The Experts below are selected from a list of 141 Experts worldwide ranked by ideXlab platform
Kenneth J Leveno - One of the best experts on this subject based on the ideXlab platform.
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oral misoprostol for Labor Augmentation a randomized controlled trial
Obstetrics & Gynecology, 2011Co-Authors: April T Bleich, Kathryn S Villano, James M Alexander, Donald D Mcintire, Kenneth J LevenoAbstract:OBJECTIVE:To estimate the efficacy of oral misoprostol for Labor Augmentation.METHODS:We performed a randomized, controlled trial comparing intravenous oxytocin to a 75-microgram dose of oral misoprostol. Women in spontaneous Labor were eligible if they had cervical dilation of 4–8 cm and required l
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a dose finding study of oral misoprostol for Labor Augmentation
American Journal of Obstetrics and Gynecology, 2011Co-Authors: Kathryn S Villano, James M Alexander, Donald D Mcintire, Kenneth J LevenoAbstract:OBJECTIVE: We designed a dose-finding trial of oral misoprostol administered for Labor Augmentation. STUDY DESIGN: Healthy, nulliparous women in active Labor and diagnosed with arrest of dilation were enrolled in cohorts of 10 at a time. Five regimens were studied: (1) 25 μg every 4 hours, (2) 50 μg every 4 hours, (3) 100 μg every 4 hours, (4) 50 μg every 2 hours, and (5) 75 μg every 4 hours. RESULTS: A total of 46 women were enrolled. Baseline uterine activity approximately doubled with 4 of the regimens and tripled with the highest dosage regimen (100 μg) (P < .001). The 100-μg regimen was truncated due to excessive uterine hyperstimulation (40%). CONCLUSION: An oral dose of 75 μg of misoprostol given at a 4-hour interval for a maximum of 2 doses is the highest tolerated dose. Randomized, controlled trials will be required before a regimen is employed routinely.
William D Fraser - One of the best experts on this subject based on the ideXlab platform.
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high dose vs low dose oxytocin for Labor Augmentation a systematic review
American Journal of Obstetrics and Gynecology, 2010Co-Authors: Shuqin Wei, Zhongcheng Luo, William D FraserAbstract:The objective of this systematic review was to estimate the efficacy and safety of high-dose vs low-dose oxytocin for Labor Augmentation on the risk of cesarean section and on indicators of maternal and neonatal morbidity. We searched PubMed, MEDLINE, EMBASE, and the Cochrane Library for randomized clinical trials published until January 2010. Ten randomized clinical trials, including 5423 women, met the inclusion criteria. High-dose oxytocin was associated with a moderate decrease in the risk of cesarean section (relative risk [RR], 0.85; 95% confidence interval [CI], 0.75–0.97), a small increase in spontaneous vaginal delivery (RR, 1.07; 95% CI, 1.02–1.12), and a decrease in Labor duration (mean difference: –1.54 hours, 95% CI, –2.44 to –0.64). While hyperstimulation was increased with high-dose oxytocin (RR, 1.91; 95% CI, 1.49–2.45), there was no evidence of an increase in maternal or neonatal morbidity. We conclude that high-dose oxytocin for Labor Augmentation is associated with a decrease in cesarean section and shortened Labor.
Kathryn S Villano - One of the best experts on this subject based on the ideXlab platform.
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oral misoprostol for Labor Augmentation a randomized controlled trial
Obstetrics & Gynecology, 2011Co-Authors: April T Bleich, Kathryn S Villano, James M Alexander, Donald D Mcintire, Kenneth J LevenoAbstract:OBJECTIVE:To estimate the efficacy of oral misoprostol for Labor Augmentation.METHODS:We performed a randomized, controlled trial comparing intravenous oxytocin to a 75-microgram dose of oral misoprostol. Women in spontaneous Labor were eligible if they had cervical dilation of 4–8 cm and required l
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a dose finding study of oral misoprostol for Labor Augmentation
American Journal of Obstetrics and Gynecology, 2011Co-Authors: Kathryn S Villano, James M Alexander, Donald D Mcintire, Kenneth J LevenoAbstract:OBJECTIVE: We designed a dose-finding trial of oral misoprostol administered for Labor Augmentation. STUDY DESIGN: Healthy, nulliparous women in active Labor and diagnosed with arrest of dilation were enrolled in cohorts of 10 at a time. Five regimens were studied: (1) 25 μg every 4 hours, (2) 50 μg every 4 hours, (3) 100 μg every 4 hours, (4) 50 μg every 2 hours, and (5) 75 μg every 4 hours. RESULTS: A total of 46 women were enrolled. Baseline uterine activity approximately doubled with 4 of the regimens and tripled with the highest dosage regimen (100 μg) (P < .001). The 100-μg regimen was truncated due to excessive uterine hyperstimulation (40%). CONCLUSION: An oral dose of 75 μg of misoprostol given at a 4-hour interval for a maximum of 2 doses is the highest tolerated dose. Randomized, controlled trials will be required before a regimen is employed routinely.
