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At least 379 records · Page 21Linked to original sources
PubMed1989

Prematurity among insulin-requiring diabetic gravid women.

From Jan. 1, 1983, through Dec. 31, 1987, 420 gravidas with insulin-requiring diabetes antedating pregnancy delivered on the Joslin Clinic service. Among them, 110 pregnancies (26.2% of the total) delivered before 37 completed weeks of gestation compared with a 9.7% incidence (906/9368) for the general population at the Brigham and Women's Hospital during calendar year 1985. Thirty-three percent of all premature deliveries were the result of the development of preeclampsia. The relative risk of prematurity for diabetic patients with any hypertensive complication was 2.0 (95% confidence interval, 1.40 to 2.87) compared with normotensive diabetic subjects. Compared with the general population, most of the excess risk of prematurity was confined to hypertensive diabetics and normotensive patients of more advanced White class. A history of having had a previous premature delivery, increasing duration of diabetes antedating pregnancy, and carrying a male fetus in the index pregnancy were significantly associated with premature delivery. Future efforts to reduce the incidence of prematurity among diabetic gravidas should be directed toward reducing the incidence of preeclampsia.

Diabetes Mellitus, Type 1↗
PubMed1990

Transient oligohydramnios in a severely hypovolemic gravid woman at 35 weeks' gestation, with fluid reaccumulating immediately after intravenous maternal hydration.

Oligohydramnios is known to accompany chronically hypovolemic maternal conditions, usually preeclampsia, pregnancy-induced hypertension, and intrauterine growth retardation. A case is presented in which an acute maternal hypovolemic situation with oligohydramnios was treated vigorously with intravenous fluid hydration; ultrasonography documented immediate reaccumulation of normal amniotic fluid volume.

Adult↗
PubMed1991

Effect of intravenous cocaine on uterine blood flow in the gravid baboon.

Cocaine abuse during pregnancy is associated with adverse perinatal outcome, believed to be a result of potent vasoconstrictive effects that cocaine has on the maternal cardiovascular system. The direct effect of cocaine on the pregnant, nonhuman primates' uterine vasculature in vivo has not been examined. We investigated the effects of intravenous cocaine on maternal arterial blood pressure, uterine blood flow, and uterine vascular resistance in four unanesthetized, chronically instrumented pregnant baboons. Baboons were instrumented during the latter half of pregnancy, placing an ultrasonic flow probe around one uterine artery and catheters in the maternal inferior vena cava and aorta. Bolus intravenous cocaine hydrochloride doses of 0.05 mg/kg, 0.1 mg/kg, and 0.3 mg/kg by maternal weight were infused 30 minutes apart at least 5 days after surgical instrumentation. The maternal blood pressure rose 7.3% and 12.0% after the 0.1 mg/kg and 0.3 mg/kg cocaine infusions, respectively, and the uterine blood flow fell in a dose-dependent fashion 13.1% and 22.7%. Plasma norepinephrine levels rose in response to the 0.3 mg/kg cocaine infusion. These studies show that low doses of cocaine significantly reduce uterine blood flow in the pregnant baboon in a dose-dependent manner by increasing uterine vascular resistance.

Animals↗
PubMed1993

A prospective comparison of two endogenous creatinine clearance testing methods in hospitalized hypertensive gravid women.

OBJECTIVE: Although 24-hour endogenous creatinine clearance testing is common in pregnancies complicated by hypertension, inaccuracies limit its usefulness. We controlled the conditions under which 4-hour endogenous creatinine clearance testing was performed and compared the results with outcomes of 24-hour tests from the same patients. STUDY DESIGN: In 83 women hospitalized with mild hypertension in the third trimester, we measured endogenous creatinine clearance with a 4-hour urine collection during lateral recumbency and supervised oral hydration. This test was paired with a 24-hour test performed immediately thereafter. No restrictions or recommendations regarding ambulation or oral intake were imposed for the 24-hour test. RESULTS: The 4-hour endogenous creatinine clearance value exceeded the 24-hour value in 133 of the 136 paired comparisons (p < 0.0001). Results of the tests from only the 29 patients with multiple paired tests showed more similarity (p < 0.005) among the 4-hour than among the 24-hour clearances. CONCLUSION: The 4-hour endogenous creatinine clearance test, as described, provides a higher and less variable estimate of renal function in hypertensive pregnant women than does the 24-hour test.

