oxytocin and Fetal-Growth-Retardation

Newborn piglets have a high incidence of preweaning mortality that is not only associated with low birth weights but also with the presence of intra-uterine growth-restricted (IUGR) piglets. Such IUGR piglets are commonly seen in litters from hyperprolific sows as a result of insufficient placental transfer of nutrients. Nutritional strategies can be used prior to and during gestation to enhance foetal development and can also be implemented in the transition period to reduce the duration of farrowing and increase colostrum yield. Recent findings showed that the energy status of sows at the onset of farrowing is crucial to diminish stillbirth rate. Newborn piglets often fail to consume enough colostrum to promote thermostability and subsequent growth, and this is particularly problematic in very large litters when there are fewer available teats than the number of suckling piglets. One injection of 75 IU of oxytocin approximately 14 h after farrowing can prolong the colostral phase, hence increasing the supply of immunoglobulins to piglets. Nevertheless, assistance must be provided to piglets after birth in order to increase their chance of survival. Various approaches can be used, such as: (1) optimising the farrowing environment, (2) supervising farrowing and assisting newborn piglets, (3) using cross-fostering techniques, (4) providing nurse sows, and 5) providing artificial milk. Although research advances have been made in developing feeding and management strategies for sows that increase performance of their newborn piglets, much work still remains to be done to ensure that maximal outcomes are achieved.

Topics: Animals; Animals, Newborn; Colostrum; Female; Fetal Growth Retardation; Immunoglobulins; Lactation; Litter Size; Milk; Oxytocin; Placenta; Pregnancy; Swine

During the past few years enormous progress has been made in the understanding of the molecular mechanisms involved in parturition; however, the answer to the fundamental question of how labor is initiated remains elusive. This is a very important question because alterations in the timing of birth (preterm and post-term deliveries) are associated with much of perinatal morbidity and mortality. Currently available treatments for preterm labor are not clearly effective. Prevention of preterm delivery by home uterine monitoring has been proposed; however, the value of this technique has not been conclusively shown. A variety of substances have been implicated in the genesis of labor, including oxytocin, prostaglandins, cytokines, and endothelin. The role of infection in preterm labor has also been extensively studied, but it seems clear that a relatively small percentage of preterm labor is caused by infection. Attention has also focused on the role of estrogen and progesterone, and the possible uses of progesterone antagonists in the induction of labor. A better understanding of the relationship of intrauterine hypoxia and preterm delivery may also help us in establishing treatment and prevention strategies.

Topics: Cardiotocography; Cytokines; Endothelins; Estrogens; Female; Fetal Growth Retardation; Fetal Hypoxia; Fibronectins; Gap Junctions; Home Care Services; Humans; Labor, Obstetric; Molecular Biology; Obstetric Labor, Premature; Oxytocin; Pregnancy; Progesterone; Prostaglandins; Uterine Contraction

Topics: Adrenergic beta-Agonists; Bed Rest; Cesarean Section; Developing Countries; Female; Fetal Growth Retardation; Fetal Organ Maturity; Humans; Hypertension; Infant Mortality; Infant, Newborn; Infant, Premature; Lung; Obstetric Labor, Premature; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Twins

Topics: Adult; Cervix Uteri; Female; Fetal Growth Retardation; Gestational Age; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Obstetric Labor, Premature; Oxytocin; Pregnancy; Risk; Uterine Contraction

Topics: Anthropometry; Birth Weight; Cephalometry; Congenital Abnormalities; Estrogens; Female; Fetal Growth Retardation; Humans; Oxytocin; Placental Lactogen; Pregnancy; Progesterone; Ultrasonography

