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Query: UNIPROT:P01178 (oxytocin)
 15,767 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hypertonic saline administered intraamniotically and followed by oxytocin infusion has been known to cause uterine rupture in a single grandmultiparous patient. A case report is presented on the 1st documented incident of uterine rupture following intraamniotic saline injection followed by oxytocin infusion in a patient of low parity. This uterine rupture occurred prior to expulsion of the fetus or manual removal of the placenta. The patient had experienced already a previous 1st-trimester, vaginal abortion. It is unknown whether this previous abortion had a causative effecton the abnormal placental implantation of this pregnancy, but it is certain that the abnormal implantation probably contributed to the uterine rupture. The adult respiratory distress syndrome which occurred in the case reported is consistent with intraabdominal ahemorrhage and shock. Any hypertonic saline instillation followed by unusual abdominal discomfort, orthostatic hypotension, and anemia should be investigated for the possibility of uterine rupture.
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PMID:Uterine rupture caused by midtrimester saline abortion. 53 74

Intramuscular injections of 15(S)-15-methyl prostaglandin F2alpha (15-Me-PGF2alpha) induced abortion in 38 patients who had failed to abort with other techniques, such as intra-amniotic instillation of saline or PGF2alpha and intravaginal insertion of prostaglandin-impragnated Silastic devices. The intramuscular injections of 15-Me-PGF2alpha were initiated when the original abortion techniques, even when augmented by intravenous oxytocin, failed to produce expulsion of the fetus. The dose schedule was 250 microgram or 500 microgram every 2 to 4 hours, and the concomitant intravenous oxytocin was continued at a rate of 167 mU/minute. Of the 38 patients, 26 aborted with two or fewer injections of 15-Me-PGF2alpha, and 30 patients required only 1 mg of the drug to expel the fetus successfully. The mean time from the first injection of 15-Me-PGF2alpha to the expulsion of the fetus was 5.25 hours; one-half of the patients aborted in less than 4 hours. The placenta was expelled spontaneously in 15 patients, removed manually from the vagina in 18, and removed by sponge forceps in 3. Two abortions were incomplete and surgical intervention was required. Twenty-eight patients (74%) experienced gastrointestinal disturbances, chiefly vomiting and diarrhea. Intramuscular administration of 15-Me-PGF2alpha eliminates the need for repeated amniocentesis, and the dose may be adjusted to meet the precise requirements of the clinical situation.
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PMID:The effects of intramuscular injections of 15(S)-15-methyl prostaglandin F2alpha in failed abortions. 56 11

Platelet function has been studied during intravenous, intraamniotic, and extraamniotic administration of prostaglandin F2alpha (PgF2alpha) for termination of missed abortion and missed labor, for therapeutic abortion, and for induction of term labor. The controls received oxytocin i.v. (missed labor and term labor). Our investigations have shown that there was a normalization of the increased spontaneous platelet aggregation and a significant reduction of ADP- and collagen-induced platelet aggregation in the groups given PgF2alpha i.v. The desaggregation in these groups was increased. The other groups given PgF2alpha showed no significant changes in platelet function. Inducing labor by oxytocin we found a tendency to increased platelet aggregation and decreased desaggregation. The clinical importance of these findings and the consequences for hemostasis are discussed.
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PMID:Studies on platelet function during different modes of administration of PgF2alpha in obstetrics and gynecology. 58 Oct 52

It has been known for years that prostaglandins can be used to bring on labor. The authors experienced with alpha PGF2 by extraamiotic, intracavitary infusion. The group of 23 patients included 20 cases of incomplete abortion in the second trimester, 9 cases of intrauterine fetal death in the third trimester, and 1 case of vesicular mole. This method proved 82.6% successful: in 56.9% of cases the product of conception was expelled within 12 hours; in 26.5% of cases within 24 hours. Only in 4 cases, 17.4%, this method proved unsuccessful; oxytocin was used in 3 of these 4 cases. Hypertonia was evident immediately after infusion; uterine contractions, measured and registered with a tocograph, were frequent and increasingly intense. Nausea, vomiting and diarrhea were observed in 26.5% of cases; 1 patient had facial flush. These side effects were probably due to the low absorption of the drug into the circulation. Results obtained confirm others described in the literature on the subject.
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PMID:[Induction of labor in missed abortion, fetal death and vesicular mole, using PGF2 alpha by extra-amniotic intracavitary administration]. 60 2

A case is reported of a 42-year-old woman who experienced uterine rupture in the course of a prostaglandin-induced abortion. The patient, gravida 5 para 4, was approximately 16 weeks pregnant upon admission. 8 cc (40 mg) of prostaglandin F2a and 50 cc apyrogenic 23.4% hypertonic saline were infused intraamniotically. Irregular uterine contractions developed shortly afterward, but at 35 hours no cervical changes or characteristic balooning of the lower uterus could be seen. At 39 hours the patient complained of cramps, and at 48 hours the uterus was tender, and the cervix was still unchanged but with bloody mucus at the os. On the assumption of intrauterine bleeding, a laparotomy was performed which revealed a 6 cm rent in the uterine fundus through which the uterine contents had passed into the abdominal cavity. There was a 3-cm-diameter leiomyoma close to the perforation. Complications such as this previously have been thought to be associated with the additional use of oxytocin; oxytocin, however, was not used in this case. It is concluded that a diagnosis of uterine rupture should be considered early whenever normal cervical and uterine changes do not follow instillation of the abortifacient. Further, because of the seriousness of such complications, midtrimester abortions should be induced only in a hospital setting.
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PMID:Uterine rupture: a complication of midtrimester abortion. 62 72

