Immersion in water during the second stage of labor: a randomized controlled trial.

Background: Current obstetrical guidelines in the United States caution firmly against birth in water, but patients remain interested in this intervention. Limited data are available to evaluate the safety and efficacy of water immersion in the second stage of labor for patients and neonates.

Objective: This study aimed to ascertain the effects of water use during the second stage of labor on maternal outcomes.

Calcium supplementation during pregnancy for preventing hypertensive disorders is not associated with changes in platelet count, urate, and urinary protein: a randomized control trial.

Objective: To test the hypothesis that calcium supplementation inhibits the underlying pathological processes in women with preeclampsia.

Methods: Seven hundred and eight nulliparous women were enrolled in a WHO randomized double-blind trial, who received 1.5 g of calcium or placebo from 20 weeks of pregnancy or earlier.

Promoting childbirth companions in South Africa: a randomised pilot study.

Background: Most women delivering in South African State Maternity Hospitals do not have a childbirth companion; in addition, the quality of care could be better, and at times women are treated inhumanely. We piloted a multi-faceted intervention to encourage uptake of childbirth companions in state hospitals, and hypothesised that lay carers would improve the behaviour of health professionals.

Methods: We conducted a pilot randomised controlled trial of an intervention to promote childbirth companions in hospital deliveries.

Regulation of GTP cyclohydrolase I expression by orphan receptor Nurr1 in cell culture and in vivo.

Nurr1 is an orphan nuclear transcription factor essential for the terminal differentiation of dopamine (DA) neurons in the ventral midbrain (VM). To identify the Nurr1-target genes, we carried out microarray and quantitative real-time PCR analyses of Nurr1 null and wild-type mice in VM at embryonic day (E) 12.5 and shortly after birth (P0).

Reduced tyrosine hydroxylase and GTP cyclohydrolase mRNA expression, tyrosine hydroxylase activity, and associated neurochemical alterations in Nurr1-null heterozygous mice.

The nuclear receptor Nurr1 is essential for the development of midbrain dopamine neurons and appears to be an important regulator of dopamine levels as adult Nurr1-null heterozygous (+/-) mice have reduced mesolimbic/mesocortical dopamine levels. The mechanism(s) through which reduced Nurr1 expression affects dopamine levels has not been determined. Quantitative real-time PCR revealed a significant reduction in tyrosine hydroxylase (TH) and GTP cyclohydrolase (GTPCH) mRNA in ventral midbrain of +/- mice as compared to wild-type mice (+/+).

Regulation of osteoblast differentiation by Nurr1 in MC3T3-E1 cell line and mouse calvarial osteoblasts.

The orphan nuclear receptor Nurr1 is primarily expressed in the central nervous system. It has been shown that Nurr1 is necessary for terminal differentiation of dopaminergic (DA) neurons in ventral midbrain. The receptor, however, is also expressed in other organs including bone, even though the role of Nurr1 is not yet understood.

Early postnatal isolation reduces dopamine levels, elevates dopamine turnover and specifically disrupts prepulse inhibition in Nurr1-null heterozygous mice.

Sensorimotor gating is a phenomenon that is linked with dopamine neurotransmission in limbic and cortical areas, and disruption of sensorimotor gating has been consistently demonstrated in schizophrenia patients. The nuclear receptor Nurr1 is essential for development of dopamine neurons and, using Nurr1-null heterozygous mice, has been found to be important for normal dopamine neurotransmission as null heterozygous mice have reduced limbic and cortical dopamine levels and elevated open-field locomotor activity. The current investigation compared sensorimotor gating, as measured by prepulse inhibition of the acoustic startle response, in Nurr1 wild-type and null heterozygous mice.

Misoprostol for treating postpartum haemorrhage: a randomized controlled trial [ISRCTN72263357].

BACKGROUND: Postpartum haemorrhage remains an important cause of maternal death despite treatment with conventional therapy. Uncontrolled studies and one randomised comparison with conventional oxytocics have reported dramatic effects with high-dose misoprostol, usually given rectally, for treatment of postpartum haemorrhage, but this has not been evaluated in a placebo-controlled trial. METHODS: The study was conducted at East London Hospital Complex, Tembisa and Chris Hani Baragwanath Hospitals, South Africa.

Differential role of ERK in cAMP-induced Nurr1 expression in N2A and C6 cells.

We investigated the signal pathway related to induction of Nurr1, transcription factor, by cAMP in neuroblastoma N2A and C6 glioma cell lines. Nurr1 expression was induced by forskolin, an adenylate cyclase activator, via activation of CREB in both N2A and C6 cells. The effect of forskolin on ERK, however, was cell specific.

Immersion in water in pregnancy, labour and birth.

Background: Enthusiasts for immersion in water during labour, and birth have advocated its use to increase maternal relaxation, reduce analgesia requirements and promote a midwifery model of supportive care. Sceptics are concerned that there may be greater harm to women and/or babies, for example, a perceived risk associated with neonatal inhalation of water and maternal/neonatal infection.

Objectives: To assess the evidence from randomised controlled trials about the effects of immersion in water during pregnancy, labour, or birth on maternal, fetal, neonatal and caregiver outcomes.