The study was designed as a prospective non-interventional, observational study to elucidate the potential value of fetal middle cerebral artery Doppler velocimetry to identify brain-sparing flow in a surveillance program for suspected intrauterine growth restriction (IUGR).. The study was carried out at Skåne University Hospital, Malmö, Sweden. One hundred and twenty-six single pregnancies suspected of IUGR at ≥36 gestational weeks were assessed. The main outcome measures were positive/negative oxytocin challenge test (OCT) and cesarean/vaginal delivery. The pregnancies were managed with ultrasound fetometry, uterine and umbilical artery Doppler flow velocimetry, nonstress test, and an OCT to decide the optimal time and mode of delivery. Cases with a positive OCT were promptly delivered by cesarean section, whereas negative cases were allowed a trial of labor. Middle cerebral artery Doppler flow velocimetry results were blinded to the managing obstetricians. Brain-sparing flow was defined as a middle cerebral artery-to-umbilical artery pulsatility index ratio of <1.08. Nonparametric statistics with significance set at p < 0.05 were used, and Cohen's kappa coefficient was calculated for congruence of brain-sparing flow with OCT and mode of delivery, respectively.. The positive predictive value and sensitivity figures of brain-sparing flow to indicate a positive OCT and cesarean delivery were 33-63%. The inter-rater reliability of brain-sparing flow vs. positive OCT showed a kappa coefficient of 0.19, and brain-sparing flow vs. cesarean section among OCT-negative cases a kappa coefficient of 0.23.. Fetal brain-sparing flow is a poor predictor of a positive OCT, and of cesarean section in OCT-negative cases.

Topics: Blood Flow Velocity; Cerebrovascular Circulation; Cesarean Section; Female; Fetal Growth Retardation; Fetus; Humans; Infant, Newborn; Oxytocin; Predictive Value of Tests; Pregnancy; Pregnancy Outcome; Prospective Studies; Reproducibility of Results; Sweden; Ultrasonography, Doppler; Ultrasonography, Prenatal; Umbilical Arteries; Umbilical Veins

This study aimed to evaluate the association of induction method on delivery mode in pregnancies complicated by oligohydramnios with and without fetal growth restriction (FGR).. This was a secondary analysis of a National Institutes of Health funded retrospective cohort study of singleton deliveries at a tertiary-care hospital between 2002 and 2013 with diabetes, mild hypertension, and/or FGR. Chart abstraction was performed by trained research nurses. Patients with a diagnosis of fetal oligohydramnios with and without FGR were identified. Our analytic cohort was further stratified into three groups per initial induction agent: prostaglandins (PGEs) alone, PGE plus mechanical ripening, or oxytocin only. Primary outcome was mode of delivery. Secondary outcomes included indications for cesarean delivery and neonatal morbidity.. Out of 4,929 patients in the original database, 546 subjects with fetal oligohydramnios were identified; of these, 270 were induced and included for analysis. Outcomes were compared between 171 patients who had fetuses with isolated oligohydramnios and 99 patients who had fetuses with oligohydramnios and FGR. There were no significant differences in demographic characteristics between the groups. Patients with fetuses with isolated oligohydramnios had similar rates of spontaneous vaginal delivery (SVD) when PGEs were used (. In patients with fetuses with oligohydramnios with and without FGR, most patients delivered by SVD regardless of induction method. In this population, PGE use was associated with a high chance of SVD in patients with fetuses with suspected placental insufficiency regardless of the presence of absence of FGR.. · The majority of fetuses with oligohydramnios with or without FGR deliver vaginally.. · The use of prostaglandins did not increase rates of cesarean for fetal distress in oligohydramnios.. · Prostaglandin use did not increase rate of neonatal intensive care unit admission among pregnancies with oligohydramnios..

Topics: Female; Fetal Growth Retardation; Humans; Infant, Newborn; Oligohydramnios; Oxytocics; Oxytocin; Placenta; Pregnancy; Prostaglandins; Retrospective Studies

Topics: Adult; Apgar Score; Birth Weight; Case-Control Studies; Exercise Test; Female; Fetal Growth Retardation; Humans; Infant, Newborn; Male; Nipples; Oxytocin; Perinatal Death; Physical Stimulation; Pregnancy; Pregnancy Outcome; Retrospective Studies; Treatment Outcome; Uterine Contraction

To compare effectiveness and safety of dinoprostone, misoprostol and Cook's balloon as labour-inducing agents in women with intrauterine growth restriction (IUGR) at term.. Retrospective cohort chart review of women diagnosed with foetal growth restriction at term in Reina Sofia Hospital, Cordoba, Spain from January 2014 to December 2015. Registration of baseline characteristics and method of induction was made. The main outcome was time from induction to delivery. Obstetric and perinatal outcomes were also collected.. A total of 99 women were diagnosed with IUGR in the mentioned period. Of them, 21 women were induced with dinoprostone [dinoprostone group (DG)], 20 with misoprostol (MG) and in 58 with Cook's balloon (CG). Groups were homogeneous regarding pre-induction Bishop score and parity. The CG required more time (24.36 vs. 19.23 h; p = 0.02) and more oxytocin dose for conduction of labour from induction to delivery (6.75 vs. 1.24 mUI; p < 0.01) than DG. Moreover, the CG also needed more oxytocin than MG, 6.75 vs. 2.37 mUI (p < 0.001). Caesarean rate was 5, 14.9 and 17.3% in MG, DG and CG, respectively. No differences were observed in rates of uterine tachysystole, non-reassuring foetal status and neonatal adverse events.. Prostaglandins were more effective than Cook's balloon to induce labour and achieve vaginal birth in this sample of women with IUGR at term, with a similar safety profile.

