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

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

In 103 women admitted for out-patient vaginal terminations of pregnancy, the relation was investigated between the use of ecbolics and blood loss, vomiting and other side effects. Patient self-rating was incorporated in the study for comparative purposes. Use of a combined preparation of oxytocin and ergometrine resulted in the lowest blood losses. Ergometrine administered alone was associated with immediate nausea and vomiting but no delayed effects. Seven days after abortion, 35% of the women were still complaining of vaginal bleeding, although in most the volume was low.
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PMID:Choice of ecbolic and the morbidity of day-case terminations of pregnancy. 728 81

Suction termination of pregnancy was performed in 276 patients as an out-patient procedure under general anaesthesia. Ergometrine, oxytocin, or sterile water were given with the induction of anaesthesia. There was no significant difference in blood loss in the three treatment groups, although blood loss in termination of pregnancy performed after eight weeks was increased in all three groups. Nausea, vomiting and abdominal pain occurred significantly more often after ergometrine compared to oxytocin or water.
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PMID:Blood loss and side effects in day case abortion. 729 2

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

This investigation compared blood loss following intravenous administration of oxytocin (10 U) or ergometrine (0.25 mg) in patients undergoing first trimester abortion by suction curettage. It also examined the incidence of vomiting after the procedure was completed. The 101 patients comprised the oxytocin group and 100 patients received the ergometrine. 14% of those receiving oxytocin (N=12) vomited postoperatively and 32% of those who received ergometrine (N=28) vomited. Patients who received oxytocin had significantly lower blood loss than those who received ergometrine. Both at 7 and 14 weeks gestation, there is an overlap of standard errors; at 15 weeks, the samples were too small to draw any valid conclusions for that period of gestation.
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PMID:Oxytocin: oxytocic of choice in first trimester. 742 3

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

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

The pain associated with labour can be severe. The ideal labour analgesic does not exist and systemic opioids provide little relief. Nausea, vomiting and sedation are common adverse effects of systemic opioids. Paracervical block can relieve only the pain of the first stage of labour. The duration of analgesia obtained using paracervical block is limited and repeat blocks increase the risk of direct fetal injection. Epidural analgesia effectively relieves labour pain. The insertion of an epidural catheter can provide continuous analgesia throughout labour. In addition, the catheter can be used to provide surgical anaesthesia, should operative delivery be required. Epidural local anaesthetics commonly produce maternal hypotension and motor blockade. However, opioids potentiate the effect of epidural local anaesthetics. Thus, concomitant epidural opioid injection allows the use of lower concentrations of local anaesthetics, decreasing the frequency and severity of hypotension and motor blockade. Epidural analgesia has other, potentially catastrophic, adverse effects but, with safe clinical practice, these problems are extremely rare. Intrathecal injection of opioids or local anaesthetics also effective labour analgesia. However, no single intrathecal drug or drug combination reliably provides analgesia for the duration of labour. Many clinicians use both intrathecal and epidural analgesia as a combined spinal-epidural technique. This approach provides the rapid onset of intrathecal drugs and the flexibility of continuous epidural block. Fetal heart rate decelerations occasionally follow the use of any of the above labour analgesic techniques. Most studies of the aetiology of fetal heart rate decelerations have focused on factors unique to each analgesic technique. However, the similar timing and appearance of fetal bradycardia suggests a common cause. Induction of maternal analgesia may transiently alter the balance between factors encouraging and inhibiting uterine contraction. A temporary increase in the uterotonic effects of endogenous or exogenous oxytocin may then produce a tetanic uterine contraction with subsequent decrease fetal oxygen delivery and resultant fetal bradycardia. Regardless of aetiology, these bradycardias are transient and should not produce maternal or fetal morbidity. Much controversy surrounds the effects of analgesia, especially epidural block, on the course and outcome of labour. Various studies have reported that epidural analgesia slows labour, increases the incidence of malposition of the fetal head, increases the need for forceps delivery and increases the risk of caesarean delivery. Most of the studies reporting these effects are retrospective and nonrandomised. More careful studies suggest that specific anaesthetic techniques (i.e. local anaesthetic-opioid mixtures) or obstetrical management can limit or eliminate these 'risks' of epidural labour analgesia.
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PMID:Labour analgesia. A risk-benefit analysis. 871 92

Posterior pituitary hormone secretion and central neural expression of the immediate-early gene product c-Fos was examined in adult ferrets after intravenous administration of CCK octapeptide. Pharmacological doses of CCK (1, 5, 10, or 50 microg/kg) did not induce emesis, but elicited behavioral signs of nausea and dose-related increases in plasma vasopressin (AVP) levels without significant increases in plasma oxytocin (OT) levels. CCK activated neuronal c-Fos expression in several brain stem viscerosensory regions, including a dose-related activation of neurons in the dorsal vagal complex (DVC). Activated brain stem neurons included catecholaminergic and glucagon-like peptide-1-positive cells in the DVC and ventrolateral medulla. In the forebrain, activated neurons were prevalent in the paraventricular and supraoptic nuclei of the hypothalamus and also were observed in the central nucleus of the amygdala and bed nucleus of the stria terminalis. Activated hypothalamic neurons included cells that were immunoreactive for AVP, OT, and corticotropin-releasing factor. Comparable patterns of brain stem and forebrain c-Fos activation were observed in ferrets after intraperitoneal injection of lithium chloride (LiCl; 86 mg/kg), a classic emetic agent. However, LiCl activated more neurons in the area postrema and fewer neurons in the nucleus of the solitary tract compared with CCK. Together with results from previous studies in rodents, our findings support the view that nauseogenic treatments activate similar central neural circuits in emetic and nonemetic species, despite differences in treatment-induced emesis and pituitary hormone secretion.
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PMID:Plasma hormone levels and central c-Fos expression in ferrets after systemic administration of cholecystokinin. 1155 33


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