Ritodrine is a beta-adrenergic agonist commonly used to inhibit premature labor contractions in women. The primary goal of ritodrine tocolysis is to prolong gestation, however, other indications may include fetal distress. The purpose of the current study was to examine the metabolic and behavioral effects of ritodrine in the fetus, using the chronically instrumented pregnant sheep as an experimental model. Ritodrine was infused continuously into 11 fetal lambs at a rate of 2.6 ug/minute for a period of 8, 12 or 24 hours. Samples were taken simultaneously at predetermined time periods from a fetal femoral artery, umbilical vein, maternal femoral artery and uterine vein for the analysis of fetal and maternal arterial and umbilical and uterine venous blood gases, acid-base status, hematocrit, ritodrine concentration, uterine and umbilical blood flow, and glucose, lactate and oxygen concentrations and fluxes. Cardiovascular and behavioral variables were monitored continuously. The average concentration of ritodrine in fetal arterial plasma was 20.0 ± 2.7 ng/ml (range 9.5 to 3 4.7 ng/ml) at the end of the infusion. This concentration is within the range of cord levels obtained in ritodrine exposed human fetuses at birth (7 to 79 ng/mL) . Fetal arterial plasma ritodrine levels at 8 hours post-infusion were still sufficiently elevated to exert considerable fetal effects. The apparent tolerance of the fetus to given plasma levels of drug varied considerably among animals. The infusion of ritodrine resulted in many typical beta-adrenergic receptor mediated responses in the fetus. Fetal arterial glucose levels rose to 79% above the control by the end of the infusion. This was associated with an increase in fetal glucose delivery (70% above the control), a decrease in the umbilical veno-arterial glucose concentration difference and a tendency for fetal glucose uptake to decline. Fetal arterial plasma lactate concentrations rose more than fivefold during the infusion of ritodrine. This was associated with a rise in fetal lactate delivery (540% above the control), a slight increase in the umbilical veno-arterial plasma lactate concentration difference and a tendency for fetal lactate uptake to rise. Fetal oxygen consumption rose progressively and significantly throughout the infusion of ritodrine and during the first 8 hours of post-infusion, reaching a maximum of 22% above the control by 8 hours post-infusion. Umbilical blood flow remained unchanged, therefore umbilical oxygen delivery was not increased to meet the additional oxygen demands of the fetus. The rise in fetal oxygen consumption was hence accomplished through an increase in fetal fractional oxygen extraction (from a control value of 32.0±1.1% to a maximum of 51.6±1.8% by 1.5 hours of infusion). The rise in fetal oxygen extraction resulted in concurrent declines in fetal arterial Po₂ (78% of the control) and O₂ content (55% of the control) and a widening of the veno-arterial oxygen content difference. By the end of the infusion, umbilical venous Po₂ and O₂ content values had also fallen significantly to 78% and 75% of the control respectively. These latter changes resulted in a concurrent 25% decline in fetal oxygen delivery which in turn contributed to the rise in fetal oxygen extraction. Fetal arterial and umbilical venous pH declined rapidly and significantly from control values of 7.370±0.004 and 7.401±0.005 to 7.274±0.025 and 7.306±0.023 respectively by the end of the infusion. The acidemia was reflected by significant declines in base excess values and appeared to be entirely metabolic in nature, resulting from elevated blood lactate levels. The acidemia likely contributed to the progressive fall in fetal blood O₂ content through a rightward shift of the oxyhemoglobin dissociation curve (Bohr effect). The rise in fetal oxygen consumption was reflected by a similar (although nonsignificant) increase in uterine oxygen consumption. Uteroplacental oxygen consumption appeared to remain unaltered. The rise in uterine oxygen consumption was not accompanied by a corresponding increase in uterine oxygen delivery, hence uterine oxygen extraction rose to 23.8±1.9% (from a control value of 19.5±1.6%) by 1.5 hours post-infusion. The rise in uterine oxygen extraction resulted in significant declines in uterine venous Po₂ and CO₂ values which likely contributed to the fall in fetal oxygen delivery. Fetal heart rate increased significantly to 21% (34 beats per minute, bpm) above the control (162±7 bpm) during the first 1.5 hours of ritodrine infusion. It remained elevated by an average of 16% (26 bpm) throughout the remainder of the infusion and the first 8 hours of post-infusion, returning to the control by the end of the post-infusion period. Fetal arterial pressure remained unchanged from the control (46.2±1.5 mm Hg). The incidence of fetal breathing activity fell significantly from an overall average control value of 43.2±2.6% to an average of 28.1±6.8% during the ritodrine infusion period. In most animals, breathing was most depressed near the end of the infusion. The incidence of low voltage electrocortical (ECoG) activity also fell significantly by an average of 7.5% while that of high voltage ECoG rose by 7.3%. Alterations in intermediate voltage activity were not observed. The incidence of fetal rapid eye movement also tended to fall by an average of 8.2% during the infusion of ritodrine. These behavioral changes may have resulted from the development of fetal hypoxemia, rather than as a direct effect of ritodrine. In conclusion, these data have demonstrated that ritodrine infusion to fetal lambs results in significant physiological and behavioral changes in the fetus. These effects may put the fetus at risk, particularly in situations where fetal oxygen delivery is already reduced, as in various states of compromised pregnancy. / Medicine, Faculty of / Obstetrics and Gynaecology, Department of / Graduate

