Monoamine oxidase activity in rat organs during pregnancy.

To elucidate the involvement of MAO activity in rat pregnancy, female rats exhibiting at least 3 consecutive 4-day estrous cycles were used. The day of sperm-positive smears was designated as day 0 of pregnancy. The rats were sacrificed on day 2 of diestrus (diestrus-2) and days 7, 14 and 21 of gestation. The organs were collected and weighted, and mitochondrial fractions were prepared for MAO analysis with kynuramine dihydrobromide as substrate. Specific activity (pmol/mg of protein/min) in the ovary is significantly lower in rats on diestrus-2 (792 +/- 127) (mean +/- S.D.) than on day 14 (1,038 +/- 140) and day 21 (1,580 +/- 61) of pregnancy. However, the levels of MAO activity in the uterus of rats on diestrus-2 (899 +/- 266) is higher than on day 21 (570 +/- 80) of pregnancy. The MAO activity in the placenta on day 21 (644 +/- 82) was higher than day 14 (356 +/- 88) of pregnancy. Total MAO activity per organ (nmol/min) of ovary on day 21 (27.2 +/- 5.2) is higher than on diestrus-2 (8.7 +/- 3.0) and on day 14 (14.2 +/- 3.6). Our results suggest that MAO activity in rat reproductive organs such as uterus, ovary, and placenta might fluctuate significantly near term, in correlation with steroid levels, tissue catecholamine contents and so on, in order to maintain pregnancy.

Effect of ethanol and progesterone on monoamine oxidase activity in cultured cells of human term placenta.

OBJECTIVE: The aim of this study was to evaluate the effect of ethanol and progesterone on the monoamine oxidase activity in cultured human term placental cells. STUDY DESIGN: Human placental cells were prepared from normal human term placentas by enzymatic dispersion in Dulbecco's modified Eagle medium. The viability of placental cells prepared by our method was 90%, and the yield of placental cells was 0.6 x 10(6) cells per gram of wet placental tissue. Five milliliters of Dulbecco's modified Eagle medium containing 3 x 10(5) placental cells was plated in a 25 cm2 flask and cultured for 8 days in an incubator at 37 degrees C under an atmosphere of 5% carbon dioxide and 95% oxygen with a saturated humidity. During the culture period the culture medium was replenished every 2 days. A confluent monolayer condition was achieved after 8 days in culture. The cultured placental cells were treated with different concentrations of ethanol (0, 34.6, and 69.2 mmol/L) and progesterone (0, 16, and 32 mumol/L) on day 8 of culture for 48 hours. At the end of treatment placental cells from control and treated flasks were harvested for the analysis of monoamine oxidase activity by spectrophotometry. The effects of ethanol and progesterone on cultured placental cells were statistically analyzed by one-way analysis of variance followed by Duncan's multiple comparisons procedure. RESULTS: A human placental cell culture system has been established from normal human term placentas. The monoamine oxidase activity in 8-day-cultured human term placental cells was significantly higher than that of freshly prepared placental cells. Ethanol concentrations at 34.6 and 69.2 mmol/L significantly increased and progesterone concentration at 32 mumol/L significantly decreased the monoamine oxidase activity. CONCLUSION: These results suggest that the cultured human term placental cells can be used to examine the in vitro effects of ethanol and progesterone on monoamine oxidase activity. However, the physiologic significance of progesterone's inhibitory effect and the stimulatory effect of ethanol monoamine oxidase activity in the in vivo system have yet to be further investigated.

Portable blood pressure monitoring for borderline or mild hypertension during pregnancy.

Several advantages are apparent in the use of self-monitored or automatic ambulatory blood pressure monitoring by pregnant patients who appear to have borderline or mild hypertension. Home recordings, combined with conventional office measurements, can give a more accurate picture of the patient's dynamic blood pressure. Blood pressures are often lower outside the physician's office, probably because of the patient's increased awareness and decreased anxiety in other settings. When blood pressures are normal at home, the patient may be able to avoid antihypertensive therapy, antepartum hospitalization, and intervention during her pregnancy. Monitoring at home or work also provides a more thorough screening for preeclampsia, especially with patients who have chronic hypertension or other predisposing conditions.

