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Effects of intravenous isoxsuprine and ritodrine, with and without concomitant dexamethasone, on fetoplacental and pituitary hormones and cyclic adenosine monophosphate during late pregnancy.

Beta sympathomimetic drugs are used to inhibit preterm labor and glucocorticoids to accelerate fetal pulmonary maturation. A study was designed to investigate the hormonal effects of intravenous infusion of isoxsuprine 150 to 200 mcg. per minute or ritodrine 100 to 150 mcg. per minute in a series of 28 women at 28 to 40 weeks' gestation, with and without concomitant dexamethasone therapy. Serial serum samples taken before and during the six hours of infusion were assayed for cyclic adenosine-3,5-monophosphate (AMP), estradiol, estriol, progesterone, human placental lactogen (hPL), thyrotropin (TSH), follicle-stimulating hormone (FSH), and human growth hormone (gGH). Ritodrine was more potent than isoxsuprine in increasing the circulating levels of cyclic AMP. The levels of placental steroid hormones decreased slightly, as did the ratio of progesterone to estradiol. Human placental lactogen and pituitary hormones showed no consistent changes. Simultaneous administration of dexamethasone did not modify these results.

Adult

Insulin levels in amniotic fluid. Management of pregnancy in diabetes.

A correlation between high insulin levels in amniotic fluid and the appearance of diabetogenic fetal morbidity was found in radioimmunoassays of 487 samples of the fluid. The mean insulin level in metabolically normal pregnancies rose from 9 muU/ml (Week 27) to 15 muU/ml (Week 40). The insulin level in amniotic fluid of diabetic patients was elevated up to 27 times the mean. Insulin levels in the umbilical cord and urine of newborns of diabetic mothers were also elevated, to 29 and 21 times the mean, respectively. Elevation of insulin levels in amniotic fluid portends diabetogenic fetal morbidity. High and rising insulin levels at an early stage (26-28 weeks) may indicate a high risk of preterm onset of labor. Regular adjustment of metabolic compensation on the basis of amniotic fluid insulin made it possible to reduce the level in 12 of 17 pregnant diabetic women by increasing insulin dosage. The 12 women were thereby enabled to carry their pregnancies to term and to await the onset of spontaneous labor without diabetogenic fetal morbidity. Beta-stimulating agents affect glucose management and may cause elevated insulin levels in amniotic fluid.

Amniotic Fluid

Postponement of preterm birth with salbutamol.

Salbutamol was administered intravenously and orally to 58 patients who were admitted to the hospital because of premature labor. Pregnancy was postponed until at least 36 weeks' gestation in 34 of these patients. The success of this therapy was measured by a parameter of the prolongation index which was inversely related to the Bishop's score. This measurement was highest among patients in whom pregnancy was successfully prolonged.

Administration, Oral

[Value of radiographic studies on the cervix uteri and internal uterine orifice with reference to irregular pregnancies (abortus--premature labor)].

The research concerning a decrease of premature births in the context of the efforts to reduce infant mortality resources an improvement of our knowledge about the causes of preterm delivery. This publication bases on more than 1000 hysterosalpingographies in order to prove the assumed causality between cervical insufficiency, cervix dilation, and the angle between the cervix and the corpus uteri, and uterushypoplasia. The influence of these facts dependent on menstrual rhythm and related to parity, especially the habitual form, is stated by numerical data. Concerning a retrospective analysis of abortions and premature births the x-ray photography of the uterus makes important statements possible and renders a specific and substantiate prophylactic therapy during the following pregnancies feasible.

Abortion, Habitual

Effects of maternal isoxsuprine administration on preterm infants.

A retrospective study of all inborn infants at 26 to 35 weeks' gestational age delivered from August, 1976, through July, 1977, was undertaken to determine the effects on the neonate of maternal isoxsuprine therapy for premature labor. Mothers of 43 infants received ISX within 48 hours of delivery and mothers of 107 received no ISX. Hypocalcemia, hypoglycemia, evidence of ileus, hypotension, and neonatal death were all significantly more common in infants whose mothers received ISX. Hypotension and death occurred predominantly in infants of 26 to 31 weeks' gestation and in infants whose mothers developed hypotension or tachycardia during ISX infusion. The frequency of hypotension and death decreased as the time interval from the loading dose of ISX to delivery increased.

Adult

Intrapartum fetal asphyxia: clinical characteristics, diagnosis, and significance in relation to pattern of development.

