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

Medicaments are used to prepare for instrument abortions in the 1st trimester and as inducers of abortion in the 2nd trimester. The effects, side effects, and dangers depend on the substances used and the route of application, which can be vaginal, cervical, injection, instillation, extraamniotic, intraamniotic, intravenous, or intramuscular. In the past, intraamniotic instillation of a 20% salt solution was the most common 2nd trimester method in Japan, the US, and Eastern Europe, giving a success rate of 90%. Serious side effects prompted substitution of extraamniotic instillation, which rarely produces serious side effects. Instillation of a 60% urea solution into the amniotic fluid in combination with oxytocin or prostaglandin produces an abortion in 13-21 hours, with a failure rate of 3% and a frequency of cervical laceration of under 1%. Extraamniotic use of a .1% solution of rivanol yields a success rate of about 85%, with a relatively long average time to explusion of 24-41 hours. In case of failure the procedure can be repeated. The advantage of the Rivanol method is the rarity of infectious complications. Alcohol is not used as a human abortifacient because it produces necrosis in the decidua and placenta. Prostaglandins are used in most 2nd trimester abortions. Research is underway to identify derivatives that will have an extended uterine impact without serious side effects. Different routes of administration have different effectiveness rates and dangers. All prostaglandins cause side effects including pain during uterine contractions, gastro-intestinal reactions, nausea, vomiting, fever, and headaches. Specific preparations are associated with other effects, some of them life-threatening. Emergency treatment should be available when these substances are used. Adjuvant measures may be employed before adminstration of an abortifacient agent to soften the cervix, or after administration to hasten the procedure. The choice of procedure depends upon the personality, health, and other characteristics of the woman and the experience of the doctor and the clinic.
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PMID:[Chemical methods of abortion]. 48 68

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

Four cases of water intoxication in connection with oxytocin administration during saline-induced abortions are described. The mechanism of water intoxication is discussed in regard to these cases. Oxytocin administration during midtrimester-induced abortions is advocated only if it can be carried out under careful observations of an alert nursing staff, aware of the symptoms of water intoxication and instructed to watch the diuresis and report such early signs of the syndrome as asthenia, muscular irritability, or headaches. The oxytocin should be given only in Ringers lactate or, alternately, in Ringers lactate and a 5 per cent dextrose and water solutions. The urinary output should be monitored and the oxytocin administration discontinued and the serum electrolytes checked if the urinary output decreases. The oxytocin should not be administered in excess of 36 hours. If the patient has not aborted by then the oxytocin should be discontinued for 10 to 12 hours in order to perform electrolyte determinations and correct any electrolyte imbalance.
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PMID:Water intoxication associated with oxytocin administration during saline-induced abortion. 80 83

Data on prenatal, labor and delivery, and postnatal medication exposure to neonates were collected. During an 11-week period, 100 neonates consecutively admitted to a hospital were studied. The pharmacist obtained a social and medication history from the mothers and reviewed maternal anesthesia records and the charts of the neonates. Fifteen definite and possible adverse medication reactions were detected in 13 neonates. The median number of different medications ingested prenatally was 4.7. The four most commonly ingested prenatal medications were vitamins (97%), iron preparations (90%), headache/pain/arthritis medications (68%) and antinausea/vomiting medications (40%). The most commonly used medications during labor and delivery were oxytocin (73%), meperidine (33%) and promazine (25%). The use of strong narcotics during this period produced neonatal respiratory depression in some cases. The four most commonly prescribed postnatal medications were vitamin K1 (100%), gentamicin (10%), ampicillin (8%) and Poly-Vi-Sol (6%). The maternal interview indicated that most mothers were unaware of the influence that many medications can play upon the fetus. It is recommended that the pharmacist conduct a maternal medication interview prior to labor and delivery.
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PMID:Neonatal medication surveillance by the pharmacist. 87 83

A series of 100 consecutive patients seeking pregnancy termination in pregnancy weeks 7-20 were treated with a schedule of 20-mg vaginal suppositories containing prostaglandin E2 (PGE2); the schedule was being tested for its efficacy, specifically reduction of total dose and related side effects. 94 of the 100 patients were aborted within an arbitrary time span of 36 hours. Total drug dose ranged from 40-160 mg. 31 patients received augmentative intravenous oxytocin. Induction-abortion interval varied from 6-32.5 hours. Of the 97 successes, 76 were classified as complete abortions. No significant differences were noted in midtrimester groups based on increasing parity, although parous patients in gestation week 13-15 seemed to have the best results, based on average interval time. No sepsis or need for transfusion was encountered. Side effects were emesis (n-75), diarrhea (n=17), and drug fever (n=66); less frequent side effects included headache, breast tenderness, and vasomotor symptoms (n=13, 1, and 1, respectively). The midtrimester patient results compared favorably with results of studies using saline for abortifacient. The number of first trimester patients was too small to yield any conclusion.
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PMID:Vaginally administered prostaglandin E2 as a first and second trimester abortifacient. 111 58

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

The use of intraamniotic injection of hypertonic solutions for termination of pregnancy during the second trimester has been generally adopted. Because of side effects in such treatment with other agents, it was decided to use intraamniotic instillation of urea solution (Urevert) to induce midtrimester therapeutic abortion in 38 patients. The method was successful in 35 patients (92%) with a mean injection/abortion interval of 26.1 hours, shorter than that with the use of hypertonic saline or hypertonic glucose solutions. The side effects of headache, nausea, and vomiting were mild, and an endometritis in 1 patient responded well to antibiotic treatment. Intravenous oxytocin drip was necessary in patients with hypotonic contractions or in those who failed to react within 36 hours after injection. In 3 cases of missed labor, the urea solution injected induced labor within 5-8 hours, with no side effects. The mean in-patient hospital time was 4.3 days.
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PMID:Termination of midtrimester pregnancy by intramniotic injection of urea. 482 62

