Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “OXYTOCICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 667 records · Page 37Linked to original sources

Effect of tyrosinase preparations on oxytocin, vasopressin and bradykinin.

On incubation with a tyrosinase preparation at pH 7.5, oxytocin and vasopressin were inactivated. The loss of oxytocic activity did not differ significantly from that of milk-ejecting activity in oxytocin, nor the loss of pressor activity from that of antidiuretic activity in vasopressin. Oxytocin was inactivated less rapidly at pH 6.6 than at pH 7.5. At pH 3.9 neither oxytocin nor vasopressin was inactivated. Analogues of oxytocin and vasopressin, in which tyrosine is replaced by phenylalanine, were not inactivated by the tyrosinase preparation used. On incubation of bradykinin with two different tyrosinase preparations, there was no loss of oxytocic activity at pH 7.5 but an almost total loss at pH 3.9. In the presence of p-nitrophenol, ascorbic acid, sodium diethyldithiocarbamate and during incubation under anaerobic conditions the inactivation of oxytocin at pH 7.5 was inhibited, but not that of bradykinin at pH 3.9. It is concluded that the tyrosinase preparations used contain two distinct enzymes or activities, the one inactivating oxytocin and vasopressin at pH 7.5 and the other bradykinin at pH 3.9.

Arginine Vasopressin↗

Active management of the third stage at caesarean section: a randomised controlled trial of misoprostol versus syntocinon.

The objective of this trial was to investigate whether 500 microg oral misoprostol given immediately after delivery of the neonate at Caesarean section is as effective as a bolus intravenous injection of 10 iu Syntocinon in stimulating uterine contractions and thereby reducing blood loss. Forty women undergoing elective or emergency Caesarean section were included in a placebo-controlled randomised trial. Group 1 received oral misoprostol and a placebo intravenous bolus and Group 2 received intravenous Syntocinon and oral placebo tablets. The main outcome measures were estimated blood loss at Caesarean section, drop in serum haemoglobin, and the need for additional uterotonic agents. We found that there was no significant difference (p = 0.75) in estimated blood loss between the two groups. No differences were observed in the decrease in haemoglobin, requirement for additional oxytocics, the need for blood transfusion or the degree of shivering in each group (p > 0.05 in each case). We concluded that oral misoprostol could be used as an alternative oxytocic agent for the third stage at Caesarean section. However, there is an obvious need for a larger randomised controlled trial to be undertaken. Previous published studies have concentrated on vaginal births and further studies should be extended to Caesarean deliveries.

Administration, Oral↗

Increased frequency of neonatal jaundice in a maternity hospital.

The frequency of "significant" jaundice of the newborn at this hospital increased from 8-1% of all live births in 1971 to 12-1% in 1972 and 15-4% in 1973. This coincided with an increased use of oxytocic agents and epidural anaesthetics in labour, and a change in the artificial feed given to normal infants. A retrospective study of jaundiced infants born in 1972 failed to explain the increase in jaundice. Though the use of oxytocic agents was not the direct cause, since their use results in the delivery of more infants before 40 weeks of gestation it may be a contributory factor. The use of epidural anaesthetics was sastically related to the development of jaundice but the nature of the association was not clear. Mothers of infants who became jaundiced has a significantly higher frequency of poor past obstetric histories, but once again the association was not clear. The change in artificial feeds was excluded as a possible cause.

Age Factors↗

Misoprostol in the prevention of postpartum hemorrhage.