Topics: Administration, Intravaginal; Adult; Delivery, Obstetric; Dinoprostone; Female; Fetal Growth Retardation; Humans; Labor, Induced; Misoprostol; Oxytocics; Oxytocin; Pregnancy; Pregnancy Outcome; Retrospective Studies; Spain; Term Birth; Treatment Outcome; Vaginal Creams, Foams, and Jellies

The object of work is pointing out the significance of improvement highly risk pregnancies by applying artificial fetal lungs maturation in relation to expected outcomes without adequate therapy.. We analyzed fetal lung maturation by using lecithin and sphingomyelin ratio in embryo fluid received by foam test. We examined successfulness of artificial fetal lungs maturation by applying corticosteroids to the embryo in a group of patients with serious form of growth retardation (group A), then to the mother (group B) and by inducing partial mild form of asphyxia with oxytocin infusion (group C).. The success of the method is shown by the success of finished pregnancies. We followed the difference between expected and actual term of delivery.. Artificial fetal lungs maturation by applying fetal corticosteroids efficiently increases the creation of lecithin and sphingomyelin and enables life of neonate even in period up to 30th week of gestation.

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Amniotic Fluid; Apgar Score; Body Weight; Female; Fetal Growth Retardation; Fetal Organ Maturity; Gestational Age; Humans; Infant, Newborn; Lecithins; Lung; Oxytocics; Oxytocin; Pregnancy; Prenatal Diagnosis; Sphingomyelins

To explore middle cerebral artery (MCA) and anterior cerebral artery (ACA) blood flow responses to superimposed acute hypoxemia in growth-restricted fetuses with and without established brain-sparing flow during basal conditions.. 47 term fetuses suspected of growth restriction were exposed to an oxytocin challenge test with simultaneous cardiotocography and Doppler velocimetry in the umbilical artery, MCA and ACA. The MCA-to-ACA pulsatility index (PI) ratio was calculated during basal conditions, contractions and relaxations. Basal brain-sparing flow was defined as an MCA-to-umbilical artery PI ratio of<1.08, de novo brain-sparing flow in the MCA as an MCA PI decrease with> or =1 standard deviation during uterine contractions or relaxations compared with basal measurements, and de novo brain-sparing flow in the ACA as an ACA PI decrease with > or =1 standard deviation. Non-parametric statistical tests were used with P<0.05 considered significant.. MCA and ACA PI were both significantly lower in the brain-sparing flow group (N=8) during basal conditions (P< or =0.01). During the oxytocin challenge test, MCA and ACA PI both decreased in the non-brain-sparing flow group (N=39) (P< or =0.02) but not in the brain-sparing flow group (P> or =0.4). The MCA-to-ACA PI ratio remained unchanged in both groups. de novo brain-sparing flow calculations revealed no preferential flow to any cerebral artery.. Cerebral circulatory responses to acute hypoxemia are synchronized in the middle and anterior cerebral arteries without any preferential regional flow distribution.

Topics: Adult; Anterior Cerebral Artery; Cerebrovascular Circulation; Female; Fetal Growth Retardation; Humans; Hypoxia; Middle Cerebral Artery; Oxytocin; Pregnancy; Regional Blood Flow; Telencephalon; Ultrasonography, Doppler; Ultrasonography, Prenatal; Uterine Contraction

