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PubMed1988

Does the intravenous infusion of ritodrine or magnesium sulfate alter the hemodynamic response to hemorrhage in gravid ewes?

The purpose of this study was to determine whether the intravenous infusion of ritodrine or magnesium sulfate alters the hemodynamic response to maternal hemorrhage in gravid ewes. Twenty-seven experiments were performed in 12 chronically instrumented animals at 0.8 of timed gestation. Each animal was subjected to hemorrhage (20 ml/kg over 60 minutes) during infusion of ritodrine (0.004 mg/kg/min), magnesium sulfate (4 gm/hour), or saline solution control. Infusion of magnesium sulfate increased the mean (+/- SEM) maternal serum magnesium concentration to 4.8 +/- 0.2 mg/dl before hemorrhage and 5.3 +/- 0.3 mg/dl after hemorrhage. At the end of hemorrhage maternal mean arterial pressures were 63% +/- 4%, 82% +/- 2%, and 79% +/- 6% of baseline in the magnesium sulfate, ritodrine, and control groups, respectively. The maternal mean arterial pressure response in the magnesium sulfate group differed significantly from the maternal mean arterial pressure responses in the ritodrine and control groups (p less than 0.01). Fetal pH was decreased significantly only in the magnesium sulfate group (p = 0.0001). Fetal PO2 was decreased significantly in the magnesium sulfate and ritodrine groups (p less than 0.001) but not in the control group. We conclude that magnesium sulfate but not ritodrine, worsened the maternal hypotensive response to hemorrhage in gravid ewes.

Animals↗
PubMed1990

Magnesium sulfate and promethazine do not interact to cause hypotension in gravid ewes.

The purpose of this study was to determine whether magnesium sulfate and promethazine interact to cause hypotension in gravid ewes. Fifteen experiments were performed in five chronically instrumented animals between 125 and 130 days of timed gestation (term = 145 days). In one group of experiments each animal received magnesium sulfate (4 gm intravenous bolus followed by 4 gm/hr intravenous infusion) then promethazine (50 mg intravenously). In a second group each animal received magnesium sulfate then saline solution as a control. In a third group each animal received saline solution then promethazine. Infusion of magnesium sulfate increased the mean (+/- SEM) serum magnesium concentration to 5.7 +/- 0.6 and 6.6 +/- 0.6 mg/dl in the magnesium sulfate-promethazine and magnesium sulfate-saline solution groups, respectively. Magnesium sulfate slightly decreased maternal mean arterial pressure (p less than 0.05) and increased cardiac output (p less than 0.05) in both the magnesium sulfate-promethazine and magnesium sulfate-saline solution groups. Otherwise there were no significant changes in maternal mean arterial pressure or cardiac output in any group. Promethazine increased maternal heart rate (p = 0.0001) in both the magnesium sulfate-promethazine and saline solution-promethazine groups. Magnesium sulfate increased uterine blood flow (p less than 0.01) in both the magnesium sulfate-promethazine and magnesium sulfate-saline solution groups, but promethazine blunted the increase in uterine blood flow associated with magnesium sulfate. Similarly, magnesium sulfate decreased uterine vascular resistance (p less than 0.01) in both the magnesium sulfate-promethazine and magnesium sulfate-saline solution groups, but promethazine eliminated the decrease in uterine vascular resistance associated with magnesium sulfate. Maternal and fetal arterial blood gas and acid-base values did not change in any group, except that there was a small, near-significant decrease (p = 0.06) in fetal pH 10 minutes after promethazine was given in the magnesium sulfate-promethazine group. We conclude that magnesium sulfate and promethazine did not interact to cause maternal hypotension in normovolemic gravid ewes. However, promethazine increased maternal heart rate and blunted the increase in uterine blood flow associated with magnesium sulfate.

Animals↗
PubMed1995

Decreased maternal serum hCG levels with increasing gravidity and parity.

