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

Prostaglandin F2a was used for termination of pregnancy in two groups of patients. The first included eighteen patients with either missed abortion or intrauterine fetal death, and were treated by intrauterine-extraamniotic infusion of 20 mg prostaglandin F2a. The treatment was successful in 14 patients (mean induction-abortion interval 6.7 hours). Four patients, where the above method failed to induce labor, were given intravenously prostaglandin F2a or oxytocin simultaneously or separately; the expulsion time ranged from 12 to 48 hours. The second group included twelve patients who underwent a therapeutic abortion following either a diagnosis of fetal congenital abnormality or because of a maternal indication. The therapeutic abortion was performed using prostaglandin F2a (25-40 mg) via amniocentesis. The treatment was successful in all patients (mean induction-delivery interval 10.6 hours).
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PMID:Intra/extra-amniotic administration of prostaglandin F2a in fetal death, missed and therapeutic abortions. 219 5

A double-blind placebo-controlled trial was performed in 20 primigravidae to assess the physiological and clinical effects of oral mifepristone on myometrial contractility and sensitivity in the second trimester. Ten women received 600 mg of oral mifepristone and 10 women a placebo 24 h before abortion was induced in both groups, with extra-amniotic PGE2 instillation. Intrauterine pressure recordings demonstrated increased spontaneous uterine activity and increased sensitivity to PGE2 and ergometrine, but no change in oxytocin sensitivity after mifepristone treatment. There were no significant differences in PGE or PGF metabolite concentrations in peripheral maternal plasma over the 24-h study period after treatment between the mifepristone and placebo groups. The mean induction abortion interval in the mifepristone group was 512 (SD 321) min compared with 1128 (SD 606) min in the placebo group (P less than or equal to 0.02). The mechanism whereby mifepristone provokes enhanced uterine contractility and sensitivity to prostaglandins, with a reduction in abortion times, does not appear to be through endogenous production of PGE or PGF.
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PMID:The physiological and clinical effects of progesterone inhibition with mifepristone (RU 486) in the second trimester. 219 18

There are several medical methods of inducing 2nd trimester abortion, each with merits and drawbacks, difficult to compare, especially when supplemental techniques are used. Drugs used are hypertonic saline, urea, natural and synthetic prostaglandins (PGs), mannitol, formalin, ethacridine lactate (Rivanol) and others for intraamniotic route; saline, PGs, Rivanol, utus paste and other extraamniotically; and the above methods combined with oral antiprogestins, iv oxytocics, in or intravaginal PGs, or mechanical cervical dilators. Few double-blind studies exist comparing drugs. About 50,000 mid-trimester abortions are done in the US yearly, about 10% of all terminations, but these cause 2/3 of all complications and half of the deaths. Saline can be used after 15 weeks, can cause hypernatremia or coagulopathy, and takes up to 72 hours unless augmented with ocytocin and/or laminaria. Urea may have less risk of coagulopathy. Rivanol is considered safer than both in some countries, e.g., Scandinavia, Eastern Europe, Israel, India and Japan. It can be instilled transcervically. Various intrauterine PGs have been compared in several doses and routes by WHO Task Force research groups and others. Extraamniotic PGs require a lower dose, cause fewer cervical lacerations, and can be used when membranes are ruptured, in molar pregnancy, at Weeks 13-15, and in cases of fibroids. This route is somewhat less effective than intraamniotic PGs, and may require multiple doses. Intraamniotic PGs act slower but are more effective, after only 1 dose. Laminaria speed up the process, but adding oxytocin increases risk of injury. PGs may be safer than saline, especially if intramuscular route is used, because there is no danger of coagulation, cardiovascular, renal or hypernatremic complications or inadvertent injection. It is possible that some of the higher complications attributed to PGs are related to selection of patients with more severe medical conditions. PGs are more expensive, and require medication for side effects.
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PMID:Intrauterine administration of drugs for termination of pregnancy in the second trimester. 222 3

