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PubMed1987

[Histologic and histochemical study of placentomes in cows after induced labor].

The placentomes were extirpated from 16 cows after parturition induced with 750 micrograms cloprostenol or 20 mg dexamethasone on the 277th day of gravidity, on an average, from 9 cows after spontaneous parturition, and from 7 cows after hysterectomy in the eighth month of gravidity. In the cows with induced calving the foetal placenta was not expelled within 12 hours after calving in 68.7% of the cases whereas in the spontaneous parturitions this proportion was only 22.2% of cases. The placentomes obtained immediately after calf expulsion, and then after four and eight hours, were subjected to histological and histochemical examination. In the terminal crypts of the placentome in cross sections obtained from cows which expelled the placenta in time after natural and induced parturitions, the number of binuclear cells of the fetal syncytium and of cells of the dam epithelium (P less than 0.001) was found to be significantly lower than in the cases of afterbirth retention (1.2 and 3.9; 6.4 and 18.5). The cells of the cow's epithelium of the expelled placentae had a higher activity of acid phosphatase and lipids and the foetal syncytium had a higher activity of non-specific esterase. Increased alkaline phosphatase activity was characteristic of the cow's epithelium in the cases of subsequent retention of afterbirth. These findings should be taken into account in efforts for developing new methods of the induction of parturition if the undesired occurrence of afterbirth retention is to be reduced.

Animals↗
PubMed1993

[Cortisol in amniotic fluid during PGE2-induced labor].

Concentrations of cortisol in amniotic fluid had been estimated during induced deliveries by prostaglandin E2 (group PG) and induced ones by oxytocin (control group OX). Cortisol concentration in amniotic fluid was much higher in group PG. The mode of action of prostaglandin on fetal lung had been analyzed. Our results prefer prostaglandin as drug of choice for induction of labour.

Amniotic Fluid↗
PubMed2000

Effects of epidural fentanyl on labor pain during the early period of the first stage of induced labor in nulliparous women.

BACKGROUND AND PURPOSE: It is generally accepted that epidural injection with local anesthetics and narcotics administered when the cervix has dilated to a diameter exceeding 4 cm can adequately control labor pain. However, many nulliparous women still suffer from labor pain for a few hours prior to the administration of epidural analgesia. This study examined the effectiveness of relief of labor pain obtained by injection of narcotics epidurally once the labor pain begins and the subject requests analgesia. METHODS: Subjects scheduled for induced labour were divided into three groups: Group A (n = 60) received 5 x 10(-4)% fentanyl (10-20 mL) administered epidurally to relieve early first-stage labor pain. Group B (n = 60) received no analgesic in the early first stage of labor. For groups A and B, when cervical dilatation exceeded 4 cm, 10 to 15 mL of 5 x 10(-2)% bupivacaine and 2 x 10(-4)% fentanyl were injected epidurally and a continuous low dosage was maintained until full dilatation of the cervix resulted. Group C (n = 198) received no analgesic during the entire labor course. RESULTS: There were no significant differences in the duration of the early period of the first stage of labor, the duration of the late period of the first stage, the duration of the second stage, the Apgar score, or the arterial blood gas of neonates among the three groups. However, group C had a significantly higher cesarean section rate (28.8%) than group A (16.7%) or group B (15%). Pain scores assessed with the Visual Analog Scale (VAS) throughout the entire labor course, were lower in group A than in group B; particularly during the early period of the first stage. The VAS scores in both groups A and B were significantly lower than those in group C during the late period of the first stage of labor. CONCLUSIONS: The results indicate that once labor pain begins and the subject requests analgesia, epidural injection with fentanyl alone can relieve labor pain during the early period of the first stage. The analgesia does not cause adverse effects to the mothers or neonates. In addition, the labor course and the method of delivery are not affected.

Adult↗
PubMed1985

Increase in cervical extensibility during labor induced after isolation of the cervix from the uterus in pregnant ewes.

