Labor analgesia for patients with preterm premature rupture of membranes.

Objective: Cervical examination is relatively contraindicated in women with preterm premature rupture of membranes (PPROM), limiting our ability to determine the onset of labor by traditional definition (contractions with cervical change). We sought to determine whether two maternal requests for analgesia within 3 h predicted delivery within 24 h to allow appropriate epidural placement.

Study Design: We performed a retrospective chart review of all patients with PPROM for a period of 18 months.

Racial differences in prenatal care of mothers delivering very low birth weight infants.

Objectives: To determine whether there are any racial differences in the prenatal care of mothers delivering very low birth weight infants (VLBW).

Study Design: Retrospective cohort study of infants cared for at a single regional level III neonatal intensive care unit over a 9-year period, July 1993-June 2002, N = 1234. The main outcome variables investigated included antenatal administration of steroids, delivery by cesarean section, and use of tocolytic medications.

Extramembranous placement of an air-coupled vs. transducer-tipped intrauterine pressure catheter.

Objective: To compare the rate of extramembranous placement between 2 types of intrauterine pressure catheter.

Study Design: Women were randomized to a transducer-tipped intrauterine pressure catheter or an air-coupled intrauterine pressure catheter from October 1998 to August 1999. Women were eligible for the study if their attending physicians decided to place an intrauterine pressure catheter.

Preinduction cervical ripening with the Foley catheter and the risk of subsequent preterm birth.

Objective: The Foley catheter is a safe and effective form of preinduction cervical ripening and is quickly growing in popularity. Its major effect appears to be through mechanical dilation, which has raised the concern that the use of the Foley catheter for cervical ripening may damage the cervix and result in a higher rate of subsequent preterm birth.

Study Design: We conducted a review of all induction of labor at our institution from July 1998 to July 2001 that required preinduction cervical ripening and had a subsequent birth.

Acute pulmonary edema in pregnancy.

Objective: To describe the incidence, predisposing conditions, and inciting factors culminating in pulmonary edema in the pregnant patient.

Methods: A review of 62,917 consecutive pregnancies delivered at our institution from January 1, 1989 to June 1, 1999 was undertaken for the diagnosis of pulmonary edema. Each chart was reviewed for maternal demographics, admission diagnoses, medication use, gestational age at diagnosis, fluid balance, coexisting maternal illness, tocolytic use, evidence of preeclampsia, and diagnostic criteria.