Abstract:
:The intended and unintended effects of epidural labor analgesia are reviewed. Mothers randomized to epidural rather than parenteral opioid analgesia have better pain relief. Fetal oxygenation is not affected by analgesic method; however, neonates whose mothers received intravenous or intramuscular opioids rather than epidural analgesia require more naloxone and have lower Apgar scores. Epidural analgesia does not affect the rates of cesarean delivery, obstetrically indicated instrumented vaginal delivery, neonatal sepsis, or new-onset back pain. Epidural analgesia is associated with longer second labor stages, more frequent oxytocin augmentation, and maternal fever (particularly among women who shiver and women receiving epidural analgesia for > 5 hours) but not with longer first labor stages. Epidural analgesia has no affect but intrapartum opioids decrease lactation success. Epidural use and urinary incontinence are weakly, but probably not causally, associated. Epidural labor analgesia would improve if the mechanisms of these unintended effects could be determined.
journal_name
Semin Perinatoljournal_title
Seminars in perinatologyauthors
Leighton BL,Halpern SHdoi
10.1053/sper.2002.32201keywords:
subject
Has Abstractpub_date
2002-04-01 00:00:00pages
122-35issue
2eissn
0146-0005issn
1558-075Xpii
S0146-0005(02)80004-0journal_volume
26pub_type
杂志文章,评审abstract::Universal prenatal Rhesus (Rh) screening and prophylaxis with Rh immunoglobulin have been highly effective practices for preventing neonatal morbidities and mortality. However, there has been an enormous failure to prevent Rh sensitization and its adverse consequences worldwide, especially in low- and middle-income co...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1016/j.semperi.2020.151357
更新日期:2021-02-01 00:00:00
abstract::Down syndrome (DS) screening has been an integral part of routine prenatal screening for the last three decades. Recent efforts have been directed at developing additional non-invasive prenatal screening techniques that could not only improve sensitivity of prenatal screening, but also be employed in the first trimest...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2005.05.003
更新日期:2005-08-01 00:00:00
abstract::Thyroid hormone plays an important role in regulating cardiovascular function during the transition to extrauterine physiology. Multiple mechanisms participate, ranging from transcriptional to more immediate nongenomic modes of regulation. ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2008.09.007
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:To describe inpatient management strategies and considerations for pregnant patients with severe acute respiratory syndrome coronavirus 2 infection. FINDINGS:The novel coronavirus has posed challenges to both obstetric patients and the staff caring for them, due to its variable presentation and current limit...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1016/j.semperi.2020.151280
更新日期:2020-11-01 00:00:00
abstract::We have hypothesized that an alteration in the production of endothelium-dependent factors by sex hormones is a potential unifying mechanism for both the decreased arterial contractility and the redistribution of cardiac output characteristic of normal pregnancy. Thus, the effect of pregnancy/ estradiol on any one vas...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(97)80003-1
更新日期:1997-10-01 00:00:00
abstract::The product label required by the FDA for every drug approved for marketing in the US is a legal document that originates with the company that wants to market the drug, but it must be approved by the FDA. Despite the recognized limitations of registries, the FDA's new labeling rule, effective from July 1, 2015, has g...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2015.08.004
更新日期:2015-11-01 00:00:00
abstract::Adverse pregnancy outcome from environmental factors may include congenital anomalies, increased risk for miscarriage, preterm delivery, intrauterine growth restriction, and still birth. Apart from adverse pregnancy outcome, there may be effects on the other reproductive functions, like menstrual disorders and inferti...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2007.07.013
更新日期:2007-08-01 00:00:00
abstract::The words research and experimentation continue to have the power to evoke fear in potential subjects. But much of standard practice, particularly in critical care settings, involves interventions of unknown efficacy and safety. Innovation also abounds in practice settings, typically unchecked by prospective or retros...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(98)80038-4
更新日期:1998-06-01 00:00:00
abstract::Here we provide a brief overview of the natural process of labor and its biochemical, hormonal, and mechanical characteristics that can be exploited in methods employed for induction of labor. ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2015.07.001
更新日期:2015-10-01 00:00:00
abstract::In experienced hands, cranial ultrasonography (cUS) is an excellent tool to detect the most frequently occurring brain abnormalities in preterm and full-term neonates, to study the evolution of lesions, and to follow brain maturation. It enables screening of the brain and serial imaging in high-risk neonates. However,...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2009.10.002
更新日期:2010-02-01 00:00:00
abstract::Nonsteroidal anti-inflammatory drugs are frequently used during pregnancy (premature labor, polyhydramnios) and the immediate postnatal period (closure of patent ductus arteriosus). This article evaluates the renal effect of 3 nonspecific COX inhibitors (aspirin, indomethacin, and ibuprofen) in newborn rabbits. Five g...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/sper.2002.37310
更新日期:2002-12-01 00:00:00
abstract::The ductus arteriosus is a vital fetal structure designed to close shortly after birth. Although many physiologic and pharmacologic investigations have characterized the closure of this structure, genetic studies of persistent patency of the ductus arteriosus (patent ductus arteriosus, PDA) are relatively recent. Prog...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2011.09.019
更新日期:2012-04-01 00:00:00
abstract::STDs can be one of the most common antepartum complications in high-risk gravidas. Screening for gonorrhea, syphilis, HPV, and possibly hepatitis B and chlamydial infection, should be considered in most, if not all, pregnant women. Familiarity with the common clinical presentations and treatment of bacterial STDs will...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1990-04-01 00:00:00
abstract::Inhalation of nitric oxide (NO) is an experimental treatment for severe pulmonary hypertension. Being rapidly metabolized by hemoglobin, inhaled NO causes selective vasodilation in the pulmonary vascular bed. In addition to the vascular smooth muscle, other pulmonary structures are exposed to inhaled NO, resulting in ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(96)80046-2
