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Journal ArticleDOI

Uterine blood flow and plasma norepinephrine changes during maternal stress in the pregnant ewe.

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TLDR
It is concluded that maternal stress may decrease uterine blood flow secondary to release of endogenous norepinephrine.
Abstract
Because maternal stress may adversely affect the fetus, the authors tested the effects of brief episodes (15-60 sec) of maternal stress in 18 awake pregnant ewes. Maternal agitation and stuggling occurred either following non-painful stimuli such as loud noises or sudden movements of personnel (ten animals) or following the brief application of the ewe's skin of a uniform electrical stimulus of 30 volts with a frequency of 167 Hz for 30-60 sec (eight animals). Stimulation of either type produced a 45-50 per cent increase in mean maternal arterial blood pressure and a concomitant 32-52 per cent decrease in uterine blood flow (P less than 0.05). The decreases in uterine blood flow were brief, lasting less than 3 min, and were not associated with fetal asphyxia. Maternal plasma norepinephrine levels were measured following electrically induced maternal stress and were increased 25 per cent. The authors conclude that maternal stress may decrease uterine blood flow secondary to release of endogenous norepinephrine.

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Epidural Analgesia for Labor and Delivery

TL;DR: A 30-year-old pregnant woman is undergoing induction of labor and is experiencing severe pain despite intravenous opioid administration, andEpidural analgesia is recommended.
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Maternal catecholamines decrease during labor after lumbar epidural anesthesia.

TL;DR: Lumbar epidural anesthesia during labor reduces maternal epinephrine levels, probably by eliminating the psychological and physical stress associated with painful uterine contractions or by denervating the adrenal medulla.
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Fetal and maternal plasma catecholamine levels at elective cesarean section under general or epidural anesthesia versus vaginal delivery

TL;DR: Fetal and maternal plasma levels of catecholamines were measured at birth in 40 women with normal term pregnancies who underwent elective cesarean section and in the latter group, it was found that the type of maternal anesthesia influenced fetal sympathoadrenal activation.
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The effects of maternal depression on fetal heart rate response to vibroacoustic stimulation.

TL;DR: Delayed habituation of FHR in the fetuses of mothers with depression may be due to alterations in the internal hormonal environment and could have implications for postnatal information processing.
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Maternal and neonatal effects of remifentanil at induction of general anesthesia for cesarean delivery: a randomized, double-blind, controlled trial.

TL;DR: A single bolus of 1 &mgr;g/kg remifentanil effectively attenuated hemodynamic changes after induction and tracheal intubation and thus should be used for clear maternal indications when adequate facilities for neonatal resuscitation are available.
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