The best mode of delivery in cases of intrauterine growth restriction (IUGR) with umbilical artery blood flow changes is not well elucidated.. To evaluate outcome in IUGR with umbilical artery blood flow changes planned for vaginal delivery after a negative oxytocin challenge test (OCT).. In 84 term singleton pregnancies with suspected IUGR and no unanimous indication for abdominal delivery, Doppler velocimetry and OCT were performed. Positive OCT cases were delivered by cesarean section, negative OCT cases planned for vaginal delivery.. Umbilical artery Doppler velocimetry was normal in 51 cases (normal group) and abnormal in 33 cases (increased pulsatility index with maintained forward diastolic flow). Gestational age at delivery was shorter (p = 0.008), positive OCT more common (33% vs. 16%; p = 0.06), and vaginal delivery less common (40% vs. 63%; p = 0.04) in the abnormal blood flow group compared with the normal flow group. When in labor, 68% in the abnormal flow group and 76% in the normal flow group delivered vaginally (p = 0.6). One baby had a lethal malformation and another suffered meconium aspiration and pneumothorax, but was discharged home healthy.. The vaginal delivery rate was significantly lower in the abnormal flow group compared with the normal flow group, but in cases finally destined for a trial of labor the vaginal delivery rates were similar. There was no indication that any fetus was exposed to detrimental hypoxia or distress.

Topics: Adult; Case-Control Studies; Delivery, Obstetric; Female; Fetal Growth Retardation; Gestational Age; Humans; Infant, Newborn; Oxytocin; Pregnancy; Pregnancy Outcome; Prospective Studies; Regional Blood Flow; Ultrasonography, Doppler; Ultrasonography, Prenatal; Umbilical Arteries

To evaluate retrospectively pre-term induction; with Prostaglandin (PG) E(2)-gel and i.v. oxtytocin, respectively.. Fifty pre-term women with a gestational age between 28 + 0 and 36 + 6 and medical indications for labor induction were compared with the two next induced at term and post-term. The obstetric end points were numbers of PGE(2)-gel applications, failed inductions, instrumental delivery and heavy bleeding after partus (>1000 ml). The neonatal outcome was registered as operative delivery for fetal distress (ODFD) or Apgar score <7 at 5'.. The number of PGE(2)-gel applications did not differ. The duration of labor was shorter in the pre-term group (P = 0.043). A five-fold higher risk of heavy postpartum bleeding (>1000 ml) was noticed in the post-term group compared to the pre-term. The incidence of low Apgar scores were similar in the three groups.. Safe vaginal labor induction and delivery can be anticipated pre-term with PGE(2)-gel.

Topics: Administration, Intravaginal; Adult; Cervical Ripening; Cervix Uteri; Delivery, Obstetric; Dinoprostone; Female; Fetal Death; Fetal Growth Retardation; Gels; Gestational Age; Humans; Labor, Induced; Oxytocin; Postpartum Hemorrhage; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Retrospective Studies

To examine and compare the value of the nonstress test (NST), oxytocin challenge test (OCT), Doppler velocimetry (S/D ratio), and biophysical profile (BPP) in predicting fetal acidosis.. NST, OCT, S/D ratio and BPP were performed in 23 pregnancies with growth-retarded fetuses. The value of each parameter in predicting fetal acidosis (umbilical vein pH obtained by cordocentesis) was examined.. The NST, OCT and BPP were found to have the same positive predictive value of 57.1% in predicting fetal acidosis. The S/D ratio was found to have a very low positive predictive value (14.3%). The only combination of two parameters that showed improved positive predictive value, was that of OCT and NST (66.7%).. (1) The best indirect method in assessing fetal well-being is the combination of NST and OCT. (2) Since the positive predictive value of the indirect methods is still low, direct assessment of the fetal metabolic status is recommended in premature growth-retarded fetuses with an abnormal test.

Topics: Acidosis; Blood Flow Velocity; Cordocentesis; Female; Fetal Diseases; Fetal Growth Retardation; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Laser-Doppler Flowmetry; Oxytocin; Predictive Value of Tests; Pregnancy; Prospective Studies; Umbilical Arteries; Umbilical Veins

Topics: Cesarean Section; Female; Fetal Growth Retardation; Gestational Age; Humans; Infant, Newborn; Labor, Induced; Maternal-Fetal Exchange; Oxytocin; Pregnancy; Ultrasonography

