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PubMed1983

Abortifacient effects of the roots of Momordica angustisepala.

Aqueous extract of the root of Momordica angustisepala (Cucurbitaceae) has been studied for abortifacient effects in albino female mice. The aqueous extract containing 0.8 mg dry matter/ml at dosages of 3.5 ml and 4 ml per kg body wt. of the female mice and guinea pig, respectively, was administered i.p. Several hours after administration, the pregnant animals aborted their fetuses. The drug appears to be effective at all stages of pregnancy confirming its use by herbalists to induce abortion in humans in some parts of Nigeria. The mechanism of action appears to be similar to the actions of oxytocics and ergot alkaloids. However, hormonal influence may be implicated.

Abortifacient Agents↗

PubMedDate not supplied

Abortifacient properties of an extract from Sida veronicaefolia.

A fraction from an alcoholic extract of Sida veronicaefolia, previously reported to be a potent oxytocic, was studied for its abortifacient effects in pregnant rats. Oral doses producing the abortifacient effects were greater than or equal to 32 ml/kg when administered from the 15th-17th day of pregnancy. Similar effects were produced by intravenous doses of greater than or equal to 3 ml/kg. At the minimum effective oral dose of 32 ml/kg, those animals that carried the conceptuses to term (40%) had litters with reduced average number/litter and weight. At twice this dose, only 10% delivered and the litters were sickly. The effects of intravenous administration of the extract was similar but more pronounced and included also some unique acute effects.

Abortifacient Agents↗

PubMed1996

Effects of the volatile oil of Nigella sativa seeds on the uterine smooth muscle of rat and guinea pig.

The effects of the volatile oil of Nigella sativa seeds on the uterine smooth muscle of rats and guinea pigs was tested in vitro using isolated uterine horns. The volatile oil of Nigella sativa seeds inhibited the spontaneous movements of rat and guinea pig uterine smooth muscle and also the contractions induced by oxytocin stimulation. These effects were concentration-dependent and reversible by tissue washing. These data suggest that this volatile oil may have some anti-oxytocic potential.

Animals↗

PubMed2005

The extracorporeal perfusion of the swine uterus as an experimental model: The effect of tocolytic drugs.

OBJECTIVE: Comparison of the effect of tocolytic drugs on isolated swine uterus preparations. STUDY DESIGN: Forty swine uteri were perfused with the aim to preserve a viable organ, which should be responsive to oxytocic hormones and tocolytic pharmaca. An intrauterine catheter recorded the pressure changes. After initiation of rhythmical uterine contractions we administered known tocolytic drugs (fenoterol, ritodrine, terbutaline, propofol, acetylsalicylic acid, alcohol, atosiban, verapamil, and glyceryl trinitrate) in various concentrations. RESULTS: Perfusate pH and lactate, partial oxygen and carbon dioxide tensions, and oxygen saturation in the perfusate showed good preservation of the organ for up to 8h. All substances showed a tocolytic effect on the swine uterus. The effect varied substantially with regard to the length of the contraction free intervals, which was our main effect parameter. Fenoterol, acetylsalicylic acid, and alcohol showed the most and glyceryl trinitrate the least powerful effect. CONCLUSIONS: A direct comparison of various tocolytic substances in the same experimental model showed the best effect for fenoterol. Furthermore, we could demonstrate that the swine uterus perfusion system is a suitable model to study the influence of various conditions like the administration of drugs or the induction of oxidative stress on the uterus function.

Animals↗

PubMed2004

[Rectal misoprostol for postpartum hemorrhage].

OBJECTIVE: To evaluate a post-partum hemorrhage treatment guideline, using rectally administered misoprostol. PATIENTS AND METHODS: A descriptive study was carried out in a tertiary referral center from January 2002 to March 2003. During this period, 2670 patients delivered and 41 (1.5%) with severe post-partum hemorrhage unresponsive to oxytocin received 1000 microg of misoprostol (five tablets) rectally while awaiting sulprostone. Twenty-eight had delivered by the vaginal route and 13 by cesarean section. RESULTS: Hemorrhage was controlled among 63% (26/41) of the patients within 10 min of the administration of rectal misoprostol. Fifteen (37%) patients received both misoprostol and sulprostone and no major adverse effects were noted when combining these two prostaglandins. Overall, hemorrhage was controlled among 87% (36/41) of the patients when oxytocics were combined with misoprostol and sulprostone. Five patients (12%) did not respond to the combination of uterotonics and required a conservative surgical treatment. DISCUSSION AND CONCLUSION: Rectal misoprostol may be an effective second line treatment for the management of post-partum hemorrhage unresponsive to oxytocin. We did not observe major side effects when combining misoprostol with sulprostone. Our findings encourage further research on rectal misoprostol in the treatment of postpartum hemorrhage.

