A prospective double blind study comparing the effects of oxytocin and human chorionic gonadotrophin as trigger for ovulation.

This study was undertaken to compare the effect of oxytocin and human chorionic gonadotrophin (hCG) on ovulation and conception. A total of 100 women with anovulatory infertility were allocated into two equal groups to take clomiphene citrate plus hCG or clomiphene citrate plus oxytocin. The size and number of follicles by transvaginal sonography determined the administration of hCG or oxytocin. The serum progesterone concentration was measured to provide evidence for ovulation. The ovulation and pregnancy rate of the two groups were compared. There was no significant difference between the groups with respect to mean number of follicles, mean follicular size and rate of ovulation in three cycles. The rate of pregnancy was higher in the oxytocin group compared with the hCG group (12% vs 4%) but it failed to reach statistical difference (p = 0.140). Mild pain was the only side-effect observed in the two groups. Oxytocin was found to be a viable alternative to hCG for triggering ovulation in infertile patients.

Blood lead and zinc in pregnant women and their offspring in intrauterine growth retardation cases.

As part of our program to investigate the possible role of environmental pollutants in the incidence of intrauterine-growth retardation (IUGR) in India, we determined the lead and zinc levels in mothers and neonatal blood, collected at parturition, in cases with normal and IUGR babies. Both maternal and cord blood lead levels were significantly higher in IUGR cases than in normal cases (p < 0.05). The mean level of zinc was also higher in maternal blood of IUGR cases. Significantly, the mean cord blood lead level was > 10 microg/dL, which is greater than Centers for Disease Control's intervention level, in 54% of newborns. A good correlation (r = 0.53, p < 0.01) between maternal and cord blood lead levels confirmed the transfer of lead from mother to the fetus. There was a weak but significant relationhsip between cord blood lead levels and birth weight of newborns (r = -0.22, p < 0.05). The study may serve as a pointer to the perils of in utero exposure to chemical contaminants and a call for measures by the public health authorities for a continuous bio-monitoring program to evaluate impact of environmental pollutants on women and children's health.

Brainstem auditory evoked potentials (BAEPs) in pregnant women.

The electrophysiological correlate of change in sensory function during pregnancy has not been reported. The brain stem auditory evoked potentials were recorded in eight pregnant women during third trimester from CZ-A1 and CZ-A2 position, with alternating 90 dB sound pressure click stimuli delivered at 10/sec and -40 dB (white noise) masking of contralateral ear. Two thousand and forty eight responses were analysed and replicated. The noise and other artefacts were rejected with filter bandpass setting 150 to 3000 Hz. The evoked responses in pregnant women were compared with ten age matched normal subjects using Student's 't' test. The threshold for eliciting wave V of the brainstem auditory response was higher in pregnant women (28.1 +/- 2.1 dB). The absolute peak latencies of waves I to V were similar in both groups. However, Inter peak latencies (IPLs) I-III, III-V were on higher side in the pregnant women, and I-V, in particular (3.9 +/- 0.14) was significantly higher when compared with controls (3.73 +/- 0.16). These findings suggest that besides an increase in evoking wave V threshold, neural conduction process in brainstem auditory pathways during pregnancy is also delayed within + 2SD of the mean central conduction time in nonpregnant state.

Persistent chlorinated pesticides and intra-uterine foetal growth retardation: a possible association.

OBJECTIVE: To examine the association between DDT (dichlorodiphenyl trichloroethane) and HCH (hexachlorocyclohexane) exposure and intra-uterine growth retardation (IUGR, <10th percentile of birth weight for gestational age). METHOD: We detected p,p'-DDT, o,p'-DDT, p,p'-DDD, p,p'-DDE and alpha-HCH, beta-HCH, gamma-HCH, delta-HCH in maternal blood, placenta and cord blood, collected at parturition, from mothers with IUGR babies ( n=30) and from those with babies of normal weight ( n=24), using gas-liquid chromatography equipped with electron capture detector ((63)Ni). The adjusted odds ratios (ORs) for these pesticides in mothers and infants were determined by multiple logistic regression. RESULTS: There were statistically significant associations ( P<0.05) between maternal blood levels of alpha-HCH (OR=1.22; 95% CI: 1.02-1.46), gamma-HCH (OR=1.38; 95%CI: 1.05-1.80), delta-HCH (OR=1.61; 95% CI: 1.01-2.54), total HCH (OR=1.07; 95% CI: 1.01-1.13) and p,p'-DDE (OR=1.21; 95%CI:1.03-1.42) and IUGR after adjustment for potential confounders. Also, significant association (P<0.05) between cord blood levels of gamma-HCH (OR=1.14; 95% CI: 1.00-1.31), delta-HCH (OR=1.31; 95% CI: 1.00-1.75), total HCH (OR=1.07; 95% CI: 1.00-1.14) and IUGR were found after adjustment for potential confounders. A significant negative correlation between body weight of newborn babies and p,p'-DDE in maternal blood (r= -0.25; P<0.05) and delta-HCH and p,p'-DDE in the cord blood (r= -0.27 and -0.26; P<0.05) was noticed after gestational age had been accounted for. CONCLUSION: Exposure of pregnant women to organochlorine pesticides may increase the risk of IUGR, which is a contributing factor for infant mortality in India.