Intra-uterine growth retardation (IUGR), often combined with other pregnancy-related complications, constitutes a rather common indication for labor induction. The objective of this prospective study was to evaluate a strict intracervical application of 0.5 mg PgE2 in gel for cervical ripening and labor induction. Eighty term pregnant women with an ultrasonically diagnosed IUGR (less than -2 SD) and an unripe cervix were given PgE2-gel. The main indication for labor induction was IUGR, but 26 women had other complications. IUGR was verified at delivery in 50 women (study group), whereas 30 women (control group) gave birth to infants of normal birth weight (greater than -2 SD). The cervical ripening effect did not differ between the groups. In the study group, 19 nulliparous and 15 parous women out of 50 had a favorable cervix after 12 h and were delivered within 24 h of gel application. The corresponding result for the control group was 11 nulliparous and 8 parous women out of 30. Failed induction was registered in 2 and one woman respectively. On the other hand, the number of instrumental deliveries was greater in the study group, 11 caesarean sections (CS) and seven ventouses, compared with one CS and three ventouses in the control group (p less than 0.05). The frequency of operative deliveries for fetal distress (ODFD) was higher among the women with verified IUGR (14/50) than in the controls, where the corresponding figure was 3/30. No side effects were observed. We conclude that strict intracervical application of 0.5 mg PgE2 is a safe and effective method for cervical ripening and labor induction in women with IUGR.

Topics: Adult; Birth Weight; Cervix Uteri; Dinoprostone; Female; Fetal Growth Retardation; Humans; Infant, Newborn; Labor, Induced; Oxytocin; Pregnancy; Prospective Studies; Treatment Outcome; Ultrasonography

Heat-stressed pregnant ewes deliver intrauterine growth-retarded lambs. Selected maternal and fetal changes were investigated during acute heat stress in order to elucidate the mechanism for this growth retardation. Uterine blood flow decreased 20 to 30% in pregnant ewes during 1 degree C increases in core temperature. The decreases were accompanied by 60 and 100% increases in serum oxytocin and antidiuretic hormone, respectively. These effects were mimicked by salt loading or injections of antidiuretic hormone or oxytocin, suggesting a role for either or both hormones in regulating uterine blood flow during pregnancy. Chronically heat-stressed pregnant ewes were delivered by Caesarean section. Their fetuses were approximately 20% smaller than thermoneutral controls. Within each pair of heat-stressed twins, one fetus weighted one-third less than its litter mate. No difference in weights were observed within the control twins. The livers and brains of the heat-stressed fetuses were disproportionate in size. The livers from the small heat-stressed twins contained only one-half the protein of the controls and one-fourth the protein of their litter mates. Muscle protein was decreased in the heat-stressed fetuses, and liver and muscle glycogen were elevated as were liver arginase, glutamate-pyruvate transaminase and muscle creatinine. These results are consistent with the following hypothesis: heat stress stimulates the release of maternal antidiuretic hormone or oxytocin, which reduces uterine blood flow and causes a shift in fetal metabolism from anabolic to catabolic pathways; one fetus of heat-stressed twins is more severely affected than its litter mate.

Topics: Animals; Body Weight; Female; Fetal Growth Retardation; Hot Temperature; Litter Size; Myocardium; Organ Size; Oxytocin; Pregnancy; Pregnancy Complications; Regional Blood Flow; Sheep; Sheep Diseases; Stress, Physiological; Uterus; Vasopressins

Oxytocin and vasopressin are hormones having a number of peripheral and (more recently detected) central activities. The two peptides are found to be present in both human amniotic fluid and in that of rats. The origin of these substances was studied in combined clinical and experimental investigations, as were also the relationships of these compounds with intra-uterine growth and the process of labour. Oxytocin was not found to originate from the foetal brain, the foetal adrenals being suggested as a possible alternative source. There was found to be a positive correlation between amniotic oxytocin and measures of the foetal brain, amniotic vasopressin possibly reflecting a poor condition of the foetus (stress?).