OBJECTIVE: To investigate the preliminary observation that primigravid women have higher hCG multiples of the median (MoM) than multigravid women. METHODS: An analysis of the effect of gravidity and parity on maternal serum alpha-fetoprotein (MSAFP) and hCG was performed using data from 20,009 consecutive singleton pregnancies of 15-20 weeks' gestation in a maternal serum screening program. RESULTS: The human chorionic gonadotropin MoM for primigravid women was 0.1 MoM higher than for multigravid women. As parity or gravidity increased, maternal serum hCG decreased. The median hCG MoM for nulliparous women was 1.05, compared with 0.94 MoM for para 3 women. The decrease in hCG was similar at each gestational week from 15-20. In contrast, MSAFP and MSAFP MoM were unaffected by parity. Maternal age and race were potential contributing factors to the effect of parity. However, the decrease in hCG MoM with parity was observed within each 5-year increment of maternal age. Similarly, both black and non-black populations displayed decreases in hCG with parity, although black women had a consistently higher MoM in all matched sets. The decrease in hCG MoM with parity was also observed in 50 Down syndrome cases. Correcting patient data for parity resulted in the hCG MoM changing only 2.7% on average. The detection rate for the 50 Down syndrome cases would not have changed. CONCLUSION: The decrease in maternal serum hCG with increasing parity demonstrates that pregnancy history influences the level of maternal serum hCG. Further studies are needed to define the contributing factors, but the impact of parity on Down syndrome screening appears to be small.

Adult↗
PubMedDate not supplied

Serological reactivity to the ring-infected erythrocyte surface antigen and circumsporozoite protein in gravid and nulligravid women infected with Plasmodium falciparum.

To investigate potential mechanisms for pregnancy-associated alterations in the immune response to malaria, we tested plasma samples from Plasmodium falciparum-infected nulligravida (42), primigravida (23) and multigravida (38) Kenyan women for reactivity to the ring-infected erythrocyte surface antigen (RESA) by a modified indirect fluorescent antibody assay and to synthetic peptides derived from amino acid sequences of RESA and the circumsporozoite (CS) protein of P. falciparum by an enzyme-linked immunosorbent assay. Reactivity to RESA showed the lowest titres in primigravid women, intermediate titres in nulligravid women and the highest titres in multigravid women (loge mean antibody = 3.28, 4.64, and 5.28, respectively, P less than 0.03), but was not associated with initial parasite density or response to chloroquine treatment. No relationship in antibody reactivity to the 3 synthetic peptides of the RESA molecule was observed by gravidity (0, 1, or greater than or equal to 2), age, initial parasite density or response to treatment. Levels of antibody to the synthetic peptides of the CS protein increased with age and were higher in gravid than in nulligravid women in the 15-19 year age group. The increased malaria prevalence and parasite density and the decreased response to antimalarial treatment in pregnant women is not explained by lower levels of antibody to RESA or CS protein during pregnancy.

Adolescent↗
PubMed1978

Blood alcohol level and caloric intake in the gravid rat as a function of diurnal period, trimester, and vehicle.

Blood ethanol levels, caloric intake and weight gain were monitored over the 21-day gestational period in the gravid Sprague-Dawley rat as a function of the administration of ethanol in either a liquid diet (Ensure) or an aqueous saccharin solution. The mean daily percentage of ethanol consumed (38% vs 31%), and g/Kg of ethanol consumed (11.9 vs 9.7 g/Kg) were higher for the liquid diet group than the aqueous solution group. Ethanol consumption varied by the trimester in the Ensure but not in the saccharin solution rats. Proportional maternal weight gain, live litter size, and live litter weight did not vary as a function of the method of ethanol administration. Both groups exhibited significant diurnal periodicity in ethanol consumption, and the greatest caloric intake during the second trimester. The implications of these results for ethanol administration in gravid rats is discussed.

Alcoholism↗
PubMed1993

Pathways of pyrimidine nucleotide biosynthesis in gravid Angiostrongylus cantonensis.

