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

In 3rd trimester fetal death, when the cervix requires softening, labor may be induced by the administration of intravenous, intra-or extraamniotic, or vaginal prostaglandin E2 or intramuscular injections of synthetic prostaglandins, such as 15(S)-methyl prostaglandin F2 alpha. These methods all have various disadvantages. In 10 women with 3rd trimester intrauterine death, labor was induced by vaginal insertion of a 1 mg gemeprost (16,16-dimethyl-trans delta 2 prostaglandin E1 methyl ester) pessary. The mean number of pessaries s required was 1.9, and the mean duration of labor was 11.7 hours. The women remained mobile during most of the procedure. No patient required additional oxytocin, and the only side effects were mild fever and diarrhea.
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PMID:Gemeprost vaginal pessaries for inducing third-trimester intrauterine deaths. 262 39

Gemeprost (16,16-dimethyl-trans-delta2 Prostaglandin E1-methyl ester) is a synthetic analogue of Prostaglandin E. It is used to induce midtrimester abortion. 40 women, with diagnoses of fetal abnormality or fetal death in utero, were given a 1 mg Gemeprost pessary in the posterior vaginal fornix. After resting for 30 minutes, the patients were free to move around. The treatment was repeated every 3 hours, until either the products of conception were expelled or 5 pessaries had been inserted. If delivery did not occur within 12 hours, oxytocin infusion was commenced. 42% of the patients delivered with Gemeprost alone, and only 17.5% required surgery. Side effects were few and included incomplete abortion, fever, vomiting, diarrhea, and bleeding. Gemeprost is considered safer and simpler than its alternative, extraamniotic infusion of Prostaglandin F2 alpha.
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PMID:Vaginally administered 16,16-dimethyl-PGE1-methyl ester (Gemeprost) to induce termination of pregnancy after the first trimester. 323 78

The use of gemeprost (16,16 dimethyl-trans-delta 2-PGE1 methyl ester) vaginal pessaries for the termination of pregnancy in the early second trimester has been further investigated. Of 113 women between 12 and 16 weeks gestation, 93 (82%) aborted within 24 hours of the administration of 4.4 +/- 0.1 1 mg gemeprost pessaries. The mean induction-abortion interval was 881 +/- 31 minutes. Successful abortion was achieved in 16 of the remaining 20 women after a second course of gemeprost pessaries without the need for oxytocin supplementation. There were no serious complications. Crampy abdominal pain and vaginal bleeding started after 275 and 756 minutes respectively. Twenty-two (19%) patients did not require pain relief during treatment, but 90 (80%) required parenteral opiates. Vomiting and diarrhoea occurred in 16 (14%) and 23 (20%) cases respectively. The safe induction of therapeutic abortion in 96% of women using vaginal prostaglandin alone offers an acceptable alternative to surgical evacuation in the early second trimester.
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PMID:Prostaglandin-induced pregnancy termination: further studies using gemeprost (16,16 dimethyl-trans-delta 2-PGE1 methyl ester) vaginal pessaries in the early second trimester. 368 94

Several physiological variables were measured after endotoxin administration in the rat to examine the relationship between these variables. Rats responded to endotoxin with a biphasic body temperature response, an initial decrease and a subsequent increase in body temperature. Plasma vasopressin and oxytocin levels increased markedly after endotoxin administration. Diarrhea occurred in some animals. There was a strong negative correlation between increase in body temperature and base-line body temperature, and weak correlations between body weight and plasma vasopressin release and between base-line body temperature and minimum body temperature reached. Plasma vasopressin and oxytocin levels were correlated if samples from all time points were analyzed together, whereas they were not correlated if data from each time point were analyzed separately or if total peptide release for each rat was evaluated. These data suggest similar regulation for the release of vasopressin and oxytocin, that is, release by a common stimulus, but the magnitude of release of vasopressin and oxytocin appears to be independent, probably reflecting differences in synthesis and storage of these two peptides.
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PMID:Characteristics of body temperature, vasopressin, and oxytocin responses to endotoxin in the rat. 382 4

