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

In a prospective, randomized study, 106 patients underwent induction of labor with either pulsed (every 8 minutes) (n = 50) or continuous (n = 56) intravenous infusion of oxytocin. Maternal characteristics, gestational age at induction, induction-delivery interval, analgesia for labor, cesarean section rates, and newborn characteristics were similar in both groups. The mean +/- SEM total oxytocin administered was significantly less in the pulsed group (3564 +/- 487 mU) than in the continuous group (7684 +/- 844 mU; p less than 0.0001); the average dose of oxytocin administered per minute was significantly lower in the pulsed group (3.9 +/- 0.3 mU/min) than in the continuous group (7.8 +/- 0.4 mU/min; p less than 0.0001); the peak or highest administered dose of oxytocin expressed per minute was also signficantly lower in the pulsed group (9.6 +/- 0.8 mU/min) than in the continuous group (14.1 +/- 0.7 mU/min; p less than 0.0001). These significant differences persisted even when controlled for parity, Bishop's score of the cervix, and number of days induction of labor was carried out. Uterine hyperstimulation occurred infrequently in both groups (3.6% to 4.0%). The pulsed group required a significantly smaller infusion volume (25 +/- 14 ml) than the continuous group (780 +/- 84 ml; p less than 0.0001). Thus pulsatile administration uses significantly less oxytocin and infusion fluid but is as effective and safe as continuous infusion.
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PMID:Induction of labor with pulsatile oxytocin. 225 97

Obstetric care in rural communities is in crisis due to the shortage of practitioners and the pressures of regulatory agencies on small obstetric units. We reviewed the records of 297 pregnant women presenting to the offices of 12 family physicians in rural areas of Western New York State. Local deliveries were done in rural hospitals that reported fewer than 500 deliveries per year. Family physicians obtained consultation in 36% of the pregnancies. Of these, care responsibility was transferred to an obstetrician 50% of the time (18% of all pregnancies). Two percent of the cases were transferred to a regional referral center. There was one perinatal death and one intrauterine fetal death in this series. Of the 222 deliveries by family physicians, oxytocin was used in 23%, narcotic analgesia was used in 15.3%, and outlet assist in 8.1%. Labors were somewhat longer than standard labor curves, and the overall cesarean section rate was 13.5%. We conclude that obstetric care by rural family physicians utilizing small rural Western New York hospitals is consistent with standards of care elsewhere when practiced in the context of an organized referral network.
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PMID:Primary care obstetrics in rural western New York. A multi-center case review. 228 95

A 31 years old multiparous woman was delivered by caesarean section at her first pregnancy. For her third, spontaneous, full-term labour an epidural analgesia was realized with 0.125% epinephrined bupivacaine and fentanyl (1 mg per kg). In spite of its initial efficacy, pains appeared only localized at the caesarean scar. An uterine rupture was suspected, due probably to the use of oxytocin. The operating room was immediately prepared for an emergency caesarean section. As none other pejorative clinical manifestation was present, vaginal delivery was pursued and an healthy boy was taken out after application of forceps. The uterine revision and the secondary laparotomy, performed under epidural anesthesia, confirmed an uterine break, not very wide. The end result was satisfactory both for the mother and the child. The use of epidural analgesia and oxytocin are discussed from the literature and the clinical facts. The absence of internal tocography is an arguable point in this case report.
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PMID:[A uterine rupture during peridural anesthesia]. 236 2

