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PubMed1979

Prolactin levels during labor.

To test the hypothesis that prolactin (PRL) plays a role in the hormonal events of labor, serum PRL levels in 15 normal secundigravidas were measured on 2 occasions 10-15 days before delivery, at the onset of labor, at cervical dilatation of 5 and 10 cm, at the time of delivery, and on the first, second, and fifth days postpartum. The mean level of PRL was 163 ng/ml +/- 26 ng/ml at the onset of cervical dilatation; it typically decreased with the progress of labor, reaching a value of 140 ng/ml +/- 21 ng/ml at the time of delivery. The differences during the various stages of labor, however, were not found to be statistically significant. Postpartum values were significantly lower (P less than 0.01) on the fifth day after parturition. It is therefore unlikely that PRL is involved in or influenced by the hormonal interplay that occurs during labor.

Delivery, Obstetric↗
PubMed1979

Regulation of bovine labor with a long-acting carba-analog of oxytocin: a preliminary report.

The long-acting oxytocin (OT) analog 1-desamino-1-monocarba-E12-Tyr(OMe)]-OT(dCOMOT) was given IV to 13 pregnant cows near to term, but not in actual labor. The animals were para 1 to 5. Of these cows, four were treated with 20 mg of dexamethoasone 48 hours before the peptide was injected; the remaining nine animals were given no other medication. The animals usually were given a single injection of 5 mg of dCOMOT into the jugular veiw (5 to 7 micrograms/kg of body weight). In those instances where delivery was not complete within six hours, a second injection of peptide was given. In all instances, the first injection initiated labor as judged by the behavior of both uterus and cow. In most instances, there was also intermittent spurting of colostrum from the udder over a six-hour period after injection. In the four cows treated first with dexamethasone, the mean duration of induced labor was 4.35 hours after dCOMOT injection. In the nine non-treated cows, the mean duration of induced labor was 14.25 hours. The difference between the two values was significant. For both groups separately, and all data together, there was a linear inverse relation between the size of the external ostium uteri at injection and the duration of labor after peptide injection. All calves were healthy with no signs of hypoxia and the dose rates used did not result in any instance of uterine tetany or tachyphylaxis.

Animals↗
PubMed1979

Influence of preinduction prostaglandin E2 vaginal gel on cervical ripening and labor.

A sterile gel containing prostaglandin (PG) E2 (2 mg PGE2 10 ml gel) was instilled vaginally in 65 primigravidas with unripe cervixes to accelerate ripening before planned surgical induction of labor. The patients treated with the gel were compared with 30 similar untreated controls. In the PGE2-treated group a significant improvement on cervical score was achieved before labor began, and 47% began to labor "spontaneously" without further treatment. Both the duration of subsequent labor and the incidence of cesarean section were significantly lower in the PGE2-treated group. There were no unwanted fetal or maternal effects. Pretreatment with intravaginal PGE2 gel reduces the risk of failed induction and provides the mother with an experience similar to spontaneous labor without harming the fetus.

Adult↗
PubMed1980

The treatment of threatened premature labor by drugs.

CLINICAL STUDIES: There are many reports describing the extent of uterine excitement in vitro and clinical conditions of uterine contractions at the time of threatened premature labor. Changes in blood levels of c-AMP, Ca and PG appear to be the most useful parameters for uterine contraction and relaxation. 1) The blood level of c-AMP during threatened premature labor increased when any of the uterine inhibitors went administered. 2) An inhibitory effect was also seen with intravenous administration of dibutyryl c-AMP, an analogue of c-APM. When the inhibitory effects against threatened premature labor by various inhibitors were classified by their inhibitory pattern, terbutaline and dibutyryl c-AMP had the a strongest and quickest effect, whereas ethanol and indomethacin were weaker and slower in promoting the onset of their activities. 3) Analysis of 263 cases of threatened premature labor treated in our department in the past 5 years demonstrated that there are 2 phases of contraction during premature labor. They are the active phase and the depressed phase. The active phase is best treated with beta 2-stimulants whereas the drug of choice for the depressed phase can be varied to suit the clinical situation.

