Induced active labor: color doppler study of fetal hemodynamics

To evaluate fetal hemodynamic changes before and during active labor, either spontaneous or prostaglandin E2 [PGE2] versus prostaglandin E1 [PGE1] induced labor, 120 healthy women at 37-41+ weeks of gestation without signs of maternal medical problem and fetal distress were investigated before and during labor. Group I [60 women] had spontaneous active labor, group II [60 women] were in active labor induced by intra-vaginal PGE2 [1.5-3 mg] and group III [60 women] were in active labor by oral PGE1 [50-100 ug]. Blood flow waveforms indices [systolic/diastolic ratio [S/D ratio], resistant index [RI] and pulsatility index [PI] were assessed by pulsed color Doppler from the umbilical artery [UA] and fetal middle cerebral artery [MCA] before and during labor. The groups were compared for the waveform indices, progress of labor and perinatal outcome including birth weight, umbilical artery pH at delivery, Apgar score and neonatal intensive care unit [NICU] admission. It was found that in group I, the S/D ratio, RI and PI became significantly decreased in the UA and MCA compared with those measured before labor. In group II, there were no significant changes in the waveform indices in the UA and MCA. While, in group III, all the waveform indices in MCA and the S/D ratio in UA were significantly decreased; but the umbilical artery RI and PI were not significantly changed. The incidence of UA pH was significantly more in group II than in group III and I [25%, 10% and 5%, respectively]. No other significant adverse perinatal outcomes were observed in the three groups

Immediate post-abortion intrauterine contraceptive device insertion

To evaluate immediate post-abortion IUCD insertion, 200 women with spontaneous first trimester abortion were selected. IUCDs were inserted immediately post-abortion in 90 women, within 2-3 weeks after abortion in 30 women and after the first menses in 70 women. Blood loss was estimated during the first post-abortive 24 hours as well as the first and the second menses. All patients were followed for six months post insertion. In this study, it was found that the incidence of leukorrhea was significantly higher among post-abortion IUCD users than among non users. There was a significant reduction in the menstrual blood loss, in the incidence of menorrhagia and inter- mensrual bleeding in immediate post-abortion IUCD users in comparison to interval IUCD users. The incidence of other side effects and complications of IUCD [i.e. pain, infection, expulsion and pregnancy] in immediate post-abortion IUCD users were comparable or even lower than in the interval IUCD users. These data suggested that immediate post-abortion IUCD insertion is a safe and recommendable procedure

Vaginal versus oral bromocriptine in treating women with hyperprolactinemia

Treatment of hyperprolactinemia with oral bromocriptine had been associated with a high incidence of gastrointestinal side effects. To assess the efficacy and safety of an alternate route of treatment, 2.5 mg of bromocriptine were randomly administered vaginally to 20 investible and hyperpolactinemic women, and 5 mg [in 2 divided doses] orally to another 20 infertile and hyperpolactinemic women. The duration of treatment was two months in both groups. The differences in reduction between the groups were statistically insignificant. The incidence of gastrointestinal side effects [nausaea and vomiting] were significant less in vaginal group. The results of this study suggest that the vaginal route bromocriptine administration is a safe and effective alternative to oral route and needs smaller doses. Also, this mode of therapy may be particularly useful in treating patients with severe gastrointestinal side effects on oral bromocriptine