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

Recently, the oxytocin challenge test (OCT) has gained increasing prominence in the management of high-risk pregnancies. 1 distinct advantage is its predictive value of intrauterine fetal well-being. Most authors agree that if a negative OCT is obtained the status of the fetus is relatively secure for 1 week. Even so, there have been reports of false negative OCTs. Dr. Freeman (Obstetrics and Gynecology 47: 8, 1976) reported 2 fetal deaths 6 and 7 days after negative OCTs, and Dr. Farahani (Obstetrics and Gynecology 47: 159, 1976) reported 1 fetal death 7 days following a negative OCT. In a Letter to the Editors (American Journal of Obstetrics and Gynecology 123: 106, 1975), Dr. Baskett related 2 additional fetal deaths in utero, preceded 6 1/2 days by negative OCTs. Dr. Klapholtz recorded the earliest fetal death occurring only 6 hours after a negative OCT (Journal of Reproductive Medicine 15: 169, 1975). Our experience of 255 negative OCTs in 140 high-risk patients favorably supports previous data. However, 1 exception has been noted. A primigravid patient with an uncomplicated pregnancy at 43 weeks' gestation by firm dates and third trimester ultrasound examination had initiation of monitoring by OCTs and triweekly estriol determinations. The 1st estriol level was low normal (12 mg/24 hours). An OCT that same evening was negative (data detailed in a figure). The cervix was considered unfavorable for induction of labor. A second 24-hour urinary collection for determination of estriol was begun. 13 hours after the OCT, fetal movement stopped and upon arrival at the hospital, 1 hour later, intrauterine death was confirmed. No fetal, placental, or cord abnormalities were identified after delivery of a normal female infant. (Cord entanglement was not present.) No signs of postmaturity were noted at postmortem examination. Squamous cells were present in the bronchi, and interstitial pulmonary hemorrhage was observed. (This case illustrates a negative OCT followed by fetal death within 14 hours. In contrast, most previously reported intrauterine deaths occurred near the end of the 1-week ''safe period.'') Despite this tragedy, the negative OCT remains as a remarkable indicator of fetal safety. However, it is still necessary to utilize all available aids and to explore new modes of detecting changes in intrauterine fetal status in the high-risk pregnancy.
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PMID:False negative oxytocin challenge test. 85 Nov 53

The efficacy of fixed dose PGE2 (prostaglandin E2) in inducing labor was studied in 40 multiparous patients. Low amniotomy was performed, and 1 tablet of 6.5 mg PGE2 was given orally in the absence of uterine activity after 30 minutes, and hourly thereafter until the patient delivered. Successful induction was defined as the establishment of effective uterine contractions and cervical dilatation within 12 hours of amniotomy. Indications for induction are postmaturity (n=15); pre-eclampsia (n=10); essential hypertension (n=6); weight loss (n=4); bad obstetric history (n=2); and others (n=3). 38 patients (95 percent) had successful labor induction, with 37 delivering vaginally within 18 hours of amniotomy and 1 delivering by Cesarian section because of fetal distress. In the remaining 2 patients, labor did not commence within 12 hours and consequently necessitated intravenous oxytocin. Mean amniotomy-delivery interval was 7.53 hours. Maternal side effects included vomiting (12.5%); diarrhea (5%); pyrexia (15%); ketonuria (22.5%); and postpartum hemorrhage (12.5%). There were no apparent fetal side effects. Advantages of oral PGE2 for labor induction include: 1) ease of administration; 2) increased patient acceptability; 3) greater convenience for medical and nursing staff; 4) absence of complications associated with intravenous infusion such as sudden changes in infusion rate, air emboli or occasional pyrogen reactions. Advantages of using a low fixed dose are: 1) excessive administration and subsequent uterine hypertonus are less likely to occur; 2) low incidence of vomiting/diarrhea; and 3) absence of uterine hypertonus and apparent fetal side effects.
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PMID:Fixed dose prostaglandin E2 tablets in the induction of labour in multipara. 108 93

Seven hundred sixty-seven oxytocin challenge tests (OCT) were performed on 333 high-risk maternity patients. All of the patients had pregnancies complicated by diabetes mellitus, suspected postmaturity, preeclampsia, intrauterine growth retardation, hypertension and other disorders. In conjunction with OCT, 24-hour urinary estriol determinations were performed. Negative OCT's were reassuring for fetal well-being. There were 26 positive OCT's on 24 patients. A positive test was significant in identifying endangered fetuses existing in a markedly unfavorable environment. In our experience, we found the OCT more reliable and more predictable than urinary estriol determination. The oxytocin challenge test proved to be significant in the successful management of these 333 high-risk patients.
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PMID:Oxytocin challenge test in high-risk pregnancy. 125 May 37

