No abstract

Simultaneous measurements of prostaglandin F, total unconjugated oestrogens and progesterone have been made in utero-ovarian venous or posterior vena caval plasma from pregnant ewes during parturition. In all cases, levels of oestrogens and prostaglandin F increased before delivery, after a decrease in the level of progesterone. In four out of six sheep, during both spontaneous and dexamethasone-induced labour, increases in the levels of oestrogens and prostaglandin F occurred in parallel. In the other two animals, levels of prostaglandin F increased before those of oestrogens. The increases in prostaglandin F consistently preceded any measurable increase in uterine activity, suggesting levels were not raised as a consequence of labour. Infusion of oestrogen to two dexamethasone-treated animals resulted in increased utero-ovarian venous prostaglandin F levels within 2\p=n-\3 h. These findings support previous evidence indicating that levels of prostaglandin F may be controlled by oestrogen and progesterone. Manual examination of the cervix, with associated distension of the vagina, resulted in dramatic increases in the level of utero-ovarian venous prostaglandin F during the last 13 h of gestation, both in dexamethasone-induced labour and in labour of natural onset. Since expulsion of the foetus also results in vaginal distension, this finding raises the possibility that the very high levels of prostaglandin F observed at delivery may be caused by tactile stimulation of the vagina.

Levels of unconjugated oestrone and oestradiol were measured in maternal peripheral and umbilical arterial and venous plasma. The levels before and after the spontaneous onset of labour were compared, samples being obtained either at elective Caesarean section or at normal delivery following labour of spontaneous onset. In the umbilical circulation, the mean concentrations of both oestrone and oestradiol were higher in the vein than in the artery, but the V-A difference was highly significant only for oestrone (P

No abstract

A case of placenta praevia accreta is described. Delivery was achieved by Caesarean section and the placenta was left in place because of the risk of haemorrhage. Successful internal iliac artery embolization was performed 9 days postpartum to control uterine bleeding. Hysterectomy was performed at 55 days postpartum because of bleeding and sepsis.