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

A primigravida was induced for PET, the liquor was meconium stained; she was put on oxytocin in-fussion and developed hypertonic uterine action. She then had an amniotic fluid embolism which presented clinically as profound shock, dyspnoea, tachycardia, cyanosis, hypotension and pyrexia. The patient was delivered by vacuum extraction. The picture was further complicated by pulmonary oedema intravascular microcoagulation and anuria. She deteriorated rapidly and died despite treatment with double strength plasma (in the absence of fibrinogen), massive hydrocortiosone therapy, blood transfusion amd sub-total hysterectomy. Post mortem findings in the lungs confirmed amniotic fluid embolism.
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PMID:Case report: a fatal case of amniotic fluid embolism. 12 35

Water intoxication during or following oxytocin induced labor, albeit a rare event, can nevertheless cause potentially fatal complications or risk of neurological damage. Large doses of oxytocin plus large volumes of electrolyte-free solutions are the prime factors associated with water intoxication. Suggested treatment consists of hypertonic saline. Although circulatory overload and pulmonary oedema can occur from saline treatment it is believed that the risk of cerebral oedema is greater than risk from saline treatment. Prevention of water intoxication includes: 1) restriction of fluid intake; 2) monitoring of analgesia given; 3) interruption of continuous infusion; 4) fluid balance with control of serum electrolytes and osmolality; and 5) use of electrolyte-containing fluid as a vehicle for the oxytocin.
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PMID:Water intoxication after oxytocin-induced midtrimester abortion. 28 25

Oxytocin, a posterior pituitary hormone, is commonly used for induction of labor, stimulation or reinforcement of labor, management of incomplete or inevitable abortion and control of post partum bleeding. We describe a case of acute pulmonary edema possibly developing secondary to the administration of iv oxytocin. Clinicians should be aware of the potential for pulmonary edema secondary to iv oxytocin. Close hemodynamic monitoring should be done during oxytocin therapy.
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PMID:Pulmonary edema possibly developing secondary to the intravenous administration of oxytocin. 180 38

A case report is presented of a parturient who suffered severe hypotension and pulmonary oedema following an overdose of intramyometrial prostaglandin F2 alpha. Oxytocin induction of labour in this patient led to a rapid delivery, followed by a hypotonic uterus and postpartum haemorrhage. After resuscitation with blood and crystalloid fluids, the uterus was explored under general anaesthesia. The uterus was free of retained products but the lower uterine segment failed to contract despite bimanual uterine compression and intravenous oxytocin. Prostaglandin F2 alpha was injected into the lower uterine segment via a transvaginal approach. This was rapidly followed by cardiovascular collapse and later by pulmonary oedema. The differential diagnosis and subsequent management are discussed.
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PMID:Cardiovascular collapse following an overdose of prostaglandin F2 alpha: a case report. 278 38

Since 1955, a standardized treatment regimen has been used to manage 245 cases of eclampsia at Parkland Memorial Hospital. Magnesium sulfate alone effectively controlled controlled convulsions in the great majority of cases. The only maternal death among the 245 cases reemphasizes the risk of respiratory arrest that is inherent in the administration of magnesium sulfate when given in large doses intravenously. Hydralazine to lower the diastolic blood pressure somewhat, when it was 110 mm Hg or higher, prevented intracranial hemorrhage. Avoidance of diuretics and hyperosmotic agents and limitation of fluid intake were not associated with severe renal failure. Pulmonary edema was rare. Vaginal delivery was achieved in the majority of cases. Oxytocin often proved effective for initiating and maintaining labor even remote from term. The results obtained with this regimen justify its continued clinical application.
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PMID:The Parkland Memorial Hospital protocol for treatment of eclampsia: evaluation of 245 cases. 671 34

The effect of terbutaline sulfate on left ventricular size and performance was studied by M-mode echocardiography in pregnant women with premature labor. Patients with uterine activity initiated during either oxytocin challenge testing or induction of labor served as a comparison group. During terbutaline therapy, heart rate, ejection fraction, and cardiac output increased significantly. End-diastolic volume and systolic blood pressure (BP) were unchanged, and diastolic BP and end-systolic volume fell. No changes in echocardiographic or hemodynamic parameters were present during oxytocin-induced uterine activity. Terbutaline, as currently used to prevent premature labor, is a potent inotropic and chronotropic agent. Pulmonary edema accompanying terbutaline treatment is probably not due to cardiac failure.
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PMID:Terbutaline and maternal cardiac function. 731 Sep 63

