The antepartum findings of conjoined twins.

Various estimates abound as to the incidence of conjoined (Siamese) twins, but they are indeed uncommon. The probability of their occurance has been calculated to be once in every 12,000 to once in every 100,000 deliveries. Although uncommon, the antepartum diagnosis can be extremely important to the twins and the mother, if only to spare the trauma of a trial by labor.

Fetal heart rate patterns preceding death in utero.

Four cases of intrauterine fetal demise in term infants are presented. From these cases and other published reports, a sequence of fetal heart rate changes preceding intrapartum death is presented. Late or variable decelerations, if unrelieved or uncorrected, lead to baseline heart rate changes of tachycardia and loss of variability reflecting loss of fetal reserve and fetal distress.

Correlation between amniotic fluid optical density and L/S ratio.

A test that circumvents the complex methodology needed for the determination of L/S ratios has been developed. It has been observed that the optical density, measured at 400 nm, of supernatants collected from fresh amniotic fluids centrifuged at 2000 g for 10 minutes correlates with L/S ratios.

The evaluation of continuous fetal heart rate monitoring in high-risk pregnancy.

Intrapartum electronic fetal heart rate monitoring of the high-risk obstetric patient is thought to improve the perinatal outcome. A prospective randomized study of 483 high-risk obstetric patients in labor was carried out comparing the effectiveness of electronic fetal monitoring with auscultation of fetal heart tones. The infant outcome was measured by neonatal death, Apgar scores, cord blood gases, and neonatal nursery morbidity.

An evaluation of the significance of positive oxytocin challenge test.

Sixty-six of 390 patients studied at LAC/USC Women's Hospital between 1970 and 1973 had positive oxytocin challenge tests (OCT). Twenty-four percent of patients who were allowed direct monitored labor after a positive OCT showed no late deceleration and must be assumed to have had false-positive tests. Patients with positive OCT's had significantly increased incidences of perinatal mord late deceleration in labor when compared to patients with no positive OCT.

Ritodrine HCL for the prevention of premature labor in twin pregnancies.

The perinatal mortality rate for twin gestation is in the range of 15%, and this is due predominantly to prematurity, although twins may also be born growth retarded. Ritodrine HCl, a beta sympathomimetic drug, has been shown to be effective, both in stopping premature labor and in preventing intrauterine growth retardation. With this in mind, a double-blind study using ritodrine HCl or placebo was begun in order to study its effect on premature labor, intrauterine growth retardation, and the perinatal mortality rate in twins.