Fetal heart rate pattern before, during and after amniotomy.

This prospective study concerned the immediate possible effects of low amniotomy on the fetal heart rate pattern of 32 normal term subjects. Artificial membrane rupture was performed early in labour in 16 gravidas and to induce labor in the others. In only 1 fetus was no specific alteration of the heart rate pattern recorded. The type and incidence of fetal heart rate pattern alterations observed during and within 1 h after low amniotomy were comparable in laboring and induced gravidas. The most frequently observed patterns were short-lived FHR acceleration and increased band-width. Short-lived bradycardia was recorded in only 4 patients after amniotomy. The majority of the alterations observed were not indicative of fetal distress as a direct result of artificial membrane rupture.

The effect of locally administered estrogens on the human cervix.

A randomized study to evaluate the effect of natural estrogens on the unripe uterine term cervix was conducted. One hundred and five term gravidas were studied, of whom 70 were treated with 180 mg 17 beta-estradiol or 250 mg estriol (treated women) and 35 were treated with gel only (control group). In all subjects the distented Foley catheter used for the instillation was left in situ. Twelve hours after the instillation there was no apparent difference in mean cervical progress between treated women and controls and the rather unexpected degree of cervical ripening is atributed to the intra-uterine balloon catheter. The procedure could not be shown to have any untoward effect on the mother or the fetus.

Pre-induction ripening of the cervix with extra-amniotic prostaglandin E2 in gel.

Pre-induction ripening of the unfavorable cervix was attempted in 104 normal term gravidas by means of a single extra-amniotic instillation of a viscous gel containing 0.5 mg prostaglandin E2. The procedure was highly successful and no adverse effect on mother or fetus was observed.