No abstract

Coital activity at term reportedly is associated with shorter gestation and less need to induce labor because of prolonged pregnancy, but such findings have not been consistently affirmed. In this randomized study, 108 women scheduled to have nonurgent induction of labor at term (37 weeks' gestation or later) were randomly assigned to be advised to have vaginal intercourse with the goal of hastening the onset of labor. They were told that intercourse late in pregnancy was safe and could promote the onset of labor. The 102 women in a control group were neither encouraged nor discouraged to have coitus. Labor was induced by amniotomy if the cervix was favorable and by vaginal dinoprostone if it was unfavorable. All participants kept a coital and orgasm diary and received standard obstetrical care.The rate of reported coital activity was 60% in women advised to have sex and 40% in control women; the relative risk was 1.5, with a 95% confidence interval of 1.1 to 2.0. Nevertheless, rates of spontaneous labor did not differ significantly; they were 56% in the study group and 52% in control women. More than 80% of women who reported one or more episodes of vaginal sex after randomization also reported having at least one orgasm. The 2 groups did not differ significantly with regard to either the timing of admission for birth or spontaneous labor, or presentation at admission for birth. There also were no group differences in rates of cesarean delivery, maternal fever, or neonatal outcomes.These findings do not validate the practice of advising women scheduled for induction of labor at term to have vaginal intercourse in order to hasten the onset of labor. ABSTRACTAlthough treating cervical weakness after dilation has rescued many pregnancies, there is a trend toward performing cerclage before the cervix has begun dilating, and this requires a diagnostic test to confirm cervical weakness. This observational study measured the cervical resistance index (CRI)-the force required to dilate the cervix to 8 mm-as an aid in choosing which women with a history of spontaneous mid-trimester miscarriage should have cervical cerclage in subsequent pregnancies. The study group included 175 nonpregnant women with a history of one or more spontaneous mid-trimester losses at 12 to 28 weeks' gestation, and the control group comprised 123 nonpregnant women having CRI measurements during routine gynecological surgery. Women whose CRI indicated an incompetent cervix were advised to have cervical cerclage in future pregnancies. A CRI below 5 lb, or 22 Newtons (N), was taken as an indicator of cervical weakness.The study and control women had median CRI values of 17 and 38 N, respectively. Thirty study women were considered to have a competent cervix by CRI while the obstetrical history suggested otherwise. At the same time, 32 ABSTRACTBecause little is known about repeat laparotomy in the early postoperative period following cesarean section-one of the least frequent short-term complications-the investigators reviewed 3380 women having cesa...

Pregnancies complicated by IUGR are significantly more likely than non-IUGR pregnancies to have lateral placentation in the second trimester.