OBJECTIVE: To evaluate the data regarding the use of misoprostol in the prevention of postpartum hemorrhage. DATA SOURCES: Pertinent literature was identified through a MEDLINE search (1966-January 2001) and through other secondary literature databases and/or bibliographies of pertinent articles. DATA SYNTHESIS: New strategies in the prevention of postpartum hemorrhage are being evaluated due to the obstacles surrounding conventional therapies. One therapeutic option is the use of misoprostol. This literature review evaluates the published clinical data involving misoprostol in the prevention of postpartum hemorrhage. Current data suggest that the use of misoprostol for the prevention of postpartum hemorrhage reduces mean estimated blood loss compared with placebo. However, no clinical trials have detected a statistically significant decrease in the incidence of postpartum hemorrhage in misoprostol-treated subjects. There is conflicting evidence regarding the efficacy of misoprostol compared with conventional uterotonics, such as oxytocin or Syntometrine. CONCLUSIONS: In situations where conventional oxytocics are not readily available, storage requirements for oxytocics cannot be met, or the equipment for parenteral administration is not obtainable, misoprostol may be an acceptable prophylactic option.

Clinical Trials as Topic↗

Side-effects of oral misoprostol in the third stage of labour--a randomised placebo-controlled trial.

BACKGROUND: Misoprostol, an inexpensive, stable, orally active prostaglandin analogue, has been suggested for use in the prevention of postpartum haemorrhage. Potential side-effects, however, need to be quantified. OBJECTIVE: To compare the rate of postpartum shivering and pyrexia following oral misoprostol 600 micrograms and placebo. DESIGN: A double-blind placebo-controlled trial. Women in labour were randomly allocated to receive either misoprostol 600 micrograms orally or placebo after delivery. Conventional oxytocics were given immediately if blood loss was thought to be more than usual. Side-effects were recorded. Postpartum blood loss in the first hour was measured by collection in a special flat plastic bedpan. SETTING: The labour ward of an academic hospital in Johannesburg, with 7,000 deliveries per annum. MAIN OUTCOME MEASURES: Shivering and pyrexia. RESULTS: The groups were well matched. Misoprostol use was associated with more shivering (44% versus 11%, relative risk (RR) 4.03, 95% confidence interval (CI) 2.85-5.70), pyrexia > or = 37.8 degrees C (38% v. 6%, RR 6.23, CI 3.89-9.97), 1-hour systolic blood pressure > or = 140 mmHg (33% v. 25%, RR 1.32, CI 1.03-1.70), and diastolic blood pressure > or = 90 mmHg (10.5% v. 3.0%, RR 3.44, CI 1.67-7.11). There were no other significant differences. The study was not designed to be large enough to assess a difference in blood loss > or = 1,000 ml (9% v. 9.7%, RR 0.93, CI 0.56-1.53). Possible effects on blood loss may have been obscured by the lesser use of additional oxytocics in the misoprostol group (14% v. 18%, RR 0.78, CI 0.54-1.13). CONCLUSIONS: This study has shown the association of postpartum oral misoprostol 600 micrograms with shivering, pyrexia and hypertension. The increased blood pressure, as for the trend towards increased abdominal pain, may be secondary to the uterotonic effect of misoprostol. Large randomised trials are needed to assess the effectiveness of misoprostol in the prevention of postpartum haemorrhage, against which the disadvantages demonstrated here can be weighed.

Adult↗

Prevention of postpartum hemorrhage, safety and efficacy.

OBJECTIVE: This study was carried out to describe the safety and efficacy of intramuscular syntometrine (oxytocin plus ergometrine) compared to intravenous oxytocin for prevention of postpartum hemorrhage, and the difference between administration at the end of the 2nd stage of labor compared with that after delivery of the placenta. METHODS: A prospective study was carried out at Prince Zaid Ben Al-Hussein Hospital, Tafilah, Jordan. Two thousand one hundred and sixty one women delivering singletons during 12 consecutive months were included in our study. Women received either intramuscular syntometrine (oxytocin plus ergometrine) or oxytocin alone. The drugs were used either before or after the 3rd stage of labor, in order to compare their safety and efficacy in prevention of postpartum hemorrhage. RESULTS: There was no significant difference in the rate of postpartum hemorrhage for syntometrine compared with oxytocin, when used at the end of the 2nd stage of labor (odds ratio 1.08, 95% confidence interval 0.72-1.63) or after the 3rd stage (odds ratio 0.93, 95% confidence interval 0.65-1.34). The patients receiving oxytocics at the end of the 2nd stage of labor had significantly lower rates of postpartum hemorrhage, for both syntometrine (odds ratio 0.86, 95% confidence interval 0.59-0.1.12) and Oxytocin (odds ratio 0.59, 95% confidence interval 0.39-0.88), compared with those treated after the 3rd stage. CONCLUSION: Oxytocin alone is as effective as the use of syntometrine (ergometrine plus oxytocin) in the prevention of postpartum hemorrhage, but associated with significantly fewer maternal side effects. Oxytocics administered after the 2nd stage of labor compared with after the 3rd stage of labor (placental expulsion) are associated with a significantly fewer rate of postpartum bleeding.