Administration, Rectal↗

PubMed2006

Pro-ejaculatory effect of the aqueous crude extract of cihuapatli (Montanoa tomentosa) in spinal male rats.

In the present study, the pro-sexual effect of the cihuapatli (Montanoa tomentosa) and its possible pro-ejaculatory properties in spinal male rats were examined. Systemic administration of the aqueous crude extracts of Montanoa tomentosa exerted a pro-ejaculatory effect and produced an increase in the number of discharges in the ejaculatory motor patterns in the spinal rats. The cihuapatli-induced ejaculatory responses included the expression of penile erections and penile movements and the potent expulsion of urethral contents and in some cases the expulsion of seminal plugs. The cihuapatli-induced ejaculatory motor patterns were similar to that obtained after systemic oxytocin. Cihuapatli- and oxytocin-induced ejaculatory motor responses and the penile erections and movements were abolished by the pre-treatment with hexamethonium, a selective oxytocin antagonist. Present data show that the cihuapatli extract acts directly at the spinal system in charge of the expression of the ejaculatory motor patterns and suggest that the aqueous crude extract exerts its aphrodisiacs properties by increasing sexual potency acting as an oxytocic agent.

Animals↗

PubMed1993

Dynamic ultrasonographic imaging of the third stage of labor: new perspectives into third-stage mechanisms.

OBJECTIVE: Dynamic ultrasonographic imaging of the third stage of labor was performed to document ultrasonographic findings and to present new perspectives into third-stage mechanisms. STUDY DESIGN: Twenty-five normal deliveries and five with prolonged third-stage labor were studied. RESULTS: Normal third-stage labor could be divided into four phases: (1) latent phase, characterized by thick, placenta-free wall and thin, placenta-site wall; (2) contraction phase, with thickening of placenta-site wall (from < 1 cm to > 2 cm); (3) detachment phase, in which the placenta completes its separation and detaches; and (4) expulsion phase, with a sliding movement of the placenta. Although oxytocic agents were routinely used, they do not seem to influence the findings. In five cases with retained placenta the placenta-site wall was initially thin. In four of them it became thick, and the placenta was removed by traction of the cord, whereas in the fifth case the placenta-site wall remained thin and the placenta had to be removed manually. CONCLUSION: Shearing forces seem to tear the decidual septae and thereby separate the placenta. This process is completed only when the placenta-site wall attains full thickness. In cases of prolonged third-stage labor, traction of the cord should be applied only when this phase is completed and the actual sliding movement of the placenta is observed.

Female↗

PubMed1983

Ripening of the human cervix with porcine ovarian relaxin.

Recent experience has suggested that porcine ovarian relaxin may promote cervical changes. We have performed two double-blind randomized studies: (1) comparing cervical changes with relaxin versus placebo during oxytocic labor induction and (2) as outpatients in postdates pregnancies. In the induction study, cervical changes were speeded up by both 2 and 4 mg doses of relaxin, and times to delivery were decreased. In the outpatient study, 2 mg doses of relaxin produced greater cervical changes than did control or 4 mg doses. We conclude that relaxin may have benefit in ripening of the cervix. Since relaxin works directly on the cervix and not through uterine contractions, relaxin may have advantages in cervical ripening of pregnancies in which stress to the fetus is an issue.

Adolescent↗

PubMed1981

Abortion during mid-pregnancy by rivanol-catheter supplemented with PGF2 alpha drip-infusion or quinine hydrocholoride.

