Maternal intravaginal postaglandin E2 gel before elective caesarean section at term to induce catecholamine surge in cord blood: ransomised, placebo controlled study

M. Singh, Sanjay Patole, A. Rane, D. Naidoo, P. Buettner

    Research output: Contribution to journalArticle

    Abstract

    Objective: To test the hypothesis that the application of intravaginal prostaglandin E2 gel before elective caesarean section (ECS) will induce a catecholamine surge in umbilical arterial blood.Design: Randomised, double blind, placebo controlled trial.Setting: A regional perinatal referral centre.Patients: Mothers booked for ECS at or above 38 weeks gestation.Interventions: Thirty six consenting mothers were randomly allocated to receive either 2 mg intravaginal prostaglandin E2 gel (study group; n = 18) or an equal volume of K-Y jelly as a placebo (control group; n = 18) 60 minutes before the ECS. Computer generated random numbers contained in coded, sealed envelopes were used for allocation. The obstetric and neonatal teams were blinded to the randomisation status of enrolled mothers.Main outcome measures: Catecholamine concentrations in the umbilical arterial blood samples collected at delivery.Results: The median (interquartile range) neonatal gestation and birth weight were 271 (269–274) days and 3605 (3072–3970) g for the study group and 271 (270–273) days and 3340 (3000–3622) g for the control group. Median (interquartile range) noradrenaline (norepinephrine) concentrations in the umbilical arterial blood were significantly higher in the study group than the control group (15.9 (9.8–28.92) v 4.6 (1.65–14.4) ng/l, p = 0.03). Adrenaline (epinephrine) concentrations did not differ significantly between the two groups (1.6 (<0.5–3.1) v 1.4 (<0.5–2.75) ng/l, p = 0.6). No treatment related complications occurred.Conclusion: A labour related catecholamine surge could be simulated by intravaginal prostaglandin E2 gel.
    Original languageEnglish
    Pages (from-to)F131-135
    JournalArchives of Disease in Childhood, Fetal and Neonatal Edition
    Volume89
    Issue number2
    Publication statusPublished - 2004

    Fingerprint

    Umbilicus
    Fetal Blood
    Dinoprostone
    Cesarean Section
    Catecholamines
    Gels
    Placebos
    Mothers
    Control Groups
    Epinephrine
    Norepinephrine
    Pregnancy
    Random Allocation
    Birth Weight
    Obstetrics
    Referral and Consultation
    Outcome Assessment (Health Care)
    Therapeutics

    Cite this

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    title = "Maternal intravaginal postaglandin E2 gel before elective caesarean section at term to induce catecholamine surge in cord blood: ransomised, placebo controlled study",
    abstract = "Objective: To test the hypothesis that the application of intravaginal prostaglandin E2 gel before elective caesarean section (ECS) will induce a catecholamine surge in umbilical arterial blood.Design: Randomised, double blind, placebo controlled trial.Setting: A regional perinatal referral centre.Patients: Mothers booked for ECS at or above 38 weeks gestation.Interventions: Thirty six consenting mothers were randomly allocated to receive either 2 mg intravaginal prostaglandin E2 gel (study group; n = 18) or an equal volume of K-Y jelly as a placebo (control group; n = 18) 60 minutes before the ECS. Computer generated random numbers contained in coded, sealed envelopes were used for allocation. The obstetric and neonatal teams were blinded to the randomisation status of enrolled mothers.Main outcome measures: Catecholamine concentrations in the umbilical arterial blood samples collected at delivery.Results: The median (interquartile range) neonatal gestation and birth weight were 271 (269–274) days and 3605 (3072–3970) g for the study group and 271 (270–273) days and 3340 (3000–3622) g for the control group. Median (interquartile range) noradrenaline (norepinephrine) concentrations in the umbilical arterial blood were significantly higher in the study group than the control group (15.9 (9.8–28.92) v 4.6 (1.65–14.4) ng/l, p = 0.03). Adrenaline (epinephrine) concentrations did not differ significantly between the two groups (1.6 (<0.5–3.1) v 1.4 (<0.5–2.75) ng/l, p = 0.6). No treatment related complications occurred.Conclusion: A labour related catecholamine surge could be simulated by intravaginal prostaglandin E2 gel.",
    author = "M. Singh and Sanjay Patole and A. Rane and D. Naidoo and P. Buettner",
    year = "2004",
    language = "English",
    volume = "89",
    pages = "F131--135",
    journal = "Archives of Disease in Childhood, Fetal and Neonatal Edition",
    issn = "1359-2998",
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    number = "2",

    }

    TY - JOUR

    T1 - Maternal intravaginal postaglandin E2 gel before elective caesarean section at term to induce catecholamine surge in cord blood: ransomised, placebo controlled study

    AU - Singh, M.