Surgical transection of the cervix was done on eight ewes in late pregnancy. This procedure resulted in most of the length of the cervix being mechanically disconnected from the uterus. Labor was induced by injection of dexamethasone phosphate into a fetal hind limb during operation in four of the eight ewes. The success of the induction of labor was confirmed by observation of increased uterine activity and by measurement of the concentrations of progesterone and 17 beta-estradiol in peripheral plasma. Ewes were put to death approximately 48 hours after injection of dexamethasone and the extensibility of the isolated portion of the cervix was determined. Cervices taken from ewes in which labor had been induced were found to have softened considerably compared to control cervices taken from ewes in which the cervix had been transected without induction of labor. The results suggest that cervical softening can still occur during labor in the absence of any direct mechanical or local vascular connection between the cervix and uterus.

Animals↗
PubMed1995

Prostaglandin H synthase activity in the sheep placenta during cortisol-induced labor at 128-131 days of gestation and during spontaneous delivery at term.

This study investigated whether the prostaglandin H synthase (PGHS) enzyme activity of sheep fetal placental cotyledon can be induced by cortisol at 128-131 days of gestation (dga) as compared to gestational age matched controls, before PGHS's normal gestational increase would occur (experiment 1). This study also investigated whether active PGHS is diminished following prostanoid synthesis in the labor process (experiment 2). A PGHS activity assay was employed in which PGE2 product was measured under initial velocity conditions. Labor was induced before term by continuous infusion of 10 mg of cortisol succinate per day (day 1) followed by 15 mg per day (days 2-4, or until delivery) of cortisol succinate administered through the fetal saphenous vein. Cotyledonary tissue was collected from sheep at term (142-145 dga), as judged by the absence of labor-type myometrial electromyogram (EMG) activity, and during cortisol induction at 128-131 dga. Tissue was also collected from term laboring animals immediately after fetal delivery while the fetus was still attached to the umbilicus and before placental delivery. At 128-131 dga, cortisol had no significant effect on PGHS activity as compared to gestational age matched saline-infused controls; thus, it is unlikely that cortisol directly induces PGHS. In experiment 2, normal progression of active spontaneous labor led to a significant diminution of PGHS activity (p < 0.05) that may be partially explained, based on thin-layer chromatography (TLC) results, as a significant decrease in PGE2 (p < 0.05) production coincident with a lesser compensatory increase in PGD2 (p = 0.06) output.

Animals↗
PubMed1989

[When should peridural analgesia be started in induced labor? Result of a randomized prospective study].

Two groups of women who had labours induced were compared in a prospective randomised trial: The first group of 41 patients (group 1) in whom the epidural was started at the beginning of induction. A second group of 47 patients (group 2) in whom the epidural was only started when labour became "active" and induction had been effective. The length of labour and the obstetrical results were identically the same in both groups: at least there was no significant difference. There was no special benefit from waiting until labour started properly before injecting the epidural. This result made us look retrospectively to women whose labours had been induced and who might have benefited from the epidural being started late. The only significant difference was found apparently between primipara and multipara, and this was quite independent of the state of the cervix and the lower segment at the onset: it would appear to be better to put the epidural analgesia in once the labour has started in primiparous patients where as in multiparous ones on the other hand there seems to be a better effect if the epidural is started as soon as induction is started.

Adult↗
PubMedDate not supplied

[Effect of spasmo-analgesics on uterine activity in induced labor].

On the basis of two randomly selected, independent, clinically and statistically comparable groups of induced labours the influence of a spasmoanalgetic combination of Valium and Dolantin on uterine activity and indirectly on the progression of labour was studied. Each group consisted of nineteen primiparous women differing from one another only by having been or not having been administrated spasmoanalgetics. All the laboures were monitored by the direct method of internal cardiotocography. Uterine activity was manually calculated with planimetrically presented active pressure area (APA). The ratio between the calculated activity in kPa/sec and cervical dilatation in cms resulted in the resistance-gram. Quantitative statistical analysis has shown significantly lower total and average ten-minute uterine activity in the group to which spasmoanalgetics were administered and where there were no changes in the duration of dilatation. Assuming that the total uterine impulse is an indirect index of cervical resistance, it can be concluded that spasmoanalgetics reduce cervical resistance.

Adult↗
PubMed1975

Comparison of uterine contractions in spontaneous and oxytocin- or PGF2alpha - induced labors.

