Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01178 (oxytocin)
 15,767 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Molar pregnancy, which results from an anomaly in the development of the trophoblastic tissue, is now easy to diagnose based on clinical evidence, beta hCG level, and sonography, although it must be histologically confirmed. Treatment remains difficult because of the danger of hemorrhage or trauma during uterine evacuation. Hydatidiform mole was diagnosed in the 1st pregnancy of a 27-year-old woman on the basis of a routine 1st trimester sonogram. Clinical examination revealed a voluminous uterus and a long, closed, very tonic cervix. Sulprostone was administered to aid cervical dilatation. An initial intramuscular injection of sulprostone caused uterine contractions without cervical modifications. 5 hours later an intravenous perfusion of sulprostone was started, during which significant contractions and cervical modifications were observed. An aspiration curettage was performed, in which numerous vesicles typical of the hydatidiform mole were evacuated. There was no need for further cervical dilatation and the curettage was rapid and nonhemorrhagic. The postoperative course was uneventful, and a test of beta hCG levels 6 weeks later was negative. The patient complained of pain during uterine contractions despite use of high doses of pethidine. The frequency of hydatidiform mole varies in different countries. It has been estimated at 1/85 in Indonesia and 1/2000 in the US. The clinical picture of hydatidiform mole includes vomiting often nonresponsive to treatment and metrorrhagia of varying volume, a large uterus for the gestational age, and often bilateral ovarian cysts. A vasculorenal syndrome may also begin at 13-16 weeks of amenorrhea. Beta hCG levels are high for the gestational age. Sonography reveals no embryonic structures. Biopsy shows a complete absence of embryo and amniotic sac. The karyotype is diploid and almost always XX. The mechanism is fertilization of an ovocyte whose nucleus is absent or inactive. The 2 chromosome sets are contributed by the father, a circumstance incompatible with embryonic development. Trophoblastic proliferation occurs without embryonic development. Hydatidiform moles may be transformed to invasive moles or chorioepithelioma. Treatment includes uterine evacuation by aspiration under sonographic control if possible. Many authors recommend oxytocin and antibiotic cover. The use of prostaglandin analogs to facilitate uterine evacuation is controversial, with some authors citing the increased risk of trophoblastic embolism. The mole should be histopathologically and cytogenetically studied, and postmolar follow-up is essential.
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PMID:[Use of sulprostone in the evacuation of molar pregnancies]. 206 88

A PGE2 analogue, Sulprostone was administered to control the postpartum haemorrhage, immediately after the baby was born, to 74 healthy patients, who had normal pregnancy and delivery. Divided into three groups they received 50 or 100 micrograms intravenously, or 200 micrograms intramuscularly. The results were compared with those of a group of 54 patients, which received 0.2 mg methylergometrine i.m. and 5 IU oxytocin i.v. respectively. The blood loss was measured during the third stage of labour and during two hours thereafter. The pilot dose of 50 micrograms was not effective enough. The blood loss in the group of 100 micrograms i.v. was 386 +/- 175 ml, in the group of 200 micrograms i.m. 325 +/- 197 ml, and in the methylergometrine-oxytocin group 302 +/- 202 ml. Sulprostone 200 micrograms i.m. seems to be effective treatment to control the postpartum haemorrhage. Only four patients had mild side-effects after Sulprostone administration.
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PMID:Sulprostone in the control of postpartum haemorrhage. 349 8

13 ,14 -Dihydro-15-keto-PGF2 alpha (PGFM) serum levels were determined by radioimmunoassay in 101 postpartum women who were treated with 200 micrograms methergin, 5 I.U. oxytocin and 500 micrograms sulprostone, respectively, 30 min after expulsion of placenta. All patients had normal deliveries. The present radioimmunoassay system did not show cross-reactivity with sulprostone. In addition, radioimmunoassayable sulprostone serum levels were monitored. Covariance analysis of area under PGFM serum levels between time zero and 180 min after application of oxytocics was performed. A higher but statistically not significantly PGFM serum level was maintained in subjects treated with sulprostone. Sulprostone serum levels are rapidly attained after application. Decrease of radioimmunoassayable sulprostone indicates a half-life of 75 min. These data corroborate clinical findings of an accompanying paper and combine to suggest that sulprostone may be a useful alternative therapy in high-risk patients with severe postpartum atony and hemorrhage in whom prior preventive measures have failed.
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PMID:13,14-Dihydro-15-keto-PGF2 alpha (PGFM) and sulprostone serum levels after application of sulprostone to postpartum women. 668 61

