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)

Premature rupture of the membranes (PROM) occurs in 5-10% of pregnancies. Approximately 60% of cases are in term patients. Infection of the lower genital tract and/or amniotic cavity is one of the most important etiologies of PROM. The diagnosis is usually established by direct observation of pooling of amniotic fluid in the vaginal vault. In problematic cases, the nitrazine and fern tests can be used to confirm the diagnosis. Term patients with PROM and favorable cervices should undergo induction of labor with oxytocin. Patients with unfavorable cervices probably are best managed by induction of labor with prostaglandin compounds, although, in highly selected cases, expectant management may be considered. During induction of labor, long latent phases should be anticipated, and vaginal examinations should be minimized. Patients should receive prophylactic antibiotics, if indicated, for prevention of group B streptococcal infection and should be observed carefully for early signs of chorioamnionitis.
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PMID:Premature rupture of the membranes in term patients. 891 94

Emergency treatment of such major complications of pregnancy as obstructed labor, hemorrhage, infection, hypertension disorders, and the effects of unsafe abortion, helps ameliorate morbidity and prevent mortality. Access to life-saving treatment (e.g., antibiotics, Cesarean sections, and blood transfusions) in developing countries is limited. Maternal mortality in one area of The Gambia, for example, is 2200 per 100,000 births. Improving access to care depends upon the availability of these services in communities, trained health personnel, service improvements, transportation provision, and community education. Detection of complications and early referral to an appropriate facility with a supportive and professional environment is key to saving lives. Political will and public pressure are needed before improvement in services can be successfully accomplished; politicians may ignore women with low status. Barriers to care are physical, cultural, technical, and economic. Cost or distance from home may prevent women from seeking care. Infection, hemorrhage, and uterine injury are frequently related to unsafe abortions, particularly among teenage women. Hospitals must be equipped with a reliable management system, surgical facilities, and clinical services. The WHO recommends upgrading community health centers with trained personnel, adequate supervision, and equipment. In Uganda, midwives are specially trained in advanced skills for use in remote areas: administration of oxytocin to evacuate the uterus and reduce bleeding, use of antibiotics for infections, and surgical repair of vaginal tears. Nurses in Zaire are trained to do Cesarean sections. In Sierra Leone and Nigeria, doctors are encouraged to receive training in obstetrics and to be posted in rural areas. In Sierra Leone, young men are trained to bring pregnant women in to care on stretchers. Maternity waiting homes near hospitals are another means to save lives. Lack of permission from a male relative may prevent use of medical care. Time, money, and women's place in society determine whether a woman receives care. Superstitions, such as difficult labor being blamed on the woman's unfaithfulness, interfere. Women with knowledge of complications may not have available services. Cost of care may discourage or delay decisions. Governments must support maternal health policies.
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PMID:Access to care save lives. 1228 2

This study presents data from the first observation of labor, childbirth and immediate newborn care in a clinical setting in Sindh, the second most populous province of Pakistan. Trained midwives observed 310 births at 126 district level referral facilities and primary health care facilities in 10 districts of Sindh where the USAID-funded Maternal Child Health Integrated Program (MCHIP) was implemented. The facility participation rate was 78%. The findings show that monitoring vital signs during the initial examination was conducted for less than one-in-ten women. Infection prevention practices were only observed for one-in-four women. Modesty was preserved for less than half of women. In spite of an absence of monitoring during the first and second stages of labor, providers augmented labor with oxytocin in two-thirds of births. To prevent post-partum hemorrhage, oxytocin was administered within a minute of birth in 51% of cases. Immediate drying of the baby was nearly universal and eight out of ten babies were wrapped in a dry towel. Newborn vital signs and the baby's weight were taken in one-in-ten cases. Breastfeeding was initiated during the first hour of birth in 18% of cases. A support-person was present during labor and birth for 90% of women. While quality of care is poor across all facilities, the provision of care at district-level referral facilities was even lower quality than at primary health care facilities. This is because dais or assistants without formal training provided labor, birth, and newborn care for 40% of deliveries during night shifts at referral facilities. This study found many examples of suboptimal practice by skilled birth attendants across all levels of health facilities. There remains an urgent need to improve quality of service provision among skilled birth attendants in Pakistan.
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PMID:Quality of labor and birth care in Sindh Province, Pakistan: Findings from direct observations at health facilities. 3162 82