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

This study examines the efficacy of transabdominal intraamniotic injection of prostaglandins (PGs) in therapeutic abortions. Transabdominal amniocentesis was performed under local anesthesia (1% lignocaine) in 27 patients 14-22 weeks pregnant. Uterine activity was monitored. PGF2alpha 25 mg was given as a single intraamniotic injection in the 1st 14 cases. It was given in 3 doses at 24-hourly intervals for 3 successive days in 1 patient. PGE2 was given in 13 patients, 1 mg initially followed by 2 further 1 mg doses at 10-minute intervals. Intravenous oxytocin infusions were used where necessary, as was hysterotomy. Blood samples were collected in 10 patients before and at 4-6 hourly intervals following PGF2alpha administration until abortion occurred, and in 3 patients 40 hours prior to PG administration. A single 25 mg intraamniotic injection of PGF2alpha successfully terminated pregnancy in only 6 of 14 cases. Average-induction delivery interval was 19.52 hours. 6 other patients necessitated intravenous oxytocin infusions to stimulate effective uterine activity; average induction-abortion interval was 59 hours. 2 patients failed to abort, requiring hysterotomy. 7 of 12 vaginally delivered patients had incomplete abortion. Success rate was higher in PGE2-treated patients, with 11 of 13 patients aborting; average induction-delivery interval was 23 hours and 16 minutes. Side effects experienced included severe abdominal pain (for PGF2alpha), vomiting and mild pyrexia (38 degrees Celsius). No consistant change was observed in plasma steroid concentration until after delivery of fetus and placenta occurred. Transamniotic administration of PGE2 appears effective for therapeutic abortion, but not PGF2alpha.
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PMID:Therapeutic abortion by intraamniotic injection of prostaglandins. 480 68

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

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

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

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 study evaluates the efficacy and safety of PGE2 (prostaglandin E2) tablets for induction of labor in term pregnancy (38 to 42 weeks). 47 women (21 nullipara and 26 multiparae; ages 19 to 29 for nulliparae and 21 to 39 for multiparae) were studied; all were clinically normal according to the criteria of Thiery et al (1971), had intact membranes and mean Bishop scores (Bishop, 1964) of 7 for the nulliparae and 6.6 for the multiparae. In the parous group, the number of previous births ranged from 1 to 5. An initial dose of 0.5 mg PGE2 (1 tablet) was given to all except 1 patient who was given a 0.25 mg PGE2 as a test dose. A second dose of PGE2 was given if after 60 minutes, the recorded myometrial activity was less than 150 Montevideo Units. Subsequent doses of PGE2 (0.5 to 2.0 mg) were given at approximately 2-hourly intervals. Fetal scalp blood sample was collected at full cervical dilatation. 31 patients had spontaneous delivery while 16 patients (11 nulliparae and 5 multiparae) had to have vacuum extraction. The infants were assessed biochemically and clinically by Apgar scores at 1 and 5 minutes. Induction was successful in all except in a 23-year old obese nulliparous female at 40 weeks gestation who had a Bishop score of 5. This patient was given oxytocin infusion 27 hours after the first dose of PGE2; the baby was born following an easy vacuum extraction. Maternal morbidity included 1 to 3 episodes of vomiting in 8 of 21 nulliparae and 3 of 26 parous patients; elevated blood pressure during labor in 2 normotensive parous patients; postpartum hemorrhage which was easily controlled in 1 nullipara; and retained placenta in 1. Test dose to delivery interval ranged from 2 hours and 37 minutes to 18 hours and 29 minutes for the nulliparae and from 1 hour and 57 minutes to 9 hours and 13 minutes for the parous patients. The infants were in satisfactory condition at birth.
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PMID:Induction of labour with prostaglandin E2 tablets. 482 88

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

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

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


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