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PubMed2005

The effect of overnourishing singleton-bearing adult ewes on nutrient partitioning to the gravid uterus.

Overnourishing the singleton-bearing adolescent sheep throughout pregnancy promotes maternal tissue synthesis at the expense of the nutrient requirements of the gravid uterus. Consequently, the growth of the placenta is impaired and results in the premature delivery of low-birth-weight lambs relative to moderately fed adolescents of equivalent age. To establish if this phenomenon is unique to the growing animal, singleton pregnancies to a single sire were established by embryo transfer into primiparous adult ewes who had attained the normal mature body size for their genotype. Thereafter ewes were offered a maintenance or a high level of a complete diet throughout gestation. High maternal intakes resulted in elevated maternal insulin, no significant change in growth hormone or glucose, and attenuated progesterone and NEFA concentrations. Live weight gain during the first 93 d of gestation was 48 and 244 g/d, and adiposity score at term was 2.4 and 3.7 in the maintenance and high groups, respectively (P<0.001). In spite of achieving levels of adiposity similar to overnourished adolescents, placental (477 (sem 30) v. 518 (sem 41) g) and fetal (5190 (sem 320) v. 5420 (sem 250) g) weights were equivalent in maintenance and high groups. Gestation length was shorter (P<0.01) and colostrum yield at parturition lower (P<0.05) in high v. maintenance dams. Thus, adult sheep appear to be relatively insensitive to the oversupply of nutrients during pregnancy and have the ability to meet the nutrient requirements for normal conceptus growth in spite of their increased adiposity.

Animal Nutritional Physiological Phenomena↗

PubMed1954

Susceptibility of gravid mice to Coxsackie virus infection.

Gravid mice become progressively more susceptible to infection with the pancreatic line of Group B-1 Coxsackie virus during the last week of pregnancy. A Group A-8 strain did not have such an effect. The young that survive despite the fact that their mothers are infected with a B-1 strain appear to be normal in the gross and microscopically, to grow at the usual rate, to be free of demonstrable virus, and to be susceptible on challenge with a homologous strain.

Animals↗

PubMed1979

Effect of the chronic administration of nitrous oxide 0.5% to gravid rats.

Twenty-four gravid Wistar rats (12 experimental and 12 control) were studied. From day 1 to day 19 of gestation the experimental group was exposed day and night to nitrous oxide 0.5%, while the control group was exposed to air. On day 19 the rats were killed and a detailed examination of the uterus, ovaries and fetuses was undertaken. The fetuses were fixed, cleared and stained with alizarin red, examined for skeletal anomalies and their crown-rump lengths measured. There was a significant decrease in litter size of the dams exposed to nitrous oxide as compared with control (P less than 0.001). Fetal resorption occurred in 10 of the 12 exposed dams. Skeletal anomalies were observed in 9% of the fetuses in the experimental group and there was an overall reduction in their size. None of the above changes were observed in the control.

Abnormalities, Drug-Induced↗

PubMed1984

Gravidity and diabetic retinopathy.

The relationship between gravidity and severity of diabetic retinopathy was investigated in a population-based sample of diabetic patients. All of these women had had diabetes diagnosed before 30 years of age and were taking insulin. All received their primary medical care in an 11-county region of southwestern Wisconsin (Health Service Area 1). Each participant had an ophthalmologic examination which included stereoscopic fundus photography of seven standard fields in each eye. Photos were graded according to a standard protocol. Of the 397 women, 197 had never been pregnant, 88 had been pregnant once, 56 had been pregnant twice, and 56 had been pregnant three or more times after diabetes was diagnosed. The number of pregnancies was positively associated with the severity of retinopathy. However, after controlling for duration of diabetes, this relationship was no longer apparent. Using an ordinal regression model, duration of diabetes, diastolic blood pressure and glycosylated hemoglobin were significant predictors of the severity of diabetic retinopathy.

Adult↗

PubMed1997

Prevention of fetal and maternal cyanide toxicity from nitroprusside with coinfusion of sodium thiosulfate in gravid ewes.

Coadministration of sodium thiosulfate with sodium nitroprusside (SNP) to children and adults prevents increases in cyanide concentrations during anesthesia or long-term SNP infusions. We wondered whether maternally administered sodium thiosulfate would prevent increases in fetal red cell cyanide concentrations in gravid ewes receiving SNP infusions. Under anesthesia, the fetal head was delivered through a lateral hysterotomy for catheterization of the jugular vein; the fetus was left in utero. Six control ewes near term received SNP at 25 micrograms.kg-1.min-1 for 4 h. Norepinephrine was used to maintain maternal mean arterial pressure at 80% baseline values. Six experimental ewes received the same treatment except that sodium thiosulfate was infused with SNP (1 g sodium thiosulfate per 100 mg SNP). Serial red cell cyanide concentrations in ewes and fetuses were followed. One control fetal death resulted from abruptio placenta, and this ewe and fetus were excluded from analysis. An additional control ewe and fetus died from apparent cyanide poisoning late during the course of the experiment. While control ewes and fetuses suffered progressive increases in red cell cyanide concentrations into the toxic range, experimental ewes and fetuses never developed toxic red cell cyanide levels (ewes P < .003, fetuses P < .004). These data, if applicable to humans, suggest that coadministration of sodium thiosulfate with SNP to pregnant women at doses currently in use for nonpregnant patients will prevent fetal, as well as maternal, cyanide toxicity.