The incorporation of radioactive precursors into pyrimidine nucleotides via de novo and salvage pathways was measured in gravid Angiostrongylus cantonensis by HPLC and thin-layer chromatography. 14C-labelled orotate, uridine, uracil and deoxyuridine were traced to UMP, UDP, UTP, UDP-glucose, dTMP, CMP, CDP and CTP. 3H-labelled cytidine was also incorporated into both uracil and cytosine nucleotides in a ratio of 2:1. Cytosine was a major end-product for all the precursors. Cytosine nucleotides were probably formed from UTP by the action of CTP synthetase whose activity in crude cell-free extract was 31.5 +/- 4.9 pmol min-1 (mg protein)-1. It was dependent on glutamine, ATP and GTP and was inhibited by CTP. The total amount of pyrimidine nucleotides formed from uridine was 3 times of that from uracil. The presence of uracil in the metabolism of uridine indicates that UMP is formed by uracil phosphoribosyltransferase as well as by uridine kinase. UMP is a key intermediate for cytidylate and thymidylate biosynthesis in the gravid worms.

Angiostrongylus cantonensis↗
PubMed1995

Teratogenic effects and distribution of cadmium (Cd2+) administered via osmotic minipumps to gravid CF-1 mice.

Studies to identify the mechanisms underlying the teratogenic effects of cadmium (Cd2+) have been complicated by the inherent difficulties of chronically and subchronically administering specific doses of Cd2+ to gravid animals under strictly controlled conditions. The objective of the present study was to develop a relatively simple animal model for examining the teratogenic effects of subchronic Cd2+ exposure. Cd2+ was administered to gravid CF-1 mice by subcutaneously implanted Alzet osmotic minipumps, which released fixed amounts of Cd2+ over a 14-day period between days 5 and 18 of gestation. The results showed that Cd2+ administered in this manner produced fetal anomalies and that the patterns of Cd2+ distribution and the specific developmental defects were similar to those that have been reported for other routes of Cd2+ administration. These findings indicate that osmotic minipumps may serve as useful tools in long-term studies of Cd2+ teratogenicity. They would appear to be especially useful in teratogenic evaluations where minimizing maternal stress and administering precise doses of Cd2+ are important.

Animals↗
PubMed1986

Acute urinary retention secondary to an incarcerated gravid uterus.

Acute urinary retention has many etiologies. In the pregnant patient, especially at the end of the first trimester, an incarcerated gravid uterus is a rare but possible cause. The patient discussed is a 30-year-old, gravida 4, para 2012, woman who was 14 weeks pregnant and who presented complaining of lower abdominal pain, urinary frequency, urgency, and nocturia. Based on the patient's symptoms, a diagnosis of a urinary tract infection was made, and antibiotic therapy was begun. Her symptoms failed to resolve, however, and she was referred for further evaluation, which eventually revealed an incarcerated gravid uterus. The patient was referred to an obstetrician who re-positioned her uterus without difficulty, and she subsequently had an uneventful pregnancy.

Adult↗
PubMedDate not supplied

"Silent" rupture of unscarred gravid uterus with subsequent pelvic abscess: successful laparoscopic management.

Intrapartum rupture of an unscarred uterus is rare in current times. However, it is still associated with significant maternal and fetal mortality and morbidity. Unlike rupture or dehiscence of a previous cesarean scar, which is occasionally bloodless, complete rupture of a gravid unscarred uterus frequently results in fetal jeopardy and significant maternal intraperitoneal bleeding, causes acute abdomen, and demands emergency surgical (laparotomy) intervention. Laparoscopy generally has no role in such circumstances due to the generally unstable maternal hemodynamic condition and the necessity of prompt fetal delivery with an abdominal approach. We present a rare case of intrapartum rupture of an unscarred gravid uterus with an atypical insidious clinical course. The diagnosis of complete uterine rupture was made 20 days after the patient's successful vaginal delivery, at which time a large pelvic abscess formed. The condition was successfully managed laparoscopically. Successful vaginal delivery, even with normal lochia, good uterine contraction, and stable vital signs, does not preclude the possibility of uterine rupture. For patients with unusual postpartum pelvic pain, uterine rupture should be considered as one of the possible etiologic factors, and prompt survey should be performed. Laparoscopic intervention may be valuable in such situations.

