Frederik K. Lotgering

Pelvic pain during pregnancy is associated with asymmetric laxity of the sacroiliac joints

Objective. The aim of this study was to investigate the association between pregnancy‐related pelvic pain (PRPP) and sacroiliac joint (SIJ) laxity.

Ultrasonic cervimetry to study the dilatation of the caudal cervix of the cow at parturition.

The objective of this study was to investigate the temporal changes in dilatation of the caudal cervix during induced calvings (n = 5). We used ultrasound cervimetry, allowing the continuous recording of the distance between a transmitting and receiving ultrasound crystal, which were implanted opposite to each other on the caudal rim of the cervix. We started recording between 19 and 21 h after injecting a prostaglandin analogue (PG) on day 272 of gestation. A fluid-filled catheter had been introduced transcervically between the fetal membranes and the uterine wall for measurements of intra-uterine pressure (IUP). While the characteristics of calving varied widely between the five animals, it appeared possible to divide the process of dilatation into four phases. During the latent phase, which lasted until 25-43 h after PG, no net gain in dilatation occurred. We found an acceleration phase (4.3-6.8 h), in which the dilatation rate speeds up (0.49-0.84 cm/h) in three of the cows. During the phase of maximum slope (lasting 0.5-4.8 h), we measured an even higher rate (1.47-8.48 cm/h), decreasing again during the deceleration phase (rate 0.24-2.28 cm/h) in four cows. The quality of the IUP measurements precluded us from continuously investigating the relationship between cervical dilatation and uterine contractions. However, short term simultaneous recordings revealed that the cervical opening changed momentarily in the absence of IUP during the latent phase, while during the phase of maximum slope, temporary changes of dilatation coincided with uterine contractions. We concluded that the method of ultrasound cervimetry used in this study provides a valuable way to study the process of cervical dilatation in parturient cows in vivo.

Elevated serum transaminase levels during ritodrine administration

Two cases are presented of the occurrence of elevated serum transaminase levels during ritodrine administration for the treatment of premature labor. The clinical course of these cases suggests that elevated transaminase levels per se do not require the discontinuation of beta-sympathomimetic tocolytic treatment.

Hemodynamic effects of caval and uterine venous occlusion in pregnant sheep

In chronically instrumented pregnant ewes we studied the systemic, uterine, and fetal effects of increased uterine venous pressure with and without simultaneous changes in cardiac output, by occluding either the inferior vena cava or both uterine veins. Increased uterine venous pressure with no reduction in venous return of blood to the heart resulted in a reflex increase in arterial blood pressure. Infrarenal obstruction of the inferior vena cava resulted in a moderate reduction in venous return and cardiac output with no change in arterial blood pressure, while suprarenal obstruction of the inferior vena cava caused a major decrease in cardiac output as well as in arterial pressure. Uterine blood flow varied in proportion with perfusion pressure at all levels of obstruction. Uterine oxygen consumption and fetal oxygenation only decreased with suprarenal obstruction of the inferior vena cava, when uterine blood flow fell more than 50%.

Maternal cardiac disease and pregnancy

A woman with heart disease may benefit from early obstetric counselling because it may help to reduce uncertainty or anxiety with regard to her ability to carry a pregnancy at some time in her life and may help her to prevent unwanted pregnancy or to avoid the need for an abortion. Pregnancy imposes an additional burden upon the circulation of a woman with heart disease and additional precautions may therefore be required during the antenatal period, labour, delivery and the puerperium. Nevertheless, with proper care, maternal and fetal outcome is good in most women with cardiac disease.

Swimming and diving by pregnant women

Pregnant women have traditionally been discouraged from participating in physically demanding sports because they have been considered to be in poor condition and it was thought that strenuous exercise could harm the mother and the fetus. More recently, however, many physically active women have wished to continue sport in pregnancy and research over the past 20 years has shown that in general it is safe to do so.