The influence of birth weight on labor in nulliparas
Article Abstract:
Dystocia, difficult labor, is often treated by performing a cesarean section, especially in nulliparous women (those who have never before given birth to a child). It is generally believed that dystocia is caused by abnormalities of either the vaginal passage, the powers of delivery, or the fetus in passage. It is commonly thought that it is more difficult to give birth to a larger infant, and that conditions such as bony abnormalities of the maternal pelvis cause dystocia. A study of 1,000 nulliparous women who went into labor after 37 weeks' gestation was conducted to determine if dystocia is directly related to the infant's birth weight. The incidence of cesarean section was 5.2 percent. Analysis of women who delivered at 40 weeks' gestation revealed that the mean duration of labor increased with increasing birth weight. For infants less than 2,500 grams (5.5 lbs), the mean duration of labor was 2.9 hours, while for infants weighing between 3,000 and 3,499 grams, labor was 5.8 hours, and for those between 3,500 and 3,999 grams (7.7 to 8.8 lbs), labor lasted 6.3 hours. Similar trends were also seen at other gestational ages. Vaginal delivery was chosen for 90 percent of patients delivering infants weighing more than 3,999 grams. There was also an increase in the incidence of augmentation with oxytocin, a drug used to stimulate the uterus to contract. There was a direct relationship between the mean duration of labor and birth weight. Birth weight is thus an important factor in the development of dystocia. The current medical care of labor involves achieving efficient uterine activity. In the past, the size and shape of the maternal pelvis was emphasized, now the scientific validity of this is questioned and there is now evidence to support the role of infant birth weight in the development of dystocia. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1990
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Prediction of estimated fetal weight in extremely low birth weight neonates (500 -1,000 g)
Article Abstract:
Extremely low birth weight infants, who weigh less than 1,000 grams (g) at birth, have the greatest variation in survival. The accurate estimation of fetal weight helps to predict survival and determine methods for treating these infants. Various formulas, or mathematical equations, have been developed to estimate the weight of the fetus. The effectiveness of 20 formulas for predicting fetal weight was assessed in 76 extremely low weight infants. Various formulas utilized such measures as skull and abdominal diameter and femur length. When the Rose method was used to estimate 63 fetal weights, 46 were within 10 percent of the actual birth weight. Using another formula, the Shepard revision of the Warsof equation, 53 of 67 estimated fetal weights were within 100 g of the actual birth weight. The findings showed that similar accuracy could be achieved using various formulas to estimate fetal weight in extremely low birth weight infants, but no method was found to be significantly more precise than any other. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1991
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