Changes in prostaglandin synthesis and metabolism associated with labour, and the influence of dexamethasone, RU 486 and progesterone

1995 ◽  
Vol 133 (5) ◽  
pp. 527-533 ◽  
Author(s):  
Janet E Brennand ◽  
Rosemary Leask ◽  
Rodney W Kelly ◽  
Ian A Greer ◽  
Andrew A Calder
Keyword(s):  
Caesarean Section ◽  
Steroid Hormones ◽  
Elective Caesarean Section ◽  
Maternity Hospital ◽  
Prostaglandin Synthesis ◽  
Prostaglandin E ◽  
Ru 486 ◽  
Prostaglandin Metabolism ◽  
Obstetrics And Gynaecology ◽  
Spontaneous Labour

Brennand JE, Leask R, Kelly RW, Greer IA, Calder AA. Changes in prostaglandin synthesis and metabolism associated with labour, and the influence of dexamethasone, RU486 and progesterone. Eur J Endocrinol 1995;133:527–33. ISSN 0804–4643 The objective was to compare the changes in prostaglandin synthesis and metabolism occurring within the fetal membranes that are associated with the onset of parturition and to study the effect of steroid hormones on prostaglandin metabolism. A tissue explant study was made of discs of amnion and chorion obtained from 24 pregnant women at 37–42 weeks' gestation following spontaneous labour and delivery (12 women) and elective caesarean section (12 women). Significantly more prostaglandin E2 (PGE2) and PGE2α were synthesized by amnion obtained following spontaneous labour than elective caesarean section. Arachidonic acid stimulated both PGE2 and PGE2α synthesis by amnion in both groups. Phorbol myristoyl acetate stimulated PGE2 synthesis in both groups. There was no difference between the groups in the capacity of the chorion to metabolize prostaglandins. Mifepristone (RU 486) reduced the metabolism of added PGE2 following spontaneous labour, while dexamethasone and progesterone had no effect on prostaglandin metabolism. In conclusion, the increase in concentration of PGE2 and PGE2α associated with the onset of spontaneous labour is the result of an increase in synthesis rather than a reduction in metabolism. There was no decrease in metabolism to account for the increase in prostaglandin concentrations and, with the exception of mifepristone, metabolism was not altered by the addition of steroid hormones. Janet Brennand, Department of Obstetrics and Gynaecology, Glasgow Royal Maternity Hospital, Rottenrow, Glasgow G4 ONA, UK

scholarly journals Postpartum femoral neuropathy: managing the next pregnancy

2019 ◽  
Vol 12 (12) ◽  
pp. e232967 ◽  
Author(s):  
Cathy Rowland ◽  
Daniel Kane ◽  
Maeve Eogan
Keyword(s):  
Caesarean Section ◽  
Motor Function ◽  
Lower Limb ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Primiparous Woman ◽  
Limb Weakness ◽  
Femoral Neuropathy ◽  
Lower Limb Weakness ◽  
Spontaneous Labour

A 34-year-old primiparous woman presented in spontaneous labour and had an unassisted vaginal birth of a 3.5 kg infant. Postnatally, the patient experienced lower limb weakness and was unable to mobilise unassisted. A diagnosis of postpartum femoral neuropathy was made. Full recovery of normal motor function was not achieved until 5 months postpartum. She returned in her next pregnancy, seeking advice on how to avoid this complication from reoccurring. It was decided that an elective caesarean section was an appropriate mode of delivery, which she underwent at 39 weeks without complication and without recurrence of the femoral neuropathy.

Parathyroid hormone-related protein in human term placenta and membranes

1994 ◽  
Vol 142 (2) ◽  
pp. 217-224 ◽  
Author(s):  
S J Bowden ◽  
J F Emly ◽  
S V Hughes ◽  
G Powell ◽  
A Ahmed ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Elective Caesarean Section ◽  
Molecular Forms ◽  
Molecular Heterogeneity ◽  
Related Protein ◽  
Human Term Placenta ◽  
Parathyroid Hormone Related Protein ◽  
Spontaneous Labour

Abstract Parathyroid hormone-related protein (PTHrP), the hypercalcaemia of malignacy factor, is expressed in the tissues of the human uteroplacental unit, including the placenta, amnion and chorion. We have used three region-specific immunoassays to quantitate and compare the distribution of PTHrP in tissues obtained at term following spontaneous labour and vaginal delivery or elective Caesarean section. In non-labouring women highest PTHrP(1–86) and (37–67) immunoreactivity was found in amnion covering the placenta, rather than the decidua parietalis of the uterus (reflected amnion) (median 1020 vs 451 fmol/g; 2181 vs 1444 fmol/g respectively). In labouring women, the PTHrP(1–86) concentration in reflected amnion was inversely correlated with the interval between rupture of the membranes and delivery. Tissue PTHrP(1–86) concentrations were lower in placenta than in chorion and amnion (medians 12, 109 and 664 fmol/g respectively) and, in all tissues, PTHrP(1–34) and (37–67) concentrations were significantly higher than that of PTHrP(1–86). Bioactive PTHrP(1–34) was detected in placenta, chorion and amnion using the ROS cell bioassay. The PTHrP(1–86) concentration (mean ± s.e.m.=41·4 ± 4·5 pmol/l) was high in amniotic fluid at term, although in maternal and cord plasma levels were only modestly increased. The molecular forms of PTHrP present in tissues and amniotic fluid were investigated by column chromatography which confirmed its molecular heterogeneity and suggested that processing is tissue-specific and occurs at both amino- and carboxy-terminals of the peptide. Journal of Endocrinology (1994) 142, 217–224