The clinical and fetal heart rates and acid-base characteristics and their sequelae have been reviewed in 587 patients. The relevant clinical factors in the asphyxia group were the preterm fetus, the intrauterine growth retarded fetus, maternal toxemia, and midforceps delivery. The duration of the developing metabolic acidosis in the asphyxia group ranged from terminal to the last two hours of labor. Marked patterns of total decelerations and moderate and marked patterns of late decelerations are of predictive value in the diagnosis of intrapartum fetal asphyxia with a trend to an increased incidence in the longer duration categories, between four and two hours prior to delivery, and a significant increase in all categories during the last two hours of labor. The significance of intrapartum fetal asphyxia to the newborn infant is evident from the low Apgar scores, increased incidence of moderate and severe respiratory distress syndrome, and central nervous system complications in the asphixia group in relation to the normal group.

Acid-Base Equilibrium

Incidence of preterm delivery in patients with previous preterm delivery and/or abortion.

Patients with a history of two or more pregnancies which ended spontaneously before 37 weeks' gestation had an increased risk of spontaneous labour and delivery in subsequent pregnancies. This risk was correlated with previous second trimester abortion and spontaneous preterm delivery but not with previous first trimester abortions. Patients with one or more pregnancies ending in spontaneous second trimester abortion or with preterm labour and delivery had a 38--43% risk of again delivering before term.

Abortion, Spontaneous

[300 breech delivery in continuity (author's transl)].

In this study of 300 breech deliveries in continuity, the authors after a review of the principal attitudes and of the results of other publications; bring their attitude and their results, by a more detailed analysis of cases and specially the small for date--the preterm deliveries and the breech associated with multiple pregnancy, because these associated risks are the most important. Systematic casarian section must not be systematic on term breechs if obstetrical explorations are normal--in these cases 60 0/0 of trials labor perform well with a minimal morbidity and with mortality no account. In the other hand, in cases where risk increase cesarian section is the best solution.

Breech Presentation

Utero-placental calcium and magnesium ion channels: A systematic review of obstetric implications of their alterations.

Despite the established roles of calcium (Ca2+) and magnesium (Mg2+) in placental function and uterine contractility, limited information exists on how dysregulation of major ion channels contributes to poor pregnancy outcomes. We synthesized data on the consequences of Ca2+ and Mg2+ channelopathies in uterine and placental functions. Using PubMed, Wiley Online, AJOL, and Web of Science databases for article search, a systematic review of forty-nine papers published between 2000 and March 2026 was carried out and reported in accordance with the PRISMA 2020 guideline. Based on the PICO framework, eligible studies involving human, animal, and in vitro designs were chosen and subjected to narrative analysis. L-type and T-type voltage-gated Ca2+ channels, together with transient receptor potential channels, emerged as principal mediators of placental Ca2+ transport and myometrial contractility. Mechanosensitive Piezo1 channels mediate stretch-activated Ca2+ influx, while store-operated Ca2+ entry pathways involving STIM1-Orai1 sustain intracellular Ca2+ homeostasis. Potassium-Ca2+ coupling channels modulated membrane hyperpolarization and anti-labor effects, and intracellular regulators such as PMCA and RYR1 fine-tuned Ca2+ homeostasis. The Mg2+ transporters are essential for preserving Mg2+ homeostasis and regulating Ca2+-dependent excitability. Dysregulation of these ion channel systems was consistently linked to abnormal uterine contractility, preterm birth, preeclampsia, fetal growth restriction, and adverse pregnancy outcomes. Both Ca2+ and Mg2+ ion channelopathies represent both a potential therapeutic target and a mechanistic factor underlying key obstetric complications.

Female

Persistent pulmonary hypertension and abnormal prostaglandin E levels in preterm infants after maternal treatment with naproxen.

Twins and a singleton were born at 30 weeks' gestation although naproxen (d-2 (6'methoxy-2-naphthyl) propionic acid) had been given to the mothers in an attempt to delay parturition. Inhibition of prostaglandin synthesis was shown by very low plasma concentrations of prostaglandin E and the ductus arteriosus remained closed despite signs of pulmonary hypertension with severe hypoxaemia. Abnormalities in blood clotting, renal function, and bilirubin metabolism were also found and one infant died. Further studies of the benefits and risks of the inhibition of prostaglandin synthesis are required before this treatment of preterm labour is accepted.

Adult