New concepts in the understanding of hypertensive diseases during pregnancy. An overview.

Preeclampsia is a syndrome of unknown etiology characterized by the sequential development of facial and hand edema, hypertension, and proteinuria after the 20th week of gestation. Patients with preeclampsia may progress to a seizure-like state: The patient is then said to have eclampsia. The major goal of prenatal care is detecting the early onset of preeclampsia and to activate aggressive therapy to prevent severe complications either for the mother or the fetus. There currently are no specific forms of therapy to prevent the disease.

Gossypol effects on monoamine oxidase (MAO) activity in several organs of term rats.

In order to study the effect of gossypol on the monoamine oxidase (MAO) activity in pregnant rat organs, 20 day pregnant rats were sacrificed, and MAO activity/0.02 g tissue of several organs and total MAO activity/organ, were determined. The control group (n = 5) were injected with vehicle intramuscularly on the 17th, 18th and 19th day of pregnancy, and the gossypol treated group (n = 4) were injected with gossypol acetic acid (GAA) (25 mg/kg of body weight) intramuscularly on the 17th, 18th and 19th day and were decapitated on the 20th day of pregnancy. Maternal liver, uterus, placenta, and fetal liver were collected and examined. In placenta, total MAO activity/organ was significantly (p less than 0.05) lower in the GAA treated group than that in the control group. However, in maternal liver, uterus and fetal liver, there was no significant difference in total MAO activity/organ between the two groups. There was no significant difference in MAO activity/0.02 g tissue (specific activity), weight of organ, protein weight/organ and protein/g tissue between the two groups in maternal liver, uterus, placenta and fetal liver. These results suggest that, after intramuscular injection of GAA, total MAO activity/organ in the placenta of pregnant rats might decrease significantly.

Blood pressure self-monitoring during pregnancy: practical considerations.

Portable electronic and mechanical aneroid instruments for blood pressure self-monitoring are available, inexpensive, and reasonably accurate. Instructing the patient at risk for borderline, mild hypertension or chronic hypertension during pregnancy on self-monitoring of blood pressure has advantages. Combined with conventional office measurements, many daily recordings give an accurate picture of an individual's dynamic blood pressure. Lower blood pressures commonly found outside the office are likely attributable to an increased awareness, less anxiety, and attention by the patient to nonpharmacologic factors. Such persons may well avoid antihypertensive therapy or antepartum hospitalization. This information provides a strong incentive to undertake and adhere to an appropriate plan of treatment for those patients whose hypertension is confirmed by blood pressure self-monitoring technique. We consider blood pressure self-measurement to complement other reported monitoring techniques for active patient participation at home or in the work setting. It also permits an early evaluation of blood pressure alterations to rule out preeclampsia, especially in the pregnant patient with chronic essential hypertension.

Effects of progesterone and gossypol on monoamine oxidase activity in human term placental explant.

Human placental explant was cultured, using fresh full term placenta delivered by elective cesarean section (n = 10), and monoamine oxidase (MAO) activity was measured in the tissue by the spectrophotometric method. Placentae were obtained from patients without complications in pregnancy. Chorionic villi 2 g was incubated for 3 hr under the 95% air-5% CO2 humidified condition at 37 degrees C. When progesterone was added in the media (100-500 micrograms/ml), MAO activities significantly decreased, compared with the control. The gossypol (100 micrograms/ml) treated group showed no inhibitory or stimulatory effects on MAO activities, compared with the control. However, progesterone (100-500 micrograms/ml) and gossypol (100 micrograms/ml) treated group showed the same value of MAO activities, compared with the control. Those results indicate that gossypol might block progesterone action which is inhibitory against MAO activity. The mechanism of pharmacological function of gossypol was discussed.

The protein synthesis of human full term placenta cell in monolayer culture system.