Adult↗

[Postpartum hemorrhage--prophylaxis and treatment in Norway].

BACKGROUND: Routine oxytocic prophylaxis is known to significantly reduce the risk of severe postpartum haemorrhage (> 1,000 ml) and need for blood transfusion after delivery. To what extent this evidence is implemented in clinical practice in Norway is not known. MATERIAL AND METHODS: A telephone questionnaire survey was carried out in September 2001 to evaluate the routine clinical practice for prevention and treatment of postpartum haemorrhage in Norwegian delivery units. RESULTS: Data were available for 55 out of 57 institutions with a delivery unit. Routine third stage prophylaxis with 5-10 IU oxytocin was practiced in 47% of delivery units. Intravenous oxytocin infusion was used primarily in all the delivery units for the treatment of established primary postpartum haemorrhage. 74% of units used methylergometrine, 21% misoprostol as the second-line treatment. INTERPRETATION: Despite evidence for the use of oxytocics for the prevention of postpartum haemorrhage, less than half of delivery units in Norway practice routine prophylaxis in the third stage of labour. Norwegian women may benefit if all maternity care providers implement evidence-based practice.

Carboprost↗

[Drug interference and the role of anesthesia in such interference].

This report considers interference between medications for, on the one hand, drugs given during pregnancy, and, on the other hand, drugs given to the pregnant women and anaesthetic agents. Consideration is given to progestational agents, oxytocics, beta-mimetics, corticosteroids, insulin, hypotensive agents, diuretics and psychiatric drugs. For each case of interference, an attempt is made to provide practical data, with particular respect to those combinations frequently prescribed by obstetricians, e.g. the combination of the beta-mimetics and corticosteroids with the aim of preventing impending premature onset of labour and to ensure foetal pulmonary maturation; the combination of insulin and corticosteroids given to diabetics with the aim of preventing hyaline membrane disease; the combination of corticosteroids with anti-histamines in the treatment of rhesus disease; the association of oxytocics with large quantities of intravenous fluid in the case of post-partum haemorrhage and hypontensive medication combinations and the problems which may result with emergency anaesthesis.

Adrenal Cortex Hormones↗

[Analysis of 29 maternal deaths caused by amniotic fluid embolism].

Twenty nine maternal deaths caused by amniotic fluid embolism (AFE) during 1989-1993 in Beijing area were reviewed. The results show that the average maternal mortality ratio due to AFE was 5.9/100,000 live births responsible for 15.5% of total maternal deaths. In 13 of the 29 patients presented the clinical signs were of postpartum hemorrhage and coagulation disorders. Oxytocics had been used in 12 of the 29 cases during labor. In more than half of the patients there was delay in diagnosis. This was that the percentage of AFE which may present with the signs of coagulation disorder was higher than previously thought, and unreasonable use of oxytocics during labor may be associated with AFE. This kind of AFE is easy to misdiagnose.

Adult↗

[Cardiorespiratory depression in 8 newborn infants whose mothers took "yucuyahui" (Zoapatle-Montanoa tomentosa) during labor].

