Vibroacoustic stimulation in normal term human pregnancy.

OBJECTIVE: To examine the effects of vibroacoustic stimulation (VAS) on fetal heart rate (FHR) in term human fetuses by computerized carditocography system. METHODS: FHR was analyzed 20 min before and 30 min after vibroacoustic stimulation using the Oxford Sonicaid System 8002 for computerized FHR measurement. Recordings were made in 31 uncomplicated pregnancies at 36-42 weeks' gestation. RESULTS: Vibroacustic stimulation of the fetus evoked a significant increase in all the parameters evaluated (number of fetal movements, of accelerations above 10 and 15 bpm, in high- and low-variability episodes, and in short-term variations). Concerning the effect of behavioural states on the response to VAS, some changes (FHR, high-variability episodes) occurred independently of behavioural states, while other parameters (accelerations >10 and 15 bpm: short-term variation) underwent statistically significant changes only for behavioural states 1F and 2F. CONCLUSIONS: Our study supports the hypothesis of a significant fetal response in normal term pregnancy, as clearly shown by computerized cardiotocography. The immediate response occurred independently of behavioural states, although some differences were present (mainly for F1 and F2 states) if the evaluation was extended in time.

The effect of a levonorgestrel-releasing intrauterine device in the treatment of myoma-related menorrhagia.

In this open observational study we evaluated the effectiveness of a levonorgestrel-releasing intrauterine device (LNG-IUD) in the treatment of myoma-related menorrhagia. Nineteen patients with recurrent menorrhagia lasting more than 3 months and with fibromyomatosus uterus were treated for 12 months with a LNG-IUD releasing 20 micro g/day of levonorgestrel. Menstrual blood loss, measured objectively by the pictorial blood loss assessment chart score (PBAC), level of serum hemoglobin and pattern of uterine bleeding were recorded at 3, 6, 9 and 12-month follow-up visits. Median monthly PBAC score during the two menstrual cycles before treatment was 310. After LNG-IUD, the PBAC score gradually decreased from a median value of 186 at 3 months to a median value of 155, 108 and 96 at 6, 9 and 12 months of treatment, respectively. Despite the statistically significant reduction of PBAC score, persistent menorrhagia, defined as a monthly PBAC score of 100 or higher, was observed at 12 months in 14 patients, whereas only one woman was amenorrheic and 4 were hypomenorrheic. In conclusion our study demonstrates the clinical reduced effectiveness of LNG-IUD in the treatment of myoma-related menorrhagia.