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)

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

Most cases of postpartum haemorrhage are caused by uterine atony, maternal soft-tissue trauma, retained placenta or its parts, and obstetric coagulopathy. The factors most significantly associated with haemorrhage include advanced maternal age, prolonged labour, pre-eclampsia, obesity of mother, multiple pregnancy, a birth weight of more than 4000g, and previous postpartum haemorrhage. It seems that multiparity itself is only a weakly associated factor. The prophylactic use of oxytocic drugs (oxytocin or its combination with ergometrine at the third stage of labour is always recommended for decreasing the bleeding. Prostaglandins should be used as a second line treatment if uterine atony cannot be abolished by uterine massage and oxytocin infusion. In the surgical management, the role of hypogastric artery ligation is decreasing. The stepwise uterine devascularization may be a reasonable method in the most severe uncontrollable postpartum bleeding. The uterine tamponade with gauze or specific tubes may also be a useful alternative in some cases. Selective arterial embolization is a promising new method that seems to have success in controlling the heavy postpartum bleeding unresponsive to more usual measures. However, the value of this method should be evaluated in bigger series.
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PMID:Postpartum haemorrhage. 862 78

A primigravid woman was seen for the first time in a disoriented and combative state, with regular, painful uterine contractions. Evaluation revealed a negative illicit drug screen, no evidence of preeclampsia, and a nonfocal neurologic examination. Further workup revealed urinary diphenhydramine levels suggesting drug overdose. This case serves as a reminder of the oxytocin-like effects of diphenhydramine.
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PMID:Diphenhydramine overdose during pregnancy: lessons from the past. 894 19

Synthetic 1-deamino-8-D-arginine-vasopressin (DDAVP) is used in the management of diabetes insipidus (DI). We conducted a systematic literature review of DDAVP use during pregnancy, with particular attention to its safety for both mother and infant. Studies were identified through Ovid MEDLINE from 1976 to July 1997 using the combined terms "desmopressin," "DDAVP," and "pregnancy". Review articles and published letters were also explored. One hundred one articles were retrieved, of which 20 met all the inclusion criteria. Included in the 20 articles were 53 cases with the use of DDAVP for the management of DI. The therapeutic daily dose of DDAVP was approximately 29 micrograms intranasally (range 7.5-100 micrograms), with adequate DI control observed. Three of 14 women with sufficient information developed preeclampsia, a nonsignificant difference from the expected rate of 5 percent (the Fisher exact test, 2-P = .08). The mode of delivery was defined for 22 cases, with 16 uneventful vaginal births, and six cesarean delivery. There was no evidence of a drug interaction among the five women who received both DDAVP and intravenous oxytocin. Information was available on 49 live births born to DI mothers on DDAVP. The mean gestational age at delivery was 37.4 weeks (SD 1.3 weeks), with an estimated mean birth weight of 2963.8 gm (range 2000-4420 gm). Forty-three offspring were reported as healthy (event rate 87.8 percent; 95 percent CI 77.2-95.3 percent). Of the remaining six infants, one developed DI at 18 months of age; a second was under 2500 gm at birth, but survived; the third developed hypotonia and failure to thrive at 21 months, two others had Down syndrome; and the sixth died of severe cardiac anomalies. Similar data were seen among the 41 infants whose mothers had used DDAVP throughout pregnancy. In conclusion, DDAVP use during pregnancy seems to be safe for both mother and child. Delivery does not seem to be augmented by its use, nor are there likely any associated adverse neonatal effects. A large database of DDAVP use during pregnancy is needed to confirm these findings.
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PMID:DDAVP use during pregnancy: an analysis of its safety for mother and child. 966 31

