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

The successful termination of 19 consecutive late 1st and 2nd trimester pregnancies using a combination of intravenous prostaglandin E2 (PGE2) and oxytocin (Syntocinon) is reported. PGE2 (5 mg in 500 ml of 5% glucose) was initially infused at the rate of 2.5 mcg/minute and then increased to 5 mcg/minute after half an hour. The infusion was increased to a maximum of 10 mcg/minute. Oxytocin was infused 2 hours after the PGE2 at a constant rate of 128 mU/minute. Mean total dose of PGE2 used was 5.9 mg at an overall rate of 6.1 mcg/minute. Average induction/delivery interval was 16 hours, with only 1 patient taking more than 24 hours. Abortion was complete in 13 cases (68%). Vomiting occurred in 13 women; pain was minor and was controlled by pethidine. Mild and transient thrombophlebitis was also reported. There were no reported cases of diarrhea and or cervical damage. Compared to the use of intravenous PG alone, PG given intraamniotically alone or with intravenous oxytocin, and PG given extraamniotically alone or with intravenous oxytocin, this study shows that a combination of intravenous PGE2 and oxytocin at the dose level described is closer to meeting all the desired criteria for the acceptability of any abortion method (ease and safety of administration, side effects, lengths of induction delivery interval, and effectiveness in terms of success rate and uterine evacuation).
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PMID:Letter: Intravenous prostaglandins and oxytocin for mid-trimester abortion. 4 97

Labor was successfully induced in 20 patients with a diagnosis of missed abortion or intrauterine fetal death (IUFD) by intravaginal administration of prostaglandin E2 suppositories. Fifteen patients delivered with the prostaglandin alone while a concomitant oxytocin infusion was employed to augment contractions in the other five patients. The mean induction-delivery time was 9.80 hours; nulliparous patients delivered in a mean time if 7.78 hours, parous patients in a mean time of 12.29 hours. The uterus appeared to be sensitive to the PGE2 stimulation in all patients and all were delivered completely without the need for surgical intervention. Fifty per cent of patients were delivered within 8 hours and 80 per cent by 12 hours. The side effects associated with prostaglandin administration--vomiting, diarrhea, and temperature elevation--were well tolerated and therapy did not have to be terminated in any patient. The administration of PGE2 vaginal suppositories offers an effective and safe technique for the induction of labor in patients with IUFD. Labor can be induced with PGE2 suppositories as soon as the diagnosis of IUFD is confirmed, which eliminates the need for waiting until spontaneous labor occurs.
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PMID:Induction of labor in patients with missed abortion and fetal death in utero with protaglandin E2 suppositories. 55 89

Intramuscular injections of 15(S)-15-methyl prostaglandin F2alpha (15-Me-PGF2alpha) induced abortion in 38 patients who had failed to abort with other techniques, such as intra-amniotic instillation of saline or PGF2alpha and intravaginal insertion of prostaglandin-impragnated Silastic devices. The intramuscular injections of 15-Me-PGF2alpha were initiated when the original abortion techniques, even when augmented by intravenous oxytocin, failed to produce expulsion of the fetus. The dose schedule was 250 microgram or 500 microgram every 2 to 4 hours, and the concomitant intravenous oxytocin was continued at a rate of 167 mU/minute. Of the 38 patients, 26 aborted with two or fewer injections of 15-Me-PGF2alpha, and 30 patients required only 1 mg of the drug to expel the fetus successfully. The mean time from the first injection of 15-Me-PGF2alpha to the expulsion of the fetus was 5.25 hours; one-half of the patients aborted in less than 4 hours. The placenta was expelled spontaneously in 15 patients, removed manually from the vagina in 18, and removed by sponge forceps in 3. Two abortions were incomplete and surgical intervention was required. Twenty-eight patients (74%) experienced gastrointestinal disturbances, chiefly vomiting and diarrhea. Intramuscular administration of 15-Me-PGF2alpha eliminates the need for repeated amniocentesis, and the dose may be adjusted to meet the precise requirements of the clinical situation.
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PMID:The effects of intramuscular injections of 15(S)-15-methyl prostaglandin F2alpha in failed abortions. 56 11