Yucuyahui (zoapatle-Montanoa tomentosa), is a wild herb used as a folk oxytocic-remedy. Eight pregnant women drank infusions of the herb during the labor and their newborns showed cardiorespiratory depression that needs basic or advanced life support to recover. They improved during the first minutes with an average Apgar score at one minute of 4.5, and 7.4 at ten minutes (p < 0.05). A negative correlation was found between the number of ingested infusions and the Apgar score at the one minute (r = -0.65). Simultaneous administration of alcoholic beverages in three of the pregnant woman did not contribute to deep depression in their neonates. The mechanism of M Tomentosa action is still unknown, but it is possible that it is similar to other oxytocic-drugs, as oxytocin or ergot alkaloids, with which Montanoa shares uterine and systemic effects.

Adolescent↗

Active versus expectant management in the third stage of labour.

BACKGROUND: Expectant management of the third stage of labour involves allowing the placenta to deliver spontaneously or aiding by gravity or nipple stimulation. Active management involves administration of a prophylactic oxytocic after delivery, early cord clamping and cutting, and controlled cord traction of the umbilical cord. OBJECTIVES: The objective of this review was to assess the effects of active versus expectant management on blood loss, post partum haemorrhage and other maternal and perinatal complications of the third stage of labour. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register. SELECTION CRITERIA: Randomised trials comparing active and expectant management of the third stage of labour in women with singleton pregnancies whose babies were presenting head first and who were expecting a vaginal delivery. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted independently by the reviewers. MAIN RESULTS: Four studies were included. Three of the trials were of good quality. Compared to expectant management, active management (in the setting of a maternity hospital) was associated with the following reduced risks: maternal blood loss (weighted mean difference -79.33 millilitres, 95% confidence interval -94.29 to -64. 37); post partum haemorrhage of more than 500 millilitres (odds ratio 0.34, 95% confidence interval 0.28 to 0.41); prolonged third stage of labour (weighted mean difference -3.40 minutes, 95% confidence interval -4.66 to -2.13). Active management was associated with an increased risk of maternal nausea (odds ratio 1. 95, 95% confidence interval 1.58 to 2.42), vomiting and raised blood pressure (probably due to the use of ergometrine). No advantages or disadvantages were apparent for the baby. REVIEWER'S CONCLUSIONS: Routine 'active management' is superior to 'expectant management' in terms of blood loss, post partum haemorrhage and other serious complications of the third stage of labour. Active managment is, however, associated with an increased risk of unpleasant side effects (eg nausea and vomiting), and hypertension, where ergometrine is used. Active management should be the routine management of choice for women expecting a single baby by vaginal delivery in a maternity hospital. The implications are less clear for other settings including domiciliary practice (in developing and industrialised countries).

Delivery, Obstetric↗

Caregivers' use of strict criteria for diagnosing active labour in term pregnancy.

BACKGROUND: Application of specific criteria for diagnosis of active labour as part of a labour assessment program aims to differentiate more accurately between latent and active phases of labour. OBJECTIVES: The objective of this review was to assess the effects of the use of specific criteria by caregivers in diagnosing active labour in term pregnancy. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: January 1998. SELECTION CRITERIA: Randomised trials comparing caregivers' application of strict diagnostic criteria for active labour with routine care. DATA COLLECTION AND ANALYSIS: Trial quality was assessed. MAIN RESULTS: One study of 209 women was included. The trial was of excellent quality. Women who experienced early labour assessment were less likely to receive intrapartum oxytocics than women who received standard care (odds ratio 0.45, 95% confidence interval 0.25 to 0.80) and analgesia (odds ratio 0.36, 95% confidence interval 0.16 to 0.78). They reported higher levels of control during labour and birth (weighted mean difference 16.00, 95% confidence interval 7.52 to 24.48). There were no differences detected for rate of caesarean section and other important measures of maternal and neonatal outcome. REVIEWER'S CONCLUSIONS: Early labour assessment (which includes use of specific criteria for diagnosis of active labour) may have some positive outcomes for women at term pregnancy.

Caregivers↗

Vasopressin receptors in human pregnant myometrium and decidua: interactions with oxytocin and vasopressin agonists and antagonists.