A study was conducted in Kamla Raja Hospital, G.R. Medical College, Gwalior, India to evaluate the efficacy of 1% ethacridine lactate and to compare the results with 20% hypertonic saline as abortifacients in midtrimester abortions. The abortions were performed using 1% ethacridine lactate in 65 patients with pregnancies between 12-20 weeks (group A). The patients were admitted to the hospital 1 day before the abortion. In a 2nd group of 65 patients (group B,), the abortion was done using 20% hypertonic saline. In this group oxytocin also was used as it had been with group A patients if the abortion did not occur with 24 hours. The mean induction abortion interval was lower with ethacridine lactate (37.82 hours) than with hypertonic saline (44.40 hours). This interval continued decreasing as the pregnancy advanced -- 12-14 weeks, 42.45 hours; 15-16 weeks, 36.05 hours; 17-20 weeks, 34.96 hours. In the hypertonic saline series, the induction abortion interval continued increasing as the pregnancy advanced -- 12-14 weeks, 44.30 hours; 15-16 weeks, 45.68 hours; and 17-20 weeks, 45.61 hours. With ethacridine lactate the abortion rate (24.62%) was significantly higher within the first 24 hours than with saline (9.23%), although the overall success rate was more with saline (96.92%) than with ethacridine lactate (90.77%). If reinstillation cases were included, the success rate with ethacridine lactate (95.39%) became almost similar to that of hypertonic saline. The complete expulsion rate with ethacridine lactate was only 35.38%, but it was 66.48% with hypertonic saline. The incidence of various side effects, such as headache, rigor, and vomiting, was more with hypertonic saline than with ethacridine lactate. Another advantage of ethacridine lactate was the fact that it can be used safely in patients with cardiovascular and renal diseases. The changes in the maternal coagulation system following intra-amniotic instillation of hyptonic saline, considered to be almost universal, were never encountered in ethacridine lactate induced abortions. Simplicity of technique and equipment required to perform ethacridine lactate instillation is a significant asset for India. Dangers of amniocentesis-like accidental injury to bowel and bladder are never encountered with ethacridine lactate instillation.
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PMID:Mid-trimester pregnancy termination with ethacridine lactate. 653 11

A case is presented of a 32-year old gravida 3, para 1, ab 1, presented at 26 weeks with chief complaints of periorbital edema, headaches, and blurred vision for about 1 week. 2 weeks prior to admission she had experienced shortness of breath and decreased fetal movement. Admission was at 28 weeks with uncontrolled hypertension, blood pressure 190/120, pulse 100/min. Temperature was 98.8 degrees. Attempted induction of labor with oxytocin was unsuccessful. A hydralazine infusion decreased the blood pressure to 180/100 and a 20 mg prostaglandin (PG) E2 suppository was inserted. A few hours later the blood pressure had dropped to 100/60 and the hydrazaline infusion was discontinued. About 3 hours later a stillborn female infant was born; post delivery examination revealed a large gap in the wall of the uterus extending into the lateral vaginal fornix. A total abdominal hysterectomy and right salpingo-oophorectomy was then performed and recovery was uneventful. PGE2 reliably initiates labor even in the presence of an "uninducible cervix" and is prone to increase intrauterine pressure to a level beyond that of normal labor with a lag in cervical changes. The 2 most common traumata reported following PG administration for therapeutic abortion are either cervico-vaginal fistulas or lateral tears. In this case since there was no indication of any congenital weakness of the uterine wall, it is reasonable to assume that the mechanism leading to the rupture was intense and prolonged uterine contractions combined with a rigid cervix.
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PMID:Uterine rupture associated with the use of vaginal prostaglandin E2 suppositories. 658 51

The purpose of this study was to describe the course of preterm labor in patients receiving a standard intravenous infusion of the oxytocin antagonist atosiban. An open-labeled, non-randomized study was conducted at 4 sites. Successful tocolysis was defined as delay of delivery larger than 48 hours from starting atosiban and no need for an alternate tocolytic. Atosiban was administered by continuous intravenous infusion at a rate of 300 micrograms per minute until uterine contractions were absent for 6 hours, or up to a maximum infusion time of 12 hours. Sixty-two patients of between 20 and 36 weeks' gestation were enrolled over 6 months. One had rupture of membranes and was excluded. Successful tocolysis was noted in 43 of 61 (70.5%). Four delivered spontaneously within 48 hours and 14 (23.0%) required an alternate tocolytic agent. The chance of successful tocolysis was related to the degree of cervical dilation at the start of therapy. Cessation of uterine contractions was noted in 38 patients (62.3%). A decrease in uterine contraction frequency of 50% or more was noted in 50 of 61 patients (82.0%). Four patients reported side effects (nausea, vomiting, headache, dysguesia, chest pain), but in no case did side effects require discontinuation of the medication. Intravenous administration of atosiban is associated with a delay in delivery comparable to that seen with other tocolytics. If this effect is confirmed in planned placebo-controlled trials, its favorable side effect profile may give it a place in the armamentarium.
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PMID:Treatment of preterm labor with the oxytocin antagonist atosiban. 868 3


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