Third stage of labor: analysis of duration and clinical practice

Article Abstract:

The length of the third stage of labor and the incidence of manual removal of the placenta and hemorrhage decrease with advancing gestation. Researchers reviewed 45,852 vaginal singleton births occurring at or beyond 20 weeks gestation. Overall, 2% of births involved a retained placenta, which was defined as an undelivered placenta 30 minutes after birth. Births prior to 27 weeks gestation were 21 times more likely to have a retained placenta and births before 37 weeks were three times more likely to have a retained placenta compared with term births. Doctors removed the placenta manually in 3% of all births. They were nine times more likely to remove the placenta manually during deliveries earlier than 27 weeks and three times more likely during deliveries earlier than 37 weeks. Overall, 3.5% of women lost 500 ml or more of blood. Women whose placentas were manually removed were 10 times more likely to hemorrhage.

Care and treatment, Complications and side effects, Risk factors, Uterine bleeding, Uterine hemorrhage, Labor, Complicated, Labor complications

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Changes in health care delivery: a threat to academic obstetrics

Article Abstract:

The number of births at the top academic medical hospitals may be declining as a result of health care cost containment. Lower rates of deliveries at these teaching hospitals may compromise the training of medical students and residents and lower the quality of medical research. Researchers conducted a survey of 43 teaching hospitals and found that their delivery rates dropped by 12.3% between 1990 and 1993, more than six times the decrease in births in the U.S. Institutions in the South and West, and the largest hospitals experienced the biggest decreases. Fifty-nine percent of respondents said competition from private doctors or community hospitals was the reason for the decline, while 15% said managed care was a major factor.

Social aspects, Political aspects, Study and teaching, Health care reform, Childbirth, Hospitals, University, University hospitals, Obstetrics, Childbirth education

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Cocaine and beta-adrenergic receptor function in pregnant myometrium

Article Abstract:

Cocaine may have a direct effect on increasing uterine contractions. Cocaine is associated with premature labor. Researchers exposed uterine muscle samples taken at full-term cesarean section to cocaine in concentrations similar to what would be found after taking the drug. Cocaine blocked beta-adrenergic receptors. The beta-adrenergic system inhibits uterine muscle contractions. Blocking receptors would release that inhibition. Cocaine has other known effects on uterine contractions. It stimulates secretion of adrenal hormones, which also increases uterine contractions.

Causes of, Physiological aspects, Cocaine, Beta adrenoceptors, Adrenergic beta receptors

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