Abortion during mid-pregnancy was performed in 200 patients by extra-amniotic insertion of Nelaton catheters and instillation of 0.1% rivanol solution. To shorten the abortion time, quinine hydrochloride was given orally in one group (n=100), and intravenous infusion of prostaglandin F2 alpha (PGF2 alpha) was undertaken in the other group (n=100). The abortion rate after 72 hours was higher in the PGF2 alpha group (96%) than that in the quinine group (91%), but the difference was not statistically significant. The abortion time was significantly shorter in the PGF2 alpha group than in the quinine group (p less than 0.01). This method, together with supplementary treatment with oxytocic substances, proved to be an effective mid-pregnancy abortion method. The risks of endometritis, gastro-intestinal complications, and/or heavy bleeding either during or post-abortive were minimal.

Abortion, Induced↗

PubMed1997

Vaginal ligature of uterine arteries during postpartum hemorrhage.

Immediate postpartum hemorrhage due to uterine inertia is usually treated by injection of oxytocics. In some situations, bleeding continues and distends the uterine cavity, in turn disturbing the hemostasis that accompanies uterine retraction. Uterine bleeding must be rapidly reduced while the coagulation defect is corrected. The authors propose the vaginal ligature of uterine arteries, which can be performed in the delivery room, as an alternative to hysterectomy.

Adult↗

PubMed1979

Dual actions of prostacyclin (PGI2) on the rat pregnant uterus.

Using strips of rat pregnant uterus, treated with indomethacin to suppress spontaneous contractility, the oxytocic activity of prostacyclin was compared with other prostaglandins. A prostacyclin concentration of 32 ng/ml elicited uterine contractions in all experiments. In this respect prostacyclin was 80 times more active than 6-oxo-PGF1 alpha but less active than PGE2 or PGF2 alpha. Apart from a direct stimulant effect, prostacyclin also exhibited an indirect potentiating action. In threshold concentrations prostacyclin caused a 3-fold potentiation of threshold doses of oxytocin. A lesser 1.5-fold potentiation of PGE2 alpha was also observed. The implications of these findings in relation to prostacyclin playing a role in parturition are discussed.

Animals↗

PubMed1982

Early pregnancy-abortion model using sulprostone.

Sulprostone has been demonstrated to be effective as a parenteral abortifacient, but not as a vaginal suppository. A vaginal preparation was given to 19 women to determine its mechanism of action, and to confirm the principle of uterine conversion as a biological model for the induction of an early abortion. The drug was administered to women with confirmed pregnancies and amenorrhea and not exceeding 49 days. A 95% success rate was obtained with an incidence of drug related side effects of 20% as opposed to the general 80-90% figure of PGE2 and F2a. The hormone profile obtained revealed a parallel fall in hCG and estradiol, and progesterone. This study confirms the value of uterine conversion, a concept that describes the change in uterine reactivity following PG administration and determines the phase when uterine activity is no longer dependent on exogenous oxytocic medication.

Abortion, Induced↗

PubMedDate not supplied

Can water immersion stop labor?

The basic response to any sort of immersion is a redistribution of blood volume. The intrathoracic blood volume expansion is associated with an increased release of the Atrial Natriuretic Peptide (ANP) and an alteration of the activity of the posterior pituitary gland. Whereas the effects of ANP on vasopressin secretion have been studied extensively, there is little study of its effects on oxytocic release. This is one reason why a dialogue is needed between midwives and specialized physiologists regarding the relationship between water immersion and the physiology of labor.

Atrial Natriuretic Factor↗

PubMed2006

Unsafe abortion: the preventable pandemic.

Ending the silent pandemic of unsafe abortion is an urgent public-health and human-rights imperative. As with other more visible global-health issues, this scourge threatens women throughout the developing world. Every year, about 19-20 million abortions are done by individuals without the requisite skills, or in environments below minimum medical standards, or both. Nearly all unsafe abortions (97%) are in developing countries. An estimated 68 000 women die as a result, and millions more have complications, many permanent. Important causes of death include haemorrhage, infection, and poisoning. Legalisation of abortion on request is a necessary but insufficient step toward improving women's health; in some countries, such as India, where abortion has been legal for decades, access to competent care remains restricted because of other barriers. Access to safe abortion improves women's health, and vice versa, as documented in Romania during the regime of President Nicolae Ceausescu. The availability of modern contraception can reduce but never eliminate the need for abortion. Direct costs of treating abortion complications burden impoverished health care systems, and indirect costs also drain struggling economies. The development of manual vacuum aspiration to empty the uterus, and the use of misoprostol, an oxytocic agent, have improved the care of women. Access to safe, legal abortion is a fundamental right of women, irrespective of where they live. The underlying causes of morbidity and mortality from unsafe abortion today are not blood loss and infection but, rather, apathy and disdain toward women.