In 51 chronological prolonged pregnancies at 42 weeks gestation the preparation and induction was made usage of the Soviet spasmolytic preparation Aprophen. Aprophen blocks also N-cholinergic receptors in sympathetic ganglia. The tocolytic action of sympathetic system on uterine musculature was removed as well as its tonic alpha-adrenergic effect on the cervix. Thirty pregnant women were included in a control comparative group, in whom induction and preparation of labour activity was achieved by usage of corticosteroids-Prednisolone. The medication in both groups continued till beginning of labour activity, but in failure after 96 h till oxytocin indication. In 77% of women, treated with Aprophen, labour activity occurred before 96 h (40 out of 51 women but 50% of women treated with Predinisolone (15 out of 30 women)/p less than 0.02/. In 31% of women, treated with Aprophen, labour activity was induced by oxytocin stimulation (14 out of 40 women, but in 76% of women, treated with Predinisolone (10 out of 15 women)/p less than 0.05/. The high percentage of children delivered with signs of postmaturity according to Clifford in pregnant women treated with corticosteroid--23.3% against 9.8% of women treated with Aprophen (p less than 0.01) show the connection between the usage of corticosteroids and the increase of the frequency of signs of postmaturity in newborns.
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PMID:[Delivery in prolonged pregnancy following preparation and induction with aprofen and prednisolone]. 225 39

Induction of labor was performed in 20 pregnant females with postmaturity (greater than 294 days) using either oral PGE2 tablets (0.5 mg) or i.v. oxytocin drip (each group n = 10). The induction-establishment interval was significantly shorter in the oxytocin group (P less than 0.005). Moreover, the uterine activity (in Alexandria units) at 3 h post-induction and at the end of the first stage of labor, was significantly higher with i.v. oxytocin (P less than 0.005). However, the induction-delivery interval did not differ in both groups. All cases delivered spontaneously with a satisfactory Apgar score.
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PMID:Induction of labor by oral prostaglandin E2 in protracted pregnancy. 257 34

The intrapartum fetal heart rate changes, type of labor, mode of delivery, and neonatal outcome were evaluated in 379 consecutive continuously monitored prolonged pregnancies (greater than 42 weeks by history and early examination). These represent only a fraction of the total prolonged gestation population. There were 56% multiparous women, 33% less than 20 years of age, and 95% with cephalic presentation. Oxytocin was given to 76% (48% induced, 28% enhanced). Delivery was by cesarean section in 13% of patients (9% of induced cases), and 15% had forceps deliveries. Fetal heart rate alterations were observed in high proportion. Cesarean section for cephalopelvic disproportion was indicated in 60% of operations, and 13% of the fetuses weighed greater than 4000 gm. Depression occurred in 15% of infants at 1 minute and in 4% at 5 minutes. Prolonged hospital stay was seen in 9%, and postmaturity syndrome in 19%. There were four perinatal deaths (two corrected). Active induction does not appear to increase the cesarean section rate. The durations of predelivery observation may be longer because the cervices are frequently unripe. There is a high incidence of fetal heart rate alterations. Induction appears justified as an active intervention to prevent some sudden unexplained deaths.
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PMID:Maternal-fetal outcomes in prolonged pregnancy. 280 39

We have studied the outcome of labor induction in 145 postterm pregnant women in whom gestational age was properly assessed by ultrasound scanning. The induction techniques were adapted to the cervical states of the patients. Seventy-five patients (32 nulliparous and 43 multiparous) with favorable cervical states were successfully induced with intravenous oxytocin. In this group the frequency of Caesarean section was 2%. Seventy patients (45 nulliparous and 25 multiparous) with unripe cervices received 0.5 mg PGE2 in viscous gel intracervically to prime the cervix and to induce labor; 38 (52%) were induced into labor after a single PGE2-gel application whereas 26 (48%) needed labor augmentation with intravenous oxytocin after PGE2-gel obtained cervical ripening. In 6 of the 20 patients the cervix did not ripen and the PGE2-gel application had then to be repeated. The frequency of cesarean sections was 11%. In 5 out of the 145 patients (4%) the fetuses had signs of intrauterine growth retardation (IUGR) as assessed by ultrasound scanning, and postmaturity as verified by pediatric examination at delivery. All these fetuses belonged to nulliparous women with unripe cervices and all had to be delivered instrumentally (3 by cesarean section and 2 by ventouse) indicating the fragility of these children. If postterm pregnancy is complicated by an unfavorable cervical state intracervical application of PGE2-gel seems to be an efficient method to prime the cervix and to induce labor. In most patients an uncomplicated vaginal delivery can be achieved by this procedure. However, nulliparous women with unfavorable cervices and signs of IUGR constitute a high risk group of patients at labor induction.
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PMID:Induction of labor in postterm pregnant women. 287 70

