Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01178 (oxytocin)
 15,767 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

76 therapeutic abortions and 16 labors for missed abortion were induced by extraamniotic isotonic saline with or without oxytocin. Saline was perfused with a Number 16 or 18 Foley catheter, just inside the cervical os, at 16 drops/minute. After 2 hours oxytocin was infused iv if needed. A 2nd saline perfusion was given in some cases. Uterine contractions started in 15-30 minutes; mean time to abortion ranged from 5 to 50 hours; mean time to delivery of the macerated fetus was 7 hours, 45 minutes. This method was remarkably safe, with no complications, even in patients with hemolytic anemia, Caesarean section scars, fibroids, and a 10-week pregnancy. it would be appropriate when hypertonic saline or prostaglandins are contraindicated, such as in renal, cardiac, or respiratory disease, when coagulation disorders are likely, when the amniotic sac is difficult to puncture, and when a fetus in good condition is needed for genetic or embryologic studies.
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PMID:[Indications of choice for extra-amniotic perfusion of physiologic serum]. 95 36

Abortion was successfully induced by intravaginal administration of a newly developed silastic device impregnated with 15(S)-15-methyl-prostaglandin F2alpha methyl ester in a concentration of 0.5% in 26 of 35 women in the 12th to the 24th weeks of gestation and by prostaglandin with concomitant oxytocin infusion in an additional 5 patients. A second comparable group of 35 women, with gestational ages from 9 to 23 weeks, received a silastic device with a concentration of 1.0% of the prostaglandin. Twenty-six women in the second group aborted with prostaglandin alone and an additional 6 patients aborted with combined prostaglandin-oxytocin therapy. Seven patients of the 70 included in this study failed to abort with intravaginal administration of 15-ME-PGF2alpha methyl ester even with concomitant oxytocin therapy; this group included 4 patients receiving the 0.5% device and 3 patients with the 1.0% device. The mean abortion time for the 31 successful abortions with 0.5% device was 15.15 hours and multiparous patients aborted in a mean time of 9.69 hours, significantly faster than the nulliparous patients, mean time 18.49 hours. The mean abortion time for the 32 successful abortions with the 1.0% device was 15.61 hours and there was no significant difference in the mean abortion times between nulliparous and multiparous patients in this group. No significant difference could be demonstrated between the mean abortion times of patients receiving an 0.5% concentrations of prostaglandin and patients receiving a 1.0% concentration of the drug. In both groups more than 40% of the patients had aborted within 12 hours of the insertion of the prostaglandin device and more than 80% had aborted within 24 hours. The intravaginal device appeared to be effective in inducing abortion throughout the gestational ages tested in this series. Peripheral plasma levels of 15-ME-PGF2alpha were analyzed in 15 patients with the 0.5% device and 8 patients with the 1.0% device. In patients with the 0.5% device the mean plasma concentration of prostaglandin peaked 2 hours after insertion, while in patients with the 1.0% device the peak was achieved within 15 minutes of insertion followed by a rapid decline in plasma prostaglandin levels. Diarrhea was the most frequent side effect related to the intravaginal administration of the prostaglandin, and in this series the severity of this gastro-intestinal disturbance appeared to be significantly higher in patients receiving the 1.0% device.
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PMID:Hormone release and abortifacient effectiveness of a newly developed silastic device containing 15-ME-PGF2alpha methyl ester in concentrations of 0.5% and 1.0%. 96 66

Observations of the effects of oxytocics on the human pregnant cervix have been made in vivo using a double open ended catheter technique. Prostaglandin E, prostaglandin F2alpha and oxytocin had similar but no specific effects upon the intracervical canal pressure; ergometrine caused contractions of the cervix. The significance of these findings is discussed in relation to cervical rupture and cervico-vaginal fistulae that have been reported following second trimester abortion induced with prostaglandins.
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PMID:The effect of oxytocics on the human cervix during midtrimester pregnancy. 99 Feb 17

Midtrimester abortion was successfully induced in 55 of 60 patients with continuous extraovular infusion of prostaglandin F2alpha (PGF2alpha) following the insertion of intracervical laminaria tents. Intravenous oxytocin was also used in 38 (63%) of the 60 patients. The mean induction-abortion time (IAT) was 11.72 hours +/- 1.06 SD). Abortion was completed in 40% within 8 hours, 80% within 16 hours, and 93% within 24 hours. The mean total dose of PGF2alpha was 41.9 mg. There was no significant difference in IAT between the parous patients (13.40 hours +/- 1.90 SD) and the nulliparous patients (10.41 hours +/- 1.13 SD). There was no apparent correlation between IAT and the stages of gestation (12 to 22 weeks). The five patients who failed to abort within 24 to 36 hours underwent uterine evacuation, which was easily accomplished because there was a marked degree of cervical dilatation. Side effects and complications of the technique were few. Endometritis occurred in three patients, two of whom had had intrauterine devices in situ until just prior to the procedure. It appears that this method has a high success rate, an acceptable safety factor, good patient tolerance, and relatively few side effects.
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PMID:Induction of midtrimester abortion by the combined method of continuous extravovular infusion of prostaglandin F2alpha and intracervical laminaria tents. 100 20