Animals↗

PubMed1986

Maternal and fetal effects of epinephrine in gravid ewes.

Intravenous cannulation by an epidural catheter may complicate epidural anesthesia. Local anesthetic solutions containing epinephrine produce tachycardia and hypertension when given intravenously and may identify intravenous placement. The authors studied the maternal and fetal effects of intravenous epinephrine-containing solutions in ten chronically instrumented gravid ewes. While continuously monitoring maternal and fetal effects, epinephrine 5, 10, or 20 micrograms iv bolus was injected. Solutions of bupivacaine 5 mg and bupivacaine 5 mg combined with epinephrine 10 micrograms given iv were also examined. All epinephrine-containing solutions produced a significant increase (P less than 0.001) in maternal mean arterial pressure, which returned to baseline after 1 min. Maternal heart rates decreased transiently and returned to baseline after 1 min. All epinephrine-containing solutions decreased uterine blood flow (UBF) (P less than 0.001), and, for doses of 10 to 20 micrograms, this decrease lasted more than 3 min. Fetal heart rate and mean arterial blood pressure did not change following any test solution, nor did maternal or fetal arterial blood gas values. The authors conclude that small intravenous boluses of epinephrine decreased UBF in these animals.

Anesthesia, Epidural↗

PubMed1989

The effect of intravenously administered 2-chloroprocaine upon uterine artery blood flow velocity in gravid guinea pigs.

The purpose of the present study was to assess the effect of intravenously administered 2-chloroprocaine upon uterine artery blood flow velocity (UBFV) in gravid guinea pigs. Ten experiments were performed in ten chronically instrumented animals between 0.7 and 0.9 of timed gestation. Each animal received four solutions of 2-chloroprocaine in random order: 1) 0.67 mg/kg; 2) 1.34 mg/kg; 3) 2.0 mg/kg; and 4) 1.34 mg/kg, with epinephrine 0.2 microgram/kg. Six animals received a fifth solution, 0.2 ml of saline control. 2-Chloroprocaine 1.34 mg/kg significantly increased maternal mean arterial pressure (MMAP) at 30 s after injection, and 2-chloroprocaine 2.0 mg/kg significantly increased MMAP through 2 min. 2-Chloroprocaine 1.34 mg/kg, with epinephrine 0.2 microgram/kg, also significantly increased MMAP through 2 min. No other solution significantly altered MMAP. 2-Chloroprocaine 2.0 mg/kg significantly decreased UBFV at 30 s after injection. 2-Chloroprocaine 1.34 mg/kg, with epinephrine 0.2 microgram/kg, significantly decreased UBFV through 2 min. No other solution significantly altered UBFV. The authors conclude that iv administration of 2-chloroprocaine with epinephrine significantly decreased UBFV in pregnant guinea pigs. In contrast, only the largest dose (i.e., 2.0 mg/kg) of 2-chloroprocaine alone transiently decreased UBFV. These data suggest that, in doses up to 1.34 mg/kg, 2-chloroprocaine alone may not decrease uterine blood flow when used as a marker for intravenous injection in obstetric patients.

Anesthetics, Local↗

PubMed1990

Does ritodrine worsen maternal hypotension during epidural anesthesia in gravid ewes?

The purpose of this study was to determine whether prior administration ritodrine worsens maternal hypotension during epidural anesthesia in gravid ewes. Twenty-four experiments were performed in nine chronically instrumented animals between 0.8 and 0.9 of timed gestation. The experimental sequence included the following: 1) at time-zero, intravenous (iv) administration of ritodrine, 0.004 mg.kg-1.min-1, or normal saline (NS) for 2 h; 2) at 120 min discontinuation of ritodrine, and administration of a 500 ml iv bolus of NS over 15 min; and 3) at 135 min epidural injection of 2% lidocaine or NS. There were three groups of experiments: 1) iv ritodrine-epidural lidocaine (n = 9); 2) iv NS-epidural lidocaine (n = 8); and 3) iv ritodrine-epidural NS (n =7). Epidural injection of lidocaine resulted in a median sensory level of T9 in both the ritodrine-lidocaine and NS-lidocaine groups. At 165 min (i.e., 30 min after the epidural injection of lidocaine), maternal mean arterial pressure was 19 +/- 3% below baseline (P = 0.0001) in the ritodrine-lidocaine group and 22 +/- 7% below baseline (P = 0.0001) in the NS-lidocaine group (NS between groups). At 120 min ritodrine had increased maternal cardiac output 45 +/- 6% above baseline (P = 0.0001) in the ritodrine-lidocaine group and 39 +/- 6% above baseline (P = 0.0001) in the ritodrine-NS group. Cardiac output remained above baseline (P less than 0.01) after epidural injection of lidocaine in the ritodrine-lidocaine group. In contrast, in the NS-lidocaine group cardiac output was 13 +/- 5% below baseline (P = 0.005) at 150 min. Fetal arterial pH did not change significantly in either the ritodrine-lidocaine or ritodrine-NS group.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Epidural↗

