Abstract:
:Amide-linked local anesthetic agents, such as lidocaine and bupivacaine, can become "trapped" in their ionized forms on the fetal side of the placenta, and therefore their net transfer across the placenta is increased. An ester-linked local anesthetic agent, 2-chloroprocaine, is rapidly metabolized, and placental transfer is limited. Since the metabolism of 2-chloroprocaine by fetal plasma is slower than in maternal plasma, the potential for ion trapping exists. The purpose of this study was to determine the disposition of 2-chloroprocaine and its metabolite, chloroaminobenzoic acid, in relation to the umbilical cord vein pH at delivery, and specifically, to determine whether ion trapping exists. Epidural anesthesia with 2-chloroprocaine was administered to 44 women at term prior to cesarean section. At delivery the levels of 2-chloroprocaine and chloroaminobenzoic acid in maternal plasma and umbilical cord vein were quantitated. Neonates were divided into two groups based on the umbilical cord vein pH at delivery. Ten of the 44 patients delivered neonates with a pH less than or equal to 7.25 (acidotic group) while 34 delivered neonates with a pH greater than 7.25 (nonacidotic group). The mean umbilical cord vein pH in the acidotic and nonacidotic groups was 7.22 +/- 0.03 and 7.32 +/- 0.03, respectively (p less than 0.001). There were also no differences between the groups in maternal and neonatal clinical characteristics or in the total dose of 2-chloroprocaine administered or the drug-to-delivery interval. The pharmacologic results did not demonstrate a statistical difference in the concentration of 2-chloroprocaine or chloroaminobenzoic acid in the maternal vein or umbilical cord vein at delivery between the two groups. Thus the results of this study demonstrate that placental transfer of 2-chloroprocaine is not influenced by fetal acidosis. Therefore these data suggest that 2-chloroprocaine may be the drug of choice when fetal acidosis or distress is anticipated.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Philipson EH,Kuhnert BR,Syracuse CDdoi
10.1016/0002-9378(85)90295-9subject
Has Abstractpub_date
1985-02-01 00:00:00pages
322-4issue
3eissn
0002-9378issn
1097-6868pii
0002-9378(85)90295-9journal_volume
151pub_type
杂志文章abstract::Umbilical arterial velocity waveforms were recorded in 69 pairs of twins by means of continuous-wave Doppler analysis and an Angioscan spectrum analyzer. A systolic/diastolic ratio was measured for each twin. The sum of the systolic/diastolic ratio was calculated and the difference between each twin was expressed as t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80035-2
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:Adverse maternal outcomes associated with chronic hypertension include accelerated hypertension and resultant target organ damage. One example is long-standing hypertension leading to maternal cardiac dysfunction. Our group has previously identified that features of such injury manifest as cardiac remodeling...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2018.02.015
更新日期:2018-05-01 00:00:00
abstract::The effects of various vasodilators on the uterine vascular bed were investigated in nonpregnant, oophorectomized sheep with chronically implanted flow probes and catheters inserted into branches of the uterine arteries. A 1 mug dose of estradiol-17beta (0.224 muM) produces a maximum uterine blood flow response after ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90593-7
更新日期:1976-05-15 00:00:00
abstract:OBJECTIVE:Our purpose was to investigate whether the sensitivity of myometrial cells to oxytocin is affected by prolonged exposure to oxytocin antagonists. STUDY DESIGN:Tissue slices or cultured myometrial cells were exposed to peptides in vitro. Myometrial activation was studied by measuring the formation of inositol...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90414-6
更新日期:1994-12-01 00:00:00
abstract::Bacteriologic culture samples were taken from the cervix in three groups of 10 healthy, sexually active women using barrier contraception, oral contraceptives, or a levonorgestrel-releasing intrauterine contraceptive device. Culture samples for Candida albicans and Trichomonas vaginalis were taken, a cytologic vaginal...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90594-6
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to establish predictors of vaginal twin birth and evaluate perinatal morbidity according to mode of delivery. STUDY DESIGN:One thousand twenty-eight twin pregnancies were prospectively recruited. For this prespecified secondary analysis, obstetric characteristics and a composit...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.05.033
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare autologous versus cadaveric grafts in pubovaginal slings. STUDY DESIGN:Women who had pubovaginal slings from 1994 to 2003 completed history, questionnaires, prolapse staging, and cough stress testing. Failure was defined by recurrent urinary incontinence symptoms and ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.01.058
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVES:To precisely evaluate fetal renal function in cases of bilateral fetal urinary tract obstruction, we analyzed fetal urine metabolites by nuclear magnetic resonance spectroscopy. STUDY DESIGN:Fifty-six specimens of fetal urine samples in utero were retrospectively analyzed by proton nuclear magnetic resonanc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70235-7
更新日期:1994-02-01 00:00:00
abstract::Repeated nutritional assessments were made on 118 low-income women who registered at an urban hospital clinic prior to the twenty-eighth week of pregnancy and then on 122 comparable women who were provided with protein-mineral supplementation. Demographic and background information were obtained. Medical assessments w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90487-1
更新日期:1975-12-01 00:00:00
abstract::The study of different morphometric parameters in 17 placentas collected between 22 and 40 weeks of gestation has shown that, from mid-gestation to term, two stages are clearly discernible in the development of the human placenta. The first stage of growth, which terminates at approximately 36 weeks of gestation, is c...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(80)90696-1
更新日期:1980-07-01 00:00:00
abstract::Continuous follow-up of 224 patients treated for primary invasive squamous cell carcinoma of the vulva in a 20-year period (1955 to 1975) at the Mayo Clinic resulted in the detection of recurrent (or persistent) neoplasia in 59 (26%). Rates of treatment failure increased with advancing stage of disease-from 14% for St...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90823-7
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare the rate of vaginal birth after cesarean (VBAC) attempt, VBAC failure, and major maternal adverse outcomes in women with a previous cesarean with twin or singleton pregnancies. STUDY DESIGN:This was a multicenter retrospective cohort study between the years 1996 and 2...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.06.038
