No abstract

Orally administered misoprostol was more effective in reducing blood loss during the third stage of labor than intramuscular methylergometrine. However, there were more subjects in the misoprostol group in whom duration of the third stage of labor was greater than 15 min and who also had manual placental removal than in the methylergometrine group.

BackgroundSome studies have suggested that diastolic dysfunction precedes the clinical manifestation of hypertension. Whether changes in cardiac structure and function predate the clinical manifestation of hypertension later in life is now being investigated. The aim of this study was to assess the differences in cardiac structure and function between the offspring of hypertensive and normotensive parents.MethodsEighty normotensive offspring of hypertensive parents (OHyp) (41 females and 39 males) and 62 normotensive offspring of normotensive parents (ONorm) (31 males and 31 females) were recruited for echocardiography.ResultsThe mean age was 25.0 (5.31) and 24.3 (3.60) years in the OHyp and ONorm participants, respectively (p = 0.369). Other baseline parameters were comparable between the two groups. Septal wall thickness in systole was higher in the OHyp than the ONorm subjects [1.3 (0.35) vs 1.1 (0.25), p = 0.0173]. Indexed left ventricular mass [28.1 (7.33) vs 27.5 (7.23), p = 0.631] and relative wall thickness [(0.3 (0.10) vs 0.3 (0.90), p = 0.280] were similar in the two groups. The offspring of hypertensives had lower deceleration time [149.9 (38.89) vs 169.0 (50.08) ms, p = 0.012], prolonged duration of pulmonary A reverse flow [113.5 (70.69) vs 81.7 (38.31) ms, p = 0.024], increased myocardial isovolumic relaxation time [173.4 (47.98) vs 156.1 (46.74) ms, p = 0.033] and a lower myocardial Em [0.2 (0.05) vs 0.3 (1.38), p = 0.037] and myocardial Em/Am ratio [1.6 (0.01) vs 2.1 (0.01), p = 0.019] than the offspring of normotensives.ConclusionThis study showed that offspring of OHyp subjects had early diastolic functional abnormalities when compared with offspring of ONorm participants. Longitudinal studies are needed to determine the implications of this finding in this African population.

Changes in the geometry of the left ventricle occur early in hypertension and precede deterioration in left ventricular systolic function. The corresponding left atrial changes are marginal and are indicative of increased left atrial length and accentuated atrial systolic function.