Orientador: Isabel Cristina Cherici Camargo / Banca: Regildo Márcio Gonçalves da Silva / Banca: Eneri Vieira de Souza Leite Mello / Resumo: A Agave sisalana (sisal) é amplamente cultivada em território brasileiro. Foi constatada a presença de cinco saponinas esteroidais nessa planta, responsáveis por várias atividades farmacológicas, destacando-se as atividades antifúngica e anti-inflamatória. Popularmente, o sisal ainda é utilizado para o tratamento de doenças hepáticas, tuberculose e sífilis. Devido à sua ação detergente, as saponinas são dotadas de efeito tóxico em função de sua propriedade de causar ruptura em eritrócitos, liberando hemoglobina, além de outros efeitos ainda relacionados à lise celular como as ações inseticida, anti-helmíntica e ictiotóxica. Considerando-se as diversas ações farmacológicas da A. sisalana e seu amplo uso na medicina popular, torna-se necessário investigar seus possíveis efeitos colaterais na reprodução feminina, os quais ainda não foram relatados na literatura / Abstract: The Agave sisalana (sisal) is largely cultivated in Brazil. It was found the presence of five steroidal saponins that plant, responsible for various pharmacological activities, especially the anti-fungal and anti-inflammatory activities. Popularly, sisal is also used for the treatment of liver diseases, tuberculosis and syphilis. Due to its detergent action, saponins are equipped with toxic effect due to its property to cause disruption in erythrocytes, releasing hemoglobin, and other effects still related to cell lysis as the actions insecticide, anthelmintic and ichthyotoxic. Considering the various pharmacological actions of A. sisalana and its widespread use in folk medicine, it is necessary to investigate their possible side effects on female reproduction, which have not yet been reported in the literature / Mestre

Master of Science

The purpose of this study was to determine the relationship- between prenatal weight gain relative to initial weight and change in smoking habits relative to prepregnancy smoking habits on infant birth weight. The convenience sample was 100 women who had been prenatal clients at a clinic for low income women and who delivered term infants during a one year period. Women were selected who had term deliveries and were without medical problems during the pregnancy.Prepregnancy weight-for-height was determined using the 1959 Metropolitan Life Insurance Table. Weight gain throughout the pregnancy was charted on the appropriate graph. Changes in smoking habits during the pregnancy were evaluated verbally. Roy's Adaptation Model was the conceptual framework for this study. The physiological mode of this model depicts people as individuals who are constantly adapting to a changing environment. Procedures for the protection of human subjects were followed.The first research question illustrated that women who gained adequate weight and reduced or quit smoking had infants with higher birth weights. The second research question showed that, overall, women who quit or reduced the amount smoked early in pregnancy had infants with higher birth weights than women who quit or reduced later in pregnancy or-who did not change smoking habits. The third research question determined that nonsmokers had infants with higher birth weights than smokers.Women who smoke will have infants with lower birth weights than those that do not smoke. Women with inadequate weight gains during pregnancy are more likely to have infants: with lower birth weights than women with adequate weight gains. Health care providers must be able to relay, the risks of inadequate weight gain and smoking to pregnant women. / School of Nursing

No description available.

Thesis (MEdPsych (Educational Psychology)--University of Stellenbosch, 2007. / Fetal Alcohol Syndrome (FAS) is an ongoing problem in the Western Cape. Marginalised and poverty-stricken communities use alcohol as a method of entertainment because it is freely available and relatively inexpensive. Due to a cycle of ongoing poverty and lack of education, many women drink large quantities of alcohol when they are pregnant or before they know they are pregnant. This causes the unborn baby to be severely at risk for FAS. There has been much research done in academic and social environments on the presentation and symptoms of FAS and of behaviour. Less research has been done surrounding the mother's experience of her FAS child, it is therefore my aim to research this gap in the research. This research study investigated the experience of mothers who raised children with FAS. Many mothers of children with prenatal exposure to alcohol feel conflict and guilt regarding their children and I attempted to find out what their general experience surrounding this was. Within this research topic I aimed to investigate the mothers' attitudes, their behaviour towards and their general perceptions of their developing child with FAS. This was viewed from an eco-systemic framework in which the mother is an integral part of different systems impacting and working together, that influence her maternal functioning. Finally, the aim of this research study was to ascertain how best mothers of FAS children could be supported. In this same process, I hoped, the mothers could learn to feel empowered to help and support their child, and in the process attempt to shift ongoing cycles of negative behaviour patterns to more positive outcomes.

No description available.

Perinatal complications resulting from either alcohol or drug abuse include a high incidence of stillbirths, fetal distress, asphyxia, prematurity, low birth weight, pneumonia, congenital malformations, cerebral infarction, and an increased risk to acquired immunodeficiency syndrome.

Although there have been two-dimensional electrophoretic studies on fetal brain tissue (for instance, Yoshida and Takahashi, 1980), the emphasis in most of this work has been on developmental changes in protein expression, and not on the effects that drugs have on fetal brain protein complement. Klose and co-workers (1977) did an early study using two-dimensional gel electrophoresis to determine the effects of various teratogens on whole embryos. No protein changes were found and that line of research was not continued. In this study two-dimensional gel electrophoresis is extensively used, in the belief that the usefulness of this technique to experimental teratology has not been fully evaluated. It is reasonable to suppose that a central nervous system teratogen administered during critical periods of susceptibility will led to perturbations of orderly brain development, and that these perturbations will be reflected as changes to the protein complement. The total brain protein complement of mice that have been exposed to drugs in utero will therefore be analysed, in the hope that any inductions or deletions of proteins as a result of drug exposure may provide a clue to the molecular events underlying drug injury to the fetus.

The purpose of this study is to see if all the special circumstances, extra classes, and parenting aspects of a treatment program are effective for pregnant substance abusing women. This study also explored the factors that contributed to the perceived satisfaction and effectiveness of the clients enrolled in a drug and alcohol treatment program.