ABSTRACT
Home uterine activity monitoring and daily perinatal nursing contact were used in patients at risk for preterm labor in a rural area using provider consultation with a perinatologist in a tertiary center. In the management of 25 subjects at high risk for preterm delivery, it was noted that the patients had decreased anxiety. They felt that the service was beneficial to them and allowed them to stay in their local area. The providers felt confident that this daily contact allowed them to manage the patients without transfer to the tertiary center. Likewise, concerning women who developed preterm labor, the physicians were confident that the diagnosis would be early enough that transport, if necessary, could be carried out safely. Finally, the physicians felt that verbal reassurance from the perinatologist and weekly written contact with the monitoring service facilitated local management of such patients, particularly as it concerned administration of tocolytic agents.
Subject(s)
Monitoring, Physiologic/methods , Obstetric Labor, Premature/prevention & control , Rural Health , Uterine Contraction/physiology , Attitude of Health Personnel , Attitude to Health , Female , Home Care Services , Humans , Iowa , Nebraska , Observer Variation , Obstetric Labor, Premature/nursing , Obstetric Labor, Premature/physiopathology , Physicians , Pregnancy , Reproducibility of ResultsABSTRACT
The possibility that beta-endorphin, an endogenous opiate, is involved in the regulation of the menstrual cycle was examined. Daily serum beta-endorphin levels, in conjunction with luteinizing hormone, progesterone, and 17 beta-estradiol were measured during 26 hormonally normal menstrual cycles. Twenty-one cycles showed a preovulatory peak and postovulatory trough of beta-endorphin, 2 cycles had a postovulatory peak, and 3 had a postovulatory peak with sustained elevation. The raw data were standardized by conversion to "Z-scores," and the composite values were computed for each of the three classes described above. Significance within these three classes was assessed using a one-way analysis of variance with an F-ratio at 95% confidence limits. The composite plot of the 26 cycles showed a statistically significant preovulatory peak occurring 2 days prior to the luteinizing hormone surge and a postovulatory trough of beta-endorphin 5 days later. These results suggest that beta-endorphins play a significant role in the neurochemical mechanisms of gonadotropin release.
