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

Postpartum hemorrhage is a common and serious complication of the third stage of labor resulting in anemia and increased morbidity in the puerperium. Administration of uterotonic drugs and suitable mechanical assistance in delivery of the placenta may significantly reduce this hazard. Ergometrine and oxytocin have been used for a long time in markedly different doses and by various routes of administration with varying success. In order to compare these two oxytocics with regard to their hemostatic effects as well as their possible interference with the physiologic placental separation mechanism, three groups (ergometrine, oxytocin, and control) of women have been studied during a 2-year period. Ergometrine (0.2 mg) and oxytocin (10 IU) administered in the stated doses and as single intravenous injections are comparable with regard to hemostatic efficiency, but oxytocin seems to promote placental separation and expulsion better and thereby reduces the risk of partial retention and trapping with bleeding reguiring further emergency measures as a frequent consequence.
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PMID:Active pharmacologic management of the third stage of labor. A comparison of oxytocin and ergometrine. 31 May 30

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

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

The author relates her experience in Benin during a 3 and 1/2 year tenure as a nurse under the aegis of the German Development Agency. In Malanville, she was responsible for starting the operating room, caring for hygiene, sterility, and the related training of domestic staff. A septic and aseptic operating room was set up along with a storage room for instruments, a sterilization room, and a changing room. For the operating and surgical station, the following personnel were available: 2 nurses with 3 years of training, 1 nurse with 2 years of training, and 3 orderlies without training. A nurse with 3 years of training was assigned to the author to carry on the project after her departure. The standard of operating care was very low. It took a month to teach the staff what was not sterile. There was a even problem with putting on sterile gloves which required an exercise in patience. There were an average of 5 relatives per patient taking care of the patient and cooking. The undernutrition center for infants had 6 beds with 2 German nurses who administered Bacillus Calmette-Guerin (BCG), diphtheria, polio, and tetanus vaccinations. Their activity was strengthened by nutrition counselling and plans for underweight and malnourished children. Abrupt weaning that resulted in harmful diarrhea and vomiting was prevalent. Clinical signs of marasmus and kwashiorkor were frequent. In the middle of 1990, AIDS educators informed students of the public school as well as registered prostitutes about condom use. In the hospital, there were about 900 births per year, and women were asked to follow recommendations for prenatal care, especially to achieve anemia prevention by getting iron tablets. They were urged to deliver in the clinic, not at home assisted by untrained midwives. Oxytocin and syntometrin were available as was a hand-driven, vacuum evacuation pump. This experience made a lasting impression on the author who has resolved to go to another developing country to train traditional birth attendants in midwifery.
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PMID:[In Africa as a nurse]. 161 98

To improve the efficacy of prelabor treatment of pregnant women with some obstetrical abnormalities, such as over-term pregnancy, AB0- and Rh-isosensitization, anemia, gestosis of the second half of pregnancy, vaginal and intracervical suppositories containing 0.1 mg of enzaprost were administered to 102 women for 1-5 days. In 30 (29.4%) cases such treatment induced spontaneous labor. In 64 (62.7%) women labor was induced by deoxy-amino oxytocin, and in 8 (7.8%) women this latter drug had to be administered repeatedly to induce labor. The babies born to the women under observation had the Apgar score of 6-10, 92 (90.2%) of them had the score of 8-10. No stillbirths or early infant mortality cases were recorded. Therefore prelabor treatment with vaginal or intracervical suppositories with enzaprost is effective and safe for both mother and newborn.
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PMID:[Experience in the use of vaginal and intracervical enzaprost suppositories in preparation for labor]. 162 8