更新日期:1996-06-01 00:00:00
abstract::The Lancet Neonatal Survival Series categorized neonatal health interventions into 3 service delivery modes: "Outreach," "Family-Community Care," and "Facility-based Clinical Care." Family-Community Care services generally have a greater potential impact on neonatal health than Outreach services, with similar costs. C...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2010.09.008
更新日期:2010-12-01 00:00:00
abstract::Given the historically high rates of cesarean delivery in the United States, obstetrical providers must often consider an induction of labor for women with a history of prior cesarean delivery versus repeat cesarean delivery. Clinical evaluation of this scenario involves weighing the benefits of a successful trial of ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2015.07.011
更新日期:2015-10-01 00:00:00
abstract::Traditionally, genetic testing has been too slow or perceived to be impractical to initial management of the critically ill neonate. Technological advances have led to the ability to sequence and interpret the entire genome of a neonate in as little as 26 h. As the cost and speed of testing decreases, the utility of w...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2015.09.009
更新日期:2015-12-01 00:00:00
abstract::Nutrition plays a critical role in the prevention and management of bronchopulmonary dysplasia (BPD). Growth failure in infants with BPD is predominantly due to malnutrition. Malnutrition can worsen BPD by compromising lung growth. Feeding difficulties in these infants can further affect nutrition. Dexamethasone, used...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2006.05.007
更新日期:2006-08-01 00:00:00
abstract::Preterm birth occurs in 7% to 12% of all deliveries, but accounts for over 85% of all perinatal morbidity and mortality. Although the ability of obstetric care providers to identify women at risk for preterm delivery has improved, the overall incidence of preterm birth has remained unchanged for the past 30 years. Pre...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2001.26417
更新日期:2001-08-01 00:00:00
abstract::This article reviews the central role of nutrition in advancing the maternal, newborn, and child health agenda with a focus on evidence for effective interventions generated using randomized controlled trials in low- and middle-income countries (LMIC). The 1000 days spanning from conception to 2 years of life are a cr...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2015.06.009
更新日期:2015-08-01 00:00:00
abstract::Classical and subtypes of kernicterus associated with bilirubin toxicity can be differentiated in part with physiological auditory measures that include auditory-evoked potentials and measures of cochlear integrity. The combination of these auditory measures suggests that bilirubin exposure results in auditory system ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2011.02.011
更新日期:2011-06-01 00:00:00
abstract::The placenta was classically considered a barrier, but in 1957 this notion was shattered. This organ is only a selective filter and metabolic site. In this review, the placental transfer of the top 17 substances of abuse are analyzed. In the National Library of Medicine only 41 papers that documented placental transfe...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(96)80082-6
更新日期:1996-04-01 00:00:00
abstract::Nuchal translucency (NT) describes an echo-free area, below the skin, in the posterior nuchal and back region of the fetus and is typically observed in the first and early second trimester of pregnancy. A wide NT has been correlated with chromosomal and congenital abnormalities in the fetus. An accurate NT measurement...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2005.12.004
更新日期:2005-12-01 00:00:00
abstract::Neuroblastoma is the most common malignant neoplasm occurring in the neonate and arguably the most variable in its presentation. This review examines differences in the tumor's clinical course in the context of known biologic determinants of behavior. Tumors that would go undetected except for prenatal ultrasonography...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(99)80035-4
更新日期:1999-08-01 00:00:00
abstract::This review evaluates and compares, by using the best available medical evidence, the risks and benefits of postnatal steroid use in very low birth weight infants. Systemic postnatal steroids are effective at reducing the risk of chronic lung disease in ventilated very low birth weight infants; they appear to be most ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2001.29034
更新日期:2001-12-01 00:00:00
abstract::Sleep-disordered breathing occurs in 0.6-15% of reproductive age women. This condition is associated with an increased lifetime risk of cardiovascular disease, cardiovascular mortality, and all-cause mortality. A substantial body of evidence demonstrated increased perinatal morbidity among pregnancies affected by SDB ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2015.05.010
更新日期:2015-06-01 00:00:00
abstract::Pharmacotherapy, or medication-assisted treatment (MAT), is a critical component of a comprehensive treatment plan for the pregnant woman with opioid use disorder (OUD). Methadone and buprenorphine are two types of opioid-agonist therapy which prevent withdrawal symptoms and control opioid cravings. Methadone is a lon...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2019.01.003
更新日期:2019-04-01 00:00:00
abstract::Medical and psychological indications for lactation suppression are discussed, and methods for lactation suppression are evaluated. Medical indications for lactation suppression include 1) maternal anatomical abnormalities, such as inadequate secretory tissue and inverted nipples; 2) maternal breast infections and tu...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1979-07-01 00:00:00
abstract::The development of ultrafast magnetic resonance imaging scanners and sequences provides a new tool for the diagnosis of fetal anomalies. Magnetic resonance imaging is a valuable adjunct to prenatal ultrasound especially for the evaluation of suspected fetal brain anomalies, chest masses, abdominal masses, and renal di...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(99)80023-8
更新日期:1999-12-01 00:00:00
abstract::It is clear that external vibroacoustic stimulation with the EAL produces remarkable changes in FHR and fetal movement patterns that are related to changes in fetal behavior. The clinical significance of these studies has been addressed in small series on human fetuses by many authors. There is an obvious lack of unif...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1989-10-01 00:00:00