摘要:

Prostaglandin F2a(PGF2a) was injected intraamniotically in 122 patients between 14 and 20 weeks' gestation in the dosage schedule recommended by the drug manufacturer to induce abortion. Significantly more multiparous (47.5%) than primigrasida patients (21.5%) aborted within 16 hours, but the mean duration between PGF2ainjection and abortion was not significantly different. Complications occurred in 52 (42.6%) patients and included: fall in hematocrit of more than 5 percentage points, failure to abort within 48 hours after injection, infection requiring antibiotic therapy, cervical laceration or fistula, and uterine rupture. The atypical dilatation and effacement of the cervix occurring with PGF2a-induced contractions may possibly lead to cervical incompetence with later pregnancies. Although the efficacy of PGF2aas an abortifacient is confirmed, the large complication rate with the procedure cannot be ignored.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The purpose of this investigation was to determine whether the oxytocin challenge test (OCT) could serve as the primary method for managing pregnancies characterized by possible placental insufficiency. One hundred and five patients underwent 225 oxytocin challenge tests; no perinatal deaths occurred. Eight tests were positive, 21 suspicious, and 196 negative. Because of data obtained in a preliminary study, all 8 fetuses with positive tests were delivered by cesarean section. Four of the 8 had repetitive suspicious tests prior to a positive test, suggesting that uteroplacental function may deteriorate gradually. Urinary excretion of estriol did not decrease significantly in any patient, suggesting that the OCT is a more sensitive indicator of placental function than excretion of estriol. Except for patients with preeclampsia who were induced for maternal indications, all pregnancies with a negative OCT were allowed to terminate spontaneously. Five of the 97 fetuses with negative tests developed late-onset deceleration patterns during labor. This indicates that a negative OCT will not necessarily predict fetal tolerance to labor, contrary to assertions made by some other investigators. It is concluded that the OCT can serve as the primary method for assessing the fetal status in pregnancies characterized by placental insufficiency.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Three cases have been observed over the past 3 years at Los Angeles County-USC Medical Center, Women's Hospital, which have shown an unusual fetal heart rate response to induced uterine contractions during the antepartum period. All 3 cases resulted in perinatal death apparently due to asphyxia. This report describes this unusual pattern and presents a discussion of its possible significance.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The maternal febrile morbidity for 793 patients undergoing cesarean section was analyzed. The influence of length of labor, duration of ruptured membranes, and fetal heart rate monitoring was studied in both clinic and private patients. Morbidity among private patients was found to he consistently higher in monitored patients with comparable lengths of labor and durations of membrane rupture. The number of vaginal examinations, duration of monitoring, or number of fetal scalp electrode applications did not effect morbidity outcome.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Total maternal plasma cortisol levels were measured by a radioassay method in 9 patients who were in spontaneous labor and 10 patients who were electively induced at term with oxytocin. Determinations were made at onset of labor and repeated at full cervical dilatation. Total maternal plasma cortisol levels were also measured in 7 patients undergoing elective cesarean section without labor, determinations being made just prior to the procedure and at the time of uterine incision. Computerized analysis showed the mean initial cortisol level (SE) in the spontaneous labor group (15.4 ± 1.6 μg/100 ml) to be significantly less than the mean initial level of the group electively delivered by oxytocin induction (37.2 ± 6 μg/100 ml), withP< 0.01. The former value was also found to be significantly less than that of the group electively delivered by cesarean section (32.1 ± 9.3 μg/100 ml), withP< 0.05. A significant rise was noted at full cervical dilatation in the spontaneous labor group (P< 0.05), whereas no change occurred in the two elective groups. No significant correlation was found between the maternal cortisol levels on the one hand and the cord cortisol levels. These findings indicate thata) maternal participation is unlikely in bringing about a surge of fetal plasma cortisol which is thought to precede spontaneous labor,b) elective termination of term pregnancy by oxytocin induction or cesarean section may be initially more stress-provoking to the mother than spontaneous labor, andc) maternal stress as measured by plasma cortisol level is not reflected in the fetus.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The purpose of this study Has to investigate cortisol levels in the fetal circulation prior to delivery. Fetal scalp plasma cortisol levels during labor were significantly loner than those in maternal peripheral plasma but significantly higher than those in cord plasma at delivery. Cortisol levels in fetal scalp plasma did not correlate significantly with those in either maternal or curd plasma. The greater cortisol concentrations in fetal scalp plasma relative to those in cord plasma could have been transient increases caused by fetal adrenal response to the stress of the scalp sampling procedure. There Nos a significant correlation between cortisol levels in maternal and cord plasma, which may mean that a considerable part of the cortisol in the fetal circulation at delivery is of maternal origin.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Radioimmunoassayable plasma oxytocin (OT) has been measured in maternal and fetal blood. Simultaneous samples were obtained in maternal forearm venous blood and in umbilical venous and arterial blood in 29 patients at term delivery. In addition, maternal forearm venous blood samples were also obtained 10 minutes prior to delivery. Mean OT level in maternal plasma at delivery was 82 ± 12 μU/ml, and at 10 minutes prior to delivery the mean OT level was 90 ± 11 μU/ml. The umbilical arterial plasma OT showed 95 ± 12 μU/ml and the umbilical vein plasma OT was 60 ± 10 μU/ml. Oxytocin levels higher in maternal blood than in fetal blood were found with the following incidence: In 51% of samples there was more OT in maternal venous blood than in umbilical arterial blood, and in 84% of samples there was more OT in maternal blood than umbilical vein blood. During the postpartum period, the mean maternal plasma OT was 66 ± 8 μU/ml for the first day, and 50 ± 9 μU/ml and 54 ± 9 μU/ml for the second and third days, respectively. This study indicates that both the fetus and the mother are active producers of oxytocin.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The circulating level of ACTH (by radioimmunoassay) and curtisol (by competitive protein binding) were determined at 1− to 2-hour intervals during spontaneous labor (N = 8) and induced labor (N = 28) and after delivery. There were no differences in ACTH levels between primiparous and multiparous women. The primiparous women displayed a higher level of cortisol throughout labor than the multiparous women, but not after delivery. After spontaneous onset of labor, ACTH levels were always lower than after elective induction of labor, while there were no differences in the levels of cortisol. The hypertensive complications of pregnancy did not affect the secretion of ACTH. In normal pregnancy the rise of cortisol during labor and after delivery was significant, but it was not significant in the group of patients with hypertensive complications.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The effects of repeated freezing and thawing on certain properties of early gestation amniotic fluid were studied. Six amniotic fluids from 15− to 17-week gestations were investigated. Total protein determinations revealed that there was no significant loss of total protein with rapid freezing and thawing up to 10 times in the space of a few days. Immunoelectrophoresis revealed that the antigenic properties of the amniotic fluid, as ascertained by counting the number of precipitin bands, were unaltered by the repeated freezing and thawing.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Twenty-one women were studied nhu had received propylthiouracil or methimuzole during 26 pregnancies. Four of the infants had a goiter at birth, and 3 of these had neonatal thyrotosicosis. In 2 children neonatal thyrotocicosis eas not evident at birth because of maternal antithyroid therapy. Five children had congenital defects. Two mothers nere responsible for 4 of the children with abnormalities, and both mothers had been treated with thiourea drugs for long periods, ranging from 7 to 11 years. The majority of children who are exposed to these drugsin uteroappear to have no subsequent ill effects. However, prolonged therapy with these agents may be undesirable.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID