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

Prematurity and fetal death are common complications in patients with cholestasis of pregnancy. Both conditions appear to be associated with abnormal patterns of uterine activity. We studied the oxytocin-induced contractile activity in uterine strips taken from patients with cholestasis of pregnancy (n = 6) and from women with normal pregnancy (n = 6). Contractile activity of the myometrium in response to oxytocin was significantly higher in patients with cholestasis of pregnancy than in normally pregnant patients, at doses of 10(-6), 10(-4), and 10(-2) M. We found that there is a greater maximal response to oxytocin in strips of myometrium from patients with cholestasis of pregnancy than from normally pregnant patients.
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PMID:Maximal response to oxytocin of the isolated myometrium from pregnant patients with intrahepatic cholestasis. 379 55

A prospective study of antepartum fetal evaluation of 306 randomized hypertensive pregnancies was carried out. One hundred and fifty-four patients (group 1) were managed in accordance with a protocol (protocol A) which included non-stress test (NST), oxytocin challenge test (OCT), serum unconjugated (free) estriol measurements (E3), and ultrasound measurement of the fetal head-to-abdomen circumference ratio (H/A c.r.). A second group (group 2), composed of 152 patients, was managed using another protocol (protocol B) which included the NST, OCT and ultrasound measurement of the fetal head-to-abdomen circumference ratio (H/A). We found a good correlation between the serial normal tests and the outcome of pregnancies. We obtained good results in patients with abnormal NST-OCT and meconium-stained amniotic fluid and in patients with repeated abnormal NST-OCT with clear amniotic fluid due to active management by early deliveries ignoring fetal lung maturity. This management increased the rate of cesarean section and prematurity. There was a low correlation between patients with abnormal serum free estriol as the only antepartum pathological test and the appearance of intrapartum fetal distress, low birth weight and perinatal morbidity and mortality. The contribution of serum free estriol (E3) measurements in such patients was only of value in cases of intra-uterine fetal growth retardation, but its prediction rate was less than that of ultrasound measurement of head-to-abdomen circumference ratio. Our results indicate that hypertensive pregnancy management without serum free estriol measurement may be valuable and safe.
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PMID:Is serum free estriol measurement essential in the management of hypertensive disorders during pregnancy? 638 61

This paper describes the general management of mares and foals during the perinatal period and the methodology used in a collaborative research project on equine prematurity. Sixteen mares with dated pregnancies delivered 45 foals over three breeding seasons (1981 to 1983). In the majority, parturition was induced with oxytocin and/or fluprostenol; the remainder were allowed to foal spontaneously. Pre-colostral milk analysis provided a means of assessing the pre-foaling status of the mare. All were observed and monitored before, during and after parturition and the sampling protocol for both mare and newborn foal is discussed in detail. The foals were assessed for their degree of maturity at birth using behavioural, haematological, acid-base status and other criteria; they were then assigned to groups for further study and tests.
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PMID:Studies on equine prematurity 1: Methodology. 647 24

Twenty one pregnant patients with cardiac disease had induction of labour for various obstetric reasons with a modified oxytocin infusion method. All of them went into labour and delivered within 20 hours. Twenty patients delivered vaginally. Three neonates had birth asphyxia (Apgar score < 7) and 1 of them died on the 4th day from prematurity. No adverse effect of oxytocin infusion on maternal cardiac status was observed and all of the women went home in good condition. Induction of labour with a modified oxytocin infusion is a safe and effective alternative for selected gravidas with cardiac disease where elective delivery is warranted.
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PMID:Induction of labour in pregnancy complicated by cardiac disease. 849 35

In India, clinical researchers compared data on 100 women of gestational age 37-41 weeks who underwent elective induction of labor (cases) with data on 100 women who experienced spontaneous onset of labor and passive labor (controls) to determine whether elective induction of labor or spontaneous labor achieves safe motherhood. The women in the study group received 8 units of oxytocin in 540 ml of 5% dextrose solution. They and their fetuses were monitored closely. Once the study women began active labor, the physician conducted artificial rupture of membranes. The induced labor group had a shorter labor (e.g., among multigravidae, =or 6 hours, 38% vs. 20%), lower exposure to the stress of labor, reduced incidence of cesarean section, lower perinatal mortality (1% vs. 6%), and reduced perinatal morbidity (need for resuscitation, 1% vs. 5%) than the spontaneous labor group. The control group was more likely than the study group to have a fever (i.e., 38 degrees Celsius) (5% vs. 0). Prematurity was more common in the control group than the study group (41% vs. 0). These findings and those of other studies show that active management of labor reduces cesarean section, forceps delivery, duration of labor, and fetal/newborn morbidity and mortality.
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PMID:Towards a safer motherhood. 852 24