Topics: Amniotic Fluid; Animals; Female; Fetal Growth Retardation; Humans; Labor, Obstetric; Maternal-Fetal Exchange; Oxytocin; Physiology, Comparative; Pregnancy; Pregnancy, Animal; Rats; Vasopressins

Topics: Arteries; Female; Fetal Growth Retardation; Humans; In Vitro Techniques; Labor, Obstetric; Norepinephrine; Obstetric Labor, Premature; Oxytocin; Placenta; Pregnancy; Pregnancy Complications

Arginine-vasopressin (AVP) and oxytocin are neuropeptides that are not only released as hormones into the peripheral circulation, but are also involved in central processes, e.g., in brain development. Earlier experiments suggested an inverse relationship between amniotic AVP and fetal growth. To see whether increased peptide levels reflect fetal growth retardation, and to determine cause and effect of this relationship, AVP and oxytocin content were determined in amniotic fluid of growth-retarded fetuses by radioimmunoassay. Growth retardation was established either by intraperitoneal administration of methylazoxymethanol to the mother, or by undernourishment of the mother. Elevated amniotic AVP levels were found in the methylazoxymethanol-treated and undernourished rats, partly concomitant with smaller amount of amniotic fluid. Amniotic AVP levels were inversely related to fetal body weight, while a similar trend was found for fetal brain weight. In addition, a positive correlation was found between fetal body weight and amniotic oxytocin in control rats.

Topics: Amniotic Fluid; Animals; Arginine Vasopressin; Body Weight; Female; Fetal Growth Retardation; Fetus; Oxytocin; Peptides; Pregnancy; Rats; Rats, Inbred Strains

The elimination of indocyanin green (IGG) in selected mature newborn babies (n = 50) was investigated on the first postnatal day. The IGG dose was 2 mg/kg body weight. The half time (t1/2), the elimination constant (K2), the dye distribution volume (ml/kg), as well as the level of serum indirect bilirubin on the third postnatal day were measured and calculated. Healthy, mature newborns from spontaneous labor served as controls (n = 14): the two study groups consisted of either growth-retarded (n = 8) or acidotic (n = 8) neonates. According to the management of deliveries, they were spontaneous, assisted by oxytocin drop infusion (n = 10) or under lumbal peridural anaesthesia + oxytocin drop infusion (n = 8). In the acidotic neonates the elimination constant was significantly lower and the half time significantly longer. In the growth retarded newborn babies the difference was not significant. The increase of the level of indirect bilirubin in serum appearing in the acidotic group on the third postnatal day was significantly greater.

Topics: Acidosis; Bilirubin; Female; Fetal Growth Retardation; Humans; Indocyanine Green; Infant, Newborn; Infant, Newborn, Diseases; Labor, Induced; Oxytocin; Pregnancy

Topics: Adolescent; Adult; Female; Fetal Death; Fetal Growth Retardation; Fetal Monitoring; Hormones; Humans; Oxytocin; Pregnancy; Risk

Topics: Cervix Uteri; Dinoprostone; Female; Fetal Growth Retardation; Fetal Hypoxia; Fetal Monitoring; Humans; Infant, Newborn; Labor, Induced; Oxytocin; Pregnancy; Prostaglandins E; Risk; Uterine Contraction

FHR oxytocin challenge test (OCT), maternal serum estriol level, neonatal birth weight and placental findings were studied in 206 cases. 1) Maternal serum estriol levels were not always related to the results of OCTs. 2) In the cases of positive and equivocal OCTs, the birth weight and the placental weight were smaller than those in negative OCT cases. 3) Positive and equivocal OCTs were frequently related with calcification and infarction of the placentae. 4) Neonatal birth weight showed close relation to the placental weight, though insignificant relation to maternal serum estriol level was observed. 5) The frequency of positive and equivocal OCTs was high in the cases of right-posterior position of placenta, and low in the cases of left-anterior.

Topics: Adult; Birth Weight; Estriol; Female; Fetal Growth Retardation; Fetal Heart; Fetal Monitoring; Heart Rate; Humans; Infant, Newborn; Oxytocin; Placenta; Placental Function Tests; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular; Uterine Contraction

This study includes, 1,542 patients who underwent nonstress tests (NSTs) for primary fetal surveillance and 4,626 patients who underwent contraction stress tests (CSTs) for primary fetal surveillance. All pregnancies were at increased risk for uteroplacental insufficiency. The results showed that the two groups were comparable according to maternal diagnostic criteria for testing. Those patients who underwent NSTs as primary surveillance had a 2.9% incidence of intervention because of abnormal test results while the CST group had a 4.5% incidence of intervention because of abnormal test results ( p less than 0.05). The NST group had significantly more respiratory distress syndrome, intrauterine growth retardation, birth weight less than 2,500 gm, and 5-minute Apgar scores less than 7. The antenatal death rate was nearly eight times higher in the NST group (7.8/1,000 versus 1.1/1,000 in the CST group) (p less than 0.05). After correction for congenital anomalies and unrelated causes, the NST group had an antenatal death rate of 3.2/1,000 versus 0.4/1,000 in the CST group (p less than 0.05); there was still an antenatal death ratio of 8:1.