Protein synthesis of human placenta from cesarean section was analyzed by SDS gel electrophoresis using full term cell culture system. The qualitative pattern of cytoskeletal proteins before and after culture was also examined. After trypsinization, cytotrophoblasts were cultured for 20 days in the humidified incubator of 5% CO2 in 95% air. The confluency was obtained in 10 days after inoculation. The pattern of SDS-PAGE showed several protein bands including actin (43,000 Da) and desmin (55,000 Da) as major constituents of 12 and 20 day cultures. The significant differences between band appearances in samples before and after culturing were noted. The present results indicated that myosin may not be synthesized in high content, differing from previous observations. Cytoskeletal protein production seemed to be markedly enhanced in the cultured system.

Uterine norepinephrine levels are correlated with contraction force, but not with the occurrence of preeclampsia.

The aim of the present experiments was to investigate a possible correlation between the occurrence of preeclampsia and the levels of norepinephrine in human myometrial biopsies obtained from the lower uterine segment at the time of cesarean section. Norepinephrine was measured directly by the technique of muscle CATS, and indirectly by measuring the effect of their release on the K(+)-induced force development of the myometrial strip. Two distinct types of force development depending on the level of endogenous norepinephrine were observed, but they were not correlated with the development of preeclampsia. This was confirmed by the absence of correlation between uterine norepinephrine levels and the occurrence of preeclampsia. Therefore, no correlation between myometrial catecholamine content and the development of preeclampsia could be demonstrated.

Pharmacological characterization of the muscarinic receptors mediating phosphoinositide hydrolysis in rat myometrium.

Activation of rat uterine myometrial muscarinic receptors with a variety of agonists results in increased phosphatidylinositol metabolism. Activation with carbachol is concentration- and time-dependent and is most apparent by following the accumulation of inositol monophosphate although there are small but significant increases of inositol bisphosphate and inositol trisphosphate. Carbachol stimulation of phospholipid turnover is greatest in the upper third of the uterus. The carbachol-induced increase of inositol monophosphate is antagonized by atropine and by the selective M-3 muscarinic receptor antagonist 4-diphenylacetoxy-N-methylpiperidine methobromide. Pirenzepine, a selective M-1 receptor antagonist is less active, whereas gallamine and 11-2[[(diethylamino)methyl]-1-piperidinyl]acetyl]-5, 11-dihydro-6H-pyrido[2,3-b][1,4]benzodiazepine-6-one, selective M-2 receptor antagonists, are minimally effective suggesting that muscarinic M-3 receptors modulate phospholipid turnover in the rat myometrium. Displacement of tritium-quinuclidinyl benzilate binding by muscarinic antagonists also supports the presence of M-3 receptors in the uterus. Incubation with phorbol 12, 13-dibutyrate significantly reduced the accumulation of inositol monophosphate induced by carbachol implying that protein kinase C might modulate the responsiveness of the M-3 receptors in the rat uterus. Our results suggest that the intracellular concentration of calcium required for the contraction of the rat myometrium may be modulated, in part, through M-3 muscarinic receptors coupled to phospholipase C-activated turnover of phosphoinositides.

Angiotensin II stimulates phosphoinositide turnover in the rat myometrium.

Angiotensin II (AII) activates rat myometrium phospholipase C resulting in the hydrolysis of phosphoinositides. The response to AII is concentration- and time-dependent, and it is blocked by saralasin. During pregnancy there is a loss of responsiveness to AII at the site of placental implantation that appears to return during parturition.

Appropriateness of antenatal referrals to a regional perinatal center.

