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

30 healthy women between 14-37 and between 14-20 weeks' gestation were administered with a single injection of 40 mg of PGF2 alpha over a 5 minute period to induce abortion. 28 patients aborted within 48 hours; 14 aborted completely and 14 required surgical removal of the placenta; 1 patient required intravenous oxytocin, and 1 failed to abort within 48 hours. The mean instillation to abortion interval for multiparas was 18.6 hours, for nulliparas it was 32.2 hours. Only 1 patient had excessive bleeding, 3 had syncopal episodes, 9 experienced vomiting, 3 diarrhea, and 3 diarrhea, nausea, and vomiting. A single injection of PGF2 alpha seems superior to intraamniotic hypertonic saline solution administration alone, and is effective as administration of hypertonic saline and intravenous oxytocin. The multiple dose technique of PG administration does reduce the mean abortion time, but entails an increased incidence of gastrointestinal side effects and requires repuncture or the use of an indwelling catheter, which may increase the incidence of infection. The mode of administration described can be used in selected patients when hypertonic saline solution is contraindicated.
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PMID:The induction of midtrimester abortion with intra-amniotic prostaglandin F2alpha. A single-dose technique. 481 39

PGE2 (prostaglandin E2) had been successfully used in initiating labor in term pregnancies (Karim and Sharma, 1971). This study evaluates the safety and efficacy of prostaglandin for induction of labor in 23 patients (gestational length, 38-41 weeks; mean age, 27; age range, 17 to 40; parity 0 to 6). 20 received an oral PGE2 0.5 mg tablet hourly while 3 received an initial dose of 0.5 mg with 0.5 mg incremental increase hourly. 20 patients delivered vaginally liveborn infants without neonatal depression according to Apgar score and subsequent behavior in the nursery. 2 patients delivered by C-section and 1 was excluded from the study because of inadequate duration of treatment. Mean time to delivery was 5 hours, 47 minutes; mean drug dose, 2.53 mg. Mild transient emesis and diarrhea occurred in 2 patients, and emesis only in 1. Bishop induction score did not correlate with total dose of PGE2 used. Parity correlated negatively with dose necessary to achieve delivery (p0.05). The findings confirm the efficacy and safety of oral PGE, which provides an alternate drug and route for induction of labor. Oxytocin induction is briefly compared with prostaglandin induction.
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PMID:Oral prostaglandin E2 for induction of labor. 482 94

This in vitro study examines the possibility that the E prostaglandins (PGEs) supplement the action of syntocinon on human muscle strips. 11 strips of upper segment myometrium removed from 10 pregnant patients (17-40 weeks gestation) for various reasons were analyzed. The human myometrium at term responded to a minimum concentration of 0.01-0.05 mcg syntocinon and 1-5 ng PGE1 or PGE2 in the 5 ml bath, while the midtrimester myometrium responded to 0.2-1 mcg syntocinon and 2-20 ng PGE1 or PGE2. These results show a 20 times increase in myometrial sensitivity to syntocinon and a 2-4 fold increase in sensitively to PGE1 or PGE2 at term as compared to the midtrimester. A syntocinon dose given immediately following a dose of PGE exhibited a response greater than that elicited by the same dose of syntocinon prior to the PG; this sensitizing effect of PG was observed in both term and midtrimester myometrium. The enhancement effect was observed in the increased duration of syntocinon response or as an increase in amplitude of response or a combination of these, the effect lasting for as long as 90 minutes after the PGE dose had been washed out of the bath. These findings led to the hypothesis that during the parturition process, endogenous PGs act as mediators which sensitize the uterine muscle to circulating oxytocin. The physiological implication of this enhancement effect is that undesirable side effects (vomiting, diarrhea) associated with PG infusion may be reduced or even eliminated when the PG-syntocinon method is used.
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PMID:Interaction of E prostaglandins and syntocinon on the pregnant human myometrium. 555 14

The prostaglandins F2alpha (PGF2alpha) and E2 (PGE2) used for abortion during the 2nd trimester of pregnancy were compared and are presented along with a method of management that minimizes patient discomfort. The study included 23 consecutive patients who wanted to undergo elective 2nd trimester abortion at the Unviersity of California, Davis Medical Center, during the January 1981-May 1981 period. Gestational age was determined by menstrual history, fundal size, and, when necessary, ultrasonography. Patients between 14-20 weeks of estimated gestational age were assigned to either PGF2alpha or PGE2 therapy using a set of random numbers. Patients were excluded from the study if a history of significant renal, cardiac, or pulmonary disease was obtained, if a uterine or cervical anomaly was suspected, or if abortion was desired because of a known fetal anomaly, abnormal karyotype, or fetal demise. 13 patients were in the PGF2alpha group and 12 were in the PGE2 group. 4 patients in the PGF2alpha group and 5 in the PGE2 group were nulliparas. The mean induction to abortion interval was 9.19 +or- 6.18 hours, 3-22 hours, for those in the PGF2alpha group and 9.19 +or- 2.59 hours, 5.75-12.78 hours, for those in the PGE2 group. The difference was not statistically significant. The cumulative abortions rates of the 2 methods were similar. Except for 2 patients who received PGF2alpha, all of the patients studied aborted within 14 hours. There was a 31% incidence of emesis in those patients in the PGF2alpha group, but none of these patients had more than a single episode. A 20% incidence of emesis was noted for the PGE2 group, with each of these patients having 2 episodes. No patient had diarrhea or hyperthermia develop, and none required antidiarrheal or antipyretic medication after the intial prophylactic dosages. Of the patients in the PGF2alpha group, 61.5% required supplementary analgesia as compared with 60% for those in the PGE2 group. Of those patients requiring additional analgesia, those in the PGF2alpha group, on an average, had more medication given orally and intramuscularly. Curettage was considered to be an integral part of the abortion procedure. Products of conception were obtained from all of the patients at the time of curettage. No patient returned after discharge from the hospital because of hemorrhage or infection as a result of retained products of conception. With the use of laminaria tents for cervical priming, prophylaxis of minor side effects, oxytocin supplementation and postabortal curettage, PGF2alpha and PGE2 are equivalent midtrimester abortifacients when rapidity, safety, and patient comfort are considered.
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PMID:A comparative study of two types of prostaglandins for abortion during the second trimester. 657 7