Because of a hydrocephalic fetus, the 27 year old mother opted for abortion. This was done in the 21st week of pregnancy by ordinary intracervical application of 0.25 mg prostaglandin e2 gel. 30 minutes later the patient began to complain of nausea and dyspnea. Laboratory analysis revealed leukocytosis of 20800/ml and thrombocytopenia of 22000/ml, down from 150,000 ml before the procedure. There were no clinical indications of bleeding. The leukocytosis lasted 2 days and thrombocytopenia roughly 6 days. Treatment included administration of acetylsalicylic acid 3 x 0.5 g and dipyrimadol tablets 3 x 25 mg/day. After thrombocyte count was normalized, abortion was induced by means of spasmolysis and oxytocin i.v. In this case partial resorption of the prostaglandin indicates a systemic effect. Since the half life of E and F group prostaglandins is usually 1-3 minutes, and it is almost completely eliminated after passing through the liver and lungs, a direct prostaglandin effect leading to thrombocyte aggregation lasting several days is unlikely. Absence of thrombocyte antibodies point to a drug induced immune process in which the prostaglandin molecule could appear as a hapten. Ultimately the thrombocyte aggregation described here and normochromic anemia are of unclear origin. Changes in the patients' coagulation system are probably of no functional relevance. The initial leukocytosis must be considered a nonspecific immediate reaction.
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PMID:[Thrombocytopenia following intracervical prostaglandin priming]. 346 25

According to the World Health Organization, between 1980 and 1985 the total fertility rate was 2.0 in the wealthy countries and 4.1 in the less developed countries. The highest rate was found in Kenya with 8.1. The risk of maternal mortality in connection with pregnancy and childbirth was 1/10,000 in Northern Europe, but 1/21 in Africa. Every year about 500,000 women die because of complications before, during, or after delivery. The maternal mortality rate (30/100,000 live births in Europe) is still 500-800/100,000 in the developing countries, although Tanzania has succeeded in cutting its rate from 450/100,000 to 170/100,000. The main causes of maternal mortality are: 1) unrecognized obstructed labor, 2) postpartum bleeding that could be managed by massaging the uterus, administration of oxytocin or by the manual removal of the placenta, 3) postpartum infections that could be treated by timely administration of antibiotics, 4) preeclampsia that could be detected and treated, and 5) abortion complications requiring effective treatment. Among indirect causes of death is anemia: 66% of pregnant women in developing countries are anemic, compared to 14% in industrialized countries. So far the cause of the reduction of partial immunity against malaria parasites in primiparas has not been explained. A significant percentage of deaths (11-47%) can be traced to unqualified and negligent personnel, especially in the slums and rural areas. Only 52% of deliveries are attended by well-trained health personnel, although in 10% of pregnancies complications arise. Young age is another factor: in 1989 in Tanzania the first pregnancy occurred on the average at age 17.6 years compared to 27 years in England. In the beginning of the 1990s there were an estimated 3 million HIV-infected women, therefore maternal mortality as a consequence of AIDS is going to increase. In high prevalence areas the population growth rate will decline from 3% to 2.4%. Traditional birth attendants could be trained and used effectively to reduce maternal mortality by 3-11% as part of a functioning referral system.
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PMID:[Obstetrics in the Third World]. 811 19

In the gynecological-obstetrical municipal hospital of Pruszkowie, there were a total of 38 pregnant women admitted under the age of 17 from January, 1990, to June, 1992, for abortion, pregnancy complications, and delivery. The deliveries to those under 17 represented 1.2% of the total of 2693 births during 1990-92. The youngest was 15 years old. 60% were students, and the rest did not work or study. 63% were not married. 74% were supported by their parents. 32 patients were admitted for delivery, 4 for abortion, and 2 for pregnancy complications. 28 had their first pregnancy, 2 had induced abortion, and 2 were multiparous. The following pregnancy complications appeared: in 13.17%, anemia (treated with drugs and in one case with blood transfusions; in 10.5%, infection of urinary tract; in 3%, gestosis in the preliminary stage; in 3%, insufficiency of the cervical canal; in 16%, premature birth (60% of which was caused by the premature rupture of amniotic fluid, with 40% having contractions that could not be halted by tocolytic drugs). Two patients were hospitalized in the pathology department on account of threatening premature birth and anemia. They were treated and released home with recommended further out-patient care. In 88% of women giving birth at term genuine contractions appeared, and in the rest of the cases birth was induced by oxytocin infusion. The average duration of birth was 5 hours and 48 minutes. The longest labor lasted 10 hours and 40 minutes, the shortest one 3 hours and 5 minutes. In 9.3% of deliveries, cesarean section was performed because of threat of miscarriage in one case and the position of the pelvis in two cases. During puerperium in 15.6% of patients, slow inversion of the uterus was observed, which necessitated the administration of spasmolytic drugs. In one case there was an inflammation of the uterine muscle. The 80% rate of premature births among those not having received prenatal care had to do with their low socioeconomic status in an urban environment and consequent inferior public health care.
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PMID:[Problems with pregnancy, delivery and puerperium in teenage girls hospitalized in a city hospital]. 837 23

