American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Jan 1981
Maternal and fetal concentrations of morphine after epidural administration during labor.
In this study of 20 healthy women in labor we attempted to determine the efficacy of epidural morphine as an obstetric analgesic. Four patients experienced some relief of pain while 16 patients reported no effect on pain. One newborn infant demonstrated possible morphine-induced respiratory depression. It was concluded that morphine is ineffective as an obstetric analgesic.
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Am. J. Obstet. Gynecol. · Aug 1980
Management of intrauterine fetal death with prostaglandin E2 vaginal suppositories.
The recent Food and Drug Administration's approval of prostaglandin E2 (PGE2) vaginal suppositories provides the clinician with a technique for the immediate management of missed abortion and intrauterine fetal death (IUFD). During a 4-year period at our institution, 78 of 80 patients with gestations ranging from 13 to 42 weeks had pregnancy successfully terminated with PGE2 suppositories with a dose schedule of 20 mg every 2 hours. The mean interval from induction to delivery of the fetus was 8.9 hours. ⋯ In gestations of less than 24 weeks the oxytocin was administered via intravenous drip at a rate of 10 U/hour. In the case of a patient with IUFD and a gestation of 24 weeks or more, oxytocin should be administered only with a constant-rate infusion pump starting at a dose schedule of 1 mU/minute with careful titration of the dose against the monitored uterine activity. The availability of the vaginal PGE2 suppositories for missed abortion and IUFD makes it important for the clinician to fully acquaint himself with the drug, its administration, effects, and side effects.
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Am. J. Obstet. Gynecol. · Mar 1980
Comparative StudyThe effect of pregnancy on the angiotensin II pressor response in the rabbit.
The pressor response to angiotensin II was measured in unanesthetized, chronically catheterized pregnant and nonpregnant rabbits. Angiotensin II was infused intravenously for 10 minutes at a dose of 50 and 124 ng/kg/min. No difference in control mean arterial blood pressure was observed between pregnant and nonpregnant rabbits. ⋯ In a separate series we observed the effect of 5 mg of phenoxybenzamine on the pressor response to angiotensin II. After phenoxybenzamine treatment the control mean arterial blood pressure was significantly greater in nonpregnant rabbits than in pregnant rabbits, but the change in pressure in response to angiotensin II in nonpregnant rabbits was not significantly different from that of pregnant rabbits. These results show (1) that pregnant rabbits have a decreased sensitivity to angiotensin II, (2) that this decreased sensitivity is not due to differences in plasma concentration of angiotensin II, and (3) that this differential sensitivity to angiotensin II can be prevented by alpha-receptor blockade.