PubMed1991

Magnesium sulfate decreases maternal blood pressure but not uterine blood flow during epidural anesthesia in gravid ewes.

The purpose of this study was to determine whether administration of magnesium sulfate decreased maternal blood pressure during epidural anesthesia in gravid ewes. Twenty-two experiments were performed in 11 chronically instrumented animals between 0.8 and 0.9 of timed gestation. The experimental sequence included: 1) T = 0: magnesium sulfate 4 g intravenously over 5 min followed by an infusion of magnesium sulfate at 4 g/h, or normal saline iv followed by an infusion of normal saline alone; 2) T = 135 min: 500 ml normal saline intravenously over 12 min; and 3) T = 150 min: epidural administration of 2% lidocaine. The initial bolus of magnesium sulfate slightly decreased maternal mean arterial pressure (MAP) but increased uterine artery blood flow (UBF). The increase in UBF was accompanied by an increase in fetal PaO2 at 145 min in the magnesium sulfate group but not in the control group. At 165 min (i.e., 15 min after the epidural injection of lidocaine), epidural lidocaine resulted in a median sensory level of T-10 in the magnesium sulfate group and T-11 in the control group. During epidural anesthesia, maternal MAP was lower (P = 0.001) in the magnesium sulfate group than in the control group. At 165 min, maternal MAP was 18 +/- 3% below baseline (P = 0.0001) in the magnesium sulfate group but did not differ significantly from baseline in the control group. Maternal cardiac output and UBF did not differ from baseline after epidural injection of lidocaine in either group.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Epidural↗

PubMed1992

Epidural anesthesia worsens uterine blood flow and fetal oxygenation during hemorrhage in gravid ewes.

Recent studies suggest that epidural anesthesia initiated before hemorrhage may improve survival and acid-base status in laboratory animals. However, studies of hemorrhagic shock in nonpregnant animals may not be applicable to less severe hemorrhage in pregnant animals. The purpose of this study was to determine whether epidural anesthesia alters maternal and fetal hemodynamic and acid-base responses to hemorrhage in gravid ewes. Twenty-four experiments were performed in twelve chronically instrumented animals between 0.8 and 0.9 of timed gestation. The experimental sequence included: 1) T = 0 min: normal saline 500 ml intravenously; 2) T = 15 min: epidural administration of 0.5% bupivacaine (epidural group) or normal saline (control group); 3) T = 30 min: epidural administration of additional 0.5% bupivacaine (epidural group only) if the sensory level of anesthesia was below T10; 4) T = 45 min: maternal hemorrhage 20 ml/kg over 55 min; and 5) T = 110 min: transfusion of collected maternal blood over 55 min. At 45 min (i.e., 30 min after the epidural injection of bupivacaine), epidural bupivacaine resulted in a median sensory level of T9 in the epidural group. At that time, maternal mean arterial pressure was less (P less than 0.05) in the epidural group than in the control group (14 +/- 2% below baseline versus 4 +/- 1% above baseline, respectively). Maternal mean arterial pressure, heart rate, cardiac output, and uterine blood flow, and fetal PO2 and pH all were significantly less during hemorrhage (P less than 0.05) in the epidural group than in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Epidural↗

PubMed1992

Normal uptake in a gravid uterus on Tc-99m DTPA imaging.

A 17-year-old female kidney transplant patient was admitted to the hospital with a fever and right lower quadrant pain. Although she was 14 weeks' pregnant, renal DTPA imaging was performed because graft rejection was suspected. The study revealed fetal uptake of DTPA medial to the transplanted kidney. This has not been previously reported. Uptake in a normal uterus has been described using Tc-99m pertechnetate, Tc-99m glucoheptonate, and Tc-99m MDP. It is essential to recognize uptake in the gravid uterus and to differentiate it from uptake secondary to a pathologic entity.

Adolescent↗

PubMed1989

Incarceration of the retroverted gravid uterus: report of four patients managed with uterine reduction.

