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To analyze the effects of uterine contractions on ductus venosus (DV) pulsatility during the first stage of labor.Twenty healthy women were examined. Measurements were taken at three stages of cervical dilatation (4 cm, 4-7 cm andor=8 cm) during and between contractions. Peak velocity during ventricular systole (S) and atrial contraction (A), pulsatility index for veins (DV PIV), ductus venosus index (DVI) and the S/A ratio were measured.The DV was observed successfully in 16 cases. The mean S velocity did not change significantly (64 cm/s during and 65 cm/s between contractions). The mean A velocity decreased significantly from 35 cm/s measured between contractions to 29 cm/s during contractions (P0.0001). The mean DV PIV and DVI were significantly higher during contractions (0.72 and 0.55) than between contractions (0.57 and 0.45) (P0.0001). There were no significant differences in means between stages of cervical dilatation.Significant differences during and between uterine contractions can be observed in DV pulsatility during normal labor.

Study objective: To evaluate the effect of epidural and pethidine analgesia on the frequency of uterine contractions during the first stage of labor. Design: Retrospective study. Setting: Delivery ward of a public hospital. Patients: Forty consecutive parturients. Measurements and main results: The mean number of contractions in the 30 min before administration of pethidine analgesia was 8.2±1.7 as compared to 8.7±1.3 after administration of the analgesia. The mean number of contractions in the 30 min before administration of epidural analgesia was 8.0±1.4 as compared to 8.8±1.9 after administration of the analgesia. The differences between the two groups and between the number of contractions before and after the administration of both types of analgesia were not statistically significant. Conclusion: Properly and timely administered epidural analgesia during the first stage of labor has no effect on frequency of uterine activity.

It has been our anecdotal experience that midwives and doctors sometimes perceive uterine contractions to diminish in strength and frequency following the administration of epidural anesthesia. This is probably an incorrect perception, as there is no physiological reason for this phenomenon [1]. Nevertheless, this probable misconception is of some importance, as a perceived reduction in uterine activity could lead to inappropriate use of oxytocic agents. The hypothesis of this study was that the clinical assessment of uterine activity is reduced following the administration of epidural anesthesia. Primiparous women with singleton pregnancies in spontaneous labor who had epidural anesthesia, were selected for this retrospective study. They were identified within a maternity unit of 3500 deliveries/year, between June and December 2003.

Cervical cerclage is the traditional management of cervical incompetence. Uterine activity among these patients has never been studied. This retrospective report details the contraction frequency in 96 patients with cerclage who underwent daily home uterine activity monitoring. Twenty-three percent (22) developed preterm labor and 12% (11) had preterm delivery related to failed tocolysis or rupture of the membranes. Uterine activity in the group who developed preterm labor was significantly greater than in those who labored at term. The objective contraction frequency data obtained by uterine activity monitoring are of clinical significance to physicians managing such patients.

Nitrous oxide analgesia was introduced into obstetrics by a young Polish-Russian physician who manufactured the gas himself, mixed it with oxygen, humidified the mixture with water vapor, and devised a mouthpiece for self-administration. After assessing the results on himself, he evaluated the effects on pain relief, maternal emotion, and maternal and fetal heart rates, as well as on the frequency, duration, and strength of uterine contractions in 25 parturients. He recognized that, in contrast to chloroform, nitrous oxide did not alter uterine activity. He concluded that the advantages of nitrous oxide administration far outweighed its disadvantages.

Home uterine activity monitoring and daily perinatal nursing contact were used in patients at risk for preterm labor in a rural area using provider consultation with a perinatologist in a tertiary center. In the management of 25 subjects at high risk for preterm delivery, it was noted that the patients had decreased anxiety. They felt that the service was beneficial to them and allowed them to stay in their local area. The providers felt confident that this daily contact allowed them to manage the patients without transfer to the tertiary center. Likewise, concerning women who developed preterm labor, the physicians were confident that the diagnosis would be early enough that transport, if necessary, could be carried out safely. Finally, the physicians felt that verbal reassurance from the perinatologist and weekly written contact with the monitoring service facilitated local management of such patients, particularly as it concerned administration of tocolytic agents.

It has been shown that an intensive system of preterm birth prevention using home uterine activity monitoring can decrease the number of early births. Such a system was employed in 130 public assistance (Medicaid) patients who were at high risk for preterm birth. A retrospective review of the pregnancy outcome in these subjects was conducted and their data exposed to a model for projected patient care cost. The incidence of preterm labor in the at-risk group was 46%, with an average prolongation of pregnancy of 4.9 weeks. The occurrence of preterm delivery for failed tocolysis or advanced cervical dilatation was less than 10%. Based on a cost-analysis model that considered newborn charges and monitoring expenses, nearly [corrected] $3 million (an average of $21,813 [corrected] per patient) was saved using this system.

