American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Dec 1990
Inhibition of spontaneous uterine contractions during the last trimester in pregnant baboons by an oxytocin antagonist.
The effect of a potent oxytocin antagonist, produced in our laboratories, on spontaneous uterine contractions in the pregnant baboon was examined. Three types of uterine contractions were studied: immediately after operation, during the nocturnal period, and near or at labor. ⋯ In contrast, uterine contractions immediately after operation were diminished by only 60% within 60 minutes after the oxytocin antagonist. These results indicate that the oxytocin antagonist is a potent inhibitor and suggest that oxytocin is a primary regulator of spontaneous nocturnal and labor uterine contractions in the pregnant baboon.
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Am. J. Obstet. Gynecol. · Nov 1990
Randomized Controlled Trial Comparative Study Clinical TrialSurgical staples in cesarean section: a randomized controlled trial.
This randomized controlled trial compares the use of the Auto Suture Poly CS 57 disposable surgical stapler (n = 98) with standard hysterectomy (n = 102) in low transverse cesarean sections. Subjective assessment of blood loss by the surgeon resulted in lower mean (+/- SEM) total blood loss estimates in the stapled group (492 +/- 24 ml) than in the nonstapled group (579 +/- 38 ml) (p = 0.05). ⋯ The risk of febrile morbidity, the frequency of endometritis, and the length of hospitalization were similar in the two groups. Our results do not support the routine use of the Auto Suture Poly CS 57 disposable surgical stapler in low transverse cesarean sections.
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Am. J. Obstet. Gynecol. · Nov 1990
Fetal eye movement assessed with real-time ultrasonography: are there rapid and slow eye movements?
The goal of this study was to determine whether rapid eye movement and slow eye movement exist during the eye-movement period in the human fetus in utero. We studied 21 fetuses with real-time ultrasonography, 10 from 33 to 36 weeks and 11 from 37 to 41 weeks' gestation. We used the duration of eye-movement unit as a parameter and calculated the cumulative duration from the shortest to a given duration of eye movement per individual case. ⋯ These findings reveal two different types of eye movement: one with a duration of less than 0.6 to 0.8 second and the other with a duration of greater than 0.6 to 0.8 second. These findings are compatible with previous criteria on rapid and slow eye movements, respectively, at 33 weeks of gestation onward. The mean value of cumulative duration at the critical point increased from 29.0% between 33 and 36 weeks to 47.1% between 37 and 41 weeks of gestation, indicating an increase in the proportionate amount of time maintaining rapid eye movement as gestation advances.
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The risk of myocardial infarction in contraceptive users is limited to women over 35 years of age who smoke. The cause of myocardial infarction in oral contraceptive users is thrombotic and not atherosclerotic. Minor lipid changes have no clinical relevance to myocardial infarction in contraceptive pill users and do not appear to increase coronary plaques.
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Am. J. Obstet. Gynecol. · Sep 1990
Acute fetal hemodynamic alterations after intrauterine transfusion for treatment of severe red blood cell alloimmunization.
One of the compensatory hemodynamic mechanisms seen in the anemic human fetus is an increased cardiac output. With Doppler techniques, cardiac output was measured in 21 fetuses before and immediately after 38 intrauterine transfusions for severe red cell alloimmunization. Umbilical venous pressures were measured before and after transfusion; amniotic fluid pressure was also quantitated. ⋯ A calculated mean increase in the fetoplacental volume of 18% in conjunction with an increase in umbilical venous pressure would indicate that cardiac preload was increased. We propose that intravascular intrauterine transfusion leads to an increased cardiac afterload, possibly by increasing blood viscosity. The fetal heart responds to the increased afterload by a decrease in stroke volume, leading to a fall in cardiac output.