The effect of magnesium sulfate on the biophysical profile of normal term fetuses

Article Abstract:

The physical condition of the fetus is assessed by determining the biophysical profile, an evaluation of fetal movement, breathing and tone, volume of amniotic fluid surrounding the fetus, and the nonstress test (NST). In the NST, the changes in fetal heart rate in response to an auditory stimuli are recorded. Various factors can influence the biophysical profile, including the sleep-wake cycles of the fetus, drugs, gestational age, labor, premature rupture of membranes, and infection. Because magnesium sulfate can depress the breathing and movement of the fetus, it may also affect the biophysical profile score. Magnesium sulfate is used to treat premature labor and eclampsia, the development of coma and seizures in the second half of pregnancy. The effect of magnesium sulfate on specific factors of the biophysical profile has been difficult to determine because of the presence of other influences. Hence, the effect of magnesium sulfate was assessed in the full-term fetus in the absence of other factors that might affect the biophysical profile. The study included four women with single fetus pregnancies in which the fetus was in a breech position (where the fetus' feet rather than its head are closest to the birth canal). The women were to undergo a procedure referred to as external cephalic version, to turn the fetus downward into the proper head-down position. Magnesium sulfate was given to prevent contraction of the uterus during the fetal positioning procedure. The biophysical profile was determined before and after the administration of magnesium sulfate. Magnesium sulfate treatment depressed fetal breathing movements and thereby altered the biophysical profile score. However, these findings suggest that with the exception of respiration, magnesium sulfate treatment has no effect on other components of the biophysical profile. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Fetus, Magnesium sulfate, Fetal movement, Fetal movements

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A randomized comparison of umbilical vein and intravenous oxytocin during puerperium

Article Abstract:

The pituitary hormone oxytocin causes contraction of the uterus, thereby inducing labor, and also stimulates the breast to release milk. This hormone is used during labor to decrease blood loss following delivery; to maintain the muscle tone of the uterus; and to promote the detachment of the placenta from the uterus wall after childbirth. Oxytocin is normally injected continuously (infused) into the mother. However, some investigators have suggested that it may be more effective if it is injected directly into the umbilical blood vessels. The effects of injecting oxytocin into the umbilical vein were compared with the effect of injecting this hormone into the circulation of the mother. In addition, the transfer of oxytocin from the umbilical vein into the circulation of the fetus was also assessed. Blood loss was greater in women who received oxytocin through the umbilical vein compared with that in women who received intravenous infusion of oxytocin. Blood loss was indicated by a reduced hematocrit, a measure of the volume of red blood cells, and by decreased levels of hemoglobin, the oxygen-carrying pigment of red blood cells. The duration of labor was similar for both modes of hormone administration. The transfer of oxytocin into the fetal circulation was more likely with administration of the hormone into the umbilical vein. These findings suggest that the administration of oxytocin into the umbilical vein has no advantage over intravenous infusion into the maternal circulation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Dosage and administration, Childbirth, Delivery (Childbirth), Oxytocin, Umbilical cord

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Predicting preeclampsia

Article Abstract:

Preeclampsia is a complication of pregnancy marked by high blood pressure, swelling and protein in the urine. Prostacyclins and thromboxane, substances involved in the clotting mechanism, play a role in the development of preeclampsia. Agents that block the action and synthesis of prostacyclins and thromboxane have shown to be of benefit in treating preeclampsia. The effective use of these agents depends largely on correctly identifying women at risk for preeclampsia. Family history and the number of previous viable pregnancies are two factors involved in calculating the risk for preeclampsia. The roll-over test (supine hypertension test) measures blood pressure between 28 and 32 weeks of pregnancy, while the patient is lying sideways. After the blood pressure is stabilized, the women then turns onto her back, and blood pressure measurements are repeated immediately and five minutes later. A test is positive when the diastolic pressure increases the level of mercury by 20 millimeters. Two new tests may soon replace the well-accepted roll-over test. An increase in fibronectin, a protein that is released when the cells lining the blood vessels are damaged, can be used as a marker for potential preeclampsia event. The ratio of calcium to creatinine found in the urine also appears to be a promising indicator of high risk. Tests that identify women at risk for preeclampsia are useful in deciding which women will benefit from treatment before the onset of symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Risk factors, Preeclampsia

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