Bucladesine↗
PubMed1984

[Hypothalamic-pituitary function in women after abortion or premature labor].

Hypothalamic function during pregnancy and hypothalamic-pituitary function during the first month after abortion or premature labor have been studied. The plasma LH-RH level in pregnant women was significantly lower between 18 and 23 weeks' gestation than that in eumenorrheic women on day 8 or 9 of the normal cycle, and thereafter decreased until term. Serum FSH showed normal response to LH-RH on day 10 after pregnancy termination between 5 and 23 weeks' gestation, but no FSH response to LH-RH was found on day 10 after premature labor at 33 weeks' gestation. Serum FSH responded normally to LH-RH on day 30 after pregnancy termination at 18 weeks' gestation, but serum FSH responded excessively to LH-RH on day 30 after premature labor at 30 weeks' gestation. The positive feedback effect of estrogen on LH release was not operative on day 30 after pregnancy termination beyond 18 weeks' gestation, though it was operative on day 30 after pregnancy termination between 6 and 11 weeks' gestation. These results indicate that the duration of pregnancy has an influence on the recovery of hypothalamic-pituitary function after pregnancy termination and that the recovery of hypothalamic-pituitary function during the first month after premature labor beyond 30 weeks' gestation is similar to that after normal labor.

Abortion, Induced↗
PubMed1984

Induction of labor with prostaglandin E2 vaginal suppositories.

A prospective randomized study of 85 parturients was undertaken comparing the safety and efficacy of a 3-mg prostaglandin E2 vaginal suppository with intravenous oxytocin for the induction of labor. All patients were required to have a Bishop's score of 5 or higher. Labor was successfully induced in 98% of the patients in both groups by their respective methods. Sixty-four percent of the patients receiving a 3-mg prostaglandin E2 suppository required no intravenous oxytocin. More specifically, 82% (23/28) of the parous patients but only 29% (5/17) of the nulliparous patients who received a single 3-mg prostaglandin E2 suppository for labor induction did not require oxytocin augmentation (P less than .005). The first and second stages of labor were not significantly different for the two groups, and there was no significant difference in the incidence of cesarean section. A 3-mg prostaglandin E2 vaginal suppository may be a useful alternative to oxytocin for the induction of labor in carefully selected patients.

Adult↗
PubMed1982

Physiologic and psychosocial assessment in labor.

The details of physiological and psychosocial assessment are available in many texts, and the techniques are relatively simple. Several assumptions underlie an excellent labor assessment: 1. that the nurse has a thorough knowledge of the physiological processes of pregnancy and labor; 2. that the nurse has a thorough knowledge of the psychosocial implications of pregnancy and labor; 3. that the nurse has the ability to set priorities and balance the focus of her assessment; 4. that the nurse has the ability to refrain from stereotyping the woman in labor; 5. that the nurse does not let her own expectations of feelings and behavior in labor mask what the patient is really experiencing; and 6. that the nurse is willing to follow up, evaluate, and reassess in order to verify her assessments and improve her assessment skills.

Adolescent↗
PubMed1981

[Pressures on the human fetus during labor - intrauterine and on the fetal head (author's transl)].

During labor, the body surface of the fetus is subjected to strong pressure exerted by uterine contractions. In 40 cases, intrauterine pressure (IUP) which acts on the fetal body in the uterine cavity and pressure between the presenting part of the fetus and birth canal (PFB) which acts on the part of the fetus engaged in the birth canal were measured to determine the difference in pressure depending on the parts of the fetal body and their changes during the progress of labor. 1) Both peak IUP and PFB values increased gradually in the first stage of labor, and they became double in the period of labor with bearing-down efforts. 2) Since the peak value of PFB was 2.2 to 3.5 times higher than that of IUP, the part of the fetus engaged in the birth canal should always be subjected to 2.2 to 3.5 times more pressure than the intrauterine part of the fetal body. 3) Manual procedures such a vacuum extraction and Krysteller's compression on the uterine fundus increased the peak value of PFB markedly. The objective measurement of the pressure which acts on the fetal head during labor can be considered to contribute to the prevention of cerebral damage and fetal hypoxia.

