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

Medical termination of abnormal pregnancy requires specific techniques since some conditions make therapy more effective, e.g., missed abortion intrauterine death and molar pregnancy, and others less so, e.g. anencephalic pregnancy. In all cases it is best to terminate the pregnancy as soon as possible to reduce anguish and risks of complications such as consumptive coagulopathy. Oxytocin is not consistently effective, but intraamniotic rivanol has oxytocic properties, and prostaglandins (PGs) are effective by several routes. Surgical methods are more popular in Japan and the US. A diagnostic flow chart is included and described. For missed abortion and fetal death vacuum aspiration or dilatation and evacuation are appropriate for early pregnancy, or PGs are used for later pregnancy, unless there are medical contraindications. Anencephalic pregnancy, usually diagnoses in 2nd or 3rd trimester, is resistant to medical therapy and must often be terminated by cesarean section. Molar pregnancy can be managed with vacuum aspiration at any length of gestation, but must be completed by curettage. Intraamniotic PGs are not advised for mole or fetal death. PG analogs can be administered intramuscularly, or vaginally in gel form. Other types of abnormal pregnancy that can be managed with PGs are spina bifida, hydrocephalus, hydrops fetalis, Dandy-Walker syndrome and Down's syndrome. Tubal pregnancy can be evacuated with intratubally administered PGs under laparoscopic control, thereby preserving tubal integrity.
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PMID:Medical management of abnormal pregnancy. 222 5

Between May 1988 and December 1992, physicians at the University of Washington Hospital used a double-bolus technique of injecting no more than 10 mEq potassium chloride into the umbilical vein to cause fetal cardiac arrest in 60 pregnant women (=or 19 weeks gestation; 28 weeks in 4 cases). They induced fetal death prior to uterine evacuation to limit emotional anguish in these women. Congenital anomalies, teratogen exposure, or early obstetric complications were indications for these abortions. 52 women (86.7%) suffered no complications and experienced a successful lethal administration of potassium chloride. 7 cases required direct fetal cardiac injection of 6 mEq potassium chloride due to either inability to gain funic vascular access or irregular slow ventricular activity with subsequent complete recovery of ventricular function. In the 8th case, the gestation was 24 weeks. Severe oligohydramnios secondary to the premature rupture of chorioamnion complicated the case. After funic placement was lost, the 8th case denied further intervention. She delivered a live infant the following day, but the infant died. Upon death of the fetuses, uterine evacuation was accomplished by medical evacuation (i.e., vaginal prostaglandin suppositories and oxytocin infusion) or surgical evacuation. The clinicians noted that lethal fetal administration of potassium chloride in advanced pregnancy termination limits the involvement of medical staff in ethically sensitive issues. The findings show that this methodology is safe for the woman and effective at preventing live births.
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PMID:Induction of fetal demise in advanced pregnancy terminations: report on a funic potassium chloride protocol. 794 11