Abortion, Illegal↗

PubMed1978

Upright posture and the efficiency of labour.

The claim that an upright maternal posture during labour improves the efficiency of the uterus to the benefit of both mother and fetus has been investigated in a randomised prospective study. 40 patients undergoing induction of labour were allocated to a recumbent group or an upright group. No differences were found between the groups in the length of labour, mode of delivery, requirements of oxytocic and analgesic drugs, or fetal and neonatal condition. Our data do not support calls to change conventional intrapartum nursing attitudes.

Adult↗

PubMed1985

Quinine and severe falciparum malaria in late pregnancy.

Quinine dihydrochloride was given intravenously to 12 women with severe falciparum malaria in the third trimester of pregnancy. The initial dose consisted of 10 or 20 mg salt/kg over 4 h and was followed by 10 mg salt/kg every 8 h until patients were fit to swallow, when quinine sulphate tablets were given. Uterine activity showed little or no change despite rising quinine concentrations. Of 3 patients in labour, 2 proceeded normally while a third had a successful caesarean section for fetal distress. Late (type II) decelerations of the fetal heart rate were recorded in 6 patients before treatment but in most patients signs of fetal distress diminished as the maternal temperature fell. Hypoglycaemia and hyperinsulinaemia developed in 7 patients, in 2 before quinine was started. The important toxic effect of quinine in late pregnancy is not an oxytocic action but rather its capacity to release insulin.

Adolescent↗

PubMed1986

Maternal mortality from Mendelson's syndrome: an explanation?

There have been major changes in obstetric and anaesthetic practice since 1946, including the introduction of intravenous infusions, oxytocics, tocolytic drugs, and endotracheal intubation. Some of these may adversely affect pulmonary water balance, which is probably already altered by pregnancy. These changes may have contributed to the increased severity of Mendelson's syndrome in pregnancy and to some extent explain the failure of prophylaxis to reduce maternal deaths.

Anesthesia, Obstetrical↗

PubMed1994

Oestrogen modulation with parturition in the human placenta.

An initial group of term (36-41 6/7 weeks), preterm (less than 36 weeks), and post-term (42 or more weeks) placentae were collected from women at delivery to determine the placental levels of important steroids and steroidogenic enzymes involved in the oestrogen synthesis pathway as a function of gestational age. A second group of placentae were obtained from women delivering at term before and after the onset of labour. Placentae were evaluated individually for cytosolic steroid hormone levels and microsomal steroidogenic enzyme activities. Oestradiol (E2), oestrone (E1), progesterone (P), and delta-4-androstenedione (A) were measured by radioimmunoassay in placental cytosols. Aromatase (AR), sulphatase (S), and 3 beta-hydroxysteroid dehydrogenase/isomerase (3 beta HSD) activities were assayed in placental microsomes. Cytosolic concentrations of E1, E2, P, and A did not differ with respect to gestational age. Correspondingly, the microsomal enzyme activities of 3 beta HSD, S, and AR did not vary as a function of gestational age. However, when patients at term who were in labour prior to delivery were compared to those who were not, the placental cytosolic level of E1 was found to be threefold higher in the non-labouring group (4572 versus 1427 pg/mg cytosolic protein, P < 0.025). Additionally, microsomal aromatase activity was also significantly higher in the non-labouring patients (46 versus 19 pM/min/mg protein, P < 0.025), while the E2 to P ratio in the labouring patients was twice that of the non-labouring group, a difference which was significant at the P < 0.025 level (Wilcoxon rank sum test). These data suggest that at term, prior to labour, the placental production of E1 by AR is high, and that AR activity and E1 levels fall significantly after the onset of labour. Also, the placental cytosolic concentration of the more active oestrogen, E2, demonstrates stable to rising levels with a significant increase in E2/P after the onset of labour. We theorize that in the term pregnancy prior to labour, E1 may represent a large but relatively inactive intracellular oestrogen pool which is maintained by high AR activity, and may function to protect the pregnant local uterine environment from the more oxytocic effects of E2.

3-Hydroxysteroid Dehydrogenases↗