Creatinine↗
PubMed1990

Rupture of the gravid uterus following a road traffic accident.

A case of rupture of the uterus at 34 weeks of pregnancy due to a road traffic accident is presented. Emergency laparotomy and total abdominal hysterectomy were done with good maternal outcome. This is a rare cause of rupture of the uterus in this population.

Accidents, Traffic↗
PubMed1990

Pressor responsiveness to endothelin is not attenuated in gravid rats.

The aim of this study was to evaluate the effect of synthetic human/porcine endothelin (ET-1) on mean arterial blood pressure (MAP) in pregnant and non-pregnant rats and to compare this to the effects of two well characterized agonists, angiotensin II (AII), and vasopressin (VP). On day 14 of gestation (parturition day 22) polyethylene catheters were chronically implanted in the abdominal aorta for monitoring of MAP and in the vena cava for administration of drugs. Pressor responsiveness was measured in conscious freely moving animals on day 20 and again on the 7th day post-partum. All three agonists increased MAP in a dose related manner. However, whereas the sensitivity of pregnant rats (P) to AII and VP was significantly blunted compared to postpartal (PP) measurements, the MAP responses to ET-1 were the same in both groups. Moreover, the combined administration of ET-1 at a subpressor dose (0.05 pmol/100 g bw) and AII or VP at effective doses significantly potentiated (particularly in P) the pressor effects of AII and VP. These results demonstrate that ET-1 and possibly other vasoactive substances of endothelial origin, override the compensatory mechanism of normal pregnancy with respect to the blunted responsiveness to AII and VP. Such a mechanism may be of particular relevance in the evolution of pregnancy-induced hypertension.

Angiotensin II↗
PubMed1987

Rupture of the gravid uterus.

Seventeen cases of uterine rupture in late pregnancy managed over an eight-year period in one hospital in Hong Kong were analysed. Labour was associated with rupture in 16 cases, including ten with one or more previous caesarean section scars. Rupture occurring in an unscarred uterus was associated with high fetal losses and all required hysterectomy. All of these patients had at least one previous vaginal delivery, in contrast to the patients with a scarred uterus. Labour should be closely monitored in multiparous patients with or without a uterine scar, and oxytocics should be used carefully. Patients with previous sections who are scheduled for repeat elective sections should be delivered before 39 weeks.

Cesarean Section↗
PubMed1993

The effects of subnutrition on the components of the gravid uterus in the doe.

The effects of subnutrition on the caprine fetus and the other products of pregnancy were investigated in does. Two groups of does were fed on rations calculated to provide 100 and 25% of their energy and protein requirements for maintenance from 19 days before mating until 60 days after mating. Estrus was synchronized in does using PGF(2x). Approximately 60 days after natural mating, pregnant does were slaughtered, and the products of pregnancy were measured. Fetuses from the feed-restricted group were significantly lighter (P<0.05), had shorter crown-rump length (P<0.05), and the uterus contained a smaller volume of fetal fluids (P<0.02). Curved crown-rump length tended to be shorter and fetal placental membranes and cotyledons tended to be lighter (P<0.1) in the feed-restricted group. No significant difference was found between the 2 groups in the head length, number of placentomes, and weight of empty uterus. The number of fetuses affected the number of placentomes (P<0.001), weight of empty uterus (P<0.001), mass of total fetal fluids (P<0.001) and weight of ovaries (P<0.05), but not fetal measurements. Gestation length was found to significantly (P<0.001) affect all the fetal measurements but none of the placental measurements except for the total weight of cotyledons (p<0.001). The results of the study demonstrated detrimental effects of underfeeding on the caprine fetus and placenta.

Journal Article↗