A study was conducted to determine the effect of the form of uterine evacuation (curettage or vacuum aspiration) and of the use of oxytocin on the incidence of invasive/metastatic gestational trophoblastic neoplasia among patients with a diagnosis of molar abortion. The study was conducted on 42 patients with a histopathological diagnosis of benign complete hydatidiform mole and with a uterine height of more than 12cm. Twenty-five patients were submitted to uterine evacuation by curettage and 17 to uterine evacuation by vacuum aspiration. Twenty-seven of the same 42 patients received oxytocin to promote dilation of the cervix and/or partial mole expulsion, and 15 were not treated with this drug. Statistical analysis showed that the use of oxytocin before uterine evacuation was a factor contributing to a higher risk of development of invasive neoplasia, especially when associated with curettage of the uterus.
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PMID:[Evaluation of different technics of uterine evacuation as a risk factor for invasive and metastatic trophoblastic neoplasms]. 248 13

Increasing concentrations of nitrendipine were found to inhibit various types of muscular activation (electrical stimulation, acetylcholine, oxytocin, potassium chloride), as well as the spontaneous rhythmic activity of the isolated rat uterus. The degree of the inhibitory effect of nitrendipine depends on the type of activation. Nitrendipine showed an exceptionally high efficacy in inhibiting contractions induced by electrical stimulation and of spontaneous rhythmic activity. For inhibition of these contractions even osmolar concentrations of nitrendipine were sufficient. The relaxant effect of nitrendipine depended on the concentration of extracellular calcium and the time of incubation of nitrendipine in the bathing medium. Nitrendipine showed high selectivity for the uterine smooth muscle because in a very high concentrations is exerted an insignificant relaxation of the other isolated smooth muscles (oesophagus, urinary bladder). Our experiments indicate that nitrendipine might have a role in therapy of premature delivery and abortion because of its great selectivity for the uterine smooth muscle. Addition of calcium into the medium restores completely all types of muscular activation after the inhibitory action of nitrendipine except its depressive action on the phasic component of oxytocin-induced contractions. These findings that individual types of activation, after inhibitory action of nitrendipine, are reestablished in various degrees by the addition of calcium into the medium, are also an additional confirmation about the existence of various types of calcium channels.
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PMID:[Effect of nitrendipine on isolated uterus and other smooth muscles of the rat]. 253 Oct 21

A review of 13 cases of second trimester termination at 20-24 weeks by dilation and evacuation after insertion of laminaria in women with critical illness is presented. The patients ranged in age from 17-41, parity from 0-5, and diagnoses covered a wide range, including hematologic, respiratory, vascular, gastrointestinal, cardiac systems, malignancies, autoimmune disorders and infections, as well as several with multiple problems, including intravenous drug use. Most were the result of late diagnosis or late presentation. Procedures were performed according to a standard protocol by 1 physician, from 1983- 1987, using iv meperidine and diazepam sedation and paracervical block, 12 after laminaria insertion. Amniotomy and evacuation with large ovum forceps were followed by oxytocin and sharp curettage. There were no complications in this series. The dilation and curettage method is preferable in such cases because the timing of the procedure can be planned for maximal use of facilities and staff, the patient is spared by unattended delivery, the length of the abortion process is minimal, and incidence of infection and retained placenta is lower. Need for lengthy analgesia and fluid monitoring is reduced, an advantage for many critically ill women. This approach is best done by a physician with specific experience, in a setting capable of managing severe complications.
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PMID:Late-second-trimester pregnancy termination with dilation and evacuation in critically ill women. 258 88

Prostaglandin E2 gel is a useful agent for ripening and dilating the cervix. Since it is not available in the US, it must be prepared by thawing and grinding a 20 mg prostaglandin E2 suppository, mixing in a small amount of methylcelulose gel, and blending. The resulting gel is stored frozen in a 3 ml plastic syringe. The gel may be administered intracervically, intravaginally, or extraamniotically. Cervical administration of .5 mg prostaglandin E2 in 2-3 ml of viscous gel is most popular, but intravaginal administration is easiest, although it requires a higher dose (1-5 mg prostaglandin E2 in 2-10 ml of gel). The condition of the cervix is usually favorable for labor induction within 12 hours (range 4-24 hours). 59 clinical trials were conducted among 3313 pregnancies. In patients with unfavorable cervix induction of labor was successful in 83% of those treated with the gel but in only 53% of untreated patients. In women with an unfavorable cervix the gel is more effective if administered intracervically. In patients with favorable cervix, 66% of nulliparas and 82% of multiparas were delivered without oxytocin. Prostaglandin E2 gel has been used successfully even in women with prolonged pregnancy, hypertension, ruptured membranes, and fetal death. It can also be used to induce late 1st trimester abortion. Side effects of the gel are mild and minor. Prostaglandin E2 gel has thus been shown to effect cervical ripening and dilatation, reduce induction failures, shorten the induction-delivery interval, reduce oxytocin use, and lower the need for cesarean sections. Prefabricated prostaglandin E2 delivery systems should be approved by the Food and Drug Administration for commercial use.
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PMID:Prostaglandin E2 gel for cervical ripening and induction of labor: a critical analysis. 264 30