Topics: Apgar Score; Birth Weight; Female; Fetal Death; Fetal Growth Retardation; Fetal Heart; Fetal Monitoring; Heart Rate; Humans; Hypertension; Infant, Newborn; Multi-Institutional Systems; Oxytocin; Pre-Eclampsia; Pregnancy; Pregnancy in Diabetics; Prospective Studies; Respiratory Distress Syndrome, Newborn; Risk; Uterine Contraction

On the basis of analyses of the nonstressed fetal heart rate test (NST) and the oxytocin challenge test (OCT) in 85 fetuses with intrauterine growth retardation (IUGR), the predictive power of NST/OCT on fetal outcome and the mechanism of a positive OCT in IUGR were investigated. These fetuses with IUGR exhibited high incidences of nonreactive NSTs (35.3%) and positive OCTs (40%) attributable to a combination of compromised placental function and diminished fetal reserve. Adverse fetal prognosis is most accurately predicted by the joint occurrence of a nonreactive NST and a positive OCT (92%). In such cases, when IUGR is strongly suspected, liberal use of cesarean section is recommended to assure good fetal outcome.

Topics: Cesarean Section; Estriol; Female; Fetal Growth Retardation; Fetal Heart; Humans; Infant Mortality; Oxytocin; Pregnancy; Pregnancy Complications; Risk

Topics: Estriol; Female; Fetal Distress; Fetal Growth Retardation; Fetal Heart; Fetal Monitoring; Hemodynamics; Humans; Infant, Newborn; Oxytocin; Placental Insufficiency; Placental Lactogen; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics

The oxytocin challenge test (OCT) has been shown in other studies to be valuable in evaluating high-risk pregnancies. The purpose of this study was to show the relationship of various disease states and clinical conditions with OCT results and fetal performance in labor. Of a group of normal patients, 4% had positive OCTs or late decelerations (LDs) in labor. The incidence of positive OCTs or LDs in labor in patients with diabetes mellitus (DM) class B-R was 23.2%; in DM class A, 27.6%; in intrauterine growth retardation (IUGR), 26.2%; in pregnancy-induced hypertension (PIH), 27.6%; in chronic hypertension (CH), 13.6%; and in prolonged gestation, 10.8%. This study shows that DM of all classes, IUGR and PIH are the most likely conditions in which persistent LDs will occur.

Topics: Apgar Score; Female; Fetal Distress; Fetal Growth Retardation; Fetal Heart; Fetus; Heart Rate; Humans; Hypertension; Infant, Newborn; Labor, Obstetric; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy in Diabetics; Pregnancy, Prolonged; Risk

Topics: Abortion, Threatened; Adult; Broad Ligament; Diagnosis, Differential; Female; Fetal Growth Retardation; Humans; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy, Ectopic; Ultrasonography

Topics: Adult; Antihypertensive Agents; Chronic Disease; Female; Fetal Growth Retardation; Fetus; Growth; Humans; Hydralazine; Hydrochlorothiazide; Hypertension; Infant, Newborn; Methyldopa; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Prenatal Diagnosis; Ultrasonography

Four cases of a rare atypical fetal heart pattern obtained during the oxytocin challenge test are described. In all cases, there were marked oligohydramnios and fetal growth retardation with a severely compromised fetus, and in 3 cases the fetuses died.

Topics: Female; Fetal Death; Fetal Growth Retardation; Fetal Heart; Fetal Monitoring; Heart Rate; Humans; Oxytocin; Pregnancy

Topics: Apgar Score; Cesarean Section; Female; Fetal Death; Fetal Distress; Fetal Growth Retardation; Fetal Heart; Fetal Monitoring; Heart Rate; Humans; Infant Mortality; Infant, Newborn; Labor, Obstetric; Oxytocin; Pregnancy

Topics: Apgar Score; Estriol; Female; Fetal Death; Fetal Distress; Fetal Growth Retardation; Fetal Heart; Fetal Monitoring; Heart Rate; Humans; Infant Mortality; Oxytocin; Pregnancy; Uterine Contraction