Uterine tocolysis at cesarean breech delivery with epidural anesthesia.
Bibliographic record
Abstract
OBJECTIVE: To assess the safety and efficacy of ritodrine and nitroglycerin for uterine relaxation during cesarean section with a breech-presenting fetus, performed under nongeneral anesthesia. STUDY DESIGN: A retrospective review of all breech singletons delivered by cesarean section under epidural anaesthesia in a two-year period. The study groups consisted of those who received ritodrine and those who received nitroglycerin. A group who received no relaxant served as a comparison group. The interval from uterine incision to delivery was recorded, and comparisons for potential complications of the medications included maternal changes in pulse and blood pressure, blood loss, and changes in hemoglobin and hematocrit. Fetal outcomes that were evaluated included five-minute Apgar score, cord pH and any recorded birth trauma. Statistical significance was set at P = .05. The Student t test, Yates's correlation for chi 2, Fisher's exact test and ANOVA were used as appropriate. RESULTS: The three groups had similar demographic characteristics. There was no significant difference in the uterine incision to delivery interval between the groups. In three cases the uterine incision to delivery interval was prolonged (> 5 minutes) in the nitroglycerin group, six cases in the ritodrine group and three in the comparison group (P = .002). There was no case of serious maternal morbidity or mortality, and no patient required a blood transfusion. The three groups had similar estimated blood loss, changes in maternal heart rate and systolic blood pressure intraoperatively and fall in hemoglobin and hematocrit 24 hours postoperatively. Neonatal outcome was similar among the three groups, and there was no case of neonatal birth trauma or intrapartum death. Cord blood analysis was similar in the three groups. One of the seven infants weighing < 1,500 g died within one hour of birth. CONCLUSION: Ritodrine and nitroglycerine are safe agents for use at cesarean breech delivery with epidural anesthesia and may be considered for uterine relaxation when a traumatic delivery is anticipated or encountered. Our results do not support the use of these tocolytics for "routine" cesarean breech delivery.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".