Study of 156 cases of polyhydramnios and congenital malformations in a series of 118,265 consecutive births

Article Abstract:

Polyhydramnios, excessive volume of amniotic fluid, occurs in up to 1.5 percent of pregnancies and is associated with complications in both mother and fetus such as diabetes, multiple births, or congenital defects. The factors associated with polyhydramnios occurring with congenital malformations in 156 cases out of 118,265 pregnancies were evaluated. The abnormal births studied occurred from 1979 to 1987; 25 were stillbirths and 10 pregnancies were terminated. Anomalies were diagnosed prenatally in 64 cases. In 86 cases, there were more than one defect. The most common problems were congenital heart disease, musculoskeletal malformations, and defects of the digestive tract. Average weight and length, but not head circumference, were more often affected. Parents of affected children were significantly more likely than those of healthy children to be related, and close relatives had significantly higher rates of infants with malformations. Of 21 cases with abnormal chromosomes, only six were identified prenatally. No environmental factors such as smoking, occupation, drugs, radiation, or acute or chronic disease were associated with anomalies, but affected pregnancies more often had threatened miscarriages. This study indicates that general prenatal screening is not very accurate in identifying these cases. Higher level ultrasound imaging and chromosomal analysis are recommended in pregnancies with polyhydramnios. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Amniotic fluid

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A comparison of low birth weight, perinatal mortality, and infant mortality between first and second births to women 17 years and younger

Article Abstract:

The United States has an excessively high adolescent pregnancy rate. Young, non-white, single, poor pregnant adolescents who do not seek early prenatal care have poor pregnancy outcomes. Teenagers 17 years old and younger have more infants born of low birth weights and have higher mortality rates. Repeat pregnancy often assures a life of welfare dependency. Contrary to previous studies this comparison of 407 subjects found lower birth weights and higher infant mortality rates for the first pregnancy, even when prenatal care began earlier. A question still remains as to whether poor outcomes are a result of physiological factors or of social disadvantage. There was no relationship between the time intervals between pregnancies and second pregnancy birth weights. These results indicate practitioners should focus primarily on preventing initial pregnancies.

Social aspects, Statistics, Birth weight, Low, Low birth weight, Infant mortality, Teenage pregnancy, Pregnancy, Complications of, Pregnancy complications, Perinatal death

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Epidural analgesia associated with low-dose oxytocin augmentation increases cesarean births: A critical look at the external validity of randomized trials

Article Abstract:

An analysis on trials comparing epidural analgesia (EA) with opioid analgesia was conducted to determine their external validity in contemporary North American practice. The randomized trials showed no effect of EA on cesarean section thus revealing that early detection of dystocia and high-dose oxytocin augmentation should be considered for women receiving EA, and those delivering in low-dose oxytocin settings should be advised of a probable increase in the likelihood of cesarean section.

United States, Pharmaceutical Preparation Manufacturing, Narcotic Analgesic Preparations, Causes of, Complications and side effects, Opioids, Dosage and administration, Peridural anesthesia, Cesarean section, Epidural anesthesia, Oxytocics

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