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

Interview and record review data from 12,023 singleton deliveries were analyzed to determine the relationships between neonatal hyperbilirubinemia (10 mg/dL or greater) and maternal characteristics. Confounding variables were controlled by multiple logistic regression analysis. There was a statistically significant positive relationship between hyperbilirubinemia and low birth weight, Oriental race, premature rupture of membranes, breast-feeding, neonatal infection, use of the "pill" at time of conception, instrumental delivery, and history of first trimester bleeding. Maternal smoking and black race were negatively related to hyperbilirubinemia and statistically significant. In this study, other previously suspected etiologic factors such as epidural anesthesia, parity, use of oxytocin in labor, and white race were not associated with hyperbilirubinemia.
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PMID:Epidemiology of neonatal hyperbilirubinemia. 398 9

One hundred thirty-four indigent patients at term who had premature rupture of membranes and a cervix unfavorable for induction of labor (80% effacement or less, 2 cm dilation or less) were randomized to compare expectant with intervention management. Women with any medical or obstetric condition warranting immediate intervention were excluded from the study. Patients treated expectantly were placed at bed rest and observed for labor or infection. Patients managed by intervention were given oxytocin if labor did not ensue within 12 hours of rupture of the membranes. Patients in the intervention protocol had longer labor (P less than .02) and a higher incidence of both cesarean delivery (P less than .05) and intraamniotic infection (P less than .05). There was only one case of proven neonatal sepsis, and this occurred in a patient managed by induction of labor. There was no statistically significant difference between groups in mean length of maternal hospitalization.
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PMID:Management of premature rupture of membranes and unfavorable cervix in term pregnancy. 671 74

The overall rate of induction of labor in the United States in 1993 was 134 per 1,000 live births, or over 527,000 of the four million births that occur annually in the United States. Indications for labor induction include postdate pregnancy, premature rupture of membranes (PROM), and maternal medical complications, such as diabetes mellitus and pregnancy-induced hypertension. This article briefly reviews common indications for induction of labor and the importance of cervical ripening. It then addresses methods used to hasten cervical ripening and to induce labor, ranging from the more "natural" and noninvasive methods, such as nipple stimulation, to the newest commercially available formulation of prostaglandin. Methods well documented in the scientific literature, as well as those commonly used but less well studied, are included. Although one may argue about the "invasive" nature of these methods, they are addressed, in general, from the most natural methods to the latest pharmacologic methods, and they include the following: sexual intercourse, nipple/breast stimulation, herbal preparations, homeopathic solutions, castor oil, enemas, acupuncture, membrane sweeping or stripping, mechanical dilation (balloon catheters, laminaria, and synthetic osmotic dilators), amniotomy, and pharmacologic hormonal preparations (prostaglandin E2, oxytocin, misoprostol, mifepristone, and relaxin).
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PMID:Methods of cervical ripening and labor induction. 910 14

Results from randomised trials with formal randomisation indicate no evidence of benefits in terms of cesarean delivery of maternal/neonatal infectious morbidity by awaiting spontaneous onset of labor for more than 24 hours in women with term PROM. An overnight policy of management seems to be an attractive alternative to other management protocols. Women with prelabor rupture of membranes await stimulation of labor with oxytocin till next morning if admitted before midnight. A majority of the women may go into spontaneous labor with an excellent prospect of having a vaginal delivery. Particularly the nulliparous woman with poor cervical score could benefit from such an approach. Although prostaglandins in theory should be an useful adjunct agent to oxytocin, particularly in the nulliparous woman with unripe cervix, convincing evidence of the efficacy of the drug is still lacking. Well-conducted and randomised studies to evaluate the role of prostaglandins in nulliparous women with PROM are required.
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PMID:Controversies: premature rupture of membranes at term--no advantage of delaying induction > 24 hours. 912 Jul 40

