Effects of oxytocin induction on early postpartum hemorrhage, perineal integrity, and breastfeeding: a case-control study

SUMMARY OBJECTIVE: The aim of this study was to evaluate the postpartum hemorrhage, perineal integrity, and breastfeeding results of mothers who underwent oxytocin induction in the first stage of labor in the early postpartum period. METHODS: This single-center observational case-control study was conducted in the obstetric unit of a public hospital in Istanbul. The study sampling included 44 pregnant women who received oxytocin induction (case group) and 44 pregnant women who did not receive oxytocin (control group). The Personal Information Form, LATCH Breastfeeding Assessment Tool, Breastfeeding Self-Efficacy Scale, Redness, Edema, Ecchymosis, Discharge, and Approximation Scale, and Postpartum Hemorrhage Collection Bag were used in data collection, and pad follow-up was carried out. RESULTS: The amount of hemorrhage in the first 24 h of the postpartum period and the mean Redness, Edema, Ecchymosis, Discharge, and Approximation Scale score were significantly higher in the case group. While 47.7% of the oxytocin-induced women had 1st or 2nd, and 11.4% had 3rd or 4th degrees of lacerations, 20.5% of the control group had 1st or 2nd, and 2.3% had 3rd or 4th degrees of lacerations. There was no significant difference between the mean scores of the Breastfeeding Self-Efficacy Scale and LATCH Breastfeeding Assessment Tool in both groups. CONCLUSION: According to the study findings, it was determined that oxytocin induction administered in the first stage of labor increased hemorrhage and perineal trauma in the early postpartum period but did not affect the results of breastfeeding. Clinical Trial Registration Number: NCT04441125.

El consumo de bebidas dulces incrementa diferencialmente la expresión de Oxitocina en núcleos hipotalámicos / The consumption of sweet drinks differentially increases the expression of oxytocin in hypothalamic nuclei

Resumen Se reconoce la participación de la oxitocina en el control de la alimentación, pero su mecanismo de acción no se ha establecido totalmente. Por tanto, el objetivo de esta investigación fue evaluar el efecto del acceso intermitente a una solución de sacarosa, sobre la expresión de las neuronas del núcleo paraventricular (PVN) y del núcleo supraótico (SON) que producen oxitocina (Oxt), y caracterizar la microestructura de la conducta de beber en ratas saciadas. Se tuvieron tres grupos de ratas macho Wistar saciadas, y en la primera hora al inicio del periodo de luz, el grupo Control tuvo agua, el grupo Restringido 5g de una solución de sacarosa al 20% y el grupo Ad libitum acceso libre a la solución de sacarosa. Los sujetos incrementaron el consumo de la solución de sacarosa a pesar de estar saciados; debido a la interrupción del estado de saciedad y la demora de la satisfacción. La actividad de las neuronas de Oxt se incrementó en ambos núcleos, en el grupo Restringido la mayor expresión se observó en el SON y en el grupo Ad libitum en el PVN. No se encontró correlación entre la cantidad de bebida ingerida y la actividad de las neuronas Oxt.

Abstract The role of oxytocin in feeding control is recognized, but its mechanism of action has not been fully established. Therefore, the aim of this research was to evaluate the effect of intermittent access to a sucrose solution on the expression of paraventricular nucleus (PVN) and supraotic nucleus (SON) neurons that produce oxytocin (Oxt), and to characterize the microstructure of drinking behavior in satiated rats. Three groups of male Wistar rats satiated were used, and in the first hour at the beginning of the light period, a Control group had water, a Restricted group 5g of a 20% sucrose solution and Ad libitum group with free access to sucrose solution. The experimental subjects increased the consumption of the sucrose solution despite being satiated, due to the interruption of the state of satiety and the delay of the satiation process. Oxt neurons increased their activity in both nuclei, in the Restricted group the highest expression was observed in the SON and in the Ad libitum group in the PVN. No correlation was found between the amount of drink ingested and the activity of Oxt neurons.

Papel de las hormonas progesterona, estradiol y oxitocina en la función del miometrio durante el embarazo y el trabajo de parto / Role of progesterone, estradiol and oxytocin hormones in myometrial function during pregnancy and labor

Resumen El trabajo de parto es la transición de un estado de inactividad y relajación muscular a un estado de excitación, en el cual la capa muscular del útero (miometrio) realiza crecientes contracciones coordinadas para llevar a cabo la expulsión del feto y la placenta. Durante el inicio del trabajo de parto, el miometrio experimenta una serie de cambios fisiológicos, bioquímicos y moleculares, pasando de un estado de quiescencia a un fenotipo contráctil que inducirá el parto. En parte, esto es provocado por la acción de las hormonas progesterona, estradiol y oxitocina. En general, la progesterona mantiene la quiescencia del miometrio durante el embarazo al inhibir la expresión de moléculas proinflamatorias y proteínas asociadas a la contracción, mientras que al término del embarazo, el estradiol induce la expresión de dichas moléculas. Por su parte, la oxitocina induce un aumento en la concentración de calcio intracelular para llevar a cabo las contracciones de los miocitos uterinos. El objetivo del presente trabajo es presentar un resumen acerca de los mecanismos moleculares involucrados en la regulación de la actividad de las células miometriales por medio de las hormonas progesterona, estradiol y oxitocina, así como discutir las perspectivas de esta interesante área de investigación.

