Corticotropin-releasing hormone and pituitary-adrenal hormones in pregnancies complicated by chronic hypertension

Article Abstract:

The placental production of corticotropin-releasing hormone (CRH) appears to follow a different pattern among pregnant women with chronic hypertension compared with healthy women. CRH is believed to modulate pituitary and adrenal function in the mother and the fetus. Blood and urine samples were obtained from 37 women in whom hypertension either preceded the pregnancy or developed before 20 weeks gestation, and 47 healthy women from 21 to 40 weeks gestation. At least three samples were taken from nine hypertensive women and eight healthy women at one to two-week intervals. In normal pregnancies, CRH levels rose steeply throughout the latter half ofpregnancy. In hypertensive pregnancies, CRH levels first rose faster than in normal pregnancies, but they plateaued at 32 to 36 weeks gestation and rose no further. Levels of pituitary and adrenal hormones were similar between groups, but CRH levels correlated inversely with maternal blood levels of estriol. It is theorizied that CRH suppresses fetal production of the precursor to estriol.

Corticotropin releasing hormone, Corticotropin-releasing hormone, Hypertension in pregnancy, Gestational hypertension, Pituitary hormones

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Prevention of maternal hypotension by epidural administration of ephedrine sulfate during lumbar epidural anesthesia for cesarean section

Article Abstract:

Administering ephedrine sulphate as part of epidural anesthesia does not appear to reduce the incidence of maternal low blood pressure in women having a cesarean section. Low blood pressure is a common complication of epidural anesthesia and can pose some risk to the fetus. Researchers randomly assigned 50 nonlaboring women having a cesarean section to receive either saline or ephedrine sulphate along with an epidural anesthetic. One-third of the treated group experienced low blood pressure compared with one-quarter of the control group.

Health aspects, Prevention, Complications and side effects, Cesarean section, Ephedrine, Hypotension

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The effect of lumbar epidural anesthesia on maternal middle cerebral artery blood flow in normal pregnancy: a prospective, randomized, double-blind comparison study

Article Abstract:

Lumbar epidural anesthesia in women at the full term of pregnancy does not appear to compromise blood flow in the brain. Researchers ultrasonically measured blood flow in the middle cerebral artery of 24 healthy women undergoing cesarean section procedures following epidural anesthesia with either lidocaine or bupivacaine. Heart rate, blood pressure, respiratory rate, and arterial flow and pulsatile indices were similar in both groups, and not apparently affected by the anesthetic.

Cerebral circulation, Cerebral arteries, Lidocaine, Anesthesia in obstetrics, Obstetrical anesthesia, Bupivacaine

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