Nurr1-null heterozygous mice have reduced mesolimbic and mesocortical dopamine levels and increased stress-induced locomotor activity.

Nurr1, an orphan nuclear receptor, is essential for the differentiation of the midbrain dopamine (DA) neurons; however, its function in adult midbrain DA neurons has not been determined. The present study compared regional brain levels of catecholamines and spontaneous and pharmacologically induced locomotor behaviors between mice heterozygous for the Nurr1-null allele (+/-) and wild type (+/+) littermates. The Nurr1 +/- mice had significantly lower levels of DA in whole brain, midbrain, prefrontal cortex and nucleus accumbens, although no significant differences were observed in the striatum, olfactory bulb or hippocampus.

Erythropoietin receptor signalling is required for normal brain development.

Erythropoietin, known for its role in erythroid differentiation, has been shown to be neuroprotective during brain ischaemia in adult animal models. Although high levels of erythropoietin receptor are produced in embryonic brain, the role of erythropoietin during brain development is uncertain. We now provide evidence that erythropoietin acts to stimulate neural progenitor cells and to prevent apoptosis in the embryonic brain.

Titrated oral misoprostol solution for induction of labour: a multi-centre, randomised trial.

Objectives: To determine the effects of titrated oral misoprostol solution, compared with vaginal dinoprostone.

Study Design: Open, randomised clinical trial.

Setting: Academic hospitals in South Africa and Liverpool, UK.

Side-effects of oral misoprostol in the third stage of labour--a randomised placebo-controlled trial.

Background: Misoprostol, an inexpensive, stable, orally active prostaglandin analogue, has been suggested for use in the prevention of postpartum haemorrhage. Potential side-effects, however, need to be quantified.

Objective: To compare the rate of postpartum shivering and pyrexia following oral misoprostol 600 micrograms and placebo.

In vitro regulated expression of tyrosine hydroxylase in ventral midbrain neurons from Nurr1-null mouse pups.

The transcription factor Nurr1, an orphan member of the steroid-thyroid hormone nuclear receptor superfamily, is essential for the proper terminal differentiation of ventral midbrain dopaminergic neurons. Disruption of the Nurr1 gene in mice by homologous recombination abolishes synthesis of dopamine (DA) and expression of DA biosynthetic enzymes, including tyrosine hydroxylase (TH), in the ventral midbrain without affecting the synthesis of DA in other areas of the brain. At birth, however, dopaminergic neuron precursors in Nurr1 null (-/-) pups remain as shown by continued expression of residual, untranslated Nurr1 mRNA not altered by homologous recombination.

Nigrostriatal innervation is preserved in Nurr1-null mice, although dopaminergic neuron precursors are arrested from terminal differentiation.

Various factors, including the orphan nuclear receptor Nurr1, have been implicated in dopamine biosynthesis, but many of the specific events involved in this process have to be determined. Using genetic manipulations in mice, the obligatory role for Nurr1 in dopamine (DA) biosynthesis has been documented; however, the mechanism remains unclear. DA biosynthetic enzymes, transporters and receptors are absent in the substantia nigra (SN) and the ventral tegmental area (VTA) of Nurr1-null neonates.

Woman's position during second stage of labour.

Background: For centuries, there has been controversy around whether being upright (sitting, birthing stools, chairs, squatting) or lying down have advantages for women delivering their babies.

Objectives: The objective of this review was to assess the benefits and risks of the use of different positions during the second stage of labour (i. e.

Immersion in water in pregnancy, labour and birth.

Background: Immersion in warm water may help with relaxation, pain relief and increased elasticity of the birth canal. On the other hand, there may be risks associated with decreased mobility and inhalation of water by the baby, as well as increased risk of maternal infection.

Objectives: The objective of this review was to assess the effects of immersion in water during pregnancy, labour or birth on maternal, fetal, neonatal and caregiver outcomes.

hnRNP U inhibits carboxy-terminal domain phosphorylation by TFIIH and represses RNA polymerase II elongation.

This study describes a potential new function of hnRNP U as an RNA polymerase (Pol II) elongation inhibitor. We demonstrated that a subfraction of human hnRNP U is associated with the Pol II holoenzyme in vivo and as such recruited to the promoter as part of the preinitiation complex. hnRNP U, however, appears to dissociate from the Pol II complex at the early stage of transcription and is therefore absent from the elongating Pol II complex.

Differential expression of tyrosine hydroxylase in catecholaminergic neurons of neonatal wild-type and Nurr1-deficient mice.

The orphan nuclear receptor Nurr1 is a transcription factor that belongs to the steroid/thyroid hormone receptor superfamily and is expressed in many regions of the brain. To determine the physiological role of Nurr1, we previously generated mice with a null mutation in the Nurr1 gene. Nurr1-null mice appear to develop normally but die within 12 h after birth.

A randomised placebo controlled trial of oral misoprostol in the third stage of labour.

Objective: To compare oral misoprostol 400 microg with placebo in the routine management of the third stage of labour.

Design: A double-blind placebo controlled trial. Setting The labour ward of an academic hospital in Johannesburg, South Africa with 7000 deliveries per annum.