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)

Rh-sensitization in cases of spontaneous and induced abortions is discussed. In an intact pregnancy, the average volume of fetomaternal transfusion is about .1-.2 ml. Rh antibodies occur in 2% of the cases of Rh-negative mother with Rh-positive child during the first pregnancy and 11-17% during the second pregnancy. The standard Anti-D dosage in such cases is 250-330 mcg, enough to counteract a fetomaternal transfusion of 30 ml. In the case of spontaneous abortions, the average volume of fetomaternal transfusion ranges from .l-1.0 ml. Fetal erythrocytes are found in 5-25% of pregnant women before the 12th week of pregnancy and 12-45% after the 12th week. The risk of Rh-sensitization ranges from 3-10% in cases of spontaneous abortion; the risk increases with the length of pregnancy. Other factors, e.g., parity, age, and the use of oxytocin during subsequent curettage, show no relationship to the volume of fetomaternal transfusion. In the case of induced abortion, the volume of fetomaternal transfusion is generally greater than .1 ml. Fetomaternal transfusions were more frequent in conjunction with salt water instillation than with vacuum aspiration in pregnancies before the 12th-16th week of pregnancy; the opposite was true for induced abortions performed after the 13th week of pregnancy. Fetomaternal transfusion is also possible in cases of ectopic pregnancy and hydatidiform mole. Anti-D prophylaxis should be used in all cases of spontaneous and induced abortion, ectopic pregnancy, and hydatidiform mole, except in cases before the 6th week of pregnancy. The standard dosage of 250-330 mg should be used, except before the 12th week of pregnancy; in this case, 50 mcg has been shown to be sufficient.
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PMID:[Anti-D prophylaxis after abortions and interruptions]. 21 9

Advanced extrauterine pregnancy occurs rarely and may present diagnostic difficulty. Failure to induce uterine contractions during oxytocin infusion is a well-established diagnostic technic. The present case suggests that additional newer technics for fetal assessment, including sonography, unstressed monitoring of the fetal heart rate, uterine contractions, fetal movements, and serial urinary estriol determinations may also be useful in diagnosing and managing such complex cas-s.
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PMID:Diagnostic studies and fetal assessment in advanced extrauterine pregnancy. 87 46

A 30-year old primigravida with a history of drug addiction came to the Rigshospitalet in Copenhagen, Denmark for prenatal care at 15 weeks gestation. Physicians did an amniocentesis because of family history of trisomy 21. Ultrasound examinations in the 17th and 18th weeks of gestation indicated a living fetus with the placenta on the right lateral wall of the uterus, but there was an insufficient amount of amniotic fluid. Maternal alpha fetoprotein serum levels were extremely high (298 kIU/L). Physicians predicted a poor fetal prognosis and advised the woman to undergo an abortion. On the first day, they inserted 4 vaginal pessaries of 1 mg gemeprost and administered 25-30 mg bupivacain through an epidural catheter to control abdominal pain. 8 hours after first insertion, they began intravenous (IV) administration of oxytocin. Her cervix remain closed and uterine tension did not increase. 2 hours after beginning the oxytocin IV, she suffered from an abrupt severe abdominal pain which was transferred to the right shoulder. Heart rate and blood pressure remained normal. 4 hours later, her body temperature rose, so she received 500 m pivampicillin 3 times/day. She experienced no vaginal bleeding and no uterine contractions. Her cervix had still no opened. On the third day, health workers inserted 5 more pessaries. On the fourth day, they administered 75 ml isotonic saline/hour transcervically, but she still did not abort. Her temperature vacillated even though she received antibiotics and the pain continued despite epidural analgesics. On day 5, health workers administered 3.75 mcg prostaglandin F2 alpha/minute transcervically. After 6 hours of no progress, they performed a laparotomy and observed a macerated, malodorous fetus in the peritoneal cavity which continued 1200 ml of blood. The medial part of the left fallopian tube an the left uterine corner had ruptured. They removed the fetus via wedge resection; it had no malformations. Physicians should consider ectopic pregnancy when attempts at induced abortion do not succeed.
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PMID:Misdiagnosis of interstitial pregnancy followed by uterine cornual rupture during induced midtrimester abortion. 132 30

