RESUMO
Background: Prematurity and its prevention continue to be a major challenge for both the obstetrician and neonatologist. Preterm labour is the most common obstetrical complication associated with perinatal deaths. Despite all advances in neonatology, the delivery of a preterm neonate is a clinical crisis that threatens the life and health of an infant. The obstetrician thus faces the challenge of affecting the delivery in such a way as to optimize the status of fetus-infant at birth. It is far more preferable to prevent the intiation of preterm labour than once the cascade of events has already been established. Objective: To assess the efficacy of magnesium sulphate as a tocolytic agent in preterm labour. Material and Methods: 50 pregnant patients with gestational age 28- 37 weeks with cervical dilatation not more than 3cm and cervical effacement not more than 50 % with intact membranes with regular uterine contractions with a frequency of 2 or more per 10 minutes lasting for at least 30 seconds were put on magnesium sulphate. Results: Magnesium sulphate was successful in attaining tocolysis in majority of patients and had no adverse effects on immediate neonatal out come. Conclusion: Magnesium sulphate is effective, safe and well tolerated tocolytic agent with no adverse effects on the fetus-infant.
RESUMO
The aim of the study was to monitor the sow maternal response to a low oxitocin dose in an advanced parturition stage in eutocic and maternal-foetal dystocia. Sixty York x Landrace sows, 30 with eutocic farrowing and 30 with maternal-foetal dystocia were assigned into two different groups: 15 received 0.083 IU/kg of oxytocin after the expulsion of the fifth piglet, and 15 received no treatment at all. Blood samples from every sow in trial were taken from the ear vein at three different times: immediately after membrane rupture, after the fifth piglet was born, and at the end of the farrowing. A third generation blood gas analyzer was used. Results show that when parturition was resumed, sows with maternal-foetal dystocia had significantly greater lactate, pCO2 and ear temperature (P < 0.001), compared with the eutocic sow group. Results from physiological variables and neonatal traits monitored in this experiment show evidence that oxytocin should not be used in normal parturition without stillbirths, since oxytocin in this case had adverse effects on sow performance. Oxytocin administered at the beginning of the second half of parturition decreased 50% the number of born alive with asphyxia in eutocic and dystocic sows, and on the other hand, decreased 50% the number of intra-partum stillbirths in the dystocic group. This is the first study describing the critical blood variables in dystocic sows (pH, pCO2, pO2, glucose, lactate and HCO3), using a third generation gasometry device.
Con el propósito de evaluar las respuestas maternas a dosis baja de oxitocina en estado avanzado del parto en cerdas con eutocia y distocia materno-fetal, se seleccionaron 60 cerdas de la cruza Yorkshire x Landrace, 30 eutócicas y 30 con distocia materno-fetal. Las cerdas de cada grupo fueron divididas en subgrupos: 15 recibieron 0.083 UI/kg de oxitocina después de la expulsión del quinto lechón, las otras 15 no fueron tratadas. Se obtuvieron muestras sanguíneas en cada una de las cerdas mediante punción de vena auricular después de la rotura de la fuente, al quinto lechón y al finalizar el parto; las muestras fueron evaluadas con un analizador de gases sanguíneos. Al finalizar el parto, las cerdas que presentaron partos con distocia materno-fetal incrementaron significativamente (P < 0.001) los niveles de lactato, pCO2 y temperatura, respecto de las hembras que presentaron partos eutócicos. Los resultados de las variables fisiológicas y los indicadores neonatales evaluados en este experimento son evidencia de que la oxitocina no debe aplicarse en partos con evolución normal sin nacidos muertos, ya que posee efectos adversos sobre el desempeño de la cerda. La oxitocina en cerdas, administrada al inicio de la segunda mitad del parto, disminuyó en 50% los nacidos con asfixia en cerdas eutócicas y distócicas; asimismo, redujo en 50% el número de muertes intraparto en las hembras distócicas. Los resultados del presente experimento determinan por primera vez la evolución de los parámetros críticos sanguíneos de la cerda con partos distócicos (pH, pCO2, pO2, glucosa, lactato y HCO3) utilizando equipo de gasometría de tercera generación.