Prostaglandin (PG) gels were used to induce second-trimester abortion in 141 women aged 16-44 years, 1973-1976. PGE2 gel was used alone for 65 women, and in combination with oxytocin for 25 women; PGF2-alpha was used alone for 15, and combined with oxytocin for 36. Indications were: medical (5 cases), psychosocial (97 cases), and missed abortion or fetal death in utero (39 cases). The gel was administered extra-amniotically via catheter; abortion occurred within 36 hours in 136 cases. Mean administration abortion interval varied from 9 hours 52 minutes to 16 hours 17 minutes. A dose-response relationship was noted between the prostaglandin dose and the interval to abortion. Side effects included vomiting (29 cases), diarrhea (2 cases), fever (9 cases), hemorrhage (14 cases), endometritis (2 cases), and circulatory symptoms (2 cases) and torn cervix (1 case). No signficant differences between primigravidae and others were observed.
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PMID:[Therapeutic abortions in the second trimestre of pregnancy with prostaglandine gel (author's transl)]. 64 Mar 66

A review is made of the clinical use of prostaglandins in obstetrics and gynecology. Second trimester abortions can be induced by the transcervical extraamniotic, transabdominal intraamniotic, or intravenous injection of PGF2 alpha or PGE2. The use of these agents is currently the method of choice for this procedure. Studies have been made of methods of application which will lead to improved effectiveness and of the use of prostaglandins in combination with oxytocin. The use of prostaglandin analogues, which are metabolized more slowly than the natural prostaglandins, provides the advantages of decreased side effects and a decreased need of additional doses. The side effects associated with prostaglandin use include nausea, vomiting, diarrhea, heat waves, shivering, headache, dizziness, elevated temperatures, and leucocytosis. The mortality rate reported in a 4-year survey is 10.5/100,000 which compared favorably with the 17.7/100,000 for saline abortions. Prostaglandin gels can be used to soften and dilate the cervix in preparation for an abortion or induction of labor with no undesired side effects and without the use of laminarias. Labor can be induced by the administration of the prostaglandins F2 alpha and E2 either intravenously or, in the case of the latter, orally. Treatment with PGE2 can also continue parturition in cases of secondary insufficiency of labor. Research is currently being conducted in the use of these substances for fertility control.
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PMID:Application of prostaglandins in obstetrics and gynecology. 74 14

Intravaginal insertion of a 10 cm (2) silastic device with a .5% concentration of 15(s)-15-methyl-prostaglandin F2a methyl ester alone successfully induced abortion in 27 of 48 patients in the midtrimester and an additional 11 patients with a concomitant infusion of oxytocin. The mean abortion time for the 38 successful inductions was 15.35 hours. In 8 of the 10 patients who failed to abort even with concomitant oxytocin therapy, abortion was induced by serial im injections of 15-ME-PFG2a; the remaining 2 failures underwent surgical evacuation. The plasma levels of 15-ME-PGF2a methyl ester in the 11 patients studied varied widely over the first 2 hours, maintained at 4 hours, and then dropped sharply at 8 hours and declined over the abortion period in undelivered patients. Vomiting and diarrhea were the most common side effects and in general well tolerated by the patients. However, there was an adverse reaction in a single patient who experienced almost constant nausea, vomiting, and diarrhea. The device was removed 1 hour and 50 minutes after insertion and the patient aborted spontaneously 7 hours later. Intravaginal insertion of a sliastic device is an effective means of prostaglandin abortion, but further investigation is required to determine the most effective device which would provide a slow, continuous release of the prostaglandin.
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PMID:The effect of a 10 cm2, 0.5% 15-ME-PGF2alpha methyl ester intravaginal silastic device on abortion and plasma prostaglandin concentration. 85 75