Recent research suggests that the action of prostaglandins on the pregnant uterus is more complex than that of oxytocin. Despite the fact that prostaglandins, like oxytocin, may fall short of the ideal, preliminary work makes it apparent that prostaglandins have attributes for induction of labor that will ultimately rank them as far superior to oxytocin. A 1st sign that prostaglandins might be more than just oxytocic agents came from the discovery of the effectiveness of prostaglandin F2alpha (PGF2alpha) and prostaglandin E2 (PGE2) in inducing mid-trimester abortion. For a long time it has been known that oxytocin seldom causes abortion of a normal pregnancy. Prostaglandins cause rapid dilatation of the cervix and expulsion of the conceptus despite a lesser degree of measurable uterine activity than that induced by oxytocin. Prostaglandins do something more, either to the quality of uterine contractions or to the cervix. A major problem associated with the pharmacological use of prostaglandins has been a high incidence of unpleasant side-effects when given by routes that are associated with substantial systemic uptake. In general, doses of prostaglandins that are oxytocic result in nausea, vomiting and diarrhea when administered by the intravenous, oral or intravaginal routes. The intra-amniotic and extra-ovular routes of administration for induction of mid-trimester abortion, as described by Doctors Karim and Hillier, are examples of the successful application of the principle that prostaglandins can be effective without side-effects when they are delivered close to the site of action. Prostaglandins appear particularly well suited to induction of labor in women with prolonged fetal death, anencephaly or hydatidiform mole.
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PMID:Prostaglandins: current therapeutic status in obstetrics. 443 69

424 pregnant women seeking termination of 2nd trimester pregnancy had either PGF2alpha (290 women) or PGE2 (134 women) administration. Oxytocin was concomitantly administered as an intravenous infusion to 185 women. The patients were divided into 11 groups based on PG (prostaglandin) type and dose, route of PG administration, and oxytocin infusion (Table 1). Vital signs were monitored hourly and blood samples collected from most patients for analysis of erythrocyte sedimentation rate, hemoglobin, blood leukocytes, and glutamic oxaloacetic transaminase before induction, at or immediately after abortion, and 24-48 hours after abortion. Side effects reported included diarrhea, vomiting, headache, and vasovagal symptoms. Complications included bleeding of 500 ml or more; pelvic infection and cervical rupture. Intraamniotic administration of 50 mg PGF2a either alone or with supplemental intravenous oxytocin, and intraamniotic use of 10 mg of PGE2 supplemented with oxytocin provided the best results in terms of success rate (100%) and shortest induction-abortion interval (14.1 to 16.2 hours). Extraamniotic administration had success rates ranging from 83% to 90%, depending on frequency of PG application. Intravenous PG administration was associated with low efficacy and high frequency of side effects.
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PMID:Prostaglandin induction of 424 midtrimester abortions. 445 74

In recent years prostaglandins have been used to induce abortion. The effect is due to the ability of the prostaglandins to cause uterine contractions. Intraamniotic hypertonic saline interrupts pregnancy by terminating the foetus and destroying the placenta. For many years we have had satifactory results with the latter method. However, it was considered that results might be improved by combining prostaglandin and hypertonic saline in a single therapeutic regime. In order to investigate the problem, 75 pregnant women of 13-19 weeks gestation were divided into 3 groups. In group I abortion was induced by 20% saline given intra-amniotically (max. 200 ml), in group II by 25 mg prostaglandin F2alpha and in group III by injecting both drugs simultaneously. The injection was never repeated. If abortion had not occurred within a time limit of 48 hours an oxytocin drip (120 MU/min) was given. If abortion had still not taken place within 24 hours after setting up the oxytocin drip the case was classified as unsuccessful. In the saline group 52% had an abortion within 48 hours and 72% within 72 hours after the intraamniotic injection, the average being 45,6 hours. In the prostaglandin group the corresponding figures were 68% and 92% and the average time from injection to abortion being 37,2 hours. In the combination treatment group the figures were 96% and 100% with the average time of 20,3 hours. The frequency of side effects and complications were low and equal in the three groups. Only the frequency of vomiting was different. In group I: nil, in group II: one case, and in group III: three cases. No episodes of diarrhoea was observed.
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PMID:A comparison of termination of pregnancies in the 2nd trimester induced by intraamniotic injection of hypertonic saline, prostaglandin F2alpha or both drugs. 453 97

