Effect of naloxone on fetal behavior near term

Arduini, Domenico; Rizzo, Giuseppe; Dell'Acqua, S; Mancuso, Stefano; Romaninï, Carlo

doi:10.1016/0002-9378(87)90313-9

Cited by 30 publications

(11 citation statements)

References 11 publications

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“…35 Some studies have raised possible associations between diaze pam administration and mental retardation or neuro logic defects, 37 cardiac defects, 39 and Mobius syndrome (sixth and seventh nerve palsies). 44 Diazepam is rated a category D drug during pregnancy because of these potential associations, and its use during pregnancy is discouraged, particularly in the first trimester. Clinical data concerning fetal safety of midazolam are limited; however, the drug has not been associated with oral cleft palates.…”

Section: Introductionmentioning

confidence: 99%

Risks versus benefits of gastrointestinal endoscopy during pregnancy

Cappell

2011

Nat Rev Gastroenterol Hepatol

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Although gastrointestinal endoscopy is generally safe, its safety must be separately analyzed during pregnancy with regard to fetal safety. Fetal risks from endoscopic medications are minimized by avoiding FDA category D drugs, minimizing endoscopic medications, and anesthesiologist attendance at endoscopy. Esophagogastroduodenoscopy seems to be relatively safe for the fetus and may be performed when strongly indicated during pregnancy. Despite limited clinical data, endoscopic banding of esophageal varices and endoscopic hemostasis of nonvariceal upper gastrointestinal bleeding seems justifiable during pregnancy. Flexible sigmoidoscopy during pregnancy also appears to be relatively safe for the fetus and may be performed when strongly indicated. Colonoscopy may be considered in pregnant patients during the second trimester if there is a strong indication. Data on colonoscopy during the other trimesters are limited. Therapeutic endoscopic retrograde cholangiopancreatography seems to be relatively safe during pregnancy and should be performed for strong indications (for example, complicated choledocholithiasis). Endoscopic safety precautions during pregnancy include the performance of endoscopy in hospital by an expert endoscopist and only when strongly indicated, deferral of endoscopy to the second trimester whenever possible, and obstetric consultation.

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Section: Introductionmentioning

confidence: 99%

Risks versus benefits of gastrointestinal endoscopy during pregnancy

Cappell

2011

Nat Rev Gastroenterol Hepatol

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“…The finding is in line with the hypothesis that ß-endorphin may be considered as a marker of fetal suffering and its increase might reflect an adaptational response of the fetus to the altered environ¬ mental conditions due to the maternal pathology. Accordingly, opioid peptides have been implicated in the control of several homeostatic functions, such as body temperature, blood pressure, respi¬ ratory control, glycémie state (15), and fetal behav¬ iour (21). Our results are also in agreement with previous findings showing that the concentrations of ACTH and ß-endorphin in fetal umbilical plasma increase in parallel with the proceeding of delivery (22,23), although contrasting results have been reported (24), and with the finding that opioid levels increase after fetal hypoxia and acidosis (8), a condition always present to some extent when fetal distress occurs.…”

Section: Discussionmentioning

confidence: 99%

Correlation between amniotic levels of α-MSH, ACTH and β-endorphin in late gestation and labour in normal and complicated pregnancies

Mauri

Serri²,

Caminiti³

et al. 1990

Acta Endocrinologica

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\g=a\-MSH, ACTH and \g=b\-endorphin were measured by radioimmunoassay in samples of amniotic fluid collected from the 32nd to the 38th gestational week and at labour from normal pregnancies and pregnancies complicated by gestosis. In normal pregnancies, the concentration of \g=a\-MSH, ACTH and \g=b\-endorphin remained relatively constant during the last 7 gestational weeks, but increased at labour above the values of the 38th week by 88, 143 and 96%, respectively. A positive correlation between \g=b\-endorphin and \g=a\-MSH (r=0.92) or ACTH (r=0.76) levels was found when labour values were considered in the regression analysis. In contrast, when labour values were excluded, only a poor positive correlation between \g=b\-endorphin and \g=a\-MSH (r=0.52) was found. In complicated pregnancies, \g=a\-MSH and ACTH concentrations were similar to those found in normal pregnancies; on the other hand, the level of \g=b\-endorphin, was found to be 130% higher than normal. As in normal pregnancies, \g=a\-MSH, ACTH and \g=b\-endorphin levels increased at labour, but only by 46, 44 and 23%, respectively. In contrast to in normal pregnancies, the correlation between \g=b\-endorphin and \g=a\-MSH or ACTH was not significantly modified by labour values. The present results confirm and extend previous studies showing that \g=b\-endorphinmay be considered a marker of fetal distress and that the fetal pituitary is capable of reacting to stressful stimuli in normal and suffering fetuses.The major pro-opiomelanocorticotropin (POMC) derivatives a-MSH, ACTH and ß-endorphin (1,2) appear at very early stages of fetal development (3,4) and are found not only in the fetal pituitary gland but also in fetal plasma and amniotic fluid (5,6). The fetal pituitary gland seems to be the major source of these peptides in fetal fluids (7,8), although they have been detected also in placenta and amniochorial membranes (9,10). It has also been shown that amniotic a-MSH and ß-endorphin decrease during pregnancy, the highest levels being found in the 1st trimester and the lowest in the 3rd trimester, whereas the ACTH concentra¬ tion was found to be lowest in the 2nd and highest in the 3rd trimester (6). Moreover a-MSH seems to play an important role in the development of the feto-placental unit (11,12) and, like ACTH, in the control of fetal steroidogenesis (13,14). Neverthe¬ less, very little is known about their physiological function in prenatal life. While it is well established that in adult life these peptides are released by stressful stimuli to coordinate biochemical, endocrinological and behavioural changes that consti¬ tute an adaptative mechanism against stress (15), few and incomplete results exist about the effect of stress on fetal plasma and amniotic concentration of POMC-derived peptides in normal pregnancies or pregnancies complicated by maternal disorders that can be associated with fetal discomfort. The only exception is for amniotic ß-endorphin, whose concentration was found to be increased in suf¬ fering fetuses (8,16,17).With the a...

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“…Recordings were performed, two hours after a 1500 Kcal standardized lunch, in a quiet room with the women lying in a comfortable semi-recumbent position using a previously reported technique [3].…”

Section: Methodsmentioning

confidence: 99%