197 of the 214 women who presented to a Los Angeles, California (US), hospital in 1995-97 with spontaneous rupture of the membranes beyond 36 weeks' gestation (mean, 38 weeks) volunteered for a comparative study of the effectiveness of vaginally administered misoprostol and oxytocin infusion. Induction was started a minimum of 6 hours after the spontaneous rupture of membranes. In 98 women, 25 mcg of misoprostol (Cytotec) was placed in the posterior vaginal fornix and, if uterine contraction frequency was deemed inadequate, the dose was repeated once in the next 6 hours (average, 1.3 dose). In the remaining 99 women, oxytocin was administered by infusion pump according to standard protocol, for a maximum dose of 22 mU/minute. 75 (75.8%) of misoprostol-treated women and 73 (74.5%) of oxytocin-treated subjects were delivered vaginally within 24 hours of induction initiation. The mean time from start of induction to vaginal delivery was 811.5 +or- 511.4 minutes in the misoprostol group and 747.0 +or- 448.0 minutes in oxytocin-treated subjects. 85 (85.9%) misoprostol-treated women and 82 (83.7%) oxytocin-treated subjects delivered vaginally. There were no significant differences between treatment groups in terms of tachysystole or hypertonus incidence or in the frequency of abnormal fetal heart rate tracings. Chorioamnionitis was diagnosed in 28 (28.6%) misoprostol-treated and 26 (26.3%) oxytocin-treated subjects. Neonatal outcomes were similar in both groups. Although misoprostol administration did not reduce the cesarean section delivery rate, its efficacy and safety were similar to oxytocin's, indicating this is a suitable regimen in women with premature rupture of membranes beyond 36 weeks' gestation.
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PMID:Induction of labor with misoprostol for premature rupture of membranes beyond thirty-six weeks' gestation. 991 15

In order to compare the efficacy of immediate intravenous oxytocin administration and intracervical prostaglandin E2 gel application in premature rupture of membranes with unfavorable cervices at term, 45 term pregnant patients with premature rupture of membranes were randomized into two groups. Twenty women received immediate intravenous oxytocin after cleansing enema while the rest were treated with intracervical prostaglandin E2 gel. Means of maternal age, gestational age, Bishop score at admission and the rates of nulliparity did not show any significant differences between the two groups (p > 0.05). The mean rupture to delivery time was 12.6 +/- 4.4 hours in the oxytocin group and 16.5 +/- 4.5 hours in the prostaglandin group (p < 0.01). Mean birth weights and Apgar scores were insignificant. Cesarean section rates were 24% in the oxytocin group and 5% in the other (p < 0.05). No infectious morbidity was seen in any case. In conclusion, although delivery is delayed with the intracervical prostaglandin approach, cesarean section rate is lowered without an increase in infectious morbidity.
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PMID:A randomized trial of intracervical prostaglandin gel and intravenous oxytocin in prelabor rupture of membranes with unripe cervix at term. 974 81

Eighty late pregnancy women were randomized into two groups. Misoprostol group and oxytocin group. We observed the different effects of misoprostol and oxytocin on induction, the different effects of misoprostol on induction which was given through rectum or through vagina. The results indicate that the rate of successful induction in misoprostol group is higher than that of oxytocin group, the rate of caesarean section in misoprostol group is lower than that of oxytocin group. There was no significant difference in the durations of misoprostol which was given through rectum or through vagina on induction. It is suggested that misoprostol is more effective on induction than that of oxytocin. We can choose misoprostol given through rectum to prompt delivery in conditions such as premature rupture of membranes and vaginitis.
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PMID:[Clinical observation of misoprostol on induction in late pregnancy]. 1193 91