Siri Vangen - One of the best experts on this subject based on the ideXlab platform.
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risk factors for complete uterine rupture
American Journal of Obstetrics and Gynecology, 2017Co-Authors: I Alzirqi, Babill Straypedersen, Lisa Forsen, Siri Vangen, Anne Kjersti DaltveitAbstract:Background Complete uterine rupture is a rare peripartum complication associated with a catastrophic outcome. Because of its rarity, knowledge about its risk factors is not very accurate. Most previous studies were small and over a limited time interval. Moreover, international diagnostic coding was used in most studies. These codes are not able to differentiate between the catastrophic complete type and less catastrophic partial type. Complete uterine rupture is expected to increase as the rate of cesarean delivery increases. Thus, we need more accurate knowledge about the risk factors for this complication. Objective The objective of the study was to estimate the incidence and risk factors for complete uterine rupture during childbirth in Norway. Study Design This population-based study included women that gave birth after starting Labor in 1967–2008. Data were from the Medical Birth Registry of Norway and Patient Administration System, complemented with information from medical records. We included 1,317,967 women without previous cesarean delivery and 57,859 with previous cesarean delivery. The outcome was complete uterine rupture (tearing of all uterine wall layers, including serosa and membranes). Risk factors were parameters related to demographics, pregnancy, and Labor. Odds ratios for complete uterine rupture were computed with crude logistic regressions for each risk factor. Separate multivariable logistic regressions were performed to calculate the adjusted odds ratios and 95% confidence intervals. Results Complete uterine rupture occurred in 51 cases without previous cesarean delivery (0.38 per 10,000) and 122 with previous cesarean delivery (21.1 per 10,000). The strongest risk factor was sequential Labor induction with prostaglandins and oxytocin, compared with spontaneous Labor, in those without previous cesarean delivery (adjusted odds ratio, 48.0, 95% confidence interval, 20.5–112.3) and those with previous cesarean delivery (adjusted odds ratio, 16.1, 95% confidence interval, 8.6–29.9). Other significant risk factors for those without and with previous cesarean delivery, respectively, included Labor Augmentation with oxytocin (adjusted odds ratio, 22.5, 95% confidence interval, 10.9–41.2; adjusted odds ratio, 4.4, 95% confidence interval, 2.9–6.6), antepartum fetal death (adjusted odds ratio, 15.0, 95% confidence interval, 6.2–36.6; adjusted odds ratio, 4.0, 95% confidence interval, 1.1–14.2), and previous first-trimester miscarriages (adjusted odds ratio, 9.6, 95% confidence interval, 5.7–17.4; adjusted odds ratio, 5.00, 95% confidence interval, 3.4–7.3). After a previous cesarean delivery, the risk of rupture was increased by an interdelivery interval Conclusion Sequential Labor induction with prostaglandins and oxytocin and Augmentation of Labor with oxytocin are important risk factors for complete uterine rupture in intact and scarred uteri.
Donald D Mcintire - One of the best experts on this subject based on the ideXlab platform.
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oral misoprostol for Labor Augmentation a randomized controlled trial
Obstetrics & Gynecology, 2011Co-Authors: April T Bleich, Kathryn S Villano, James M Alexander, Donald D Mcintire, Kenneth J LevenoAbstract:OBJECTIVE:To estimate the efficacy of oral misoprostol for Labor Augmentation.METHODS:We performed a randomized, controlled trial comparing intravenous oxytocin to a 75-microgram dose of oral misoprostol. Women in spontaneous Labor were eligible if they had cervical dilation of 4–8 cm and required l
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a dose finding study of oral misoprostol for Labor Augmentation
American Journal of Obstetrics and Gynecology, 2011Co-Authors: Kathryn S Villano, James M Alexander, Donald D Mcintire, Kenneth J LevenoAbstract:OBJECTIVE: We designed a dose-finding trial of oral misoprostol administered for Labor Augmentation. STUDY DESIGN: Healthy, nulliparous women in active Labor and diagnosed with arrest of dilation were enrolled in cohorts of 10 at a time. Five regimens were studied: (1) 25 μg every 4 hours, (2) 50 μg every 4 hours, (3) 100 μg every 4 hours, (4) 50 μg every 2 hours, and (5) 75 μg every 4 hours. RESULTS: A total of 46 women were enrolled. Baseline uterine activity approximately doubled with 4 of the regimens and tripled with the highest dosage regimen (100 μg) (P < .001). The 100-μg regimen was truncated due to excessive uterine hyperstimulation (40%). CONCLUSION: An oral dose of 75 μg of misoprostol given at a 4-hour interval for a maximum of 2 doses is the highest tolerated dose. Randomized, controlled trials will be required before a regimen is employed routinely.