The efficacy and safety of labor induction using an intrauterine balloon catheter in twin pregnancies has been evaluated. During the study period (1992-1997), labor was induced at 36-42 weeks in 17 twin gestations. Labor induction was indicated for preeclampsia (n = 10), birth weight discordance (n = 3), suspected fetal distress (n = 2) and postdates (n = 2). Twin A was in vertex presentation in all cases. An intrauterine balloon catheter was inserted transcervically followed by augmentation whenever required. Vaginal delivery was achieved in 15 (88.2%) patients. The mean interval from balloon insertion to delivery was 17.05 h, with 80% deliveries occurring within 24 h of catheter insertion and 80% occurring within 12 h of catheter expulsion. Birth weight was 2,514+/-244 and 2,421+/-367 g for twin A and B, respectively. Oxytocin was required in 4 patients. Postpartum hemorrhage was noted in 1 patient. One patient with no progress of labor and 1 with suspected intrapartum fetal distress required cesarean section. All neonates had a 5-min Apgar score of 10. The data suggest that an intrauterine balloon catheter appears to be safe and effective to induce labor in twin gestations.
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PMID:Case series of labor induction in twin gestations with an Intrauterine Balloon catheter. 1035 85

Objective: To evaluate the role of dinoprostone vaginal pessary (DVP) for induction of labor in preeclampsia.Methods: This is a prospective review of 94 patients with preeclampsia, who delivered from July 1995 to December 1996 at a university center. Of these, 25 received DVP, 22 oxytocin, 11 intracervical prostaglandin E(2), and 36 received no pharmacologic agents. Patients receiving DVP and oxytocin induction were compared for outcome of pregnancy and cesarean section rate. Statistical analysis was carried out by Student t test, chi(2) test with Yates correction.Results: The two groups were comparable with respect to parity and 5-minute Apgar scores.Three patients in the DVP group developed complications-one episode of seizure, one atonic postpartum hemorrhage, and one cervical laceration. One patient in the oxytocin group developed HELLP syndrome.Conclusion: DVP is at least as effective as oxytocin in achieving vaginal delivery in preeclampsia, despite lower Bishop scores. Future larger studies are needed to better assess DVP in patients with preeclampsia.
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PMID:Is induction of labor with continuous release dinoprostone vaginal pessary a viable option in patients with preeclampsia? 1083 42

A prospective double-blind randomized study was undertaken to evaluate the use of RU-486 for induction of labor at term with living infants. 120 patients at 37 weeks of pregnancy or over were included. 60 were given 200 mg RU-486 per day for 48 hours and the others were given placebos. The 120 women all had a medical indication for induction of labor. In the RU-486 and placebo groups respectively, 27 and 28 were past term, 10 and 13 had preeclampsia, and 6 and 4 showed signs of intrauterine growth retardation. 75 were primiparas. Pregnancy ages ranged from 37.5 weeks to 41.4 and averaged 39.8. The uterus was scarred in 30 cases. The 2 groups were homogeneous in maternal age, pregnancy age, average parity, number of primiparas and number of scarred uterus, and average Bishop scores indicating cervical status. 3 patients in the RU-486 and 5 in the placebo group were excluded from the analysis because of deteriorating obstetrical status in the 12 hours after administration of the 1st pill. For all vaginal deliveries, the total dose in international units of oxytocin was lower in the RU-486 group: 2.41 +or- 2.4 international units, vs. 4.48 +or- 2.66 in the placebo group. The difference was also found in women undergoing caesareans, 2.97 +or- 1.82 vs 4.94 +or- 2.41 in the controls. 31 women in the RU-486 group but only 10 in the placebo group underwent spontaneous labor. It was possible to induce labor on the 4th day following administration of the 1st dose of RU-486 or placebo using prostaglandin (PG) E1 in 13 patients in each group. 13 patients in the RU-486 group and 32 in the placebo group still had Bishop scores under 4 on the 4th day. For this subgroup of 45 patients, there was no significant difference between the 2 groups in the average dose of PG E2. Indication of labor with RU-486 alone was especially successful after 40 weeks of gestation. In this series, RU-486 was successful in spontaneously inducing labor in over 80% of pregnancies around 41 weeks of gestation. There were no significant differences in the RU-486 and placebo groups in the type of delivery, average duration of labor, use of anesthetic, or neonatal condition. Maternal tolerance of RU-486 was good. There were no cases of metrorrhagia. RU-486 was shown to be useful for women with scarred uteri, in whom the use of oxytocin and prostaglandins for induction of labor remains relatively contraindicated.
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PMID:[RU 486 (mifepristone): a new tool for labor induction women at term with live fetus]. 1234 9

