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To evaluate the effectiveness of intrapartum prophylactic amnioinfusion in pregnancies complicated by oligohydramnios.

To evaluate the effectiveness of intrapartum prophylactic amnioinfusion in pregnancies complicated by meconium-stained amniotic fluid.

To systematically review published randomized trials that compared efficacy of a 10-mg, controlled-release dinoprostone vaginal insert with other prostaglandins for cervical ripening and labor induction.

To analyze published randomized trials assessing the safety and efficacy of misoprostol for cervical ripening and labor induction.

Women destined to develop preeclampsia show an increased systemic pressor response to infused angiotensin II, and the angiotensin sensitivity test has been accepted as an appropriate means of identifying these women. However, the effect of angiotensin II infusion on uteroplacental blood flow is unknown and may be deleterious. Patients undergoing angiotensin sensitivity tests as part of a protocol examining the effect of aspirin on the incidence of preeclampsia were studied with Doppler velocimetry performed before and during the angiotensin II infusion. Fetal well-being was documented with biophysical profiles performed before and after the infusions. Neither the systolic-diastolic ratios in the uterine and umbilical arteries nor the biophysical profile scores were altered significantly (P.43, P.23, Wilcoxon signed-rank median test, and P.35, Fisher exact test, respectively). These findings suggest that the angiotensin sensitivity test does not increase resistance to flow in the uterine or umbilical circulation, and therefore may be used safely in screening for preeclampsia.

To analyze calcium absorption using stable isotopes in patients with preeclampsia and in normotensive controls.

To evaluate the safety and clinical effectiveness of intravaginal misoprostol, a synthetic prostaglandin, E1analogue, for labor induction in gravidas with premature rupture of membranes (PROM) at term.

To evaluate the efficacy of intrapartum prophylactic administration of ampicillin-sulbactam in reducing intraamniotic infection and postpartum endometritis in patients with meconium-stained amniotic fluid (AF).

To compare oxytocin infusion alone and with intravenous (IV) propranolol in the management of dysfunctional labor.

Recent studies have suggested that preeclampsia is associated with hypocalciuria. We compared 24-hour urine data from 143 obstetric patients 33 with preeclampsia, 58 normotensives, and 52 patients with gestational hypertension. The mean maternal age, race, and parity of these three groups did not differ significantly. The patients with preeclampsia had significantly less excretion of total calcium (129.7 ± 18.7 mg 24 hours) (mean ± SEM) than normotensives (283.9 ± 12.3) or those with gestational hypertension (233.2 ± 22.3) (P.0001). The mean arterial pressure and excretion of total protein were significantly increased in the preeclampsia group (P.0001). Using the receiver operator curve, a urine calcium threshold of 12 mgdL was chosen as predictive for the development of preeclampsia, with a sensitivity of 85, specificity of 91, and positive and negative predictive values of 85 and 91, respectively. Urinary calcium levels below 12 mgdL may help distinguish preeclampsia from other hypertensive disorders of pregnancy.

To determine whether calcium supplementation prevents progression to severe disease in preterm nulliparous women with mild preeclampsia.