Premature rupture of membranes is defined as expulsion of the amniotic liquid occurring at least 1 hour before initiation of uterine contractions and without apparent cervical changes. According to the literature, premature rupture of membranes occurs in 2-15% of all pregnancies, with an average of 10%. The etiology is considered multifactorial, and treatment remains controversial. A retrospective review was conducted to determine the occurrence of maternal or perinatal morbidity and mortality in 230 cases of premature rupture of membranes in a social security hospital in Santo Domingo, Dominican Republic, observed between 1983-88. Premature rupture occurred in 3.5% of cases according to the records. 37.4% of affected mothers were 21-25 years old and 69.6% were 21.30. 62.9% of the women were nulliparas. 2.2% had had no prenatal care, 59.1% had insufficient prenatal care, defined as 1-5 visits and only 36.1% had 6 or more visits. 81.3% of ruptures occurred at 37-42 weeks of gestation. In 64.8% of cases the pregnancy was terminated within 1-24 hours and 35.2% were considered prolonged. Prematurity and low birth weight was the most common perinatal disorders, affecting 10.9%. Respiratory difficulty syndrome affected 4.3%. 60% of infants with respiratory problems were born at less than 37 weeks gestation. Neonatal sepsis occurred in 3% of cases and prolapse of the umbilical cord in 1.3%. Perinatal mortality averaged 2.6%. Prematurity was a factor in all cases. Respiratory distress syndrome and neonatal sepsis were each present in 50% of cases and hyperbilirubinemia in 33%. 8.7% of the mothers developed chorioamnionitis. Only 23.9% terminated their pregnancies spontaneously. Oxytocin was used to induce labor in 30.4% and cesareans were performed in 44.8%.
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PMID:[Premature rupture of membranes: maternal - perinatal morbidity and mortality in the Dominican Republic]. 1231 12

Current guidelines for dialysis in pregnant women have been developed in response to occasional dialysis patients who unexpectedly become pregnant. These include prolonged dialysis times, generally 20 or more hours per week. The increased dialysis time requires careful monitoring of phosphorus and potassium which may be removed in excessive amounts. Target serum bicarbonate for a pregnant woman is 18-20 mEq/L. Patients require increased supplementation of water soluble vitamins particularly folate. Increased doses of erythropoietin are needed to meet the demands for increased red cell production occasioned by pregnancy. Hypertension is the greatest danger to the mother and extreme vigilance is required up to six weeks postpartum. Volume status is difficult to predict and can only be determined by repeated clinical assessment. Only 50% of pregnancies result in a surviving infant and in the best subgroups, no more than 75% of pregnancies are successful. Over 80% of live born infants are premature, often severely premature. The key to improving the outcome of pregnancy in dialysis patients lies in decreasing premature labor and premature rupture of membranes in the late second and early third trimester. To this end, it is important for obstetricians to recognize that the risk of prematurity in pregnant dialysis patients is as higher or higher than in any other group and that any intervention, including such measures as progesterone and oxytocin antagonists, used to prevent premature labor in other groups should be considered in dialysis patients.
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PMID:Pregnancy in dialysis patients: where do we go from here? 1296 89

Premature rupture of membranes (PROM) occurs in 8% of term deliveries. In this situation labour induction with prostaglandins, compared with expectant management, results in a reduced risk of chorioamnionitis, neonatal antibiotic therapy, neonatal intensive care (NICU) admission, and increased maternal satisfaction. The use of prostaglandin is associated with an increased rate of diarrhoea and use of analgesia/anaesthesia. Compared with oxytocin, prostaglandin induction results in a lower rate of epidural use and internal fetal heart rate monitoring but a greater risk of chorioamnionitis, nausea, vomiting, more vaginal examinations, neonatal antibiotic therapy, NICU admission and neonatal infection. Women should be informed of the risks and benefits of each method of induction.Misoprostol is gaining increasing interest as an alternative induction agent. It appears to be an effective method of labour induction with term PROM. Further research is needed to identify the preferred dosage, route and interval of administration, and to assess uncommon maternal and neonatal outcomes. There has been limited research on the use of prostaglandins, including misoprostol, for induction of labour with a favourable cervix and intact membranes. Compared with intravenous oxytocin (with and without amniotomy), labour induction using vaginal prostaglandins in women with a favourable cervix (with and without PROM) results in a higher rate of vaginal delivery within 24 hours and increased maternal satisfaction. In women with a favourable cervix, artificial rupture of membranes followed by oral misoprostol has similar time to vaginal delivery compared with artificial rupture of membranes followed by oxytocin. Further research with prostaglandins, including misoprostol, is needed to evaluate other maternal and neonatal outcomes in women being induced with a favourable cervix. No form of prostaglandin induction in women with PROM or favourable cervix has proven clearly superior to oxytocin infusion.
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PMID:Induction of labour with a favourable cervix and/or pre-labour rupture of membranes. 1297 15


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