The authors aimed at studying the local application of PgE2 as a method of labor induction. 50 pregnant women divided into 3 groups were studied: I with Prostin E2 - vaginal tablets of 3 mg. Dinoprostone. II with Prepidil gel - 0.5 mg. Dinfprostone, applied intracervically and III with additional stimulation with Oxytocin - 5 E as an i.v. infusion. The criteria used were: parity, gestational age, Bishop score indications for induction. Success is considered as normal delivery by the 24th hour. Indications for PgE2 application are prematurity praeeclampsia, fetal malformations, fetal death, grave obstetrics history, RH incompatibility. It was discovered that with Prostin E2, the active phase of labor is reduced thus leading to reduction of labor. The frequency of operative deliveries also reduced and there were better fetal outcome. Two important advantages were discovered--simple application and physiologic advantages--the woman in labor is mobile and thus not traumatised. The authors stress that PgE2 application can be considered an effective method for labor induction.
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PMID:[Prostaglandin E2--an effective alternative for the induction of labor]. 874 32

This review summarises comparative aspects of equine pregnancy and birth. The allantochorion covers the entire endometrial surface of the mare's uterus and the placenta is microcotyledonary and epitheliochorial in structure. The foetus has, therefore, to pass through the allantochorion at birth. The umbilical cord has amniotic and allantoic portions and remains intact after delivery, enabling an arterial venous circulation to be maintained for several minutes. Maternal IgG does not cross the placental barrier and passive transfer post-natally is essential for immune status. Gestation in Thoroughbreds is 340 days with a wide range (320-360 days). Birth may be induced by oxytocin but dose rate is related inversely to gestational age. Normal foals rise, suck from the mare and gallop within 4 h after birth. Categorisation of newborn foal diseases into infective (Group 1) and non-infective (Groups 2, 3 and 4) conditions is presented. The neonatal maladjustment syndrome (NMS) affects full-term individuals, causing cerebral oedema, haemorrhage and/or ischaemic necrosis. NMS is related to the birth process and myocardial 'injury'. Prematurity and dysmaturity have origins in pre-natal disturbances of foetal maturation and physiology. Prematurity is a term ascribed to foals delivered at less than 320 days gestation whereas dysmaturity, for clinical convenience, describes foals born in the full-term period showing premature-like signs. Dysmature foals are generally associated with placental pathology. However, the distinction between the two groups is tenuos. Recent evidence suggests that 1) placental pathology is often present in premature foals; 2) differences exist in the degree of adrenocortical function. These affect clinical signs, prognosis and course of the condition. Placental pathology results in precocious adrenocortical maturation but the effect on maturation of other organ systems requires further study. Premature/dysmature foals fall into two groups; those with a favourable clinical outcome and those which make progress during the first 24 h post partum but deteriorate with development of neurological, metabolic and respiratory deficits (second day syndrome). Two models have been established to study premature/ dysmature foals. The first, developed in the early 1980s, was based on induction of mares from 280 days gestation to full term, using oxytocin. A premature, intermediary (twilight) and full-term status of adrenocortical function were identified; these categories correlating with changes in mammary secretion electrolytes. The same groupings have been related to other organ systems and metabolic functions of maturation. The second model establishes placental pathology from 220 to 260 days of gestation. A small area of placenta is separated from its uterine attachment, using a videoendoscope introduced through the cervix. Precocious adrenocortical function has been induced although further work is required to confirm the model as a means of investigating the pathogenesis of dysmaturity. Foetal injections of ACTH, CRH or betamethasone cause precocious increases in maternal plasma pregnane concentrations.
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PMID:Clinical view of disturbances in equine foetal maturation. 907 28