Abdominal Abscess↗
PubMed1976

Erythrocyte 2,3-diphosphoglycerate in normal and hypertensive gravid women and their newborn infants.

Red blood cell 2,3-diphosphoglycerate (2,3-DPG) levels were studied in 227 normal gravid women in all stages of pregnancy, active labor, and early post partum. An increase to peak levels was observed at 19 to 22 weeks followed by a gradual fall toward normal. During labor and early post partum, 2,3-DPG again rose significantly above levels observed at term. Serial 2,3-DPG values through the third trimester, labor, and postpartum period in 11 hypertensive mothers and 20 normal gravid control subjects and their newborn infants were studied. Maternal 2,3-DPG levels were significantly higher in the hypertensive mothers when compared to control mothers at similar gestational stages. However, no difference in 2,3-DPG levels was observed when newborn infants of hypertensive mothers were compared with those of normal control subjects.

Adolescent↗
PubMed1999

Neuropeptide Y and nitrite levels in preeclamptic and normotensive gravid women.

OBJECTIVES: Vascular tone is controlled largely by the sympathetic nervous system and is modulated by neuropeptide Y. Preeclampsia is linked to sympathetic overactivity. Nitric oxide can cause vasorelaxation of vessels or decrease sympathetic outflow by activating the baroreceptor reflex. Our purpose in this study was to compare serum levels of neuropeptide Y and nitrite levels in normotensive and preeclamptic gravid women. STUDY DESIGN: Twelve preeclamptic and 12 normotensive women matched for race, body mass index, parity, and gestational age were studied. Neuropeptide Y was measured by using a commercial radioimmunoassay. Nitric oxide was converted to nitrite by using metallic cadmium, and nitrite levels were determined spectrophotometrically by using a colorimetric assay. Data are presented as mean +/- SEM and were compared by using a t test. RESULTS: Neuropeptide Y levels were similar among preeclamptic and normotensive gravid women (33.8 +/- 3.0 and 32.2 +/- 3 pg/mL, respectively). Similarly, there were no differences in nitrite concentrations between preeclamptic and normotensive patients (11.6 +/- 0.8 vs 11.2 +/- 0.4 micromol/L, respectively). We also examined the ratios of neuropeptide Y and nitrite and found no correlation between preeclamptic and normotensive women. CONCLUSION: Peripheral levels of neuropeptide Y or nitrite do not correlate with preeclampsia. Assessment of sympathetic overactivity in preeclampsia requires an alternate model.

Adult↗
PubMed1999

Cervical wet mount as a negative predictor for gonococci- and Chlamydia trachomatis-induced cervicitis in a gravid population.

OBJECTIVE: The purpose of this study was to determine whether a wet mount preparation of endocervical secretions from obstetric patients can accurately rule out the presence of gonococci and Chlamydia trachomatis. STUDY DESIGN: Gravid patients were screened for gonococci and C trachomatis with a deoxyribonucleic acid probe and a wet mount preparation of endocervical secretions. The number of polymorphonuclear lymphocytes was counted and averaged per x400 high-power field. A count of <10 polymorphonuclear lymphocytes per high-power field was defined as predicting the absence of gonococci- and C trachomatis -induced cervicitis. A chi(2) analysis was used to compare the wet mount results to the deoxyribonucleic acid probe. RESULTS: Between January and March 1998, 341 patients were enrolled in the study. Wet mount results showed 32% (108/341) of patients had <10 polymorphonuclear lymphocytes per high-power field. The incidence of infection with gonococci and C trachomatis in this population, as determined by deoxyribonucleic acid probe, was 10 of 341 (2.9%) and 30 of 340 (8.8%), respectively. The sensitivity values for gonococci and C trachomatis were 90% and 87%, respectively. The negative predictive value of the wet mount for gonococci-induced cervicitis was 99%, and that for C trachomatis -induced cervicitis was 96%. CONCLUSION: In this population the wet mount accurately predicted the absence of gonococci- and C trachomatis -induced cervicitis. Use of this screening protocol in gravid patients has the potential to reduce the cost of screening for these 2 diseases.