Female↗
PubMed1980

Levels of free fatty acids and arachidonic acid in pregnancy and labor.

Serum levels of total FA and nonesterified AA were measured during 10 normal pregnancies, subsequent labors, and postpartum periods and in cord blood. The proportion of AA present in PL, CE, and TGs was also measured. A general rise of total FA was noted as the pregnancy progressed, followed by a marked elevation in total FA during labor. By 2 days postpartum, the FA levels had dropped to their lowest values. Cord blood levels were generally much lower than any maternal levels. Mean serum free AA levels were elevated in the second trimester and again during labor, and the percentage of AA in the total FAs was uniformly lower during labor than at any time during pregnancy. The percentage of total FAs made up by AA was much higher in cord blood than in maternal blood. The esterified fatty acid fractions in cord blood were also much richer in AA than those in maternal blood. The possibility that AA circulating in the bloodstream may play a part in the propagation of labor is suggested.

Adult↗
PubMed1995

[Transition from the latent to the active enzymatic form as a model of regulation of extracellular matrix degradation in the chorioamnion during human labor].

Matrix metallo proteinases (MMP) are the physiological mediators of collagen degradation and its participation in physiopathogenesis of premature rupture of membranes has been suggested by our group. With the idea of defining if some MMP become active active in a coordinated way with labor in fetal membranes, we analyzed enzymatic activity and immunoreactive protein present in extracts of amnion and chorion. It was possible to identify the presence of MMP-9 in extracts of membranes obtained during cesarean sections, without labor, although its activity/quantity was faintly detectable. Instead, extracts of fetal membranes obtained during active labor showed large activity/quantity of this MMP. With a monoclonal antibody, it was possible to show that the active form of MMP-9 could only be found in samples with labor. MMP-9 and its messenger RNA, were localized by immunohistochemistry and in situ hybridization in amniotic epithelium, in some fibroblasts of the compact layer and in trophoblast-like cells in chorion. It is concluded that: 1. Activity and quantity of MMP-9 increase selectively associated to labor; and 2. That this enzyme is expressed by different cellular populations of fetal membranes.

Amnion↗
PubMed1994

[Comparison of the effectiveness of prostaglandin E2 gel in evening and morning induction of labor].

100 women participated in an open randomised study. 50 of them received 0.5 mg PGE2 in 2.5 ml Triacetin gel (Prepidil) intracervically in the morning (6.00 a.m.) and 50 at night (10.00 p.m.). The success rate was 74% (37 of 50) in the treatment group of the night compared with 52 (26 of 50) in the group of morning labor induction. A second dose after 8 hours was necessary in 26% (13 of 50) in the night group and in 48% (24 of 50) of the morning labor induction. Labor induction failed completely in 32% of the morning and in 12% of the night group. The induction time for contractions was 2 hours shorter after night labor induction, in primiparae the duration of first stage was 2 hours shorter but in multiparae there was no difference between the groups. There was also no difference in intrapartum and postpartum complications between the groups. In conclusion the induction of labor with intracervical PGE2 at night seems to be more effective without increasing the rate of complications.

Administration, Intravaginal↗
PubMed1995

Chiropractic care, including craniosacral therapy, during pregnancy: a static-group comparison of obstetric interventions during labor and delivery.

OBJECTIVE: To determine whether the addition of chiropractic care including craniosacral therapy to a regimen of standard obstetric pregnancy results in fewer obstetric interventions during labor and delivery. DESIGN: Retrospective, case-matched, static-group comparison. SETTING: The study group was obtained from a college faculty-based clinic and received chiropractic care in addition to their routine obstetrical care. The setting for the comparison group was unkown, but the care rendered was presumed to be primary medical obstetric care only. PATIENTS: A consecutive sample of 63 pregnant women who sought chiropractic care within the period under study. The reason for seeking care was not necessarily related to the pregnancy. The sample was primarily between 18 and 35 yr, non-Hispanic caucasian and primiparous. After selection and matching criteria, 35 patients remained in the study group. INTERVENTION: Chiropractic care and craniosacral therapy delivered during pregnancy vs. unknown care within the same county. MAIN OUTCOME MEASURES: Obstetric interventions during labor and delivery as reported by the birth attendant on the certificate of live birth. RESULTS: No statistical differences were detected in the rates of obstetric interventions used during labor or delivery between the two samples. Approximate large-sample 95% confidence intervals are provided. CONCLUSION: Because of the limitations in the design of the project, this study provides no evidence that the addition of chiropractic care and craniosacral therapy during pregnancy results in any observable benefit or detriment with regard to obstetric interventions used during labor and delivery and that chiropractic care for pregnancy-related neuromusculoskeletal disorders should not complicate labor or delivery.