This study combined the use of preinjection laminaria, intravenous oxytocin, and 15 mg of intra-amniotic prostaglandin (PG) F2alpha in order to demonstrate a potentially improved procedure for 2nd trimester abortion. 20 patients, aged 18-27, were between the 16-20 weeks gestation, and were free of intercurrent medical or obstetrical problems. 7 of the 20 were nulliparae. A laminaria was inserted into the cervix the evening before the injection of PG. In the morning an intravenous infusion was begun using 50 units of oxytocin in 500 ml of 5% dextrose and 0.9% sodium choloride at a rate of 150 ml/hour. The amniocentesis was performed and when a free flow of clear amniotic fluid was obtained 15 mg. of PGF2alpha was injected into the amniotic cavity. Different concentrations of oxytocin were administered if contractions were increasingly painful or not. Results of the experiment were that: 1) all patients aborted within 24 hours of the prostaglandin injection, 2) the median injection-to-abortion interval was 7 hours and 25 minutes; primigravidae aborted with a median time of 15 hours 20 minutes; and multiparous patients aborted in 6 hours 20 minutes; 3) only 9 patients requested analgesia medication; 4) the average blood loss was 150-200 nl; 1 patient had a postabortion hemorrhage greater than 500 ml; 5) 3 patients underwent sharp curettage for suspected retained secundines; 6) vomiting occurred in 6 patients, 3 of whom had emesis once; and 7) no diarrhea was encountered during the study. This study demonstrates that this procedure fulfills 3 strict criteria for success, as follows: 1) single injection technic, 2) consistent abortion within 24 hours, and 3) minimal side effects.
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PMID:Midtrimester abortion using prostaglandin F2alpha, oxytocin, and laminaria. 471 13

This study assesses whether oral prostaglandin E2 (PGE2) is effective in inducing labor by membrane rupture and simultaneous oxytocic stimulation. 80 unselected patients with a singleton pregnancy were induced at or near term. 50 were primigravidas and 30 multigravidas. PGE2 was given on an increasing dose basis. The initial dose was 0.5 mg and this was repeated at 1 hour if optimal activity was not apparent. Subsequent doses were given 2 hourly until full dilation. Labor was assessed by noting the strength and frequency of uterine contractions, alteration in the state of the cervix, and descent of the presenting part. An epidural catheter was inserted immediately preceding or shortly after amniotomy. If failure ensued, the therapy was discontinued and intravenous oxytocin titration commenced within 30 minutes. Results were that: 1) induction was successful in 43 of the 50 primigravid and 28 of the 30 multigravid patients, 2) the mean induction-delivery interval was 10 hours 18 minutes and 6 hours 20 minutes for each group, respectively, 3) the mean total dose given before discontinuing therapy was 12.8 mg. Side effects included vomiting in 27 patients (34%) and diarrhea in 15 (19%). Failure of induction occurred in 11% of the unselected patients. In general, a relationship appears to exist between the prelabor inducibility score and dose of prostaglandins required to induce labor. Oral PGE2 administration in association with amniotomy was found to be a safe, convenient, and effective method of inducing labor. In patients whose conditions are unfavorable the outcome may be less unsuccessful and associated with side effects; intravenous oxytocin is a preferred means of inducing labor and abortion. Labor is most effectively induced by amniotomy and simultaneous oxytocic stimulation. Oral PGE2 is effective in inducing labor and when administered in association with amniotomy is associated with a short induction-delivery interval, especially in multigravidas.
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PMID:Oral prostaglandin E2 and amniotomy for induction of labor. 480 74

The intraamniotic route of prostaglandin (PG) administration is used mainly for terminating pregnancies after the 14th week of gestation. From the clinical point of view, a good method would give a success rate of about 90% within 18-22 hours. With current methods, this is not possible without additional treatment. PGs and its analogs appear to be promising agents. A comparison of hypertonic saline with intraamniotic PGs shows that induced abortion period is significantly shorter with the PG method, although an oxytocin drip added at time of saline administration would produce the same effect. Intraamniotic PG administration is associated with a high frequency of nondangerous side effects (vomiting and diarrhea); however, hypertonic saline is known to have a higher frequency of dangerous side effects. The extraamniotic route of PG administration induces a local stimulating effect on the myometrium, obviating the need for a high systemic concentration of compounds as required by the intravenous route. Such method involves repeated injections of PGs at 2 hour intervals and is successful in approximately 90% of the cases in the 2nd trimester with a mean induction-abortion interval of 20-24 hours. It can also be used in the 13th-14th week of pregnancy. The major disadvantages are the need for repeated instillation and inconvenience of an indwelling catheter with its attendant risk of intrauterine infection. Vaginal PG administration offers the advantage of simplicity and possible utilization on a self-administered basis. It can successfully induce abortion either in the form of a concentrated solution or as lactose tablets impregnated with compounds. The dosage has to be repeated every 2 to 4 hours to maintain a high level of uterine activity. Suppositories have also been used in clinical trials and can be used to induce abortion. Disadvantages are unpredictable individual responses to vaginal administration and high incidence of side effects. Further studies are needed to develop suitable analogs for use in controlling ovulation, fertilization and implantation.
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PMID:Summary of round-table discussion on fertility regulation. 480 97


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