Adult↗
PubMed2003

Continuous glucose monitoring for the evaluation of gravid women with type 1 diabetes mellitus.

OBJECTIVE: To compare the daily glycemic profile reflected by continuous and intermittent blood glucose monitoring in pregnant women with type 1 diabetes and to compare the treatment protocols based on the two monitoring methods. METHODS: The study sample consisted of 34 gravid patients at gestational weeks 16-32, with type 1 diabetes being treated by multiple insulin injections. Data derived from the continuous glucose monitoring system for 72 hours were compared with finger stick glucose measurements performed 6-8 times per day. During the study period, patients documented the time of food intake, insulin injections, and hypoglycemic events. Data on demographics, gravidity, parity, body mass index, hemoglobin A1c, and fructosamine levels were collected for each patient. RESULTS: An average (+/- standard deviation) of 780 +/- 54 glucose measurements was recorded for each patient with continuous glucose monitoring. The mean total time of hyperglycemia (glucose level greater than 140 mg/dL) undetected by the finger stick method was 192 +/- 28 minutes per day. Nocturnal hypoglycemic events (glucose level less than 50 mg/dL) were recorded in 26 patients; in all cases, there was an interval of 1-4 hours before clinical manifestations appeared or the event was revealed by random blood glucose examination. Based on the additional information obtained by continuous monitoring, the insulin therapeutic regimen was adjusted in 24 patients (70%). CONCLUSION: Continuous glucose monitoring can diagnose high postprandial blood glucose levels and nocturnal hypoglycemic events that are unrecognized by intermittent blood glucose monitoring and may serve as a basis for determining treatment regimens. A large, prospective study on maternal and neonatal outcome is needed to evaluate the clinical implications of this new monitoring technique.

Adult↗
PubMed2003

The direct depressant effects of desflurane and sevoflurane on spontaneous contractions of isolated gravid rat myometrium.

Our purpose was to investigate the direct depressant effects of desflurane and sevoflurane at 0.5, 1 and 2 minimum alveolar concentrations (MAC) on spontaneous contractions of isolated gravid rat myometrium. Ten gravid, albino Wistar rats, weighing 240-310 g and at 19-20 days' gestation were used. Sixty myometrial strips were obtained from 10 rats, and randomly assigned into six groups of 10. After obtaining spontaneous myometrial contractions in de Jalon solution for 45 min, 0.5, 1 or 2 MAC of desflurane or sevoflurane were continuously bubbled in the bath for 15 min and myometrial contractions evaluated during the last 10 min. Desflurane 0.5 MAC did not affect duration or amplitude of spontaneous contractions, but frequency was significantly decreased (P < 0.05). Duration, amplitude and frequency were all significantly decreased by desflurane 1 and 2 MAC (P < 0.05). Sevoflurane did not affect duration, amplitude or frequency at 0.5 MAC, but amplitude and frequency were significantly decreased at 1 MAC and all were significantly decreased at 2 MAC (P < 0.05). The frequency of contractions was decreased 21.2% with 1 MAC desflurane versus 17.1% with 1 MAC sevoflurane. The amplitude and frequency of contractions were decreased 48.2% and 48.7% with 2 MAC desflurane versus 58.9% and 49.3% with 2 MAC sevoflurane, respectively. We suggest that due to tocolytic activity, desflurane and sevoflurane can be useful in non-obstetric surgery during pregnancy.

Journal Article↗
PubMed2003

EP3-2 receptor mRNA expression is reduced and EP3-6 receptor mRNA expression is increased in gravid human myometrium.