Incarceration of the retroverted gravid uterus may have an adverse effect on pregnancy. To evaluate these effects, we reviewed obstetric records to identify parturients with the diagnosis of incarceration of the retroverted uterus during the years 1977 to 1987. Four such patients were identified by this retrospective review, for a calculated incidence in our primary population (patients not referred for evaluation who also received prenatal care at only one hospital) of one case per 10,384 live births. The incarceration was successfully reduced in all four patients without surgical intervention, and all had a normal infant of appropriate weight at term.

Diagnosis, Differential↗

PubMed1999

Administration of 9-[2-(R)-(phosphonomethoxy)propyl]adenine (PMPA) to gravid and infant rhesus macaques (Macaca mulatta): safety and efficacy studies.

9-[2-(R)-(phosphonomethoxy)propyl]adenine (PMPA) significantly inhibits viral reverse transcription and has been reported to sustain low virus load in SIV-infected rhesus monkeys. Based on these findings, studies were conducted to assess the safety, efficacy, and placental transfer of PMPA when administered once daily subcutaneously to gravid rhesus monkeys during the second and third trimesters and their offspring (30 mg/kg/day). Fetuses (SIV-infected, N = 6; noninfected, N = 6) were monitored sonographically, and maternal/fetal blood samples were collected at select time points for hematologic, clinical chemical, virologic, immunologic, and pharmacologic assessments. Newborns were delivered by cesarean section at term and nursery reared for postnatal studies. Infants were administered PMPA once daily beginning on day 2 of life until 9 months postnatal age. Results of these studies have shown significant placental transport of PMPA, with peak fetal levels at 1 to 3 hours post-maternal administration; a significant and sustained reduction in viral load in SIV-infected fetuses and infants; and marked improvements in outcome (e.g., survival, growth, health) in SIV-infected offspring. However, decreased infant body weights and alterations of select serum biochemical parameters (e.g., decreased phosphorus levels, elevated alkaline phosphatase) have been shown to occur in approximately 67% of PMPA-treated infants, with severe growth restriction and bone-related toxicity in approximately 25% of animals studied. These data suggest that although PMPA holds great promise for HIV-infected patients, there is the potential for bone-related toxicity at chronic, high dosages, particularly in infants.

Adenine↗

PubMed2005

Preterm torsion of a gravid uterus didelphys horn of a twin pregnancy.

BACKGROUND: Simultaneous pregnancy in each horn of a uterus didelphys is a rare and complex clinical situation. CASE: Torsion of one horn of a gravid didelphic uterus during a twin pregnancy was diagnosed during cesarean delivery after erroneous diagnosis of abruptio placentae. CONCLUSION: Localization of the placenta in a pregnancy complicated by uterine didelphys may improve the ability to diagnose hemiuterus torsion.

Abdominal Pain↗

PubMed1990

Anaesthesia in a gravid achondroplastic dwarf.

A patient with achondroplasia presented for elective Caesarean section under epidural anaesthesia. A block from C5 to S4 developed over 20 minutes after 12 ml plain bupivacaine 0.5%. This case serves to highlight the difficulties of regional anaesthesia in the gravid achondroplastic dwarf.

Achondroplasia↗

PubMed2005

Distribution of eosinophils and mast cells in the cervical tissue of non-gravid mares during dioestrus.

Little is known about the local cellular immune system of the equine cervix. In this study we characterize the distribution of eosinophilic granulocytes and mast cells in the cervical tissue of non-gravid mares during dioestrus. For this purpose cervices of 10 mares were histologically examined after Sirius red and Toluidine blue staining. Both cell types could be found in the lamina propria mucosae. In the tunica muscularis the two cell populations were only rarely detected. No cells could be found in the epithelium mucosae. There was a decreasing cell density from the vaginal to uterine side of the cervix (p < 0.01). Therefore, eosinophils might be a part of the local cellular immune system of the equine cervix during dioestrus, unlike in animals studied so far as cows and rats.

Animals↗

PubMed1993

Incarcerated gravid uterus mimicking placenta praevia.

Persistent retroversion of a gravid uterus (incarceration) is an uncommon occurrence which may lead to increased foetal mortality and maternal morbidity. This report documents the ultrasound findings in a case presenting in the third trimester.

Adult↗

PubMed1996

Case report: torsion of a gravid horn of a didelphic uterus.

Acute abdominal pain during pregnancy presents a dilemma as signs and symptoms are often modified. Abdominal massage by traditional birth attendants (TBAs') during early labour is a common practice in the rural population, as it is perceived to give a soothening effect to the labouring mother. Many instances of abruptio placentae were reported in the past by this procedure, and in this case, the clinical picture presented as an abruptio placenta. Malpresentation and failure to progress were the indications for caesarean section despite the fetal demise. Severe post partum haemorrhage and failure to contract despite massive oxytocics resulted in the hysterectomy of the gravid horn, leaving the other horn intact.

Abdominal Pain↗