The effect of estrogen priming on induction of labor with prostaglandins.

A double-blind, randomized study was designed to determine whether estrogen "priming" of the unripe cervix followed by prostaglandin induction of labor would have a synergistic effect on cervical ripening and improve the success rate of induction. One hundred near-term patients with Bishop scores less than or equal to 4 received an intramuscular injection of either 10 mg of estradiol valerate or a placebo 48 hours prior to induction of labor with oral prostaglandin E2. The serial changes in Bishop scores were very similar in both groups. The success rate of induction in the study group (69.8%) was not statistically different from that in the control group (61.9%). The duration of labor was 9.9 +/- 4.1 hours in the study group versus 9.1 +/- 3.7 hours in the control group (not significant). This study showed that 10 mg of estradiol valerate had no detectable effect on the unripe cervix near term and did not show a synergistic effect with prostaglandins during induction of labor.

Cardiovascular changes associated with fetal breathing.

Studies were carried out on seven fetal lambs, 3 to 1 weeks prior to the expected date of delivery to determine if, during fetal breathing, cardiovascular events were similar to those described as occurring with respiration after birth. The following changes were observed; (1) a slight decrease in pressures with the initiation of the rapid inspiratory movements followed by: (2) a marked elevation of the systolic and diastolic pressures; (3) a cyclic variation characterized by a fall in arterial pressure with inspiration; (4) a variable acceleration of the heart rate; and finally, (5) a typical respiratory arrhythmia. These findings demonstrated that, during fetal respiratory movements, there are some cardiovascular changes which are specific to this period of life. There are other changes which are identical to what has been observed after birth. These latter cardiovascular changes imply that the endotracheal pressure variations are the reflection of authentic inspiratory movements under the influence of the central nervous system.