Adolescent↗
PubMed1995

[Prostaglandin E2--an effective alternative for the induction of labor].

The authors aimed at studying the local application of PgE2 as a method of labor induction. 50 pregnant women divided into 3 groups were studied: I with Prostin E2 - vaginal tablets of 3 mg. Dinoprostone. II with Prepidil gel - 0.5 mg. Dinfprostone, applied intracervically and III with additional stimulation with Oxytocin - 5 E as an i.v. infusion. The criteria used were: parity, gestational age, Bishop score indications for induction. Success is considered as normal delivery by the 24th hour. Indications for PgE2 application are prematurity praeeclampsia, fetal malformations, fetal death, grave obstetrics history, RH incompatibility. It was discovered that with Prostin E2, the active phase of labor is reduced thus leading to reduction of labor. The frequency of operative deliveries also reduced and there were better fetal outcome. Two important advantages were discovered--simple application and physiologic advantages--the woman in labor is mobile and thus not traumatised. The authors stress that PgE2 application can be considered an effective method for labor induction.

Administration, Intravaginal↗
PubMed1996

[Clinical study on induction of labor with feedback pulsatile oxytocin system].

OBJECTIVE: To improve the safety and the effect on induction of labor with oxytocin. METHOD: 112 cases were selected for labor induction with feedback pulsatile oxytocin under the monitoring of uterine contraction controller (study group). 112 cases were selected with continuous intravenous infusion of oxytocin as a control (control group). The dose of oxytocin and the pulse time-point were adjusted. The effects of labor induction in the 2 groups were compared. RESULTS: The most suitable time-point was 1.5 minute after the uterine contraction. The best administration duration was 20 seconds. But the most suitable dose varied individually, generally 12-25 mU. The mean time to establish contraction in study group was significantly shorter (1.9 +/- 1.2 min) than that of the control group (115.5 +/- 72.3 min, P < 0.001). The average dose of oxytocin administered per hour was significantly less in the study group (312 +/- 64 mU) than that of the control group (735 +/- 125 mU, P < 0.001) the success rate was 100% in study group whereas only 90.2% in control group (P < 0.01). The total duration of labor in the study group was 6.9 +/- 4.7 hours in contrast to 20.4 +/- 10.9 hours in the control group (P < 0.001). The occurrences of dystocia, postpartum hemorrhage and neonatal asphyxia were lower in study group. CONCLUSION: This study proved that the administration of oxytocin with the feedback pulsatile oxytocin system is easier to establish the effective uterine contraction, and it is a more physiologic and effective regimen for induction of labor.

Adult↗
PubMedDate not supplied

[Evolution promotes a minimal effect of fetal labor stress during birth].

Controlled labor-caused fetal stress during birth can be tolerated better than generally suspected. This is the result of a pilot study among 1000 term infants in which the postpartum development of neonate weight was evaluated as a simple parameter of adaptation to extrauterine life. I. The clinical relevance of postpartum weight development was demonstrated in newborns whose mothers had been hospitalized during pregnancy e.g. because of hyperemesis, diabetes or gestosis. Postpartum these newborns showed longer lasting and more extensive weight loss. II. On the contrary moderate fetal stress during labor results in less and shorter lasting weight loss of the newborn term infants born after a labor-period of 12 hours showed a weight loss greater than 5% of their birth weight. Only half as often as newborns after a shorter period of labor. Further parameters of stress like a 1 minute APGAR score up to 6 versus 1 minute APGAR between 8 and 10 or umbilical cord ph-values below and over 7.20 revealed the same tendency. Newborns with green amniotic fluid (as a sign of stress) during birth also had a lower weight loss (up to 2% of birth weight) twice as often as newborns without green amniotic fluid. A statistically significant relation was also seen between the way of delivery as another aspect of stress and postpartum weight: on the 5th day postpartum newborns delivered by cesarean section showed a weight below birth weight three times as often as babies delivered by vaginal-operation means. The evolutionary aspect of catecholamine-peak during birth as protection against labor-induced hypoxemia and as advancing factor of adaptation to extrauterine life makes the results of this study seem plausible. This topic deserves more clinical research.