Uterine rupture occurring during a midtrimester abortion is rare. This complication may lead to profound shock and death as well as to interference with the patient's future fertility. Two patients sustained a uterine rupture during midtrimester abortion. This complication seems to be preventable. The risk of uterine rupture due to overstimulation is higher when amnioinfusion with prostaglandin or hypertonic saline is combined with the use of other oxytocic drugs. Grand multiparas undergoing amnioinfusion should not be given oxytocin; in the rare cases in which oxytocin is needed, it should be administered cautiously and monitored continuously. When a supplemental agent, such as an oxytocic, is needed, it should not be started until several hours after the amnioinfusion.
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PMID:Uterine rupture complicating midtrimester abortion. A report of two cases. 268 89

A case report of a ligamentary ectopic pregnancy that failed to respond to prostaglandin E2 for induced abortion for sepsis at 24 weeks is presented. The 27-year-old nullipara had normal ultrasound findings for gestational age up to 21 weeks gestation. She had consulted at 5 weeks for abdominal pain and bleeding, at 14 weeks again for abdominal pain, shoulder pain and vaginal bleeding, although both times the pain and bleeding resolved spontaneously. She was seen again at 16 and 21 weeks gestation, when ultrasound scans were normal for dates. At 24 weeks, she experienced vaginal discharge of blood and tissue, and was managed as premature rupture of membranes. She became septic 12 days later. She was treated with transcervical PGE2 and iv oxytocin without response for 3 days. Surgical evacuation was successful, but bleeding persisted. During laparotomy she had a large left broad ligament hematoma, a left ruptured uterus, and open left internal iliac artery and vein. These were repaired, and she received 40 units of blood, 8 platelets and 14 of plasma. Only after histology was the diagnosis of ligamentary pregnancy made. The lack of response to PG for abortion should raise suspicion of ectopic pregnancy, although preoperative diagnosis of ligamentary pregnancy is extremely rare.
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PMID:A rare gynecologic contraindication to the use of prostaglandins and oxytocin to induce abortion. A case report. 279 68

Increasing concentrations of fendiline inhibit various types of muscle activation (KCl, oxytocin and electrical stimulation), as well as spontaneous rhythmic activity of the isolated uterus of the rat. Contrary to verapamil and nifedipine, fendiline in micromolar concentrations (from 1.5 to 15.5 mumol) affects various types of muscle activation almost to the same degree. Fendiline probably influences a common pathway in calcium metabolism in all types of muscle activation. The relaxant effect of fendiline does not depend on cAMP, being even associated with a significant decrease of the level of this nucleotide during electrical stimulation of the isolated uterus of the rat. Fendiline may have its place in the therapy of premature delivery and abortion, particularly because it exhibits lower selectivity in relation to the type of activation of the smooth muscle. Fendiline induces a stronger inhibition of the tonic than of the phasic component of contraction produced by oxytocin and KCl. Fendiline is more active against the oxytocin-induced contraction, probably due to an additional action on the fast Na+ channels. These findings indicate that KCl and oxytocin act through different calcium channels (voltage and receptor calcium channels). Our experiments in which fendiline inhibited more strongly the tonic than the phasic component of KCl-produced contraction also confirm the hypothesis on the existence of voltage calcium channels (or subtypes of one voltage calcium channel) in the isolated uterus of the rat. By adding calcium to the medium, almost all types of muscle activation are established, after the inhibitory action of fendiline, except its depressive action on the electrical stimulation of the isolated rat uterus. Calcium most effectively antagonizes the inhibitory effect of fendiline on spontaneous rhythmic activity. The finding that certain types of activation, after the inhibitory action of fendiline, occur to a different degree by addition of calcium to the medium, are also indirect confirmation of the existence of different calcium channels. Halothane, in a concentration of 1 vol %, did not change the relaxant action of fendiline during electrical stimulation and during spontaneous rhythmic activity.
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PMID:The effect of fendiline on cAMP metabolism and activity of the isolated uterus of the rat. 282 Mar 25


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