RESUMO
Nipple stimulation techniques for achieving a contraction stress test were evaluated prospectively in 1271 nipple stimulation contraction stress tests in 753 patients. Success was unrelated to parity, gestational age, or warm, moist towels but was related to the presence of spontaneous prestimulation contractions. Various stimulation techniques were equally successful in achieving a completed test in the presence of prestimulation contractions; however, continuous stimulation was more successful when contractions were absent. Hyperstimulation test results occurred in 21.5% of attempts and increased to 28.8% when bilateral, continuous stimulation was performed.
Assuntos
Mama , Mamilos , Contração Uterina , Feminino , Idade Gestacional , Humanos , Paridade , Estimulação Física/métodos , Gravidez , Estudos ProspectivosRESUMO
Fetal plasma 2,3-Diphosphoglycerate (2,3-DPG) and glucose levels were observed during infusion of arginine vasopressin into 6 chronically catheterized fetal lambs. Low dose infusion of arginine vasopressin (5-10 mIU/min.) did not change fetal arterial blood gases significantly. At a high concentration of vasopressin (20-40 mIU/min.), infusion for 60 minutes increased fetal arterial pO2 by approximately 5 mmHg (p less than 0.005 by paired t-test), and decreased pCO2 by approximately 2 mmHg (p less than 0.005 by paired t-test) without significant changes in pH. Neither low nor high dose infusion of arginine vasopressin was accompanied by significant changes in 2,3-DPG or the glucose level.
Assuntos
Arginina Vasopressina/fisiologia , Sangue Fetal/metabolismo , Oxigênio/sangue , 2,3-Difosfoglicerato , Animais , Gasometria , Glicemia/análise , Cateterismo , Ácidos Difosfoglicéricos/sangue , Feminino , Pressão Parcial , Gravidez , OvinosRESUMO
A double-blind, randomized study comparing the antepartum use of betamethasone (12 mg), methylprednisolone (125 mg), and hydrocortisone (250 mg) was performed to evaluate effect on neonatal respiratory distress syndrome and perinatal infection. Of 144 mothers and 149 infants entered, 92 mothers and 97 infants were available for analysis. The betamethasone-treated group had a significantly reduced incidence of severe respiratory distress syndrome (4%) compared with the control group (26%; p = 0.038); this effect was confined to patients who received at least two doses. No similar effect was found in the methylprednisolone or hydrocortisone groups. Neonatal infection and neonatal mortality rate were not affected by glucocorticoid use. Maternal infection was significantly increased in hydrocortisone-treated patients who were delivered vaginally compared with control patients (all patients: 50% versus 9.5%, p less than 0.05; with ruptured membranes: 63% versus 15%, p = 0.04). No similar increase in maternal infection was found with betamethasone or methylprednisolone use.
Assuntos
Infecções Bacterianas/prevenção & controle , Ruptura Prematura de Membranas Fetais/tratamento farmacológico , Glucocorticoides/administração & dosagem , Doenças do Recém-Nascido/prevenção & controle , Síndrome do Desconforto Respiratório do Recém-Nascido/prevenção & controle , Índice de Apgar , Betametasona/administração & dosagem , Betametasona/efeitos adversos , Peso ao Nascer , Feminino , Glucocorticoides/efeitos adversos , Humanos , Hidrocortisona/administração & dosagem , Hidrocortisona/efeitos adversos , Mortalidade Infantil , Recém-Nascido , Metilprednisolona/administração & dosagem , Trabalho de Parto Prematuro/prevenção & controle , Gravidez , Complicações Infecciosas na Gravidez/induzido quimicamente , RiscoRESUMO
The incidence of clinically detectable patient ductus arteriosus (PDA) in a group of preterm infants whose birth weights were less than 2,000 g was compared with that of a similar group of infants whose mothers received antenatal glucocorticoids. A PDA was diagnosed on the basis of a typical heart murmur, increased precordial activity, and bounding peripheral pulses beyond the third day of life. Whereas 14 (44%) of 32 infants who were not exposed to antenatal glucocorticoids showed evidence of a PDA, only one (6.5% of 15 infants whose mothers received antenatal glucocorticoids had similar findings. The incidence of ruptured membranes (greater than 72 hours), the number of infants who were small for gestational age, and clinical management of the infants in the two groups were similar.
