn monkeys need not be asphyxiated to the point of terminal apnea to suffer structural brain damage. Mental retardation has not been proved, but neither has it been excluded, in these monkeys. (ii) Asphyxia neonatorum requiring resuscitation of the offspring, which otherwise would die, is associated with a remarkably constant syndrome of bilaterally symmetrical, nonhemorrhagic lesions in thalamic and brain-stem nuclei, mainly those of afferent systems...

BACKGROUND: Paracervical blocks (PCBs) relieve labor pain, but reports of associated complications have caused many physicians to question their safety. METHODS: We designed a prospective observational study to examine the association between PCBs and umbilical artery hydrogen ion concentration (pH) values. A total of 261 healthy women in labor were recruited from a community hospital. Physicians used 1% lidocaine for the PCBs. We used multivariate linear regression to model predictors of umbilical artery pH at birth...

In 1950, Allan P. Bloxsom (1901-1991), a pediatrician at the St Joseph Hospital in Houston, introduced his positive pressure oxygen air lock (AL) for the delivery room resuscitation of the asphyxiated newborn. The infant's entire body was placed into a cylindrical steel chamber that was tightly sealed and infused with warmed humidified 60% oxygen. The positive pressure within the AL was cycled between 1 and 3 lb/in(2) at 1-minute intervals to simulate the intrauterine pressures during the second stage of labor...

Although the normal pulmonary vascular transition at birth takes place quickly in the delivery room, it has its basis in the complex structural and biochemical development of the lung. It is not surprising that this process can be easily disrupted by factors such as prematurity, intrauterine hypoxia, and parenchymal lung disease. The stimuli that initiate and maintain the transition are only beginning to be understood. Understanding the normal structure and function of the neonatal lung provides the foundation that will enable clinicians to enhance resuscitation to accomplish a normal transition in the delivery room...

Electronic fetal heart rate monitoring is commonly used to assess fetal well-being during labor. Although detection of fetal compromise is one benefit of fetal monitoring, there are also risks, including false-positive tests that may result in unnecessary surgical intervention. Since variable and inconsistent interpretation of fetal heart rate tracings may affect management, a systematic approach to interpreting the patterns is important. The fetal heart rate undergoes constant and minute adjustments in response to the fetal environment and stimuli...

OBJECTIVE: To determine risk factors for perinatal asphyxia. DESIGN: Cohort study. SETTING: Teaching hospital. METHODS: All consecutive hospital births were evaluated during the study period. Asphyxia was defined on intrapartum and neonatal resuscitation criteria. Maternal, intrapartum and neonatal variables were recorded in all births. Data was analyzed after stratifying for live and stillbirths by univariate and logistic regression analyses...

CONTEXT: Exposure to maternal or placental infection is related to risk of preterm birth and, in premature infants, of brain lesions predictive of cerebral palsy (CP). Few studies have investigated whether maternal infection is associated with risk of CP in children of normal birth weight. OBJECTIVE: To investigate maternal infection during the admission for delivery as a possible risk factor for CP in infants born weighing 2500 g or more. DESIGN: Population-based case-control study...