Labor contractions in 20 patients in spontaneous labor and 40 others who reveived either PGF2alpha or oxytocin for stimulation of the active phase of labor were statistically analyzed during 1 hour of labor. Measurement criteria were the frequency, intensity, and duration of contractions. Statistical analysis failed to reveal any significant difference in contractions in the three groups, suggesting that oxytocin and PGF2alpha-induced contractions and spontaneous contractions appear to be indistinguishable.

Adolescent↗
PubMedDate not supplied

A comparative study of labor induced by oral prostaglandin E2 and buccal tablets of demoxytocin.

A comparative study of the efficacy of oral prostaglandin E2 and buccal tablets of demoxytocin for induction of labor in overdue pregnancies was made in groups of randomly selected patients. Labor was successfully induced in 95.7% of the women in the prostaglandin group and 92.1% of the women in the demoxytocin group. Although the operative delivery rate was low in both groups, it was significantly higher for the demoxytocin group. A low rate of perinatal distress was recorded and there were no serious side effects in either group. The time from start of induction until delivery, as well as the time from amniotomy until delivery, were compared for primiparae and multiparae separately. No significant differences were found. The blood loss during the third stage of labor was lower in the prostaglandin group. We find oral induction of labor in overdue pregnancies effective, safe and convenient.

Administration, Oral↗
PubMed1994

[Induced labor: a risk factor of maternal-fetal contamination during delivery?].

OBJECTIVE: This prospective study was conducted to determine the prevalence of maternal-fetal contamination at delivery in order to evaluate the factors of risk, particularly whether inducing delivery could be of additional help in selecting portage in mothers and infants. METHODS: Over a period of 4 months, samples were obtained from 360 mother/infant pairs. Vaginal sample at the beginning of labour, gastric sample from the infant at birth. RESULTS: Positive samples were obtained from 58 women (16.1%) and from 40 infants (11%). Streptococcus B was largely predominant (60%). The rate of maternal and neonatal carriers was significantly higher in pairs for which labour had been induced (n = 92) than in those with spontaneous labour (n = 268). Taking into account solely the classical factors of risk (opening of the membranes > 12 h, T > or = 38 degrees C, prolonged labour, premature delivery, premature rupture of the membranes), only selected 37% of the infant carriers (1 criteria or more); when induced labour was added as a criteria of risk, 68.4% of the infant carriers were identified. Streptococcus B was the cause of 2 neonatal infections in this series. None of the classic risk factors was observed in either of these cases but labour had been induced in both. CONCLUSION: The fact that labour is induced appears to be an additional factor of risk of maternal and fetal colonization. Routine screening at 12 and 24 hours before inducing labour could lead to the discovery of a large number of maternal colonizations and would allow prophylaxic antibiotics to be prescribed during labour. This protocol should be evaluated in a randomized prospective study involving a large number of cases in order to identify the beneficial effect in terms of neonatal morbidity and mortality.

Adult↗
PubMed2000

[Risk factors for prematurity in France and comparisons between spontaneous prematurity and induced labor: results from The National Perinatal Survey 1995].

OBJECTIVE: To study risk factors of total preterm delivery, spontaneous preterm delivery and induced preterm delivery. POPULATION: Representative sample of births in 1995 in France, including 12869 single births. METHOD: Preterm deliveries included all births before 37 weeks. Risk factors were analyzed with logistic regression. Factors of spontaneous preterm delivery (after spontaneous onset of labor) and factors of induced preterm delivery (after induction or cesarean section before labor) were compared with polytomous logistic regression. RESULTS: The main risk factors of preterm delivery were history of adverse pregnancy outcome (ORa=4. 5), history of induced abortion (ORa=1.5), 35 year old or more (ORa=1.5) and inadequate antenatal care (ORa=2.1). Other factors such as age under 20 or being single were not significantly linked to preterm delivery. Risk factors differed slightly between spontaneous and induced preterm deliveries. CONCLUSION: The present risk factors do not always correspond with the well-known factors. Thus the assessment of risk factors would be necessary at regular interval. The small differences between the risk factors of spontaneous preterm delivery and induced preterm delivery may be explained by difficulties in defining those two types of preterm delivery or by difficulties in distinguishing specific causes for each of them.

Adult↗