An open-label study was undertaken to assess the clinical impact of multiple doses of intacervical prostaglandin E2 (0.5mg) gel administered at 6-hour intervals. 50 women in Canada with low Bishop scores requiring induction of labor were recruited. The prestudy mean Bishop score was 2.3 +or-1.1 and changed significantly with 1 (p 0.001), 2 (p 0.001), and 3 (p 0.002) doses. The mean gestational age of patients receiving 3 doses was significantly less than that of patients receiving 1 dose, (38.5 versus 40.1 weeks, p 0.005). Prostaglandin E2 gel induced labor in 55% of patients, but 14% required subsequent oxytocin (Syntocinon) augmentation. Cesarean section was performed in 6% of patients. No deleterious fetal, neonatal, or maternal effects occurred. 80% of the study group fell into the categories of postmaturity, pregnancy-induced hypertension, and intrauterine growth retardation. There appeared to be a trend toward a higher mean change in Bishop score from 6 to 12 hours in the primiparous women, but a statistically significant difference was not achieved. Surgical amniotomy was performed in 25 patients after labor was established. 47 of the patients achieved vaginal delivery. 3 Cesarean sections were performed because of cord prolapse, fetal distress, and failure to progress. Postpartum hemorrhage occurred in 3 patients.
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PMID:Clinical utility of multiple-dose administration of prostaglandin E2 gel. 346 15

A prospective noncomparative study was designed to test the ability of the nonstress test (NST) and the contraction stress test or oxytocin challenge test (CST/OCT) to predict neonatal morbidity or impending mortality. Two hundred nine pregnancies tested within eight days of delivery were studied. The only two perinatal deaths occurred in association with the postmaturity syndrome, and both had a preceding reactive NST. Some patients (37.5%) with a positive CST/OCT had fetal distress in labor. Ninety-six percent of infants with distress in labor had an antecedent reactive NST. In the study, 25.8% of the patients had a major antepartum, intrapartum, or postpartum complication that was not predicted by the NST. Therefore, electronic antepartum fetal heart rate surveillance was used as only one facet of the overall patient analysis. Management of patients was based upon the combination of antepartum monitoring, real-time ultrasound evaluation of amniotic fluid, and placental morphology, as well as the clinical suspicion of increased risk (using fetal activity testing, etc).
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PMID:Antepartum fetal heart testing: a clinical appraisal. 669 Oct 17

Thrombosis of the umbilical cord vessels is a rare but life-threatening event, usually leading to the death of the fetus. This report presents a case of an intra-partum fetal death due to thrombosis of the ductus venosus, hitherto not described in the literature. Labour was induced with intravenous oxytocin in a 21-year-old nulliparous woman because of postmaturity at 43 weeks gestation. Abrupt fetal bradycardia developed at 5 cm dilatation and fetal demise occurred within minutes without any sign of abruptio placentae or uterine hyperactivity. A cesarean section was performed because of failure to deliver the macrosomic fetus by vacuum extraction. On autopsy a fresh occlusive thrombus was found at the beginning of the ductus venous in the portal sinus. Maternal and fetal risk factors known to be associated with umbilical cord thrombus formation were excluded. Repeated assessment of Bishop scores is thought to have caused local infection of the membranes at the internal cervical os, resulting in general amnionitis and vasculitis of the umbilical cord. Secondary to the infection thrombus formation took place either primarily in the portal sinus and ductus venosus or in the umbilical vein with subsequent detachment and embolisation into the portal sinus, therewith occluding the ductus venosus leading to fetal death.
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PMID:Intra-partum fetal death due to thrombosis of the ductus venosus: a clinicopathological case report. 782 94


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