The abortifacient effectiveness of three intravaginal Silastic devices impregnated with 15(S)-15-methyl prostaglandin F2alpha (15(S)-Me-PGF2alpha) methyl ester in concentrations of 0.25%, 0.5%, and 1.0% was investigated. Each concentration was tested in 10 patients with gestations ranging from 8 to 19 weeks. Abortion was successfully induced by prostaglandin alone in 6 patients with the 0.25% device, in 9 patients with the 0.5% device, and all 10 patients treated with the 1.0% device. Additionally, three patients treated with the 0.25% device and one patient treated with the 0.5% device aborted with concomitant, continuous, intravenous oxytocin therapy. The mean abortion time with the 0.25% device was 16.43 hours; with the 0.5% device, 16.49 hours; and with the 1.0% device, 10.18 hours. The peripheral plasma levels of 15(S)-Me-PGF2alpha methyl ester were the most variable with the 0.5% device. The plasma levels of 15(S)-Me-PGF2alpha methyl ester of patients receiving the 0.25% device were similar to the levels of patients receiving the 1.0% device. The intravaginal Silastic device impregnated with 15(S)-Me-PGF2alpha methyl ester appears to be an effective abortifacient, but further study is indicated to determine the most efficient device with the fewest side effects.
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PMID:The abortifacient effectiveness and plasma prostaglandin concentrations with 15(S)-15-methyl prostaglandin F2alpha methyl ester-containing vaginal silastic devices. 100 21

The 4 principle abortion techniques are 1) dilation and curettage (D and C), 2) vacuum aspiration, 3) amniocentesis (saline injection), and 4) hysterotomy. The curettage and vacuum methods are used in the first trimester of pregnancy. Both require dilation of the cervix. The fetal material is removed with a curette or suction applied to the uterine wall. First trimester abortions usually do not require hospitalization. No abortion should be performed between 12-14 weeks. After 14 weeks, ideally 20 weeks, amniocentesis is the preferred method. It is a more complicated procedure involving removal of amniotic fluid and replacement with hypertonic saline solution, resulting in fetal death and expulsion. Oxytocin may also be used to induce labor. Reported complications run from 5-15% Hospitalization is up to 48 hours. A hysterotomy requires exposure of the uterus by a surgical opening in the abdomen. The uterus is opened and fetal material delivered. Once a hysterotomy is performed, all other pregnancies must be delivered by caesarean section. The psychological considerations of abortion have not been carefully studied under the new laws. No clear consensus exists as to the psychological aftereffect of abortion. If a woman desires an abortion and does not receive one, there is a likelihood of psychological effects, as for a woman who does not desire an abortion and receives one. Conflict occurs only when a woman is not sure of her own decision. Moral considerations imposed by abortion service personnel will also set up a conflict for the patient. The abortion seeker must know her own attitudes regarding the sanctity of life and her social role as a woman and be psychologically prepared to actually arrange for the operation.
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PMID:The advent of legal abortion and surgical abortion techniques. 103 93

49 cases of myocardial infarction during pregnancy are reviewed from the literature, considering the frequency, pathogenesis, clinical findings, prognosis, treatment, obstetrical conduct including whether abortion is indicated, and finally 17 cases of pregnancy in women with previous heart attacks are summarized. A myocardial infarction is rare, about .01-.075%, more frequent in late pregnancy or the postpartum, and in older women. This series averaged 32.9 years. 88% were due to atherosclerosis. Other risk factors were usually not reported systematically. 56% of the incidents were the 1st heart attack; 44% were preceded by angina; 68% were anterior. Pregnancy affects the EKG and white blood count, but serum enzymes are the same as in nonpregnant women. 29% of these women died, 23 went to term, and 7 gave birth prematurely. 13 labors were spontaneous, 7 required forceps, and 10 were Caesarean births. Fetal loss was 27%. Treatment is the same as that in any heart attack patient, except for lignocaine and use of anticoagulants. Abortion is only necessary in cardiac insufficiency. Delivery should probably involve forceps, epidural anesthesia, and anticoagulatns immediately after delivery, but oxytocin should be avoided. The 17 cases of pregnancy after a heart attack resulted in 1 abortion, 15 term deliveries, 3 new infarctions, and 1 death due to antoher heart attack at term.
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PMID:[Myocardial infarct and pregnancy]. 103 53