The effects of intraventricular injection (ICV) of oxytocin (OT) and antioxytocin serum (AOTS) on the pain threshold and electroacupuncture (EA) analgesia in rats were investigated in this study. The potassium iontophoresis induced tailflick was used to measure the pain threshold. An increase of 20-38% in the pain threshold was observed within 80 min after OT injection (50 ng), while the OT administration (50 ng) in combination with EA produced a dramatic increase of 139-234% in the pain threshold, which was much higher than that in the saline-EA group (P less than 0.05 or 0.01). The OT effect was dose-related in the range between 25-100 ng. Although ICV of AOTS did not change the pain threshold, the EA analgesia became weakened significantly. After injection of AOTS, EA only produced an increase of 47-61% in the pain threshold, while following ICV injection of normal rabbit serum instead of AOTS the EA could cause a rise of 104-123% in the pain threshold. There was a significantly statistical difference between the above two groups (P less than 0.05-0.01). The data indicate that ICV of OT not only elevates the pain threshold, but also enhances the EA effect, and that AOTS attenuates the EA analgesia. These results suggest that endogenous oxytocin in the central nervous system may play a role in the electroacupuncture analgesia.
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PMID:[The role of central oxytocin in electroacupuncture analgesia]. 237 36

Morphinic drugs added to epidural local anesthetic during labour enhance analgesia and obstetrical conditions. Fentanyl, 1 microgram/kg-1, is safe for the newborn. Alfentanil is of faster and shorter duration and its pharmacokinetics suggests less accumulation than fentanyl. The aim of this study is to compare Alfentanil versus Fentanyl when added to an epidural continuous bupivacaine 0.125% infusion. Two groups of parturients are constituted: group A 10 micrograms/kg alfentanil, group F 1 microgram/kg fentanyl. Pain is assessed with a 0 to 10 points scale. There are no differences between the two groups for age, weight, parity, term, initial cervical dilatation and new born weight. Analgesia begins quickly in the two groups, and is more pronounced in the group A (than in the group F (p less than 0.005). Analgesia is maintained for the whole dilatation course. Pain scores increase during expulsion but are significantly lower than the initial scores. No difference is noted as regards analgesia supplementation. Obstetrical data: labour duration, oxytocin dosage, expulsion strength, instrumental extraction rate and uterin evacuation are similar in the 2 groups. No cesarean section is observed. Neonatal status, established according to Apgar scores and then Amiel Tison neurological scales (0 to 30) respectively at 30 to 120 minutes are in the same favorable ranges: Apgar score is in all cases more than 9. The neurological score is 24 (group A) and 22.9 (group F) at 30 minutes and increases significantly at 120 minutes in the 2 groups (27 in the two groups).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Addition of a morphinomimetic to the continuous perfusion of 0.125% bupivacaine for peridural obstetrical anesthesia. A comparative study of fentanyl and alfentanyl]. 256 2

A review of 13 cases of second trimester termination at 20-24 weeks by dilation and evacuation after insertion of laminaria in women with critical illness is presented. The patients ranged in age from 17-41, parity from 0-5, and diagnoses covered a wide range, including hematologic, respiratory, vascular, gastrointestinal, cardiac systems, malignancies, autoimmune disorders and infections, as well as several with multiple problems, including intravenous drug use. Most were the result of late diagnosis or late presentation. Procedures were performed according to a standard protocol by 1 physician, from 1983- 1987, using iv meperidine and diazepam sedation and paracervical block, 12 after laminaria insertion. Amniotomy and evacuation with large ovum forceps were followed by oxytocin and sharp curettage. There were no complications in this series. The dilation and curettage method is preferable in such cases because the timing of the procedure can be planned for maximal use of facilities and staff, the patient is spared by unattended delivery, the length of the abortion process is minimal, and incidence of infection and retained placenta is lower. Need for lengthy analgesia and fluid monitoring is reduced, an advantage for many critically ill women. This approach is best done by a physician with specific experience, in a setting capable of managing severe complications.
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PMID:Late-second-trimester pregnancy termination with dilation and evacuation in critically ill women. 258 88

