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Lower cesarean section rate: dose, interval key to efficacy of misoprostol for ripening.(Obstetrics)
NEW ORLEANS -- Women who received at least three doses of vaginal misoprostol for cervical ripening in a 24-hour period had a lower rate of cesarean section than did women who received two doses in 8 hours, Dr. Allahyar Jazayeri said at the annual meeting of the Society for Maternal-Fetal Medicine.
The drug has long been used off label to effect cervical ripening in labor induction, but there has been no agreement on the optimal dose or interval between doses, said Dr. Jazayeri of Bellin Health Center, Green Bay, Wis.
A total of 284 women were randomized to either 25 [micro]g of vaginal misoprostol every 4 hours for a maximum of two doses; or 25 [micro]g of vaginal misoprostol every 4 hours for a maximum of six doses. (Four patients were not included in the study data because of age restrictions or breaks in protocol.)
All women received an amniotomy and oxytocin when they reached 4-cm dilation. At the study outset, the women had a mean dilation of 1 cm, a mean effacement of 20%, and intact membranes.
There were no statistically significant differences in the time the patients took to reach 4-cm dilation, time from rupture of membranes ...
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...women demonstrated a slower progression of labor from 4 to 10 cm dilation, compared with normal-weight women, Anjel Vahratian...a significantly longer duration of labor between 4 and 10 cm dilation, compared with normal-weight women. Prolonged labor was...
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HILTON HEAD ISLAND, S.C. -- Latent phase neuraxial analgesia does not increase the risk of cesarean section or prolong labor, compared with systemic opioid analgesia, according to preliminary findings from an ongoing investigation. The interim randomized, controlled study findings, which were
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- Magazine article from: OB GYN News Walsh, Nancy March 1, 2002 700+ words
...used by 49%, and 53% used oxytocin with a median maximum dose of 6 mU per minute. Based on the speed of overall labor progression...active labor at different times, mostly between 3 cm and 5 cm dilation, and even in the active phase the speed of progression varies...
- ACOG supports epidural pain relief on demand.(American College of Obstetricians...
- Newspaper article from: Health & Medicine Week April 15, 2002 700+ words
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...Patients are not admitted for false labor, or before 3-4 cm dilation, unless they have a risk factor that necessitates admission...used judiciously, and placement is often delayed until 4 cm dilation. A walking epidural is available. o Sample targets: u Patients...
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- Magazine article from: Women's Health Weekly April 18, 2002 700+ words
...some hospitals are requiring that women in labor reach 4-5 cm dilation before being given epidural pain relief. Hospitals are doing...the deciding factor, even if she hasn't yet reached 4-5 cm dilation. ACOG reaffirmed its earlier committee opinion, published...
- Epidurals Are Safe For Women Of All Sizes.(Brief Article)
- Newspaper article from: Pain & Central Nervous System Week November 12, 2001 700+ words
...anesthesia. The patient's temperature was measured when the epidural was placed and again when the patient reached 10-cm dilation. The duration of epidural analgesia was also recorded. Using the patient's height and weight, the body mass index (BMI...
- Epidurals Are Safe For Women Of All Sizes.
- Newspaper article from: Obesity, Fitness & Wellness Week November 17, 2001 700+ words
...anesthesia. The patient's temperature was measured when the epidural was placed and again when the patient reached 10-cm dilation. The duration of epidural analgesia was also recorded. Using the patient's height and weight, the body mass index (BMI...
