The treatment of threatened premature labor by betamimetic drugs: a comparison of fenoterol and ritodrine.

Studies have shown that, in patients with threatened premature labor, fenoterol and ritodrine are effective agents for delaying its onset. However, the side-effects of these drugs can be a problem. Among 133 patients studied, the intravenous administration of either agent caused marked tachycardia (but no changes in blood pressure) and a high incidence of palpitations, trembling, and nausea. During oral therapy, subjective symptoms were less frequent. The addition of the calcium antagonist, iproveratril, to the therapeutic regimen did not influence the effectiveness of the 2 agents or the incidence of their adverse side-effects.

Relationship between amylase concentration, L/S ratio and lecithin concentrations in amniotic fluid.

Amylase concentration, L/S ratio and lecithin concentration were measured in 110 samples of amniotic fluid in 106 uneventful pregnancies. Amylase concentrations lower than 200 U/l corresponded significantly (p less than 0.001) to a gestational age less than the 37th week as well as to a L/S ratio lower than 2 and to lecithin concentrations lower than 3.5 mg%. Furthermore, amylase values higher than 300 U/l corresponded significantly (p less than 0.001) to a gestational age over the 37th week as to an L/S ratio over 2 and to lecithin concentrations over 3.5 mg%. On the other hand amylase concentrations ranging between 200 and 300 U/l failed to show any significant relationship neither to the age of gestation nor to the concentration of phospholipids. These findings show that the amylase test is a useful method for prediction of fetal maturity. Since the procedure of determination of the amylase concentration is very simple, cheap and rapid, the test can be used as screening method. However, when amylase concentrations are found to range between 200 and 300 U/l specific tests for assessment of fetal maturity have to be applied.

[Determination of gestational age by sonar (author's transl)]. / Die Ultraschalldiagnostische Bestimmung des Gestationsalters

For some time it has been recognized that abnormal intrauterine development can lead to dissociation between maturity and external size and/or weight of the fetus. The results of pathophysiological and biochemical studies of fetal growth and nutrition have resulted in attempts to monitor and time every pregnancy at risk. The most recent information in the area of intrauterine development has shown that also organic and functional maturity of fetal organ systems can develop dissociated from gestational age. This observation points out the necessity for additional measures in order to achieve the goals of Planed obstetrics. The possibilities of ultrasound biometry for determining gestational age were presented. Taking normal and abnormal fetal growth and behavior into consideration, the use of ultrasonic diagnostic methods makes it possible to acquire concrete data regarding the size and maturity of some fetal organ systems. The methodological problems such as arise in clinical practice were explained and discussed in light of the most recent developments in equipment.

Lack of effect of methyl-ergonovine on postpartum lactation.

There is little information about the action of ergot derivatives other than bromocriptine (CB 154) on plasma prolactin and milk secretion in human beings. In a recent report it has been suggested that ergonovine might interfere with lactation when administered post partum. The present study shows that methyl-ergonovine (Methergine), a closely related compound, has no action on prolactin or milk secretion as measured in a group of 10 breast feeding mothers in comparison with another 10 untreated puerperas.

[Effect of methergine, oxytocin, pyridoxine (vitamin B 6) and quinestrol on prolactin and milk secretion in puerperium]. / Wirkung von Methergin, Oxytocin, Pyridoxin (Vitamin B6) und Quinestrol auf die Prolakin- und Milchesekretion im Puerperium

PIP: Plasma prolactin levels and milk volume were studied in 50 maternity patients for 8 days after delivery. 1 group of patients received no medication, while other groups received methergine (.2 mg 3 times daily), syntocinon (200 u 3 times daily), Vitamin-B6 (300 mg twice daily), or quinestrol (4 mg, single dose), respectively. None of these influenced prolactin secretion substantially although prolactin levels were slightly higher in the quinestrol-treated group. There was no evidence of an antilactation effect of Vitamin-B6, while the lactation-inhibiting effect of Quinestrol must be ascribed to a periperal effect.^ieng