Methyldopa hepatotoxicity in pregnancy: a case report.

A case of hepatotoxicity in a multiparous Native woman, who was begun on a regimen of methyldopa for control of chronic hypertension, is described. The patient was first seen for clinical evidence of hepatotoxicity approximately 3 weeks after initiation of treatment. At presentation the aspartate aminotransferase level was 1800 IU/L and alanine amniotransferase was 2415 IU/L.

The probability of fetal metabolic acidosis during labor in a population at risk as determined by clinical factors.

The clinical data derived from 2,772 pregnancies managed in an intrapartum intensive care unit have been analyzed to establish which criteria will indicate in a more definite manner the probability that fetal metabolic acidosis will occur during labor and delivery. All antepartum and intrapartum clinical factors indicate a pregnancy and fetus with an increased probability of fetal metabolic acidosis. However, there is a remarkably consistent relationship between decreasing fetal weight in each week of gestational age and in increasing probability of fetal metabolic acidosis that will permit the magnitude of the risk to be determined with greater precision.

Effects of reduction of placental size in sheep.

The number of uterine caruncles was reduced by electrocautery in nonpregnancy sheep. Subsequent pregnancies were studied as chronic fetal sheep preparations between 110 days' gestation and term; findings were compared with those for control chronic fetal sheep preparations at a similar gestational age. As a result of decreased weight and reduced number of cotyledons, the placenta in experimental animals was significantly smaller compared with that in controls.

The effect of maternal, labor, and fetal factors upon fetal heart rate during the intrapartum period.

The effect of maternal labor, and fetal characteristics upon fetal heart rate behavior during the intrapartum period has been studied in 400 patients. Abnormal labor in comparison to normal labor has a higher baseline fetal heart rate with an increased incidence of baseline tachycardia and an increased incidence of absent or decreased baseline variability. A decreasing fetal weight gestational age percentile is associated with an increased incidence of variable decelerations.

The prediction of intrapartum fetal metabolic acidosis by fetal heart rate monitoring.

Fetal heart rate characteristics during the 8 hours prior to delivery have been studied in 200 patients in whom the fetus had evidence of a metabolic acidosis at delivery, and compared to those in 200 patients in whom the fetus had a normal acid-base at delivery. Baseline fetal heart rate moderate bradycardia and tachycardia, decreased baseline variability, and decreased fetal heart rate accelerations are predictors of intrapartum fetal hypoxia with metabolic acidosis. Marked patterns of total decelerations and late decelerations are predictive of intrapartum fetal hypoxia with metabolic acidosis.