In light of the knowledge of the association between oxytocin administration and uterine rupture in late pregnancy, supraphysiologic doses of intravenous oxytocin are used by physicians to augment second trimester saline-induced abortions. According to the Center for Disease Control, this practice causing uterine rupturing is not unique to higher parities and can be fatal if not recognized. 2 case studies are reported. The 1st case, a 23-year-old woman (gravida 3, para 2), underwent saline instilled elective abortion at 18 menstrual weeks' gestation. Following removal of 200 cc of clear amniotic fluid from the uterus, an equal volume of 20% saline was instilled. 2 hours later, intravenous oxytocin was begun and an additional 400 mg of oxytocin was administered in the next 32 hours. 35 hours after instillation the patient had a thready pulse and blood pressure of 88/60, followed by stupor and cardiopulmonary arrest. After resuscitation a laparotomy disclosed an anterior paramedian laceration of the uterus. A hysterectomy was performed, the subsequent course was complicated, and the patient died on the 5th hospital day. In Case 2 a 29-year-old obese women (gravida 4, para 3) had an elective saline-instilled abortion at 20 menstrual weeks' gestation. After saline instillation the patient received intravenous oxytocin in the following amounts: 1) 60 mg; 2) 40 mg, with mild bleeding noted, and 3) 60 mg, followed by profuse vaginal bleeding. The fetus and the placenta were removed, and no detection of uterine rupture was made. The patient was transferred to another hospital, and died 5 hours later following multiple cardiopulmonary arrests. Rupture of the gravida uterus is defined as disruption of the uterine wall, occurring predominantly in the lower uterine segment. Uterine rupture and rupture during a term birth are probably analogous. The death-to-case rate for saline-induced abortions in the U.S. from 1972 to 1975 is .08 deaths/100,000, however, this rate would be higher if only saline-induced abortions receiving oxytocin were considered.
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PMID:Fatal uterine rupture during oxytocin-augmented, saline-induced abortion. 62 17

Prostaglandin (PG) gels were used to induce second-trimester abortion in 141 women aged 16-44 years, 1973-1976. PGE2 gel was used alone for 65 women, and in combination with oxytocin for 25 women; PGF2-alpha was used alone for 15, and combined with oxytocin for 36. Indications were: medical (5 cases), psychosocial (97 cases), and missed abortion or fetal death in utero (39 cases). The gel was administered extra-amniotically via catheter; abortion occurred within 36 hours in 136 cases. Mean administration abortion interval varied from 9 hours 52 minutes to 16 hours 17 minutes. A dose-response relationship was noted between the prostaglandin dose and the interval to abortion. Side effects included vomiting (29 cases), diarrhea (2 cases), fever (9 cases), hemorrhage (14 cases), endometritis (2 cases), and circulatory symptoms (2 cases) and torn cervix (1 case). No signficant differences between primigravidae and others were observed.
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PMID:[Therapeutic abortions in the second trimestre of pregnancy with prostaglandine gel (author's transl)]. 64 Mar 66

Intra-amniotic hyperosmolar urea (59.7 per cent) augmented by intravenous oxytocin (332 millimicron per minute), prostaglandin F2alpha (20 mg.), prostaglandin F2alpha (10 mg.), or prostaglandin F2alpha (5 mg.) was utilized for 1,913 patients requesting elective midtrimester abortion. Injection-abortion intervals ranging from 13.70 to 21.49 hours were achieved with failure rates of 0.7 to 6.7 per cent. Despite frequent pre-existing medical conditions, the complication rate compared favorably with those of other methods for terminating midtrimester pregnancy such as saline amnioinfusion or dilatation and evacuation.
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PMID:Hyperosmolar urea for elective midtrimester abortion. Experience in 1,913 cases. 64 73

The purpose of this study was to determine a method of amnioinfusion which would 1) keep the instillation to abortion time (IAT) within 12 hours; 2) eliminate, as far as possible, the risk of coagulaopathy and electrolyte imbalance; 3) avoid delivery of liveborn fetuses; 4) reduce gastrointestinal side effects from prostaglandin. 89 midtrimester abortion applicants, divided into 3 groups, had laminaria inserted the afternoon prior to admission. 3 types of infusion were given: 40 mg PGF2 alpha, urea, and a combination of urea solution and 20 mg PGF2 alpha. Upon completion of the infusion the laminaria was removed. 1 hour later oxytocin was administered to all patients; the purpose of the delay was to allow time for prostaglandin impact. 21.4% of cases given urea, 47.8 of those given PGF2 alpha, and 77% of those given urea and PGF2 alpha had aborted 12 hours after infusion. 63.7% of those receiving the combination had aborted 9 hours after infusion. Gastrointestinal side effects were observed in 35% of cases given the higher prostaglandin dosage, compared to only 10% of cases given the lower dosage. The findings indicate that the synergistic effect of urea and prostaglandin was enhanced by the concurrent use of laminaria and oxytocin; the urea dosage was only half of that used in previous studies of synergism, the prostaglandin dosage half of that of prostaglandin only infusions. It seems clear that the initial prostaglandin impact is reinforced by simultaneous administration of urea. Future tests will determine whether the rate of progesterone withdrawal is increased by the synergistic activity of urea and PGF2 alpha in combination.
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PMID:Midtrimester abortion with urea, prostaglandin F2alpha, laminaria, and oxytocin. A new regimen. 66 49

The intrauterine pressure was determined by means of endoradiosonde in 42 pregnant women before induced abortion. It was measured the tonus and after stimulation with oxytocin the liminal value the basic tonus and the highest increase of pressure. The values of pressure were higher after artificial rupture of the amnion than before. Telemetering of intrauterine pressure is an advantageous method.
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PMID:[Intra-uterine pressure measurements during early pregnancy using endoradioprobes]. 66 72


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