2 cases of undiagnosed abdominal pregnancy observed in a 1-year period are reported. Both were complications of 2nd-trimester induced abortion. In case 1, a 25-year old black woman (gravida 5, para 2), multiple attempts at amniocentesis resulted only in bloody fluid. Intramuscular methyl-prostaglandin F2alpha (PGF2alpha) was administered and hypertonic saline was infused, but neither uterine cramping nor rupture of the membranes followed. PGE2 vaginal suppositories produced no change. Laparotomy revealed a large abdominal mass superimposed on the fundus, extending posterior to the uterus in the cul-de-sac. The amniotic sac contained a 15 ounce stillborn fetus. In case 2, a 33-year old black woman (gravida 2, para 1), bloody fluid was again obtained on amniocentesis. Intravaginal PGE2 suppositories and oxytocin were given, but dilation did not proceed despite uterine cramping. Examination revealed a cystic mass to the right of the uterus and fixed to the cul-de-sac. Laparotomy resulted in removal of a 45 gm macerated fetus. There appeared to be a rent in the right tube from which the gestation had been extruded with secondary implantation upon the abdominal viscera. A 3rd abdominal pregnancy observed in that time period resulted in a live birth at 41.5 weeks of gestation. Clinically, the diagnosis of abdominal pregnancy can be made by sounding the uterus. Laparoscopy will differentiate between abdominal and cornual pregnancy. Sonography is an additional diagnostic aid. When 2nd trimester abortion patients are given PGE2 as a vaginal suppository, 97% abort within 36 hours. Side effects such as vomiting, diarrhea, temperature elevation, and facial flush indicate adequate absorption. When these signs are present but expulsion of fetal tissue or membrane rupture do not occur, extrauterine gestation should be considered.
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PMID:Undiagnosed abdominal pregnancy with inadvertent prostaglandin administration. 90 Jan 63

Abortion was successfully induced by intravaginal administration of a newly developed silastic device impregnated with 15(S)-15-methyl-prostaglandin F2alpha methyl ester in a concentration of 0.5% in 26 of 35 women in the 12th to the 24th weeks of gestation and by prostaglandin with concomitant oxytocin infusion in an additional 5 patients. A second comparable group of 35 women, with gestational ages from 9 to 23 weeks, received a silastic device with a concentration of 1.0% of the prostaglandin. Twenty-six women in the second group aborted with prostaglandin alone and an additional 6 patients aborted with combined prostaglandin-oxytocin therapy. Seven patients of the 70 included in this study failed to abort with intravaginal administration of 15-ME-PGF2alpha methyl ester even with concomitant oxytocin therapy; this group included 4 patients receiving the 0.5% device and 3 patients with the 1.0% device. The mean abortion time for the 31 successful abortions with 0.5% device was 15.15 hours and multiparous patients aborted in a mean time of 9.69 hours, significantly faster than the nulliparous patients, mean time 18.49 hours. The mean abortion time for the 32 successful abortions with the 1.0% device was 15.61 hours and there was no significant difference in the mean abortion times between nulliparous and multiparous patients in this group. No significant difference could be demonstrated between the mean abortion times of patients receiving an 0.5% concentrations of prostaglandin and patients receiving a 1.0% concentration of the drug. In both groups more than 40% of the patients had aborted within 12 hours of the insertion of the prostaglandin device and more than 80% had aborted within 24 hours. The intravaginal device appeared to be effective in inducing abortion throughout the gestational ages tested in this series. Peripheral plasma levels of 15-ME-PGF2alpha were analyzed in 15 patients with the 0.5% device and 8 patients with the 1.0% device. In patients with the 0.5% device the mean plasma concentration of prostaglandin peaked 2 hours after insertion, while in patients with the 1.0% device the peak was achieved within 15 minutes of insertion followed by a rapid decline in plasma prostaglandin levels. Diarrhea was the most frequent side effect related to the intravaginal administration of the prostaglandin, and in this series the severity of this gastro-intestinal disturbance appeared to be significantly higher in patients receiving the 1.0% device.
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PMID:Hormone release and abortifacient effectiveness of a newly developed silastic device containing 15-ME-PGF2alpha methyl ester in concentrations of 0.5% and 1.0%. 96 66

The efficacy of oral prostaglandin E2 (PGE2) for induction of labor has been compared to that of intravenous oxytocin. There were 49 patients in each series. The over-all success rate with PGE2 is 82 per cent; with oxytocin, 65 per cent. PGE2 is at least as effective as oxytocin regardless of Bishop score or gravidity. There was no difference in the duration of labor in successful inductions with PGE2 or oxytocin. Nausea and diarrhea are more common with PGE2 but in only one case was this severe enough to warrent discontinuing the medication. One case of uterine hypertonus occurred in each series. No serious harmful effects on mother or fetus were noted with PGE2. These data support the concept that oral PGE2 administration is a safe and effective alternative to intravenous oxytocin for induction of labor in normal and high-risk pregnancies.
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PMID:A comparison of oral prostaglandin E2 and intravenous oxytocin for induction of labor in normal and high-risk pregnancies. 98 25

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


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