More than 20 years following the recognition of a possible role for eicosanoids in ovarian function a physiological role for prostaglandins and/or leukotrienes in human ovulation, corpus luteum function and tubal motility remains to be demonstrated. With respect to ovarian function, the well-characterized preovulatory rise in eicosanoid production in animal species and humans, in conjunction with the large body of experimental evidence employing inhibitors of prostaglandin synthesis and replacement of individual prostaglandins, has provided strong evidence for a role in follicular rupture independent of other LH-mediated ovulatory events. The possible mechanism of prostaglandin-induced follicle rupture may involve stimulation of proteolytic activity via substances such as plasmin and PA; however, this is controversial. A role for prostaglandins in ovarian luteal function is well established in laboratory animals and large ruminant species, where PGF2 alpha derived from the uterus has been demonstrated to be the luteolytic factor. In humans, luteal function may be influenced by local intraovarian eicosanoid production, which has been suggested to involve the paracrine interaction of local ovarian hormones such as oxytocin, noradrenaline, insulin and IGFs, to name but a few. Several lines of evidence have also implicated prostaglandins as an aetiological factor in ovarian pathological states such as seen in the OHSS. However, the bulk of clinical experimental evidence to date has failed to support this contention. Prostaglandin production has likewise been well characterized in the fallopian tube in both humans and animal species. Whereas a role for prostaglandins in tubal transport has been demonstrated with animal species such as the rabbit, several studies have failed to define a similar function in humans. More recently, direct injections of prostaglandin analogues into the fallopian tube and the corpus luteum have been shown to be efficacious as a treatment for ectopic pregnancy. Whether the primary mechanism of action involves effects on tubal musculature or corpus luteum function, or is simply a local vascular effect, remains to be demonstrated. Therefore, although the physiological role for eicosanoids in ovarian and tubal function remains unclear, particularly in the human, an increasing body of recent evidence has suggested an important paracrine function for this class of cellular mediators whose interaction with other more recently characterized local ovarian factors has only begun to be recognized.
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PMID:Prostaglandins in the ovary and fallopian tube. 147 96

A case report of a ligamentary ectopic pregnancy that failed to respond to prostaglandin E2 for induced abortion for sepsis at 24 weeks is presented. The 27-year-old nullipara had normal ultrasound findings for gestational age up to 21 weeks gestation. She had consulted at 5 weeks for abdominal pain and bleeding, at 14 weeks again for abdominal pain, shoulder pain and vaginal bleeding, although both times the pain and bleeding resolved spontaneously. She was seen again at 16 and 21 weeks gestation, when ultrasound scans were normal for dates. At 24 weeks, she experienced vaginal discharge of blood and tissue, and was managed as premature rupture of membranes. She became septic 12 days later. She was treated with transcervical PGE2 and iv oxytocin without response for 3 days. Surgical evacuation was successful, but bleeding persisted. During laparotomy she had a large left broad ligament hematoma, a left ruptured uterus, and open left internal iliac artery and vein. These were repaired, and she received 40 units of blood, 8 platelets and 14 of plasma. Only after histology was the diagnosis of ligamentary pregnancy made. The lack of response to PG for abortion should raise suspicion of ectopic pregnancy, although preoperative diagnosis of ligamentary pregnancy is extremely rare.
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PMID:A rare gynecologic contraindication to the use of prostaglandins and oxytocin to induce abortion. A case report. 279 68

Table 2 summarizes the proven and potential uses of anti-progesterones in obstetrics and gynaecology. In addition to their role in the induction of menstruation and the interruption of first-trimester pregnancy, anti-progesterones can definitely accelerate cervical ripening and promote the termination of second-trimester pregnancy, especially in combination with exogenous prostaglandins. Furthermore, anti-progesterones can also initiate labour in the obstetric complication of fetal death in utero, leading to delivery of the fetus and placenta without additional medical treatment and without surgery in the majority of patients. The wider use of anti-progesterones for the induction of labour, with or without other adjuvants such as oxytocin or prostaglandin analogues, is still uncertain and awaits further study. Anti-progesterones may also be useful in the medical treatment of early ectopic pregnancy, either alone or in combination with other medicines. Preliminary results indicate that progesterone receptor antagonists may also be useful both for the initiation and promotion of lactation as well as the possible management of advanced breast cancer containing progesterone receptors. Finally, the usefulness of anti-progesterones in other gynaecological malignancies containing progesterone receptors, such as endometrial or ovarian cancers, awaits further study.
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PMID:Anti-progesterones in obstetrics, ectopic pregnancies and gynaecological malignancy. 306 66