Possible association of schizophrenia with a disturbance in prostaglandin metabolism: a physiological hypothesis

1976 ◽  
Vol 6 (3) ◽  
pp. 359-369 ◽  
Author(s):  
W. Feldberg
Keyword(s):  
Lipid A ◽  
Prostaglandin Synthesis ◽  
Prostaglandin E ◽  
Cerebral Ventricles ◽  
Prostaglandin Metabolism ◽  
Prostaglandin Level ◽  
Inhibit Prostaglandin Synthesis ◽  
Febrile Episodes ◽  
The Brain

SynopsisSchizophrenia may be associated with increased prostaglandin synthesis in certain parts of the brain. This hypothesis is based on the following findings: (1) Catalepsy, which is the nearest equivalent in animals to human catatonia, develops in cats when prostaglandin E1 is injected into the cerebral ventricles and when during endotoxin or lipid A fever the prostaglandin E2 level in cisternal c.s.f. rises to high levels; however, when fever and prostaglandin level are brought down by non-steroid anti-pyretics which inhibit prostaglandin synthesis, catalepsy disappears as well. (2) Febrile episodes are a genuine syndrome of schizophrenia.

scholarly journals Respiratory Morbidity in Neonates at or Near-Term in Relation to Mode of Delivery - A Retrospective Observational Study

2021 ◽  
pp. 1-6
Author(s):  
Fouzia Rasool Memon ◽  
Asma Naz ◽  
Nusrat Fozia Pathan ◽  
Shahida Baloch ◽  
Ameer Ali Jamali ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Labour Induction ◽  
Respiratory Morbidity ◽  
Antenatal Corticosteroids ◽  
Respiratory Problems ◽  
Spontaneous Labour ◽  
Elective Induction ◽  
Near Term

Introduction: Antenatal corticosteroids are recommended by Royal College of Obstetrics and Gynaecology for caesarean section planned before thirty-eight plus six weeks gestation. However, these steroids are, not suggested for labour induced electively after thirty four weeks. Objective: This study’s aim is to enumerate the possibility of respiratory morbidity in neonates for various deliberated approaches of delivery between thirty-five and thirty eight weeks gestation. Methodology: This study was carried out during June 2018 and December 2020 at a tertiary obstetric unit and analysed 3796 neonates delivered between thirty-five and thirty eight weeks gestation for neonatal admission due to respiratory morbidity. Results: The risk for respiratory problems in spontaneous labour was 9.9% (16/161), 5.0% (12/238), 1.2% (5/426) and 0.64% (6/930) at thirty five, thirty six, thirty seven and thirty eight weeks of gestation respectively. For induced labour, it was 25% (4/16), 4.8% (5/104), 4.1% (13/318) and 0.82% (4/485) at thirty-five, thirty six, thirty seven and thirty eight weeks respectively. While the risk of respiratory morbidity in elective caesarean section, was 13.8% (4/29), 27.1% (13/48), 4.1% (5/122) and 2.8% (9/318) at thirty-five, thirty six, thirty seven and thirty eight weeks respectively. Overall chance of respiratory morbidity in neonates was 6% after elective caesarean section, 2.8% after labour induction and 2.2% after spontaneous labour (p< 0.0001). The number of neonates with respiratory problems born by elective C-section was only 31 out of total 132 (23.5%). Whereas this risk was 2.8% at 35-38 weeks and 5.0% at 35-37 weeks after induced labour. Conclusion: Elective delivery at 35-38 weeks is linked to respiratory morbidity in new born babies. More research is required to assess the role of prophylactic corticosteroids preceding elective induction of labour.