    AU - Patole, Sanjay

    AU - Rane, A.

    AU - Naidoo, D.

    AU - Buettner, P.

    PY - 2004

    Y1 - 2004

    N2 - Objective: To test the hypothesis that the application of intravaginal prostaglandin E2 gel before elective caesarean section (ECS) will induce a catecholamine surge in umbilical arterial blood.Design: Randomised, double blind, placebo controlled trial.Setting: A regional perinatal referral centre.Patients: Mothers booked for ECS at or above 38 weeks gestation.Interventions: Thirty six consenting mothers were randomly allocated to receive either 2 mg intravaginal prostaglandin E2 gel (study group; n = 18) or an equal volume of K-Y jelly as a placebo (control group; n = 18) 60 minutes before the ECS. Computer generated random numbers contained in coded, sealed envelopes were used for allocation. The obstetric and neonatal teams were blinded to the randomisation status of enrolled mothers.Main outcome measures: Catecholamine concentrations in the umbilical arterial blood samples collected at delivery.Results: The median (interquartile range) neonatal gestation and birth weight were 271 (269–274) days and 3605 (3072–3970) g for the study group and 271 (270–273) days and 3340 (3000–3622) g for the control group. Median (interquartile range) noradrenaline (norepinephrine) concentrations in the umbilical arterial blood were significantly higher in the study group than the control group (15.9 (9.8–28.92) v 4.6 (1.65–14.4) ng/l, p = 0.03). Adrenaline (epinephrine) concentrations did not differ significantly between the two groups (1.6 (<0.5–3.1) v 1.4 (<0.5–2.75) ng/l, p = 0.6). No treatment related complications occurred.Conclusion: A labour related catecholamine surge could be simulated by intravaginal prostaglandin E2 gel.

    AB - Objective: To test the hypothesis that the application of intravaginal prostaglandin E2 gel before elective caesarean section (ECS) will induce a catecholamine surge in umbilical arterial blood.Design: Randomised, double blind, placebo controlled trial.Setting: A regional perinatal referral centre.Patients: Mothers booked for ECS at or above 38 weeks gestation.Interventions: Thirty six consenting mothers were randomly allocated to receive either 2 mg intravaginal prostaglandin E2 gel (study group; n = 18) or an equal volume of K-Y jelly as a placebo (control group; n = 18) 60 minutes before the ECS. Computer generated random numbers contained in coded, sealed envelopes were used for allocation. The obstetric and neonatal teams were blinded to the randomisation status of enrolled mothers.Main outcome measures: Catecholamine concentrations in the umbilical arterial blood samples collected at delivery.Results: The median (interquartile range) neonatal gestation and birth weight were 271 (269–274) days and 3605 (3072–3970) g for the study group and 271 (270–273) days and 3340 (3000–3622) g for the control group. Median (interquartile range) noradrenaline (norepinephrine) concentrations in the umbilical arterial blood were significantly higher in the study group than the control group (15.9 (9.8–28.92) v 4.6 (1.65–14.4) ng/l, p = 0.03). Adrenaline (epinephrine) concentrations did not differ significantly between the two groups (1.6 (<0.5–3.1) v 1.4 (<0.5–2.75) ng/l, p = 0.6). No treatment related complications occurred.Conclusion: A labour related catecholamine surge could be simulated by intravaginal prostaglandin E2 gel.

    M3 - Article

    VL - 89

    SP - F131-135

    JO - Archives of Disease in Childhood, Fetal and Neonatal Edition

    JF - Archives of Disease in Childhood, Fetal and Neonatal Edition

    SN - 1359-2998

    IS - 2

    ER -