Acid-Base Equilibrium↗
PubMed1997

Eligibility criteria for labor induction with prostaglandins.

Particular conditions exist at the end of some pregnancies which cause an increase in maternal and fetal risk. A valid alternative for these pregnancies is represented by the administration of prostaglandins, in order to obtain labor induction. The goal of our study was to define the eligibility criteria and the epidemiological characteristics that correlate most with a favorable obstetrical outcome. The study was conducted on 133 informed, consenting patients subjected to labor-induced delivery with prostaglandins E2. The mode of delivery in relationship to parity demonstrated that the pluriparous patients had fewer difficulties in labor and in its induction: of the 43 pluriparous cases, none had a cesarean section for failed induction and 95.3% delivered vaginally. One hundred percent of the patients with a Bishop score of more than 4 went into labor, as opposed to 81% of the patients with a score of less than 4. Therefore, taking into consideration the cost of the method, we retain that choosing an active position is valid, respecting the eligibility criteria for the induction of labor described above.

Adult↗
PubMed1996

[Clinical study on painless labor under drugs combined with acupuncture analgesia].

To study the analgesia efficacy of drugs combined with acupuncture analgesia for painless labor, 462 normal pregnancy women were observed. During the latent phase in labor, several analgesia methods: acupuncture analgesia, analgesics, magnetotherapy and auricular acupressure, TENS combined with dihydroetorphine were used respectively. While the intrauterine pressure and the peripheral content of beta-EP were measured during labor, the experiments of SEPS were also performed on healthy adults to demonstrate the analgesia efficacy of those analgesia methods. The combination of drugs with acupuncture is an excellent method for painless labor without any complications and all the mothers and babies are safety. The effectiveness is 97.5%. The results demonstrate that the mechanism of analgesia efficacy should be regulated the incoordinate uterine action and improve the hypertonic status of uterus, but also can decrease the pain threshold and elevate the tolerance of uterine contractions during labor.

Acupressure↗
PubMed1996

[Mifepristone for induction of labor].

OBJECTIVES: To evaluate the effectiveness of mifepristone administered prior to labor induction, and to study its safety for mother and fetus. METHODS: 124 nullipara, 37-42 gestational weeks, with indications for labor induction were recruited, and randomly allocated into 2 groups. Group A (n = 62) was given mifepristone 50 mg q.12.h. for 2 days, followed by PG05 or oxytocin, while group B (n = 62) was were observed for 2 days before labor induction by PG05 or oxytocin. Blood samples were obtained for determination of mifepristone concentration and hormone levels including estradiol, progesterone, testosterone, cortisol, aldosterone and human placental prolactin at recruitment and immediately after delivery, and umbilical cord blood was collected at the same time. RESULTS: Cervical Bishop score increased significantly in the mifepristone pretreatment group when compared with the control group. 22.58% of the women underwent spontaneous delivery after mifepristone treatment and 4.84% of the controls followed suit (P < 0.01). The oxytocin dose required was significantly less in group A, but the success rate was higher (P < 0.05). Side-effects associated with mifepristone was mild. Maternal serum mifepristone peak levels ranged from 200 to 700 micrograms/L, with t1/2 of 21.7 hr. The concentration of mifepristone in umbilical blood was low and stable. The ratio of umbilical/maternal mifepristone level was 0.25 +/- 0.08. Determination of hormone profiles did not show any significant difference between the 2 groups. CONCLUSIONS: Mifepristone is an effective inductive agent for cervical ripening and initiation of labor in term pregnancy, and can improve the outcome of labor induction.

Abortifacient Agents, Nonsteroidal↗