In neonatal calves besides adaptations in organ function there are marked metabolic and endocrine changes. The growth hormone (GH)-insulin-like growth factor (IGF) axis is basically functioning, but needs maturation. Various metabolic and endocrine traits do not exhibit marked ontogenetic changes after the first week of life, but others remain different from the adult stage. Thus, plasma oxytocin or an oxytocin-like substance and nitrate concentrations are elevated for months. The ability to digest colostrum (C) and milk involves great alterations in structure and function of the gastrointestinal (GI) tract. C intake is important for passive immunity, provision of nutrients, minerals and vitamins, and contains biologically active substances. IGF-I, present in C in high amounts, appears to enhance GI tract development and function. For sufficient absorption not only of immunoglobulins, but also of fatty acids and fat-soluble vitamins, C should be ingested immediately after birth. The amino acid pattern and the glutamine/glutamate ratio depends greatly on whether C is fed or not. Effects on insulin, IGF-I, and IGF binding proteins depend on time-point and amounts of C fed. After the colostral period calves are almost exclusively fed milk and milk substitutes or weaned. Low iron intake, required for the production of pale meat, besides anemia causes metabolic and endocrine adaptations, such as enhanced insulin-dependent glucose utilization and appears to reduce IGF-I responses to GH. Metabolic and endocrine changes, such as insulin resistance and disturbed glucose metabolism, can be observed in part in association with high feeding intensity in veal calves.
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PMID:Endocrine and metabolic aspects in milk-fed calves. 1052 25

The low postpartum levels of PGI2 interacting with oxytocin vis-a-vis myometrial contractility may prevent postpartum hemorrhage. Predisposing factors for atonic postpartum bleeding are uterine overdistension, grand multiparity, prolonged labor, anemia, toxemia, and heavy narcosis. Routine administration of oxytocic agents reduce uterine atony. In 1 group of 40 patients .2 mg methyl ergometrine given iv postplacentally produced less bleeding than in the other group of 40 getting placebo. 1 mg of iv PGE1, .2 mg ergometrine, 3 IU oxytocin or a combination of PGE1 and ergometrine was compared in 180 women. PGE1 did not reduce blood loss. PGF2alpha was used successfully to induce labor in 21 women reducing blood loss compared to oxytocin. Another 10 women received in syntometrine and 5 got im .25 mg sulprostone at the moment of crowning, and the latter reduced postpartum blood loss. 90 women in 3 groups of 30 each at high risk of hemorrhage were injected im .2 mg methyl ergometrine maleate, .25 mg 15-methyl-PGF2alpha, and .5 mg sulprostone, respectively, resulting in prevention of severe hemorrhage. Intramyometrial injection of .5-1 mg of PGF2alpha induced uterine contractions and controlled bleeding in atonic hemorrhage when oxytocin failed. 20 mg PGE2 vaginal suppositories controlled postpartum atony after cesarean section, although fever and hypotension did occur. Im 15-methyl-PGF2alpha proved superior in producing hemostasis to intramyometrial PGF2alpha injection. In 2 studies .25 mg of 15-methyl-PGF2alpha was injected at 1.5 hour intervals arresting hemorrhage in 15 out of 16 and 18 out of 20 cases, respectively. Intrauterine infection caused all 3 failures. Sulprostone by infusion of 1.7-30 mcg/min or by 500 mcg im injection also controls postpartum hemorrhage.
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PMID:The use of prostaglandins in post-partum haemorrhage. 1231 32


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