Ambulatory tocodynamometry has been used for some time to record uterine activity during pregnancy. Most studies, however, have been performed in the third trimester (more than 24 weeks). The current study was initiated to assess uterine activity at earlier gestational ages. One hundred thirty-seven patients were studied between 14-19 weeks' gestation (inclusive). Seven patients who were being monitored were noted to have preterm labor, and six of these seven were found to have increased uterine activity before the diagnosis of preterm labor. There was no difficulty encountered in the vast majority of cases in recording objective, accurate uterine activity information even at these early gestational ages. There was an increase in the uterine activity (during the 18th and 19th weeks) in patients destined to develop preterm labor later in gestation as compared with the contraction pattern of those who labored at term. This study demonstrates that accurate uterine activity information can be gained at these early gestational ages and that when increased contraction frequency is present, it is related to preterm labor.

Daily antepartum nursing contact and ambulatory uterine activity monitoring have been used for the early detection of preterm labor. However, it may be difficult to separate true labor from false labor. In this study, the uterine activity records of 110 women at risk for preterm birth with excessive contraction frequencies were evaluated by blinded reviewers. Maternal symptomatology and uterine activity characteristics such as low-amplitude high-frequency contractility, contraction amplitude, contraction duration, contraction interval, and contraction rhythmicity were assessed for their ability to differentiate true from threatened preterm labor. Neither maternal symptomatology nor any uterine activity characteristic other than contraction frequency could differentiate true from threatened preterm labor. Antepartum uterine activity monitoring should continue to rely on contraction frequency to identify the woman at risk for premature labor.

Forty private patients using a home uterine activity monitoring system and daily contact with nursing staff (Term Guard monitor and Tokos Perinatal Nursing Service; Tokos Medical Corp., Santa Ana, CA) were surveyed after delivery. Twenty-seven responses (67.5%) were obtained. The majority of the responding patients (81%) felt that the monitor helped their pregnancy and 92% would recommend it to family and friends. Eighty-five percent thought that the monitor and related nursing services would be something that they would use in future pregnancies. No subject concluded that the monitor depersonalized their obstetric care. Forty-one percent of the patients felt that the device was an intrusion into their life-style. Seventy-eight percent thought that the device was beneficial in their understanding of preterm labor and in learning to perceive their own baseline uterine activity. Almost 60% of the subjects noted that the monitor was useful in determining uterine activity because they did not perceive any contractions. Approximately 65% felt that unnecessary trips to the hospital for prolonged monitoring were prevented by the availability of 24-hour-a-day, 7-day-a-week emergency transmission and nurse contact. Nearly three-fourths of the patients felt that unnecessary calls to the physician were prevented by their ability to monitor. In summary, the services were well accepted by the patients and, despite the intrusion into their life-style, most felt that home uterine activity monitoring improved the outcome of their pregnancy.

Twelve fetuses in whom the diagnosis of fetal distress was made during first stage of labor were included in the study. All 12 patients underwent urgent cesarean section during which fetal heart rate (FHR) was recorded continuously. In 50% of the cases, marked improvement of FHR was registered early in the course of the operation. Improvement in fetal status is attributed to adequate oxygenation and cessation of uterine activity.

To determine if increased uterine motility at the time of nidation in the myometrial cycle (MC) occurs as part of the IUD contraceptive effect the intrauterine pressures (IUP) of 41 women fitted with Lippes loop (1.5 ml) were analyzed for an average of 16.7 cycles. A demobilized fluid-filled microballoon was used to record IUP resting pressure (RP) average active pressure (AP) and average frequency. Spontaneous activity and oxytocin response (OR) were recorded for 30 minutes each on Days 2 16 23 and 26 of the menstrual cycle before and after IUD exposure. Before IUD exposure the average AP was 63.9 mm Hg at Day 2 markedly suppressed at Day 16 (7.2 mm) and partially recovered (14.7 mm) at Day 26. These differences in IUP values were found to be statistically significant (p

The effect of local application of heat on the abdominal wall on uterine activity was evaluated in 15 full-term multiparous women early in the first stage of labor. Cardiotocographic monitoring showed that heat induces a significant increase in uterine activity without causing any abnormal fetal heart changes. The stimulated contractions return back to base line level following removal of heat. The application of heat on the abdominal wall of women in early labor appears to offer a new non-pharmacological modality for the stimulation of uterine activity.