Saturation analysis and competition experiments were performed to identify and characterize [3H]arginine vasopressin binding to human myometrium and decidua in late pregnancy. [3H]Arginine vasopressin bound with affinity similar to that of [3H]oxytocin to both tissues (dissociation constant 1 to 2 nmol/L). The concentration of [3H]arginine vasopressin binding sites was high, particularly in decidua, but in all instances was about 50% to 60% of [3H]oxytocin binding. Analogs with selective oxytocic potency (4-threonine oxytocin, isotocin) had high affinity to both [3H]arginine vasopressin and [3H]oxytocin binding sites, as did analogs with both oxytocic and vasopressor activity (vasotocin). Analogs with selective antidiuretic activity (1-deamino-8-D-arginine vasopressin) showed drastically reduced affinity to [3H]oxytocin binding sites and relatively low but significantly higher affinity to [3H]arginine vasopressin binding sites. A new oxytocin antagonist (RW22164 or [1-deamino-2D-tyrosine-(O-ethyl)-4-threonine-8-ornithine]oxytocin) competitively bound to both binding sites. Its affinity to [3H]oxytocin binding sites was greater than to [3H]arginine vasopressin binding sites whereas the relative affinities of a predominantly vasopressor antagonist [Manning compound) were reversed, suggesting the presence of distinct receptors for oxytocin and arginine vasopressin in pregnant human myometrium and decidua.

Animals↗

Management of severe preeclampsia detected in early labor by prostaglandin A1 or dihydralazine infusions.

The presence of severe pregnancy-induced hypertension at the onset of labor requires therapy with a potent hypotensive agent. Prostaglandin A1 is a powerful vasodepressor that augments renal blood flow and glomerular filtration and possesses antiplatelet aggregator and oxytocic properties. A continuous intravenous infusion of prostaglandin A1 (40 to 50 micrograms/min) or dihydralazine (35 to 50 micrograms/min) was administered to 20 women with severe preeclampsia (10 in each group). The induced hypotensive response was similar with both drugs but the maximum reduction in blood pressure was achieved sooner with dihydralazine (4 hours) compared with prostaglandin A1 (7.5 hours). The more gradual hypotensive response is probably less dangerous on placental perfusion than a sudden change. Moreover, the oxytocic property of prostaglandin A1 shortened the time to delivery, which constitutes another potential advantage.

Blood Pressure↗

Pharmacological effects and metabolism of neurotensin and bradykinin in the isolated rat uterus.

Neurotensin (NT) and bradykinin (BK) were found to cause contractions of isolated rat uterus preparations. In 97% of the experiments, acute tachyphylaxis followed soon after the initial administration of NT. Interrelation between the oxytocic effects of NT and BK was not observed. Among the NT fragments studied, only NT-(9-13) had an oxytocic effect (less than 1.0%). All NT fragments tested induced tachyphylaxis to NT regardless of their efficacy. Using HPLC analysis, NT but not BK was found to be degraded by the intact rat uterus. A major involvement of a carboxydipeptidase cleaving at Tyr11-Ile12 is suggested. Carboxyl-blocked neurotensinamide (NT-NH2) was found to be resistent to proteolysis and not develop tachyphylaxis. No cross-tachyphylaxis was observed with NT or NT-(1-11). The results suggest the existence of different receptors for NT and BK in the uterus, as well as the existence of different receptors or receptor states that interact with NT or NT-NH2 in the rat uterus.

Animals↗

Uterine rupture in pregnancy reviewed.