Respiratory adaptation in term infants following elective caesarean section

2017 ◽  
Vol 103 (5) ◽  
pp. F417-F421 ◽  
Author(s):  
Daragh Finn ◽  
Julie De Meulemeester ◽  
Lisa Dann ◽  
Ita Herlihy ◽  
Vicki Livingstone ◽  
...  
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Maternity Hospital ◽  
Neonatal Unit ◽  
Term Infants ◽  
Apgar Scores ◽  
Mean Values ◽  
End Tidal Carbon Dioxide ◽  
End Tidal

ObjectiveTo determine respiratory rate (RR), tidal volume (TV) and end-tidal carbon dioxide (EtCO2) values in full-term infants immediately after caesarean section, and to assess whether infants that develop transient tachypnoea of the newborn (TTN) follow the same physiological patterns.Design and patientsA Respironics NM3 Monitor (Philips, Netherlands) continuously measured RR, TV and EtCO2 for 7 min in infants >37 weeks’ gestation following elective caesarean section (ECS). Monitoring was repeated at 2 hours of age for 2 min. Gestation, birth weight, Apgar scores and admissions to neonatal unit were documented.SettingThe operative delivery theatre of Cork University Maternity Hospital, Ireland.ResultsThere were 95 term infants born by ECS included. Median (IQR) gestation was 39 weeks (38.2–39.1) and median (IQR) birth weight 3420 g (3155–3740). Median age at initiation of monitoring was 26.5 s (range: 20–39). Data were analysed for the first 7 min of life. Mean breaths per minute (bpm) increased over the first 7 min of life (44.31–61.62). TV and EtCO2 values were correlated and increased from 1 min until maximum mean values were recorded at 3 min after delivery (5.18 mL/kg–6.44 mL/kg, and 4.32 kPa–5.64 kPa, respectively). Infants admitted to the neonatal unit with TTN had significantly lower RRs from 2 min of age compared with infants not admitted for TTN.ConclusionsTV and EtCO2 values are correlated and increase significantly over the first few minutes following ECS. RR increases gradually from birth, and rates were lower in infants that develop TTN.

scholarly journals Evaluation of anaesthetic techniques for caesarean

2018 ◽  
Vol 6 (5) ◽  
pp. 1742
Author(s):  
Alaka Banerjee ◽  
Dhrubajyoti Sarkar ◽  
Banasree Bhadra
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Epidural Anaesthesia ◽  
Regional Anaesthesia ◽  
Caesarean Section Rate ◽  
Elective Caesarean Section ◽  
Anaesthetic Techniques ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Spinal Epidural

Background: The anaesthetic technique to be used in Caesarean section is determined according to factors such as urgency, presence of coexisting health problems, preference of patient and preference and experience of the anaesthetist and surgeon.Methods: This is a retrospective study of all the caesarean deliveries that occurred in the period between 1st Jan 2010 to 31st Dec 2017 in the department of obstetrics and Gynaecology in Silchar Medical College. The anaesthesia techniques used for caesarean sections were evaluated in this study. Anaesthesia methods were recorded as general anaesthesia (GA) and regional anaesthesia (RA), and RA was classified into spinal anaesthesia (SA), epidural anaesthesia (EA) and combined spinal epidural anaesthesia (CSEA) subgroups.Results: During the study period a total of 75685 patients delivered and 25805 patients had undergone caesarean section. The caesarean section rate at the institution comes to be around 34.1%. Among the indications, it was observed that foetal distress (32.8%) was the commonest cause followed by post caesarean pregnancy (26.76%). The majority of the CS (75.6%) were done as an emergency procedure. Regional anaesthesia was the most frequently used method both in emergency (92.87%) and elective caesarean section (84.21%). SA was the commonest used RA (89.2%).Conclusions: In recent years, the rate of regional anaesthesia administration in caesarean section is gradually increasing, and the spinal anaesthesia technique is the mostly preferred regional anaesthesia. There is need to explore the use of the other forms of regional anaesthesia also.

Venous Thromboembolic Disease in Obstetrics and Gynaecology: The Scottish Experience

1996 ◽  
Vol 41 (3) ◽  
pp. 83-86 ◽  
Author(s):  
N.S. Macklon ◽  
I.A. Greer
Keyword(s):  
Caesarean Section ◽  
Pulmonary Thromboembolism ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Age Groups ◽  
Emergency Caesarean Section ◽  
Venous Thromboembolic Disease ◽  
Thromboembolic Complications ◽  
Obstetrics And Gynaecology ◽  
Venous Thromboembolic

The incidence and pattern of thromboembolic complications in obstetric and gynaecological patients in Scotland between 1981 and 1992 was investigated by analysing ICD coded data retrieved from the SMR1 and SMR2 database. The effect of mode of delivery and maternal age over 35 on risk of thromboembolism in pregnancy was also assessed. 0.076% of gynaecological episodes were subsequently complicated by thromboembolic events. Nineteen percent of those suffering thromboembolic complications within two weeks of discharge were referred back to gynaecology. The incidence of deep venous thrombosis (DVT) in those under 35 years and over 35 years was 0.615/1000 maternities and 1.216/1000 maternities respectively. Respective figures for postnatal DVT were 0.304/1000 and O. 720/1000 and for pulmonary thromboembolism (PTE), 0.108/ 1000 and 0.405/1000. In both age groups, emergency caesarean section was associated with a higher incidence of DVT than elective caesarean section and vaginal delivery.

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