Antepartum testing in the hypertensive patient: when to begin

Article Abstract:

High blood pressure during pregnancy increases the risk of intrauterine fetal death. Pregnant women with a history of high blood pressure should be kept under close surveillance to reduce the risk of fetal death. Since two-thirds of the fetal deaths occur before labor, it is important to begin monitoring the fetus before labor begins. To determine the optimum time for initiating testing, the medical records of 917 pregnant women with high blood pressure were reviewed. Of these patients, 408 had a history of high blood pressure prior to pregnancy (chronic hypertension) and 509 developed high blood pressure during pregnancy (preeclampsia). Ten of the pregnancies resulted in stillbirth during the study period; in nine of these cases, the fetus was not monitored during pregnancy. Six percent of the women had at least one positive contraction stress test, indicating that something may be wrong. The first positive test result was recorded at week 26 of pregnancy and 43 percent of the positive test results occurred before week 35 of pregnancy. Of the women who had positive test results before week 35, most had either diabetes, systemic lupus erythematosus (a connective tissue disease), preeclampsia or evidence of fetal growth retardation (IUGR). A total of 119 women were delivered early because of abnormal test results, and 22 of these women were delivered before week 35 of pregnancy. Fifty-five of the women with chronic hypertension and 59 of those with preeclampsia had infants that were smaller than normal at birth. Based on these observations, it is concluded that fetal testing should begin at week 33 of pregnancy. However, testing should begin at week 25 or 26 of pregnancy for women with high blood pressure along with diabetes, systemic lupus erythematosus, IUGR, or preeclampsia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Risk factors, Fetus, Systemic lupus erythematosus, Diabetes in pregnancy, Gestational diabetes, Pregnancy, Complications of, Pregnancy complications, Hypertension in pregnancy, Gestational hypertension, Fetal death

---

Controlled trial of hydration and bed rest versus bed rest alone in the evaluation of preterm uterine contractions

Article Abstract:

True early (preterm) labor affects 8 percent of all pregnancies, and is responsible for three fourths of all deaths occurring around the time of birth. The condition is confirmed when premature uterine contractions result in cervical dilation and flattening in preparation for the passage of a fetus during delivery. True preterm labor can be treated with drug therapy (tocolytic therapy). Some patients, however, experience strong Braxton Hicks contractions, the normal tightening of the uterine muscle which gets increasingly stronger as the pregnancy progresses, and it is difficult to tell false preterm labor from actual preterm labor on the basis of contractions alone. Bed rest and increased intake of fluids (hydration) are recommended when the cervix remains unaffected, to stop the uterine contractions in false preterm labor. The effects of bed rest and hydration (28 patients) versus bed rest alone (20 patients) on preterm labor were evaluated. In the patients treated with bed rest and hydration, uterine contractions ceased in 54 percent, compared with 40 percent of the patients who had bed rest alone. Fluids were then offered to the group having bed rest alone and only one patient stopped contracting. Of the patients whose contractions were halted in either category, 18 percent delivered early, constituting 20 percent of those were in the hydrated group and 14 percent of those having bed rest alone. Thus, the use of hydration as a reliable indicator of false preterm labor cannot be supported by these results.

Research, Labor (Obstetrics), Uterus, Pregnant, Pregnant uterus

---

Is tocolysis safe in the management of third-trimester bleeding?

Article Abstract:

Using drugs to stop uterine contractions appears to be safe in women with third-trimester bleeding. This is often caused by abnormal placenta placement inside the uterus. In a study of 236 pregnant women with third-trimester bleeding, these drugs were safe and effective in stopping premature labor.

Evaluation, Prevention, Tocolytic agents

Similar abstracts:

• Abstracts: A 39-year-old man with hypertension, a renal-artery aneurysm, and eosinophiluria
• Abstracts: Effects of terbutaline sulfate on fetal cardiac function. Hypersensitivity to magnesium sulfate. Prenatal diagnosis of laryngeal atresia
• Abstracts: The role of ultrasonography and amniocentesis in the evaluation of pregnancies at risk for neural tube defects
• Abstracts: Management of women with one abnormal oral glucose tolerance test value reduces adverse outcome in pregnancy. The postprandial glucose profile in the diabetic pregnancy

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.