The association between the length of first stage of labor, mode of delivery, and perinatal outcomes in women undergoing induction of labor.

Objective: To estimate the association between the lengths of the first stage of labor, mode of delivery, and perinatal outcomes in women undergoing labor induction.

Study Design: Retrospective cohort study of singleton, term pregnancies with labor induction and delivered during the second stage. The length of the first stage was examined by 6-hour intervals as predictors of mode of delivery and perinatal morbidity using chi(2) test and multivariable logistic regression analysis.

The use of ultrasound in fetal surgery.

Obstetric ultrasound (US) is an integral part of fetal surgery for open and minimally invasive techniques. With advances in US imaging, the ability to refine diagnosis, predict prognosis, and contribute to fetal treatment continues to grow. Current research in fetal diagnosis and treatment includes identifying the most reliable sonographic features for determining prognosis before and after surgery.

Does length of labor vary by maternal age?

Objective: The purpose of this study was to examine lengths of first and second stages of labor across maternal age groups to determine whether different norms should be established.

Study Design: We conducted a retrospective cohort study of all laboring, term, singleton, and cephalic deliveries at a single institution between 1980-2001. Median lengths of labor were compared among 6 maternal age groups.

First-trimester combined screening: experience with an instant results approach.

Objective: This study was undertaken to assess an instant results protocol for first-trimester combined screening.

Study Design: Retrospective analysis of patients having first-trimester combined screening between Nov. 1, 2003 and Oct.

Duration of the second stage of labor in multiparous women: maternal and neonatal outcomes.

Objective: This study was undertaken to examine perinatal outcomes associated with the second stage of labor in multiparous women.

Study Design: This is a retrospective cohort study of all term, cephalic, singleton births delivered by multiparous women between 1991 and 2001. Duration of the second stage of labor was stratified into hourly intervals: 0-1 hour, 1-2 hours, 2-3 hours, and 3 hours or longer.

Concordance of chart abstraction and patient recall of intrapartum variables up to 53 years later.

Objective: The purpose of this study was to determine the concordance of patient recall compared with chart abstraction for distant intrapartum variables and to evaluate predictors of concordance.

Study Design: A random sample from a cohort of diverse women aged 40-74 years. Intrapartum variables reported by participants were compared with the medical record.

Are there ethnic differences in the length of labor?

Objective: The purpose of this study was to examine the lengths of the first and second stages of labor among different racial/ethnic groups to determine whether different norms should be established.

Study Design: This was a retrospective cohort study of all laboring, term, singleton, vertex deliveries in a single academic institution. Median lengths of first and second stages of labor were compared among 4 racial/ethnic groups: black, Asian, white, and Latina.

Gestational weight gain and adverse neonatal outcome among term infants.

Objective: To examine the relationship between gestational weight gain and adverse neonatal outcomes among infants born at term (37 weeks or more).

Methods: This was a retrospective cohort study of 20,465 nondiabetic, term, singleton births. We performed univariable and multivariable analyses of the associations between gestational weight gain and neonatal outcomes.

Chorionic villus sampling compared with amniocentesis and the difference in the rate of pregnancy loss.

Objective: To compare loss rates following amniocentesis and chorionic villus sampling (CVS) over time.

Methods: A retrospective cohort study of all amniocentesis and CVS procedures resulting in a normal karyotype from 1983-2003 at a single prenatal diagnostic referral center was conducted. Pregnancy loss rates for amniocentesis, CVS, and nonintervention groups (ie, those who had nuchal translucency screening or counseling, but no procedure) were compared using the chi 2 test.

Racial/ethnic differences in perineal, vaginal and cervical lacerations.

Objective: To determine if variation exists between ethnicities for risk of perineal, vaginal, and cervical laceration at vaginal delivery.

Study Design: Retrospective cohort study of nulliparous women who underwent vaginal delivery of a vertex presentation. Predictor variable was ethnicity with outcome variables cervical, vaginal, and second-, third-, or fourth-degree perineal laceration.

How long is too long: Does a prolonged second stage of labor in nulliparous women affect maternal and neonatal outcomes?

Objective: The purpose of this study was to examine maternal and neonatal outcomes in relation to lengthening intervals of the second stage of labor.

Study Design: This is a retrospective cohort study of 15,759 nulliparous, term, cephalic, singleton births at the University of California, San Francisco, between 1976 and 2001. The second stage of labor was divided into 1-hour intervals.

Gestational weight gain, macrosomia, and risk of cesarean birth in nondiabetic nulliparas.

Objective: To examine how the association between excessive weight gain and cesarean birth is modified by infant birth weight in nondiabetic women.

Methods: We designed a retrospective cohort study of singleton, term, nulliparous women with cephalic presentations delivering at a single university hospital. Subjects with diabetes were excluded.