For the purpose of reducing the side effects and complication rate when inducing second trimester abortion, intracervically administered PGE2 gel was tested for the first time and compared with a single intraamniotic instillation of PGF2 alpha by a randomized allocation of 41 consecutive patients in the 13th to 24th week of gestation. In both groups the treatment was supplemented with oxytocin 5 - 6 hours after starting the induction. The methods proved of equal value as regards the abortion success rate and the induction-abortion interval, whereas the incidence of gastrointestinal side effects on intracervical application of PGE2 gel was only half as high and the occurrence of diarrhea significantly lower (p less than 0.05) with this non-invasive method than with intraamniotic PGF2 alpha. Intracervical PGE2 gel also possessed other advantages, being int. al. more acceptable by the patients and technically easier to administer.
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PMID:Randomized trial of intracervical prostaglandin E2 gel and intraamniotic prostaglandin F2 alpha for induction of second trimester abortion. 658 95

144 patients aged 18-41 were observed to study a new method of cervical perfusion of prostaglandins (PGs) to induce labor and missed abortion. 46 patients were primigravidae, 86 had a normal pregnancy, and 58 had missed abortion. Duration of gestation was 37-42 weeks, and duration of amenorrhea in case of missed abortion was 16-34 weeks. Induction of labor with oxytocin had been unsuccessful in all patients. A new technique of local perfusion of PGs directly into the cervix was attempted. In pregnant women 10 mg of PGF2alpha was diluted in 1000 ml of saline and infused; the initial concentration of 1-2 mcg/minute was increased every 2 hours. In cases of missed abortion 40 mg of PGF2alpha was diluted in 800 ml of saline; initial concentrations ranged from 5 to 10 mcg/minute and were increased every 2 hours. Mean delivery time was 6 hours 50 minutes; mean abortion time was 9 hours 55 minutes. 6 patients underwent cesarean section. When the uterine activity was analyzed in terms of amplitude and frequency of contractions it showed a maximum from 1 1/2 hours from beginning of labor, up to the 3rd hour of observation. In patients with missed abortion the maximum activity was recorded after the 2nd hour. Cardiotocographic curves, fetal heart rate, and clinical tests were normal. There were no complications, but only vomiting in 4 patients, and mild diarrhea in 9 patients. Labor was immediate in all patients, the latent phase exceeding 6 minutes in only 1 case; a contractile response was normally obtained after 30-40 seconds. In patients with incomplete abortion, the basal tone increased more rapidly than in pregnant patients while staying within the limits of safety. There were no pathologic or other changes in the genital organs at check up. Further studies on the effectiveness and safety of PGs are needed.
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PMID:A new cervical perfusion method for induction of labor with prostaglandins. 695 50

A comparative study of labor induction has been performed on 471 consecutive patients. Primary amniotomy was performed in 227 cases, and 103 of these patients were stimulated, 57 patients with PGE2 tablets and 46 with oxytocin. In the remaining 124 cases labor was induced within 4 hours without medical stimulation. Primary amniotomy was omitted in 244 cases, as the head was not engaged and the cervix was unripe. After random allocation to the treatment groups 125 patients received PGE2 tablets (ProstinR), and 119 patients received oxytocin intravenously. After 2 days of stimulation without primary amniotomy, delivery was induced in 83 per cent of the patients receiving PGE2 and in 84 per cent of the patients receiving oxytocin. All patients on whom primary amniotomy had been performed were delivered on the first day. There was no difference in the success rate between PGE2 and oxytocin treatments in patients with the same Bishop score. The performance of amniotomy at the beginning of induction led to a significantly lower total dose as well as a lower maximal dose of PGE2 and oxytocin. There was no difference in the duration of active labor in patients receiving PGE2 or oxytocin. There were no differences in the incidence of fetal distress and low Apgar scores between the different groups. No serious side effects occurred. Vomiting and diarrhea in 14 patients (8 per cent) receiving PGE2 was in contrast to 3 patients with these symptoms (2 per cent) in the oxytocin group. Oral administration of PGE2 is a convenient, effective and safe alternative to oxytocin for the induction of labor; however, PGE2 was not found superior to oxytocin in cases with a low Bishop score.
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PMID:Induction of labor with and without primary amniotomy. A randomized study of prostaglandin E2 tablets and intravenous oxytocin. 702 73