A clinical team in the Dept. of Obstetrics and Gynecology of the Albert Einstein College of Medicine investigated the effects of several prostaglandin compounds of human pregnancy. Women between 8 to 20 weeks gestational age had pregnancy termination through: 1) intraamniotic PGF2alpha (prostaglandin F2a) administration (n=20, 15.9 + or - 0.6 weeks pregnant, 1.4 + or - 0.4 parity); 2) extraovular PGF2a administration (n=20, 13 + or - 0.3 weeks gestation); 3) intramuscular 15-methyl PGF2a administration; 4) vaginal suppositories of PGE2 (n=110 women, 1.45 + or - 0.17 parity, 15.4 + or - 0.3 gestational weeks); and 5) induction of term labor through PGF2a and PGE2 administered orally, intravenously, vaginally, and extraovularly. In the 1st group, the 20 women aborted in 16.5 + or 2.1 hours with an average total dose of 24.3 + or - 1.1 mg. In the 2nd group, the 20 women aborted in 17.9 + or - 2.9 hours with 11 + or - 1.8 mg PGF2a. The 24-hour cumulative abortion rate was 83%. In both intraamniotic and extraovular groups, prostaglandin side effects were noted in 25% to 70% of the women. Incidence of retained placentas was also high. In the 3rd group, abortion did not follow a predictable pattern and side effects occurred in virtually all women, making this approach unacceptable as a therapeutic method. The vaginal suppositories resulted in a mean abortion interval of 14.12 + or 0.7 hours with an average total dose of 78.3 + or - 0.12 mg. Induction of term labor using PGF2a and PGE produced results which are not superior to those of intravenous oxytocin in term pregnancies, possibly because of the biophysical properties of the term uterus. Prostaglandins appear to be effective abortifacient agents with minimal material risk, and are most effective when administered intraamniotically, extraovularly, and paracervically. The chemistry and pharmacology of prostaglandins are briefly described.
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PMID:Prostaglandins in conception control. 108 Feb 45

The author describes the history of 2 patients who experienced rupture of the uterus during prostaglandin-induced abortion. Both patients, aged 29 years (15 weeks gestational length, parity 2) and the other, 35 years old (24 weeks gestation, parity 6) presented with fetal death in utero. Both patients were managed with high doses of oxytocin as well as intravenous infusion of prostaglandins (PG) E2. Laparotomy and hysterectomy were performed on both patients. The 29-year old patient recovered uneventfully with the help of antibiotics. The 35-year old patient experienced a mild pelvic peritonitis which responded to penicillin and kanamycin. She recovered uneventfully but had to be readmitted to the hospital later because of pulmonary infarction. The infarction was successfully treated with intravenous heparin and later, warfarin. It is possible that uterine infection and multiparity predispose to rupture of the uterus although there was no evidence of old scarring in the excised uteri of the patients. The uterine rupture in both cases was associated with considerable morbidity from anemia, infection, and pulmonary infarction. It is possible that rupture of the uterus (very uncommon in midtrimester pregnancies) is a rare complication of prostaglandin-induced termination of pregnancies.
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PMID:Letter: Rupture of uterus during prostaglandin-induced abortion. 111 46

A series of 100 consecutive patients seeking pregnancy termination in pregnancy weeks 7-20 were treated with a schedule of 20-mg vaginal suppositories containing prostaglandin E2 (PGE2); the schedule was being tested for its efficacy, specifically reduction of total dose and related side effects. 94 of the 100 patients were aborted within an arbitrary time span of 36 hours. Total drug dose ranged from 40-160 mg. 31 patients received augmentative intravenous oxytocin. Induction-abortion interval varied from 6-32.5 hours. Of the 97 successes, 76 were classified as complete abortions. No significant differences were noted in midtrimester groups based on increasing parity, although parous patients in gestation week 13-15 seemed to have the best results, based on average interval time. No sepsis or need for transfusion was encountered. Side effects were emesis (n-75), diarrhea (n=17), and drug fever (n=66); less frequent side effects included headache, breast tenderness, and vasomotor symptoms (n=13, 1, and 1, respectively). The midtrimester patient results compared favorably with results of studies using saline for abortifacient. The number of first trimester patients was too small to yield any conclusion.
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PMID:Vaginally administered prostaglandin E2 as a first and second trimester abortifacient. 111 58


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