Abstract Labor is the transition from a state of inactivity and muscle relaxation to a state of muscle excitation, in which the muscular layer of the uterus (myometrium) performs increasingly coordinated contractions to deliver the fetus and expel the placenta. During the onset of labor, the myometrium undergoes a series of physiological, biochemical, and molecular changes, allowing the tissue to transition from a quiescent state to a contractile phenotype that will support labor. This is partly caused by the action of the hormones progesterone, estradiol, and oxytocin. In general, progesterone maintains the quiescence of the myometrium during pregnancy by decreasing the expression of proinflammatory molecules and contraction-associated proteins. In contrast, at the end of pregnancy, estradiol induces the expression of these molecules. For its part, oxytocin induces an increase in intracellular calcium concentration to carry out the contractions of uterine myocytes. The objective of this review is to present a summary of the molecular mechanisms involved in regulating myometrial cell activity through the hormones progesterone, estradiol and oxytocin, as well as to discuss the perspectives of this exciting area of research.

Progress based on the clinical translation of the anxiolytic effects of oxytocin / 四川精神卫生

The etiology and pathogenesis of anxiety disorders were still unknown with limited progress in treatment， and had a low cure rate and a high relapse rate. Oxytocin has attracted attention in recent years due to its anxiolytic effect， especially validated in animal experiments， but there are few studies in humans. Therefore， the purpose of this paper is to illustrate the pathological mechanism of anxiety through review researches on oxytocin and anxiety in recent years. Anxiety disorder is one of the most common mental disorder， and the imbalance of neurotransmitters is one of the pathogenesis. As a common neurotransmitter in the brain， oxytocin participated in the process of anxiety regulation. The purpose of this article is to summarize the research related to oxytocin to explore its possible mechanism of regulating anxiety， and to provide new ideas for diagnosis and treatment of anxiety disorders in combination with the clinical findings. ［Funded by Zhejiang Health Science and Technology Plan （number， 2022KY367）］.

Tipos de partos y niveles de oxitocina, cortisol y hormonas tiroideas en plasma del cordón umbilical / Types of deliveries and levels of oxytocin, cortisol and thyroid hormones in umbilical cord plasma

Introducción: La placenta sintetiza y secreta varias hormonas que permiten la regulación del embarazo, el trabajo de parto y la adaptación metabólica materno-fetal. Su comportamiento asociado al tipo de parto puede dar información relevante sobre efectos epigenéticos. Objetivo: Describir el tipo de parto con los niveles de oxitocina, cortisol y hormonas tiroideas en plasma de cordón umbilical al nacer. Método: A 50 mujeres con embarazos principalmente normales se les cuantificaron los niveles neurohormonales en plasma de cordón umbilical, obtenido inmediatamente tras el periodo expulsivo. Los resultados se incorporaron a la base de datos clínicos de cada participante y se analizaron con Stata v.14.0. El protocolo fue aprobado por el comité de ética. Resultados: Hubo 33 partos vaginales (12 espontáneos, 13 acelerados y 8 inducidos) y 17 cesáreas (7 electivas y 10 de urgencia). Se observaron mayores niveles de cortisol en los partos vaginales acelerados; las cesáreas tuvieron menores niveles de cortisol y hormona estimulante de la tiroides. Las intervenciones clínicas, con altos o bajos niveles hormonales, están en directa relación con el tipo de parto. Conclusiones: El cortisol y la hormona estimulante de la tiroides medidos en plasma de cordón umbilical variaron según el tipo de parto. Esto es una primera cuantificación de hormonas en plasma de cordón umbilical y su posible regulación placentaria a propósito del tipo de parto.

Introduction: The placenta synthesizes and secretes several hormones allowing the regulation of pregnancy, labor and maternal-fetal metabolic adaptation. Their behavior associated with the type of delivery, may provide relevant information on epigenetic effects. Objective: To describe the type of delivery with the levels of oxytocin, cortisol and thyroid hormones in umbilical cord plasma at birth. Method: Neurohormonal levels from umbilical cord plasma obtained immediately post expulsion, were quantified in 50 women with mainly normal pregnancies. Results incorporated into the clinical database of each participant, statistically analyzed in Stata v.14.0. Protocol approved by ethics committee. Results: 33 were vaginal deliveries (12 spontaneous, 13 accelerated, 8 induced) and 17 cesarean sections (7 elective and 10 emergency). Higher cortisol levels were observed in accelerated vaginal deliveries, cesarean sections had lower cortisol and thyroid stimulating hormone levels. While clinical interventions, with high or low hormone levels, were related to the type of delivery. Conclusions: Cortisol and thyroid stimulating hormone measured in umbilical cord plasma varied according to the type of delivery. This is a first quantification of hormones in umbilical cord plasma and their possible placental regulation in relation to the type of delivery.

