Electromyography as an objective index for pelvic floor damage during childbirth

Seventy nulliparous women were investigated by needle electromyography of the pelvic floor muscles to establish whether childbirth causes damage to the pelvic floor muscles and its nerve supply and to establish the neurophysiological parameters to diagnose such conditions. It was found that women with long second stage of labor and heavier babies showed definite evidence of denervation in EMG. However, forceps delivery and perineal tears did not contribute to the degree of denervation. It was concluded that labor [vaginal delivery and cesarean section after trial of labor] causes partial denervation with consequent reinnervation in most women having their first baby. In six women, the damage is serve and associated with urinary and fecal incontinence

Umbilical plasma concentration of endothelin-1 in intrapartum fetal heart rate abnormalities

The umbilical and maternal plasma concentrations of endothelin-1 [ET-1] were measured in 40 pregnant women at full-term [20 with elective cesarean section as a control group and 20 with emergency cesarean section done because of severe fetal heart rate [FHR]abnormalities. The FHR pattern was assessed, measured umbilical blood gases and investigated the relationships between the umbilical vein-artery ET-1 concentration difference and these variables. The concentration of ET-1 in the umbilical vein was higher than the umbilical artery in the all 40 women. The umbilical vein-artery ET-1 concentration difference [mean +/- standard error of the mean] was significantly greater in the emergency cesarean group [4.5 +/- 2.5 pmol/L] than those delivered by elective cesarean [1.7 +/- 1.5 pmol/L]. The umbilical vein-artery concentration difference correlated negatively with the umbilical arterial oxygen pressure. The study concluded that in cases with FHR abnormalities and with fetal hypoxia, the fetoplacental concentration of ET-1 was increased