Elizabeth Martin

The effect of amniotic fluid on the human omental artery in vitro

OBJECTIVE The aim of the study was to determine the effect of amniotic fluid on the in vitro contractility of the human omental artery. STUDY DESIGN Amniotic fluid and a segment of omentum were obtained from each of 5 patients at the time of planned cesarean delivery at normal term gestation for the indication of previous cesarean delivery. The omental artery was cleaned and cut into 3-mm rings, which were placed in 10-mL organ chambers for isometric tension recording. The chambers were filled with Krebs-Henseleit solution bubbled with 5% carbon dioxide in air and maintained at 37 C, pH 7.4. The rings were then equilibrated at 1 g passive tension for 90 minutes. The amniotic fluid was centrifuged for 10 minutes at 3000 rpm to remove all debris. Increasing volumes of supernatant (10-2000 microL) were added to the omental artery rings at baseline tone or after contraction with U46619 (10(-7) mol/L) or potassium chloride (60 mmol/L) to detect contractile and relaxant effects, respectively. Time-solvent control preparations were also run in parallel. RESULTS Amniotic fluid had no effect on the basal tone of omental artery rings. Amniotic fluid had no effect on the tension in rings previously contracted with either U46619 or potassium chloride. CONCLUSIONS Amniotic fluid has no direct effect on isolated human omental artery. The catastrophic hemodynamic changes associated with the syndrome of amniotic fluid embolism are not due to a direct effect of circulating amniotic fluid on vascular tone but rather may be due to secondary responses

Fluorescence probe for cervical examination during various reproductive states

These studies represent further investigations that have been done utilizing the fluorescence from pyridinoline, one of the major crosslinks of type I and III collagen, to evaluate cervical connective tissue changes during various female reproductive periods. Based on our previous studies, a prototype instrument has been constructed. The instrument was specifically designed for the purpose of vaginal examination of cervical connective tissue by measuring light induced fluorescence directly from the surface of the external os of the cervix. The studies were carried out on nonpregnant rats, rats during gestation at different periods, rats at different times during postpartum, and rats during preterm birth after being treated with antiprogesterone drugs. A study has also been done on humans during pregnancy and postpartum. The results parallel previous investigations that have used various invasive methods to analyze cervical extensibility, cervical collagen content and collagenase. In consideration of the important role of the collagen fibers and their turnover in the process of cervical function during pregnancy (softening or ripening at term), this method could be a useful tool for evaluating treatment strategies of the cervix. Moreover, the instrument could serve as a device for the non-invasive estimation of cervical status in the clinic and the diagnosis of the changes in the cervix during the preparation for labor.

Use of Mott compression garment in postoperative cesarean-delivery patients

Abstract Objective: To evaluate the use of an abdominal compression garment (Mott Binder) in postoperative cesarean patients. Methods: Seventy-seven pregnant subjects were prospectively studied using a newly designed abdominal binder as compared with a standard postoperative bandage, with the binder placed immediately postoperatively. Binder subjects used the device at least through the first postoperative day (POD1) and as desired afterward. Pain, wound complication, length of stay, and patient satisfaction were analyzed using the Student t test, ANOVA, and χ 2 , with P Results: Results are summarized in the table (± SD): Binder (n = 58) Control (n = 19) P Hospital stay (days) 3.9 ± 0.6 3.8 ± 0.7 NS PO medication doses 9.6 ± 4.8 10.4 ± 4.0 NS POD1 pain score 1.8 ± 1.3 2.3 ± 1.4 NS Wound infection 4 2 NS Two binder subjects had wound-site erythema. Two of the 19 controls and none of the 58 binder patients had superficial wound dehiscence. Subjective satisfaction with the binder was appreciable (control randomization was not possible after 19 controls were enrolled secondary to patient preference for the binders). Conclusion: Use of the Mott postoperative binder resulted in subjective satisfaction from its users despite absence of objective benefit. A nonsignificant reduction in superficial wound dehiscence through binder use warrants additional study.