Uterine rupture is associated with maternal and fetal mortality and morbidity. In developed countries there have been many recent advances in the management of labour. This study, therefore, reviewed this Hospital's experience of uterine rupture in the decade 1982 to 1991. Excluding cases of asymptomatic scar dehiscence, there were 15 cases of uterine rupture in 65,488 deliveries, giving an overall incidence of 1 in 4,366. There was no case of rupture in 21,998 primigravidas. Of the 15 cases, only two occurred in 39,529 multigravidas without a previous uterine scar (1 in 19,765), and 13 cases occurred in the 3,961 multigravidas with a previous caesarean section scar (1 in 304). Twelve of the 13 ruptures after caesarean section occurred in the delivery immediately after the section. There were no maternal deaths but five (33%) patients required a hysterectomy. Three of the five perinatal deaths were attributable to the rupture. Ten of the 15 patients had labour induced, and a total of 13 patients received an oxytocic agent. Of the 15 cases, 8 were diagnosed during labour and 7 postpartum. Compared with earlier reports from Dublin, the incidence of uterine rupture was low due to a decrease in the number of ruptures associated with trauma or obstetric manipulation. The main associated feature was previous caesarean section. This review highlights the risk of uterine rupture when an oxytocic agent is administered to a multigravid patient with a previous caesarean section scar.

Female↗

The effects of progesterone, prostaglandin F2alpha and oxytocin on the calcium-activation of the uterus.

The relationship between "activator-calcium" (A-Ca), progesterone (P), prostaglandin F2alpha (PGF2alpha) and oxytocin (Oxy) has been examined in 100 uterine strips of 34 pregnant and 100 strips of 34 post partum rabbits. At the 25th day of gestation, uterine P was 13.9+/-1.3 ng/g, while within 3-12 hours post partum 3.3+/-0.3 ng/g tissue (P less than 0.001). Uterine strips, mounted isometrically in Krebs' solution, sustained maximum excitability in a steady state when exposed every 30 seconds for 4 seconds to an electric field of 12 V/5 cm (a.c.). The maximally contracting muscles were then rinsed at intervals of 6 minutes with Ca-free Krebs. In Ca-free Krebs, the post partum uterus lost 31% of its Ca and 96% of its excitability in a short 25 minutes, while the pregnant uterus lost 30% of its Ca and 93% of its excitability in 50 minutes (P less than 0.001). Since the extracellular space is approximately 30% in the uterus, this approximately 30% Ca, lost by both muscles, most probably was extracellular Ca and the small A-Ca fraction which is presumably "bound" more strongly at the membrane systems of the P-dominated pregnant, than the non-dominated post partum uterus. The significantly faster and more complete recovery from Ca-deficiency and inexcitability of the pregnant than the post partum uterus (P less than 0.001), at different levels of external Ca, further substantiates this premise. So does the demonstration that exposure to Ca-free Krebs increases 45Ca-efflux 400% in the post partum and only 110% in the pregnant uterus (P less than 0.001). Exposure to 100 ng/ml PGF2alpha in normal Krebs has a similar effect on the 45Ca-efflux of the post partum uterus, while the response of the pregnant uterus is indistinct (P less than 0.001). These highly significant differences between the post partum and the pregnant uteri in their Ca-efflux explain the higher threshold (P less than 0.001) and lower "sensitivity" to PGF2alpha and Oxy (P less than 0.001) of the pregnant than the post partum uterus. The already very highly significant differences between the two muscles, in threshold and sensitivity to these two most potent oxytocics, were increased still further by rendering the uterine strips Ca-deficient. All together, these findings substantiate the early contention (1-7, 18, 19) that uterine function at the cellular level is regulated by opposing actions of the suppressor P and the intrinsic stimulant PG or other oxytocic agents on threshold, excitability and the Ca-activation of the contractile process.

Animals↗

Survey of the management of third stage of labour in The Netherlands.

UNLABELLED: The standard practice during the third stage of labour of Dutch midwives and obstetricians was elucidated by a questionnaire mailed to all Dutch midwives and obstetricians. Prophylactic oxytocics in the third stage are used as a routine by 55% of the obstetricians and only 10% of the midwives. Oxytocin is the drug of first choice. CONCLUSION: Routine use of prophylactic oxytocics in the third stage is not the standard practice in the Netherlands. Obstetricians are much more likely to use prophylaxis than midwives.

Female↗