OBJECTIVE: To assess relative expression levels of mRNA for EP3 isoforms EP3-2, EP3-3, and EP3-6 in human myometrium in various physiologic states. METHODS: Using semiquantitative reverse transcriptase-polymerase chain reaction, we analyzed myometrial samples from 46 women (ten menopausal, ten nongravid premenopausal, 19 gravidas, seven premenopausal misoprostol-treated nongravid women) for the specific expression of mRNA messages for the EP3 receptor isoforms EP3-2, EP3-3, and EP3-6. RESULTS: We found that the expression of EP3-2 was significantly lower in gravid than nongravid myometrium (P < .0001). Levels of the EP3-6 message were higher in gravid samples than in nongravid specimens (P < .02). EP3-3 mRNA was present in higher levels in menopausal samples compared with the other groups. CONCLUSIONS: The selective fluctuation of mRNA expression of the different EP3 isoforms suggests the possibility of an important regulatory role for these receptors in myometrial contractility. Additional studies are necessary to evaluate the exact mechanism of action of EP3 receptor isoforms in human myometrium.

Adult↗
PubMed1987

Shedding of gravid proglottids and destrobilation in experimental infections of foxes with Mesocestoides leptothylacus Loos-Frank, 1980 (Cestoda).

The implications of the confused taxonomy of the genus Mesocestoides and the misuse of the name M. lineatus are described. In Southwest Germany rodents are intermediate hosts and red foxes are definitive hosts of M. leptothylacus. The shedding patterns of experimentally infected foxes showed that destrobilation occurs frequently and that there are long periods during which no gravid proglottids are shed at all. Lengths of worms can be taken as a measure of a possible crowding effect only when worms with gravid segments are present, i.e. at the end of the prepatent period (11 to 13 days) or at the beginning of a shedding period.

Animals↗
PubMed2003

Inhibitory effects of desflurane and sevoflurane on contractions of isolated gravid rat myometrium under oxytocin stimulation.

BACKGROUND: We studied the inhibitory effects of desflurane and sevoflurane on oxytocin-induced contractions of isolated gravid rat myometrium. METHODS: Twenty strips were obtained from rats and these were randomly assigned into two groups. The effects of desflurane and sevoflurane were evaluated by treating strips with oxytocin alone 2x10-9 M or with oxytocin after desflurane and sevoflurane at 0.5, 1, and 2 MAC. RESULTS: Oxytocin significantly increased the amplitude and duration of contractions (P< 0.05), but it did not increase the frequency. The duration (84%, 79%), amplitude (90%, 84%) and frequency (88%, 75%) were inhibited at 2 MAC of desflurane and sevoflurane, respectively. CONCLUSION: These results suggest that the in vitro application of desflurane and sevoflurane similarly inhibit oxytocin-induced myometrial contractions of gravid rat in a dose-dependent manner.

Anesthetics, Inhalation↗
PubMedDate not supplied

Effect of polyphloretin phosphate on the response of non-gravid rat uterus to folkloric and standard oxytocics in vitro.

Polyphloretin phosphate (PPP) has been reported by previous workers to be a specific antagonist of prostaglandin (PGE(1), PGE(2) & PGF(2 alpha))-induced contractions of isolated jird colon, gerbil colon, guinea pig ileum, and rabbit jejunum. In the present study, we examined the effect of PPP on uterotonic activities of crude papaya latex (a folkloric oxytocic), PGF(2 alpha), oxytocin, acetylcholine, and 5-hydroxytryptamine (standard oxytocics) on non-gravid, oestrogen-primed (50 microg/kg) rats in vitro. The effect of PPP on the oxytocics was evaluated qualitatively by incubating the tissues in PPP (25 - 400 microg/ml) for 20 min prior to the addition of a constant concentration of each oxytocic. PPP concentration dependently inhibited the contractile response of the uterine muscles to all the oxytocics. The inhibition was reversible after washing out the drugs. Results of the present study suggest that PPP is a non-specific and reversible antagonist of the response of non-gravid rat uterine smooth muscle to oxytocics in vitro. The specificity of PPP as a prostaglandin antagonist could therefore be species/tissue dependent.

Animals↗