Increased platelet activation has been reported during labor. We evaluated changes in platelet count, volume and function during labor and 24 hours postpartum. Platelet function during labor was not previously evaluated. Twenty-five healthy women in labor, subsequently having singleton spontaneous vaginal delivery following uncomplicated pregnancy at term were recruited for this prospective study. Blood was withdrawn during latent phase, active phase, second stage of labor, and 24 hours postpartum. Platelet function was assessed by hemoSTATUS2 test (Hepcon, Medtronic, USA). Twenty-five healthy non-pregnant volunteers served as controls. Platelet count and volume did not change significantly throughout labor and 24 hours postpartum. Platelet function was 120.8 +/- 26.9 %, 106.8 +/- 24.6 % (p = 0.06), 105.2 +/- 30.9 % (p < 0.05), and 117.6 +/- 21.5 % during latent phase, active phase, second stage of labor, and 24 hours postpartum, respectively. Platelet function was altered during labor while platelet count and volume did not change significantly. Platelet function remained increased when compared to non-pregnant controls.
We aimed to study, retrospectively, the neonatal outcome of 45 preterm neonates with intraventricular hemorrhage (IVH) who were delivered vaginally with intravenous meperidine (n = 23) or epidural analgesia (n = 22). Neonates in the epidural group had a better outcome in terms of a first-minute Apgar score of 7 or less, in 31% vs 69% (P = 0.001); 5-min Apgar score of 7 or less, in 18% vs 82% (P = 0.003); a lower incidence of respiratory distress syndrome (RDS; 23% vs 30%; P = 0.03); a lower dopamine requirement during the first neonatal week (13% vs 72%; P = 0.01); and a higher survival rate (91% vs 58%, respectively; P = 0.008). It is concluded that preterm neonates with IVH had a better outcome when delivered to mothers receiving epidural analgesia as compared to those receiving intravenous meperidine.
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