(Patho)physiological implications of chronic dietary sodium restriction during pregnancy; a longitudinal prospective randomized study

Article Abstract:

Pregnant women in the Netherlands are generally advised to eat a low-salt diet, with the goal of preventing hypertensive disorders. However, since the volume of body fluids is increased by several liters during pregnancy, it is possible that restricting sodium (responsible in large measure for controlling fluid volume) could actually have negative effects. To learn more about this issue, 42 healthy women were randomly assigned to eat either a low-sodium diet (20 millimoles of sodium daily) or to eat their normal diet. The low-sodium group followed this diet from the 14th gestational week until after delivery. None of the women had previously borne a child. Evaluation of the subjects' blood pressure, weight, urine, and heart size was carried out at regular intervals during pregnancy. The women in the low-sodium group had urinary sodium levels that were one-third lower than those of women who ate unrestricted diets. The former group also gained less weight. Even six weeks after delivery, they weighed less than the women in the unrestricted group, and also weighed less than at the start of the study, while the unrestricted group weighed more. Blood pressure during pregnancy did not differ between the groups. The low-sodium group had lower stroke volume (the amount of blood pumped by the heart with each contraction) and reduced cardiac output, as compared with the other group. Systemic vascular resistance was also lower. No differences were seen in infant birthweights. The results indicate that restricting sodium during pregnancy is associated with reduced body fat accumulation and a reduction in the circulating blood volume, as well as with increased systemic vascular resistance. Maternal blood pressure and infant birthweight do not seem to be affected. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Netherlands, Prevention, Pregnant women, Pregnancy, Hypertension in pregnancy, Gestational hypertension, Obstetrics

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Early recurrent miscarriage: histology of conception products

Article Abstract:

The majority of miscarriages are caused by fetal chromosomal abnormalities. Currently, there are no studies that have examined the chromosomes of the products of conception in women who experience recurrent miscarriages. Most chromosomal abnormalities occur by chance and are not likely to recur in subsequent pregnancies. On the basis of this assumption, it is theorized that fewer chromosomal abnormalities would be found in women experiencing recurrent miscarriages than women who have sporadic miscarriages. Pathologists can study the chromosomes contained in the cells of the products of conception (in this case the villi) to differentiate between normal and abnormal chromosomes. The microscopic structure of the villi cells was investigated among 44 women with recurrent miscarriage (three or more consecutive losses before the 16th week of pregnancy) and 105 women with sporadic miscarriage (one loss followed by a healthy delivery). Of the 100 samples containing adequate villi cells, abnormal villi were found in 62 percent of the women with recurrent miscarriage. In the 76 suitable samples of conception, abnormal villi were found in 58 percent of the women with sporadic miscarriage. Fetal tissue was detected in only 19 of the 100 samples obtained from women with recurrent miscarriages. Although all the fetuses were malformed, the exact nature of the abnormality was difficult to ascertain, since the tissue was damaged during the procedure to remove the products of conception. On the basis of these results it does not appear that recurrent miscarriage is a separate medical entity. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Diagnosis, Causes of, Chromosome abnormalities, Miscarriage, Fetal tissues

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A randomized comparison of oxytocin, sulprostone and placebo in the management of the third stage of labour

Article Abstract:

This article describes the results of a study designed to determine if the amount of blood lost by the mother immediately following childbirth (the third stage of labor) can be reduced using oxytocin or sulprostone. The study included 74 women. Immediately following childbirth, 28 women were given injections of oxytocin, 23 were given sulprostone, and 26 were given saline solution (a placebo). The amount of blood lost during expulsion of the placenta and during the first hour following childbirth was determined for each woman. Of the 26 women in the saline group, 14 were having their first baby and 12 were having their second or third baby. The women who were having their first babies lost 30 percent more blood following delivery than those who were having their second or third babies. Treatment with oxytocin reduced the amount of blood loss after delivery by 30 percent, and treatment with sulprostone reduced the amount of blood loss by 35 percent. Both drugs reduced the length of time spent in the third stage of labor by 20 to 30 percent (8 to 10 minutes). Treatment with oxytocin did not cause high blood pressure, headache, nausea, or vomiting. It is concluded that treatment with oxytocin or sulprostone reduces the amount of blood loss following delivery, as well as reducing the length of time spent in the third stage of labor. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Labor (Obstetrics), Oxytocin

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