Current tocolytic protocols rely largely on the use of beta-mimetics to induce myometrial quiescence and delay delivery. Unfortunately, the rapid transplacental passage and poor receptor specificity of the commonly used beta-mimetics results in widespread activation of intrauterine and extrauterine beta 1 and beta 2 receptors. The use of beta-mimetics is associated with a range of well-recognized and potentially dangerous side effects for mother and fetus. The value of continued use of beta-agonists after obtaining uterine quiescence also has been the subject of recent debate. In this article we have attempted to explore the biochemical and molecular rationale for the use of alternative therapeutic modalities in the treatment and prevention of PTL. In the light of the current view that the term "preterm labor" covers a considerable diversity of causes, we propose that a range of treatment regimes should be chosen on the basis of the diagnosis and classification of the patient according to the their particular condition. Although the measurement of several biochemical parameters have been suggested to be of use in predicting PTL, we believe that a panel of diagnostic indicators (e.g., free or total CRH, IL-6, extracellular matrix proteases, fetal fibronectin) is more likely to provide useful diagnostic information on which appropriate treatment modalities can be selected (Table 1). Because of the complex and interactive nature of the mechanisms operating within the intrauterine environment to regulate myometrial activation and uterotonin production, we speculate that a combination of tocolytics, anti-inflammatory agents, uterotonic antagonists, and receptor blockers is likely to be more effective than a monotherapeutic approach, which focuses on only one facet of the process of uterine activation for pharmacologic intervention. For example, the use of antibiotics, PGHS inhibitors, and/or beta-mimetics might be an appropriate first line of treatment for infection-associated PTL in extreme prematurity. If it is successful, this treatment might be followed by longer term use of a progestagen and/or NO donor to maintain myometrial quiescence until closer to term. Alternatively, use of progesterone or oxytocin antagonists may be effective in augmenting the actions of beta-mimetics while reducing their side effects, whereas other combinations may be useful as long-term prophylactics in women with a high risk of developing PTL. Improvements continue in our diagnostic ability to correctly identify the different causes of preterm labor. We anticipate that careful selection of differing combinations of therapeutic options will result in significant reductions in the morbidity, mortality, and healthcare costs associated with preterm birth.
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PMID:The molecular mechanisms of term and preterm labor: recent progress and clinical implications. 932 26

The transition from fetus to neonate involves three phases: late gestation, parturition and the processes needed to establish independent homoeostatic regulation after separation from the placenta. These phases are regulated by a series of fetal and placental endocrine events. Glucocorticoids have an important role in the preparation for birth, including involvement in lung and cardiac development, and the maturation of enzymes in a variety of pathways. Fetal cortisol production is, in turn, also under hormonal control. Parturition is a complex process, which is still poorly understood in humans. The final steps are largely dependent on the effect of prostaglandin F2 alpha on the myometrium associated with increased oxytocin activity. The transition to birth is accompanied by changes in respiration, circulation, glucose homoeostasis, and the onset of independent oral feeding and thermoregulation. Several examples of endocrine components of the transition from fetal to neonatal life are reviewed here: the role of prostanoids, the onset of thermogenesis, and changes in the thyroid hormone and growth hormone axes. The effects of hormone levels on prematurity and growth retardation are also discussed.
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PMID:The transition from fetus to neonate--an endocrine perspective. 1010 45

Prematurity is the leading cause of neonatal morbidity and mortality, yet the incidence of preterm birth has not declined despite the use of multiple pharmacological agents to treat preterm labour. After reviewing the literature we conclude the following. beta-Agonists have been shown to prolong gestation for 24 to 48 hours; however, these agents have not been shown to decrease neonatal morbidity or mortality. Adverse effects are inevitable and can be life-threatening. There are no proven benefits to mother or fetus with long term therapy. More data are needed regarding the tolerability and efficacy of calcium antagonists before routine clinical use can be recommended. Oxytocin antagonists should be considered investigational drugs and further studies are needed to evaluate their effectiveness in the treatment of preterm labour. Furthermore, the tolerability of oxytocin antagonists in both mother and fetus has not been adequately established. Indomethacin, a prostaglandin inhibitor, has been shown to delay delivery in a limited number of randomised placebo-controlled clinical trials. Sulindac appears promising but has never been evaluated in a well controlled trial. Neonatal adverse effects appear to be minimal with prostaglandin inhibitors as long as the duration of treatment is short (<48 to 72 hours) and the gestational age is <32 weeks. Magnesium sulfate appears to inhibit myometrial contractility but is ineffective at prolonging gestation or preventing preterm birth. Furthermore, magnesium has not been shown to decrease neonatal morbidity or mortality; in fact, some investigators have shown an increase in infant mortality with this agent. There are no data to support adjunctive antimicrobial therapy for the treatment of preterm labour. Oral maintenance therapy with any of these tocolytic agents has not been shown to decrease the rate of preterm birth or recurrent preterm labour.
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PMID:A risk-benefit assessment of therapies for premature labour. 1043 52


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