This retrospective study was undertaken to compare the efficacy, side effects, and complications of prostaglandin E2 (PGE2) given as a vaginal suppository with those of PGE2 administered via the intrauterine extra-amniotic route to induce labor after fetal death. The induction-to-delivery intervals were comparable, with 9.2 +/- 3.94 hours and 8.6 +/-4.49 hours, respectively. However, the mean total amount of PGE2 administered was much less via the intrauterine extra-amniotic route (1.8 milligrams) than by the vaginal suppository (45.2 mg). There was a 100% success rate in the patients treated by the intrauterine extra-amniotic route, but only a 91.3% success rate in those patients treated via the vaginal route. The side effects (vomiting, diarrhea, fever) and the complications (incomplete abortion, uterine rupture, oxytocin augmentation) occurred more frequently with the use of PGE2 as a vaginal suppository. The vaginal route of administration of PGE2 is somewhat more convenient, but the intrauterine extra-amniotic route may offer a higher degree of efficacy and safety with fewer side effects in the management of fetal death in utero.
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PMID:A comparison between vaginal prostaglandin E2 suppositories and intrauterine extra-amniotic prostaglandins in the management of fetal death in utero. 740 68

In Scotland, gynecologists used 200 mg mifepristone followed 36 hours later by 1 mg gemeprost pessary every 6 hours for the first 24 hours and, if termination did not occur, every 3 hours for the next 12 hours, to induce second trimester abortion (12-21 weeks gestation) in 100 women 13-42 years old, attending the Simpson Maternity Pavilion of the Edinburgh Royal Infirmary. Most women only required 2 pessaries (range, 1-9). 47 only needed 1 pessary. 96 and 99 women experienced an abortion within 24 hours and 48 hours, respectively. The median interval between gemeprost administration and abortion was 7.5 hours (range, 2.9-52.3 hours). Just 1 woman experienced the abortion after 48 hours, and she required intravenous infusion of oxytocin. The interval for primigravidas was significantly longer than for multigravidas (8.2 hours vs. 6.6 hours; p .01). 31 women vomited after insertion of the gemeprost pessary. 5 experienced diarrhea after gemeprost administration. 84 required intramuscular diamorphine for analgesia. Evacuation of the uterus was required in 33 women after they expelled the fetus. 24 of these women retained the placenta. None of the 100 women required a blood transfusion. These results compared favorably with those of a similar study using 600 mg mifepristone in combination with 1 mg gemeprost every 3 hours. In other words, clinical efficacy was not lost with a reduction in the dose of both mifepristone and gemeprost. These results demonstrated that 200 mg mifepristone followed by 1 mg gemeprost pessary is a cost-effective, simple, and noninvasive method to induce a second trimester abortion on an outpatient basis.
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PMID:Induction of second trimester abortion with mifepristone and gemeprost. 839 16

Termination of second trimester pregnancies has been related to side effects. ATtempts have been made to shorten the induction-abortion interval and to lower dosage of the prostaglandins in order to reduce the incidence of side effects. In this study, 13 second trimester patients 18-35 years of age were administered mifepristone before the procedure which called for administration of intramuscular sulprostone; the trial was prospective and randomized and called for double-blind placebo controls. The objective was to determine whether administration of mifepristone would facilitate termination of the pregnancy. 6 women received 600 mg oral mifepristone in an unmarked packet 36 hours before the administration of .5 mg sulprostone intramuscularly every 6 hours until the patient felt strong uterine contractions. 7 women received a placebo in an unmarked packet at the same time as those receiving mifepristone followed by sulprostone. Side effects, uterine contractions, blood pressure, and pulse were recorded every 2 hours. There were no significant differences in mean age of patients or in weight and height. Women were excluded who had any significant past or present medical disorder, who were using prescription drugs regularly, who were nursing or using hormonal contraception during or just before conception, or who were using an intrauterine device. The statistically significant results showed that the induction-abortion interval was shorter and the amount of sulprostone lower in the mifepristone group. 3 patients in the placebo groups did not abort within 24 hours and required administration of oxytocin and further injections of sulprostone. 2 patients (28.6%) in the placebo group required uterine evacuation under general anesthesia, and 4 patients (66.7%) in the placebo group required uterine evacuation due to incomplete abortions, which was not a statistically significant difference. Temperature highs were similar in both groups, but the amount of vomiting or diarrhea and the analgesic requirement was greater in the placebo group, but not significantly so. There was early termination of the study because of unexpected cardiovascular complications in another study; intravenous injection of sulprostone is recommended. The advantages of mifepristone are that it requires no special skills and avoids the complications of the laminaria tent.
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PMID:Termination of second trimester pregnancy with sulprostone and mifepristone: a randomized double-blind placebo-controlled trial. 844 13


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