Five cases of rudimentary horn pregnancy are discussed. Two presented as acute ruptured ectopic pregnancy, whereas in 3 the pregnancy was advanced and intact with intrauterine death of the fetuses. The diagnostic difficulties are discussed and in centres where ultrasound facilities are not available, a high index of suspicion in nonresponders to oxytocin induction is emphasized.
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PMID:Problems of rudimentary horn pregnancy. 374 27

Fetal heart rate (FHR) decelerations during a contraction stress test are recognized as signs of possible uteroplacental insufficiency. Although these decelerations have been described commonly in intrauterine pregnancies, they have not been noted in extrauterine pregnancies. Reported herein are FHR decelerations associated with oxytocin infusion in an extrauterine pregnancy and a discussion of the possible pathophysiologic mechanisms.
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PMID:Fetal heart rate decelerations after oxytocin infusion in an abdominal pregnancy. 402 11

The incidence of ectopic pregnancy has been steadily growing during the past decade; this fact can only partially be related to known factors (PID, use of IUDs, minipill, inductors of ovulation, sterilization reversal). Ectopic pregnancy is still a frequently misdiagnosed pathology; nevertheless, the recent advances in early diagnosis have allowed a decrease in the mortality rate and an improvement in subsequent fertility. In absence of obvious tubal abnormalities it is difficult to assess the cause of an ectopic implantation. Yet the factors regulating and nidation of the embryo in the human are far from clear. The transport of the embryo in the oviductal fluid depends on ciliary beat (generally regarded as the leading factor) and on muscle contractions mainly in the ampullary-isthmic and in the utero-tubal junction, where a sphincter action is stimulated by estrogens and relaxed by progesterone. Other substances (catecholamines, prostaglandins, oxytocin) are thought to be involved in ovum transport, although their role is unclear. Even less is known about local influence of the embryo on the oviduct. During preimplantation and implantation both the embryo and the mother engage in an elaborate interaction, elsewhere referred to as a 'conversation', involving long-and short-range signals. An essential role is played by the endocrine luminal milieu. A local action of estrogens on a progesterone-primed endometrium may be required for either the release of crucial signals for the blastocyst activation, or to make epithelial cells sensitive to the presence of the embryo, thus inducing the decidualization. In some animals, these estrogens are not ovarian, but synthesized by the blastocyst itself.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Biology of nidation and ectopic implantation. 639 29

Based on autopsy findings in 306 cases of maternal death from 1964 to 1980, recent trends in maternal death in Japan were discussed. Main topics dealt with were as follows: 1. Although rate of maternal death in Japan is decreasing markedly year by year, approximately 90 per cent of our autopsy cases were direct or indirect maternal deaths. 2. The most common category of the direct maternal death was hemorrhage. Unexpectedly uterine rupture was thought to be a common etiological factor for that. 3. One of the most valuable impression obtained in this study was a high percentage of "sudden death". In our series, 85 of 306 cases (27.8 per cent) were of maternal deaths within 6 hours after their general condition began to deteriorate. The first cause of sudden death was hemorrhage, and the second and the third were ectopic pregnancy and amniotic fluid embolism respectively. 4. Although it was very difficult, 16 cases (5.2 per cent) were judged as the maternal death possibly related to drugs. The most widely suspected and used drugs were hysterotonica such as prostaglandin, oxytocin and Deliverin. In these 16 cases of maternal deaths possibly related to drugs either directly or indirectly, amniotic fluid embolism (in 6 cases), uterine rupture (in 3 cases), and cervical laceration (in 2 cases) were confirmed at autopsy and diagnosed as the direct cause of death. However, in the remaining 5 cases, no acceptable findings could be obtained and an exact cause of death had remained unsolved. 5. Fifteen cases (4.9 per cent) of amniotic fluid embolism were confirmed by autopsy. However, only in 6 out of 15 cases, a clinical diagnosis of amniotic fluid embolism was given. In the remaining 9 cases, clinical diagnoses such as "shock of unknown etiology", "septic or endotoxin shock" and "postpartum collapse" were presumed.
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PMID:An autopsy study of 306 cases of maternal death in Japan. 686 16


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