Three-day-old Sprague-Dawley rat pups were intracisternally infused with a single dose of oxytocin (1 microgram/2 microliters) or saline, or were untreated. As adults, these animals were observed for novelty-induced grooming, analgesia measured by the hot-plate test, and behavior in the open field. Oxytocin treatment during infancy resulted in an elevation of novelty-induced grooming when compared to saline and untreated animals. There were no significant oxytocin treatment effects on analgesia response or open-field behaviors. Oxytocin given early in life may have permanent effects on certain behavioral responses to stress.
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PMID:Neonatal administration of oxytocin increases novelty-induced grooming in the adult rat. 258 97

In a randomized study, 94 patients with term pregnancies underwent augmentation of labor with either continuous or pulsed (every 8 minutes) intravenous oxytocin infusion. There were no significant differences with respect to the maternal characteristics, cervical dilatation and effacement, induction-to-labor interval, induction-to-delivery interval, cesarean section rate, analgesia for labor, or low Apgar scores. No hyperstimulation was noted in either group. In each group, 20% of the patients had dysfunctional labor patterns, with coupling and tripling of the uterine contractions. The mean +/- SEM oxytocin administered in the pulsed-infusion group was significantly lower than that in the continuous-infusion group (2.1 +/- 0.4 versus 4.1 +/- 0.4 mU/minute; P less than .001). The mean +/- SEM total amount of oxytocin administered was 1300 +/- 332 mU for the pulsed group and 1803 +/- 302 mU for the continuous group, indicating that lower amounts of oxytocin were required for pulsed administration. Our study demonstrates that pulsatile administration of oxytocin is similar in efficacy to our standard continuous oxytocin infusion and requires a lower total amount and rate of oxytocin administered, which may afford a greater margin of safety.
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PMID:Pulsatile administration of oxytocin for augmentation of labor. 268 76

In a 15 year period (1972-1987) a total of 2434 parturients with one or more previous Caesarean sections were delivered at University College Hospital, Galway. There were 1084 (44.5%) patients booked for elective repeat Caesarean delivery, because they had two or more prior sections (maximum number = 10) or a recurrent indication for section other than the prior section. Trial of labour was undertaken in 1350 (55.5%) patients, and 81.26% achieved a vaginal delivery. Regional analgesia was employed in 25.5% and oxytocin in 31.9%. There were 6 (0.44%) or 1:225, true scar ruptures, resulting in 1 stillbirth and 2 neonatal deaths with no maternal death. There were 4 (0.37%), or 1:271, uterine ruptures in patients booked for elective repeat section: a classical scar rupture before labour, with a fresh stillbirth; placenta praevia percreta with bladder involvement in two patients (both resulting in maternal death), and a patient with placenta praevia accreta.
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PMID:True rupture of the caesarean section scar (a 15 year review, 1972-1987). 270

Epidural analgesia in labor is generally accepted as safe and effective and therefore has become increasingly popular. However, little is known regarding the effect of epidural analgesia on the incidence of cesarean section for dystocia in nulliparous women. During the first 6 months of 1987 we studied 711 consecutive nulliparous women at term, with cephalic fetal presentations and spontaneous onset of labor. Comparison of 447 patients who received epidural analgesia in labor with 264 patients who received either narcotics or no analgesia was performed. The incidence of cesarean section for dystocia was significantly greater (p less than 0.005) in the epidural group (10.3%) than in the nonepidural group (3.8%). There remained a significantly increased incidence (p less than 0.005) of cesarean section for dystocia in the epidural group after selection bias was corrected and the following confounding variables were controlled by multivariate analysis: maternal age, race, gestational age, cervical dilatation on admission, use of oxytocin, duration of oxytocin use, maximum infusion rate of oxytocin, duration of labor, presence of meconium, and birth weight. The incidence of cesarean section for fetal distress was similar (p greater than 0.20) in both groups. There were no clinically significant differences in frequency of low Apgar scores at 5 minutes or cord arterial and venous blood gas parameters between the two groups. This study suggests that epidural analgesia in labor may increase the incidence of cesarean section for dystocia in nulliparous women.
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PMID:The effect of continuous epidural analgesia on cesarean section for dystocia in nulliparous women. 238 78


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