In an ideal system, all women should receive perinatal care adequate to their needs. For specific high-risk groups, this can only be accomplished by antenatal referral to another source of care. The appropriateness of antenatal referrals for patients at risk for premature delivery (less than or equal to 34 weeks) was studied. Records of 122 women in preterm labor and/or with premature rupture of membranes (PROM) presenting to two level I rural hospitals located 60 miles from the regional perinatal center (RPC) were reviewed. Fifty-three patients were not referred and were delivered of 59 infants within 24 hours of admission. Cervical dilatation greater than or equal to 4 cm (34 patients), vaginal bleeding (6 patients), extreme prematurity (6 patients), and advanced labor (7 patients) precluded referrals. Realistically, two of these patients should have been referred. Twenty-two of the 59 infants weighed less than or equal to 1,500 g at birth, 17 weighed 1,501-2,000 g, and 20 weighed greater than or equal to 2,000 g. Five infants died in the hospital, two during the first month and three later. Twenty-two percent had Apgar scores of less than or equal to 3 at 5 minutes. Thirty-four infants were transported to a level III neonatal intensive care unit (NICU). Fourteen of the 69 antenatal referrals required hospitalization (average 11 days), were returned to their local hospital, and delivered at term. Forty-four patients were delivered within 24 hours and 11 between 1 day and 9 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Gestational alterations in phospholipase C coupled muscarinic response.

In the pregnant rat, carbachol-induced phosphoinositol hydrolysis by myometrium at the placental attachment region progressively decreased toward term, whereas hydrolysis was relatively stable in the myometrium of the non-attachment region. Tritium-quinuclidinyl benzilate binding increased in the myometrium of non-attachment regions as pregnancy progressed. At placental attachment sites binding remained relatively stable until parturition when it increased. Apparently the myometrium associated with the placental attachment site is less sensitive to cholinergic influence during pregnancy compared with the non-attachment site when evaluated by muscarinic activation of phospholipase C or ligand binding.

The impact of subspecialties on obstetrics and gynecology.

The role of subspecialties in obstetrics and gynecology was evaluated by a mail questionnaire to department chairpersons, members of the American Gynecological and Obstetrical Society, nonuniversity directors of obstetrics and gynecology residency programs, and others. Results from the questionnaire were evaluated by conventional statistical methods. The issues identified included subspecialties and the further development of our specialty in role modeling, enhanced education for both residents and students, and the recruitment of a higher-quality resident for our specialty. Additional issues included: Were subspecialties a mistake, and have they fragmented our specialty? Some of the results include the following: (1) More than 90% of respondents agree that subspecialties have helped in the development of obstetrics and gynecology. (2) The subspecialties have enhanced our image in medical schools (88%) and in the community hospitals (77%). (3) The education of medical students (73%) and of residents (86%) has been enhanced by the development of subspecialties. (4) As predicted, the subspecialties have fragmented our specialty (69%), but patient care has not suffered. (5) Disagreement is noted between chairpersons and other respondents that a higher-quality resident is going into subspecialties, but all agreed that the improved quality of residents was due to the development of subspecialties. (6) Only 10% of respondents wished subspecialties had never been developed as contrasted to 82% of all respondents who felt they were commendable. (7) If another subspecialty area is to be identified, more respondents prefer reproductive urology than the next two areas combined.

Retrospective comparison of blood pressure course during preeclamptic and matched control pregnancies.

A decrease in systemic blood pressure by midtrimester of normal pregnancy has been observed by many investigators. To examine the timing of onset of this decline and to study early behavior of blood pressure in pregnancies complicated by preeclampsia, we reviewed the outpatient charts of all patients with preeclampsia who received prenatal care at our clinics during the past 3 years. The 30 patients who met our criteria for preeclampsia were matched for age, race, and parity with normotensive control subjects. We found that in normal pregnancies, decline in blood pressure occurred before the second trimester and blood pressure remained low throughout gestation, rising insignificantly near term. Both systolic and diastolic blood pressures were significantly higher (p less than 0.05) for patients with preeclampsia than for normal control subjects beginning in the first trimester. This difference persisted throughout pregnancy and was also present at the 6-week postpartum visit (p less than 0.025).

Spontaneous rupture of uteroovarian veins in pregnancy: two case reports.

Two cases of acute spontaneous rupture of uterine ovarian veins during the third trimester of pregnancy are reported. This condition has an obscure etiology and a relatively infrequent incidence and has been associated in the past with very high maternal and fetal mortality. The clinician is faced with both a puzzling diagnostic dilemma and a perplexing management scheme.