Parquetina nigrescens (Afz.) Bullock (Periplocaceae) hydromethanolic extract (PAR) in reference solution exerts a stimulating and spasmogenic action on the pregnant rat myometrium in vitro. This action is characterised by increasing amplitude of spontaneous isometric contractions and a slight elevation of muscular basic tonus. These effects on myometrium may be compared with those provoked by sulprostone (PGE2) in the same experimental conditions. In calcium free solution, Parquetina nigrescens extract could restore partially spontaneous contractile activity. On the contrary, in presence of EDTA PAR induces a complete abolition of the activity. On the other hand, in calcium free solution, sulprostone is able to develop a clear elevation of basic tonus (contracture). These observations support the hypothesis that the extract has an oxytocin-like effect, which is characterised by an extracellular influx of calcium, responsible for the increase of the maximum isometric contraction amplitude. Sulprostone activates both extracellular and intracellular calcium responsible for the increase of contractile activity and development of the contracture of uterine smooth muscle.
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PMID:Uterotonic effects of hydromethanolic extract of Parquetina nigrescens (Periplocaceae) on spontaneous contractile activity in the isolated myometrium of pregnant rats. 880 72

The low postpartum levels of PGI2 interacting with oxytocin vis-a-vis myometrial contractility may prevent postpartum hemorrhage. Predisposing factors for atonic postpartum bleeding are uterine overdistension, grand multiparity, prolonged labor, anemia, toxemia, and heavy narcosis. Routine administration of oxytocic agents reduce uterine atony. In 1 group of 40 patients .2 mg methyl ergometrine given iv postplacentally produced less bleeding than in the other group of 40 getting placebo. 1 mg of iv PGE1, .2 mg ergometrine, 3 IU oxytocin or a combination of PGE1 and ergometrine was compared in 180 women. PGE1 did not reduce blood loss. PGF2alpha was used successfully to induce labor in 21 women reducing blood loss compared to oxytocin. Another 10 women received in syntometrine and 5 got im .25 mg sulprostone at the moment of crowning, and the latter reduced postpartum blood loss. 90 women in 3 groups of 30 each at high risk of hemorrhage were injected im .2 mg methyl ergometrine maleate, .25 mg 15-methyl-PGF2alpha, and .5 mg sulprostone, respectively, resulting in prevention of severe hemorrhage. Intramyometrial injection of .5-1 mg of PGF2alpha induced uterine contractions and controlled bleeding in atonic hemorrhage when oxytocin failed. 20 mg PGE2 vaginal suppositories controlled postpartum atony after cesarean section, although fever and hypotension did occur. Im 15-methyl-PGF2alpha proved superior in producing hemostasis to intramyometrial PGF2alpha injection. In 2 studies .25 mg of 15-methyl-PGF2alpha was injected at 1.5 hour intervals arresting hemorrhage in 15 out of 16 and 18 out of 20 cases, respectively. Intrauterine infection caused all 3 failures. Sulprostone by infusion of 1.7-30 mcg/min or by 500 mcg im injection also controls postpartum hemorrhage.
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PMID:The use of prostaglandins in post-partum haemorrhage. 1231 32

Sulprostone infusion must be started without further delay if the first treatment (oxytocin, manual removal of the placenta, uterine revision, vaginal and cervical examinations) has been unsuccessful in the first 30 minutes after delivery. In France, the use of this treatment has been officially authorized in this indication (marketing approval, AMM). Intramuscular and intramyometrial injections being contraindicated, sulprostone is administered through continuous intravenous infusion. Dosage is 500 microg (one vial) per hour. Starting dose is 1.7 microg/min (10 ml/h), and can be increased if necessary in steps of 1.7 microg/min (but not exceeding 8.3 microg./min). The success rate of this treatment is linked to the rapidity of its commencement (within 30 min of the diagnosis of postpartum hemorrhage). In case of contraindications, since postpartum hemorrhage is life-threatening, the benefit-risk ratio needs to be estimated. A strict monitoring of cardiovascular parameters is compulsory before and after its administration. There is no time limit after which this treatment can be considered as ineffective: it depends on the amount of blood lost, the patient's clinical state, and on means that have already been used to stop the bleeding. However, if after 30 min of sulprostone infusion, there is no improvement or if the situation is worse, other therapeutic strategies must be considered (e.g., embolization, surgery). The use of intra-rectal misoprostol is still under assessment. To date, we have been unable to find studies that justify this treatment. Intra-uterine balloon, tube, or mesh packing has been studied in a few small series, where it was successful. Use of these strategies must not delay the treatment by sulprostone.
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PMID:[Obstetrical management in the event of persistent or worsening postpartum hemorrhage despite initial measures]. 1557 32

Postpartum hemorrhage is defined by bleeding > 500 mL through the vagina. It is one of the obstetrical complications that obstetricians fear most. It is the leading cause of maternal mortality in the world, especially in developing countries. The reference treatments in France are parenteral oxytocin and sulprostone. Sulprostone involves sometimes fatal side effects, and must be administered only in appropriate health care facilities. It also has the major disadvantage of requiring refrigeration. Misoprostol has uterotonic properties that have led to its occasional off-label use in the treatment of postpartum hemorrhage, by rectal or sublingual administration, as an alternative to sulprostone. A careful review of the literature on this particular use of misoprostol is essential.
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PMID:[Misoprostol for treating postpartum hemorrhages]. 1764 41