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Biomedical subjects

A A Calder

Publications and source records attributed to A A Calder.

At least 109 records · Page 6Linked to original sources
PubMed1978

Upright posture and the efficiency of labour.

The claim that an upright maternal posture during labour improves the efficiency of the uterus to the benefit of both mother and fetus has been investigated in a randomised prospective study. 40 patients undergoing induction of labour were allocated to a recumbent group or an upright group. No differences were found between the groups in the length of labour, mode of delivery, requirements of oxytocic and analgesic drugs, or fetal and neonatal condition. Our data do not support calls to change conventional intrapartum nursing attitudes.

Adult↗
PubMed1978

Induction of labour by different methods in primiparous women. I Some perinatal and postnatal problems.

A personal prospective study was made of some perinatal and postnatal problems associated with induction of labour by three different methods in primiparous women with unripe cervices. The methods of induction were: (A) amniotomy followed by intravenous oxytocin [49], (B) amniotomy followed by intravenous prostaglandin E2 [39], (C) prostaglandin E2 by the extra-amniotic route [42]. A spontaneous group (D) comprising 54 mother--infant pairs was also studied. Length of gestation was between 37 and 42 wk in all but 2 cases. There was no perinatal mortality, and no infant had hyaline membrane disease. A close association was found between method of delivery and method (or absence) or induction. The caesarean section rate was highest in group C and lowest in group D. The spontaneous vaginal delivery rate was lowest in group C and highest in group D. More infants in the three induction groups were admitted to the Special Care Baby Unit (SCBU) than in the spontaneous group. No significant associations were found between the severity of the conditions leading to induction and caesarean section rates, low Apgar scores, admissions to SCBU, or the favourability of the cervix before induction. Among those who intended to breast feed fewer infants in the spontaneous group changed from breast to bottle while in hospital and after discharge from hospital than in the combined induction groups. Success in breast-feeding was not significantly associated with method of delivery or whether the infant was admitted to SCBU or not.

Apgar Score↗
PubMed1978

Single shot prostaglandin gel for labor induction.

A viscous suspension of prostaglandin E2 was introduced endocervically to induce labor in patients with favourable induction features. The method was found to be effective and compared favourably with the conventional practices of amniotomy and intravenous oxytocin infusion or oral prostaglandin therapy. Several advantages were found including a high degree of patient acceptability.

Clinical Trials as Topic↗
PubMed1977

Ripening of the cervix with extra-amniotic prostaglandin E2 in viscous gel before induction of labour.

A metohod of extra-amniotic prostaglandin administration to achieve ripening of the cervix as a preliminary to induction of labour is described. Compared with a control group the method achieved a 25 per cent reduction in the length of the induced labour, a fall in the incidence of maternal pyrexia and fetal distress, an improvement in neonatal condition of the infants and a reduction in the need to resort to Caesarean section.

Adolescent↗
PubMed1976

Production of prostaglandins E and Falpha by corpora lutea, corpora albicantes and stroma from the human ovary.

This study has shown that corpora lutea, stromal tissue and corpora albicantes from human ovaries contain prostaglandin E (PGE) and PGFalpha, and that the two former tissues can synthesize these prostaglandins during incubation. Enhanced syntheses, especially of PGE, occurred on adding arachidonic acid to the incubation medium, and the presence of prostaglandin synthetase activity was conclusively demonstrated. In corpora lutea obtained during the early and mid-luteal phase, the mean concentrations of PGE and PGFalpha were 34.3 and 9l9 ng/g respectively (mean ratio PGE:PGFalpha = 3.7); similar values were found in three corpora lutea from women at 10-12 weeks of pregnancy. All these corpora lutea contained appreciable amounts of progesterone and oestradiol-17beta. Prostaglandin levels were generally lower in corpora lutea obtained during the late luteal phase, although the PGE:PGFalpha ratio had increased to a mean value of 8.4. In corpora albicantes, the concentrations of both PGE and PGFalpha were significantly higher than the levels found in corpora lutea (P less than 0.01), whilst the mean ratio of PGE:PGFalpha had fallen significantly to 1.8 (P less than 0.01). Prostaglandin levels in stromal tissue varied considerably between individuals. The mean values were significantly lower than those of the corpora albicantes (P less than 0.01) but not significantly different to corpora lutea at any stage. These findings are discussed in relation to the possible role of prostaglandins in ovarian steroidogenesis and corpus luteum regression in man.

Adult↗
PubMed1976

Intrauterine (extraamniotic) prostaglandins in the management of unsuccessful pregnancy.

Extraamniotic administration of prostaglandin E2 or prostaglandin F2alpha has been used in the treatment of 72 cases of unsuccessful pregnancy which included 50 of fetal death in utero, 13 of anencephaly and nine of hydatidiform mole. This management is highly effective in achieving abortion or delivery within 24 hours in almost all cases and results in few side effects. Pyrexia occurred during treatment in three patients, but in none was intrauterine infection observed. Blood loss greater than 250 ml occurred in only two patients, and none required transfusion. We advocate the use of extraamniotic prostaglandins as an active approach to the problem of unsuccessful pregnancy to relieve the patient of emotional distress and avoid the hazards of blood coagulopathy and intrauterine infection, both of which increase the longer a dead fetus is retained in utero.

Abortifacient Agents↗
PubMed1975

Comparison of intravenous oxytocin and prostaglandin E2 for induction of labour using automatic and non-automatic infusion techniques.

A double blind trial of prostaglandin E2 and oxytocin given by intravenous infusion after amniotomy for induction of labour in 100 primigravidae with unfavourable induction features is reported. No clear-cut advantage of either drug emerged although PGE2 was perhaps superior when the cervix was highly unfavourable. Prostaglandin E2 appeared to produce less deleterious effects on the fetus but was associated with a higher incidence of maternal side effects. The automatic Cardiff Infusion apparatus was found to be a safe means of PGE2 infusion and to have advantages over the use of non-automatic techniques both for PGE2 and for oxytocin infusion.

Adolescent↗
PubMed1973

Effect of intravenous prostaglandin E 2 on platelet function, coagulation, and fibrinolysis.

Prostaglandin E(2) (PGE(2)) was infused intravenously to eight women for the termination of pregnancy and tests of platelet function: coagulation and fibrinolysis were studied before and during the infusion.Platelet adhesiveness, as measured by a cellophane membrane test-cell system, was significantly diminished by PGE(2), a change which was not noted by the glass-bead column technique. The administration of PGE(2) caused more rapid platelet disaggregation following ADP-induced aggregation but had no effect on the platelet count, collagen-induced aggregation, or platelet factor 3 activity. An increase in plasma antithrombin concentration and euglobulin lysis activity was also noted. These results support the concept that prostaglandin E(2) might have a role in the prevention of thrombosis.

Abortion, Induced↗
PubMedDate not supplied

Oestradiol applied locally to ripen the unfavourable cervix.

The unfavourable cervix in late pregnancy presents a difficult clinical problem if labour has to be induced. In an attempt to improve the outcome, the effect of applying oestradiol directly to the cervix the day before planned induction was investigated. Two groups of twenty-five primigravidas were studied, one group receiving 150 mg oestradiol in viscous gel and the other the viscous gel alone. There was a significant increase in cervical ripeness in the group who received oestradiol and a reduction both in the length of the labour and in the need to resort to caesarean section.

Adolescent↗