Because intravenous hydration is a commonly used first clinical effort to reduce preterm labor contractions, this review was initiated to determine whether the literature supports the effectiveness of this clinical strategy. An integrated, critical literature review was done by searching medical, nursing, public health, social, dissertation, and governmental databases to identify the studies relevant to this topic. Literature was chosen for review if it contained (1) objective data on the action of hydration on uterine contractility or (2) data on the clinical syndrome of threatened preterm labor. Research with animals has shown that rapid fluid administration blocks the central release of antidiuretic hormone and oxytocin through blood volume expansion, left atrial distention, and the resulting Henry-Gauer reflex, which thus alters uterine activity. Only four studies have been published that examined the effects of hydration for stopping labor. The effect of hydration was not significantly different from that of bedrest or of tocolytics in any of those studies. In all of them, time appears as an uncontrolled covariant. Although the consequences of hypervolemia might be expected to affect uterine contractions, there is no published evidence that pregnancies have been prolonged through the use of hydration. Hydration has rarely been studied as a single therapy in the prevention of preterm delivery. Caution concerning the use of intravenous hydration is advised by many authors reviewed, because if tocolytic drugs are administered after initial intravenous hydration with large amounts of fluids, the risk for pulmonary edema increases.
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PMID:Should intravenous hydration be the first line of defense with threatened preterm labor? A critical review of the literature. 891 39

Because criteria used for the prediction of preterm labor are poorly effective, many patients receive tocolytic therapy in excess during pregnancy. Beta-mimetic agonists are the reference tocolytic drugs in most countries. Their efficacy in prolonging pregnancy compared to a placebo is proven although no benefit in neonatal morbidity or mortality has been demonstrated. Beta-mimetics have many contraindications, and side-effects are frequent. Serious complications such as pulmonary edema and maternal deaths, though rare, have been reported. Recent research has focused on tocolytic drugs with similar efficacy to beta-mimetics but with less side effects. Calcium-channel-blockers and oxytocin antagonists have been compared with beta-agonists in randomized trials. Both have demonstrated similar efficacy in the prolongation of pregnancy for at least 48 hours. Contrary to beta-mimetics, very few interruptions of treatment have been observed with these treatments. Other tocolytic drugs such as cyclooxygenase inhibitors, although effective in prolonging pregnancy, have unacceptable fetal side effects. Progesterone, antispasmodic drugs and magnesium sulfate have been widely used but their efficacy has not been demonstrated. More recent treatments such as NO-donors and cyclooxygenase-II specific antagonists are not sufficiently evaluated. In conclusion, three main classes may be used as first line tocolytic therapy, beta-adrenergic agonists, calcium-channel-blockers, and oxytocin antagonists. The choice among these treatments may be based on contraindications to beta-mimetics, side-effects of the treatment, or even economic reasons.
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PMID:[Which tocolytic drugs in case of preterm labor?]. 1245 31

Spontaneous prematurity is more frequent in multiple than singleton pregnancies. It is estimated that 72% of the multiple pregnancies delivered before 33 weeks are spontaneous births, compared with 58% among singletons (NP3). As in singleton pregnancies, uterine contractions, close together, often precede preterm delivery by several days (NP2). The benefits of home tocodynamometry for patients who have already been hospitalized for threatened preterm delivery (TPD) (NP4) is difficult to assess from the data currently available, but it has not been shown to provide any benefits in a population of asymptomatic twin pregnancies (NP1). Cervical ultrasound appears to have good predictive value for preterm delivery when performed for TPD (NP3), although again few data are available. The efficacy of tocolysis appears similar to that for singleton pregnancies (NP3). Although the lack of data prevents us from judging the efficacy of tocolytics such as calcium channel blockers or oxytocin antagonists, it seems logical to use them as first-line drugs, especially because of the increased risk of pulmonary edema in multiple pregnancies with Bmimetics (NP3). Antenatal corticosteroid therapy appears to be less beneficial in multiple than singleton pregnancies (NP3). Pharmacological studies suggest that the dose currently used may be insufficient for multiple pregnancies (NP3). While awaiting results from clinical studies comparing the efficacy of higher doses, we must for now recommend antenatal corticosteroid therapy only at the usual doses. While the rate of in utero transfers to level III facilities is nearly 85% in the case of severe TPD (NP4), this practice must be encouraged still more in view of the benefits of inborn status compared with postnatal transfer. Finally, delayed-interval delivery is a relatively rare obstetrical practice that should be considered on a case-by-case basis when the first fetus is born before 26 weeks. This approach requires tocolysis and antibiotic therapy. The usefulness of cerclage in this situation has yet to be demonstrated. A delayed-interval delivery can prolong the pregnancy by an average of 15 to 30 days (NP4).
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PMID:[Special management for threatened preterm delivery in multiple pregnancies]. 1245 33

Water Intoxication is not a common complication of oxytocin infusion. A 26 years primigravida developed acute onset severe pulmonary oedema in postpartum period to whom oxytocin was infused for the induction of labour and to prevent postpartum haemorrhage. The relative role of oxytocin and of electrolyte-free fluids in the pathogenesis of this problem is discussed.
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PMID:Acute pulmonary oedema following oxytocin administration: a life threatening complication. 1705 72


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