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:Our aim was to determine whether there was a cerclage height threshold associated with spontaneous preterm birth in patients with an ultrasound-indicated cerclage. STUDY DESIGN:We performed a retrospective cohort study of women with an ultrasound-indicated cerclage. Functional cervical length and the cerclag...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.09.021
更新日期:2009-05-01 00:00:00
abstract:UNLABELLED:Placentas obtained from women with preeclampsia produce more thromboxane and less prostacyclin than normal. They also produce more progesterone than normal. This study tested whether a progesterone concentration equivalent to that in the medium after in vitro incubation of placentas from women with preeclamp...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90931-9
更新日期:1989-12-01 00:00:00
abstract::Previous investigations have shown that the human placenta is a complex organ with different zones, each with a unique morphology. These zonal morphologic difference have been related to a probable blood PO2 gradient operating in the intervillous space. This study describes zonal variations in the vertical plane of th...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90007-8
更新日期:1978-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare how hospital rankings, based on risk-adjusted primary cesarean rates, change over time. STUDY DESIGN:Washington State Birth Events records data from 1995 through 1998 were used. Risk-adjustment models were built for each year. Risk-adjusted hospital rankings and outli...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2003.07.024
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to test whether ultrasound-measured fetal adrenal gland volume (AGV) and fetal zone enlargement (FZE) predicts preterm birth (PTB) better than cervical length (CL). STUDY DESIGN:Three-dimensional and 2-dimensional ultrasound were used prospectively to measure fetal AGV, FZE, an...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.11.034
更新日期:2011-04-01 00:00:00
abstract::A case report of hemolytic uremic syndrome with placental involvement in 2 of 3 consecutive pregnancies highlights the impact on the fetal placental compartment and the importance of diligent antenatal care in subsequent pregnancies. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.116829
更新日期:2001-11-01 00:00:00
abstract::Mercury exposure during pregnancy can have serious health effects for a developing fetus including impacting the child's neurologic and cognitive development. Through biomonitoring in a low-income Latina population in California, we identified a patient with high levels of mercury and traced the source to face creams ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2013.05.030
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:We undertook this investigation to explore the effects of ethanol exposure on nitric oxide synthase levels and nitric oxide release. Our hypothesis was that ethanol exposure modifies nitric oxide activity within the placenta as a result of oxidative stress. STUDY DESIGN:Four 10-g samples of term normal human...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.104201
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Induction of labor occurs in >20% of pregnancies, which equates to approximately 1 million women undergoing an induction in the United States annually. Regardless of how common inductions are, our ability to predict induction success is limited. Although multiple risk factors for a failed induction have been...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.11.603
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Oxytocin is a potent uterotonic agent that is widely used for induction and augmentation of labor. Oxytocin has a narrow therapeutic index and the optimal dosing for any individual woman varies widely. OBJECTIVE:The objective of this study was to determine whether genetic variation in the oxytocin receptor ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.05.023
更新日期:2017-09-01 00:00:00
abstract::This study attempts quantification of prostaglandins (PGs) in amniotic fluid antepartum at 24, 26-33, 34-36 weeks of gestation and in labor in 6 normal patients, 6 diabetic patients, 3 patients taking methadone, and 1 patient taking heroin. Results of measurements of PGs showed that in the different weeks of gestatio...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33793-0
更新日期:1974-02-01 00:00:00
abstract::Ultrasound has proved to be a valuable diagnostic tool in the practice of obstetrics. Its rapidly increasing use by the office-based obstetrician, however, has opened a potential new area of legal vulnerability. The malpractice liability that may arise from its use is reviewed and practical ways to avoid it are consid...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90452-6
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:The Twin Birth Study randomized women with uncomplicated pregnancies, between 32(0/7)-38(6/7) weeks' gestation where the first twin was in cephalic presentation, to a policy of either a planned cesarean or planned vaginal delivery. The primary analysis showed that planned cesarean delivery did not increase o...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ajog.2015.12.051
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:The physiopathology of preeclampsia is still unclear, but an imbalance between reactive oxygen species (ROS) and antioxidants, also called oxidative stress, appears to be an important contributing factor. The ROS promote lipid oxidation and are known to induce stress proteins, such as hemeoxygenase 1 (HO-1) a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.12.031
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:Our purpose was to study the effect of oophorectomy on the passive and active mechanical characteristics of rabbit small cerebral and small coronary arteries. STUDY DESIGN:Ring preparations of small cerebral and small coronary arteries from rabbits that had undergone oophorectomy and sham operation were moun...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70040-6
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the association between gestational age (GA) at the time of treatment initiation for gestational diabetes mellitus (GDM) and maternal and perinatal outcomes. STUDY DESIGN:We conducted a secondary analysis of a multicenter randomized treatment trial of mild GDM in whic...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ajog.2015.06.022
更新日期:2015-10-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to compare transobturator tape (MONARC) with tension-free vaginal tape in patients with borderline low maximum urethral closure pressure. STUDY DESIGN:Historical cohort analysis of 3-month outcomes in 145 subjects (MONARC = 85; tension-free vaginal tape = 60). A cut-off point...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.07.011
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to estimate the age-specific incidence of endometrial hyperplasia: simple, complex, and atypical, in order of increasing likelihood of progression to carcinoma. STUDY DESIGN:Women aged 18-90 years with endometrial pathology specimens (1985-2003) at a large integrated health pla...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.02.032
更新日期:2009-06-01 00:00:00