All fluid intake and urine output were monitored and measured in 103 consecutive women with normal blood pressure and without a history of pre-existing renal disease during induced labour for various indications. Epidural analgesia was administered in all these women and labour was augmented with oxytocin infusion. All urine specimens passed were tested for specific gravity. The temperature of the labour rooms was between 25 and 27 degrees C. Analysed results (from 50 women) shows that at a mean fluid intake of 75 ml/hour (standard deviation (SD) 21.84), oliguria (urine output <30 ml/hour) occurred in 42 (84%) of the women. There was a positive correlation between fluid intake and urinary output (r(2)=0.8515, P<0.0001). Urinary specific gravity was high (>1010) in all the specimens throughout the study. This study suggests that oliguria may be a common component of labour managed in this manner and its interpretation in pre-eclamptics in labour may be viewed in this context. Oliguria may therefore be a poor indicator of renal function or worsening pre-eclampsia during labour and its management needs to be limited to the severe and persistent variety to avoid renal complications. We believe from this study that relevant urine and blood biochemistry are better correlates of renal function in labour.
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PMID:Urinary output during induced labour in normotensive women: a prospective pilot study. 1551 72

Human pregnancy serum and placenta have the ability to degrade uterotonic peptide oxytocin (OT). Placental leucine aminopeptidase (P-LAP), which is also called cystine aminopeptidase, is the only membrane aminopeptidase known to functionally degrade OT as oxytocinase (OTase). P-LAP/OTase hydrolyzes several peptides other than OT including vasopressin and angiotensin III. P-LAP/OTase predicted from cDNA sequence is a type II integral membrane protein, which is converted to a soluble form existing in maternal serum by metalloproteases, possibly ADAM (a disintegrin and metalloproteinase) members. P-LAP/OTase activity increases with normal gestation, while decreases in the patients with preterm delivery and severe preeclampsia. In placenta, P-LAP/OTase is predominantly expressed in differentiated trophoblasts, syncytiotrophoblasts. Activator protein-2 (AP-2) and Ikaros transcription factors play significant roles in exerting high promoter activity of P-LAP/OTase in the trophoblastic cells. Moreover, P-LAP/OTase is transcriptionally regulated in a trophoblast-differentiation-dependent fashion via up-regulation of AP-2, putatively AP-2alpha. P-LAP/OTase may be involved in maintaining pregnancy homeostasis via metabolizing peptides such as OT and vasopressin.
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PMID:Gene regulation and physiological function of placental leucine aminopeptidase/oxytocinase during pregnancy. 1589 23

The occurrence of complications of intracranial arteriovenous malformation (AVM) during labor induction is relatively uncommon. Intracranial AVM can cause convulsions, headache, focal neurological deficits and intracranial hemorrhage if ruptures. We present a 33-year-old parturient with history of paroxysmal supraventricular tachycardia, who was admitted for labor induction. She experienced a bout of convulsion following a 30-min oxytocin infusion, by which time it was three and half hours since she was given the test dose of epidural analgesic. She also denied having history of convulsions or preeclampsia. Magnetic resonance imaging (MRI) of brain demonstrated a cerebral AVM in the left frontal base without signs of intracranial hemorrhage or brain edema. The obstetrician opted for Cesarean section in order to avoid stress during vaginal delivery. The surgery was successfully performed under general anesthesia without hemodynamic fluctuations or neurological complications. We discuss the possible mechanisms of the convulsions attack in this patient and the ensuring anesthetic management for the Cesarean section she sustained.
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PMID:Cerebral arteriovenous malformation diagnosed during labor induction with headache and convulsions as presentations--a case report. 1645 Jun 1


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