Concentrations of melatonin have been measured in amniotic fluid obtained during late pregnancy and labour. Samples obtained by amniotomy during labour contained higher concentrations of melatonin than samples taken at amniotomy for the induction of labour. Amniotic fluid obtained by amniocentesis in late pregnancy contained lower concentrations of melatonin than amniotic fluid obtained by amniotomy. The implications of these findings are discussed in relation to pineal influences on parturition.
This study, like those reported from other transplant units, did not rely on historical controls but was a retrospective analysis of concurrently treated groups. Haybittle4 states that when there is a large difference between two groups in such an analysis the following criteria must be satisfied before acting on the result: the results should be supported by other, similar studies (our study is supported by those referenced and by others); there should be a logical explanation (
Summary
Maternal plasma levels of cortisol were measured serially by radioimmunoassay in two groups of 12 patients during induced labour and in the puerperium. One group was given continuous extradural analgesia throughout labour, the other group received pethidine and promazine in response to pain. Pre‐induction cortisol levels were significantly higher in patients who were to have extradural analgesia but the percentage increase in plasma cortisol during labour was considerably less than in patients with parenteral analgesia; in second stage labour, mean cortisol levels were the same in the two groups. This study suggests that patients who had chosen to have extradural analgesia may have been more anxious before labour than the other patients but continuous, extradural analgesia suppressed to some extent the percentage increase in mean cortisol levels found during labour in patients given parenteral analgesia. In the puerperium, there was no difference in mean cortisol levels in the two groups.
Summary
The concentration of melatonin in maternal peripheral plasma was measured during late pregnancy, term and pre‐term labour. There was a small increase in the mean concentration of melatonin during labour which was significant in term labour. Umbilical arterial and venous plasma, whether obtained at term, after spontaneous vaginal delivery or at Caesarean section, contained significantly greater concentrations of melatonin than maternal plasma. A significant arterio‐venous difference was demonstrated for both groups of umbilical samples with raised venous levels after spontaneous vaginal delivery but higher arterial levels at Caesarean section.
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