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

The recent Food and Drug Administration's approval of prostaglandin E2 (PGE2) vaginal suppositories provides the clinician with a technique for the immediate management of missed abortion and intrauterine fetal death (IUFD). During a 4-year period at our institution, 78 of 80 patients with gestations ranging from 13 to 42 weeks had pregnancy successfully terminated with PGE2 suppositories with a dose schedule of 20 mg every 2 hours. The mean interval from induction to delivery of the fetus was 8.9 hours. Fifty percent of the patients spontaneously expelled the placenta; active intervention to remove the placenta within 2 hours of delivery of the fetus is recommended to avoid excessive vaginal bleeding. The most frequently encountered side effect was a temperature elevation, which was managed by less frequent administration of the prostaglandin. Gastrointestinal side effects were minimized by premedication with antidiarrheal and antiemetic agents, which also were administered during the induction period when indicated by the patient's symptoms. A concomitant oxytocin infusion was utilized in 38 patients. In gestations of less than 24 weeks the oxytocin was administered via intravenous drip at a rate of 10 U/hour. In the case of a patient with IUFD and a gestation of 24 weeks or more, oxytocin should be administered only with a constant-rate infusion pump starting at a dose schedule of 1 mU/minute with careful titration of the dose against the monitored uterine activity. The availability of the vaginal PGE2 suppositories for missed abortion and IUFD makes it important for the clinician to fully acquaint himself with the drug, its administration, effects, and side effects.
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PMID:Management of intrauterine fetal death with prostaglandin E2 vaginal suppositories. 740 65

Extra-amniotic infusion of prostaglandin F2 alpha (PGF2 alpha) and intravenous (IV) oxytocin in increasing doses were compared in a retrospective study to establish the efficacy of the two methods for termination of pregnancies with second trimester missed abortion. Sixty women with this complication underwent pregnancy termination, 28 by extra-amniotic infusion of PGF2 alpha and oxytocin augmentation, if necessary, and 32 by IV oxytocin in increasing doses. All patients in the PGF2 alpha group aborted within 24 hours from onset of infusion and seven of them needed oxytocin augmentation. There were nine failures in the oxytocin group and the other 23 aborted within 17 hours. The mean (plus or minus standard error of the mean) induction-abortion interval was significantly less in the oxytocin group (6.9 +/- 3.4 hours) than in the PGF2 alpha group (12.6 +/- 5.7 hours) p < 0.001. Eight patients in the group had mild side effects, such as nausea, flushes or transient hypotension. Uterine hypertonus was observed in two women receiving PGF2 alpha and treated by temporary interruption of the infusion. In the oxytocin group, one patient had coagulation disturbances and one, hemorrhage. We conclude that extra-amniotic PGF2 alpha infusion is more effective than IV oxytocin in increasing doses, for termination of second trimester missed abortion, but takes effect more slowly. We can assume that further use of IV oxytocin immediately after termination of the PGF2 alpha administration can shorten the induction-abortion interval.
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PMID:Comparative study of extra-amniotic prostaglandin F2 alpha infusion and increasing intravenous oxytocin for termination of second trimester missed abortion. 816 79

18 cases of missed abortion occurring during or after the 12th week of gestation in Professor Kellar's Unit of the Simpson Memorial Maternity Pavilion during the past 3 years were managed using intravenous high concentration oxytocin drips. Estimated duration of fetal death ranged from 3 to 14 weeks. A summary of the results of analysis is presented in Table 1. Delivery was achieved in the last 13 cases (except 2) within 24 hours of treatment. Of the 2 exceptions, 1 patient in whom the fetus had been dead for the longest time (14 weeks) took 31 1/4 hours to pass the fetus; the other patient took 21 1/4 hours to pass the fetus but as the placenta failed to follow, another drip was administered 11 hours later. The placenta was passed 50 minutes later. Surgical evacuation of the uterus was performed in 7 patients to complete the abortion process. No evidence of failure of clotting mechanism after delivery was observed, nor was the possibility of toxic substances being introduced into the maternal circulation from the placenta seen. It was concluded that the use of oxytocin drips is a reliable, rapid and safe method of managing missed abortion.
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PMID:The use of high concentration oxytocin intravenous drips in the management of missed abortion. 1233 45


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