Association of maternal salivary oxytocin levels with feeding patterns and depressive mood / 中华行为医学与脑科学杂志

Objective:To explore the association between different feeding patterns, emotional states, and salivary oxytocin (OT) levels during breastfeeding.Methods:From January to December 2019, 153 pairs of 3-month-old infants and their mothers were recruited from 4 maternal and child health hospitals in Chongqing, Liuzhou, Dalian and Hangzhou in China.Saliva samples were collected from the mothers at the first 5 minutes of feeding, 5 minutes during feeding, and 10 minutes after feeding.Edinburgh postnatal depression scale (EPDS) was used to evaluate maternal depression.Infants were divided into exclusive breastfeeding group and artificial feeding group according to feeding patterns.ELISA of salivary oxytocin was performed by ELISA kits, and the OT levels measured at the 3 time points were converted using linear interpolation.Area under the curve with respect to ground(OTAUCG) was used to represent the total concentration of salivary OT during the mother's breastfeeding.SPSS 25.0 software was used for statistical analysis.Multiple linear regression analysis and two factors analysis of variance were used to explore the association between different feeding methods, emotional state and salivary oxytocin during breastfeeding.Results:The results of the two factors analysis of variance showed that the interaction between feeding pattern and mother's emotion was not significant ( F=2.440, P=0.120), the main effect of mother's emotion was not significant ( F=0.380, P=0.539), and the main effect of feeding style was significant ( F=3.350, P=0.021). The level of OTAUCG under pure breastfeeding ((151 561.47±75 738.11) pg/mL) was higher than that under artificial feeding ((122 269.03±65 029.88) pg/mL), and the difference was statistically significant ( P=0.02). There was no statistically significant difference in OTAUCG levels between mothers with normal emotions ((146 106.37±75 106.76) pg/mL) and mothers with depressed emotions ((129 079.56±67 565.87) pg/mL) ( P=0.221). Multiple stepwise regression analysis showed that artificial feeding had a negative predictive effect on maternal salivary OT levels compared to exclusive breastfeeding( β=-0.211, t=-2.513, P=0.013). Conclusion:Feeding pattern is a factor that affects the mother's salivary OT level, and breastfeeding can improve the mother's OT level.

Estudio piloto: contacto padre-hijo(a) y oxitocina en varones preparados especialmente para el nacimiento / Pilot study: father-child contact and oxytocin in males with a special education for childbirth

INTRODUCCÍON: Los padres se han involucrado cada vez más en el embarazo y el nacimiento de sus hijos, pero aún se requieren intervenciones paternas que permitan reubicar al padre en su rol de corresponsabilidad en la crianza. OBJETIVO: Observar el comportamiento-actitud paterna hacia el/la hijo(a) y la cantidad de oxitocina (OT) secretada en el nacimiento, en padres preparados de un modo especial para el parto. Método: Estudio piloto de 8 meses, parte de una investigación mayor cuali-cuantitativa de dos fases. La fase cualitativa inicial desarrolló una intervención preparatoria de padres para el nacimiento, con énfasis en la vinculación padre-hijo(a). La fase cuantitativa correspondió al piloto de la intervención paterna antenatal. RESULTADOS: Los padres presenciaron activamente el momento del expulsivo y el encuentro madre-hijo(a). Posteriormente, todos optaron por el contacto físico piel-piel con su hijo(a). La OT paterna experimentó un aumento (no significativo) durante el contacto padre-hijo(a) en comparación con la OT basal (momento inmediato al nacimiento). CONCLUSIONES: Padres preparados, sensibilizados y vinculados con su hijo(a) desde el embarazo experimentarían variaciones de la cantidad de OT cuando realizan contacto piel-piel con su hijo(a) en el nacimiento. Se requiere investigación experimental con una muestra mayor de participantes para concluir de manera categórica.

INTRODUCTION: Fathers have been increasingly involved in the pregnancy and birth of their children, but paternal interventions are still required to relocate the father in his role of co-responsibility in parenting. OBJECTIVE: To observe the paternal behavior-attitude towards the child and the amount of oxytocin (OT) secreted at birth in parents prepared (in a special way) for childbirth. METHOD: Pilot study of 8 months, part of a larger qualitative-quantitative research of two phases. The initial qualitative phase developed a male preparatory intervention for the birth, with emphasis on the father-child bonding. The quantitative phase corresponded to the pilot of the antenatal paternal intervention. RESULTS: Fathers actively witnessed the moment of delivery and the mother-child attachment. Subsequently, all of them opted for physical skin-to-skin contact with their child. Paternal OT experienced a (non-significant) increase during father-child contact, compared to baseline OT (immediately after birth). CONCLUSIONS: Males prepared, sensitized and involved with their child since pregnancy would experience variations in the amount of OT when they make father-child skin-to-skin contact at childbirth. Experimental research with a larger sample of participants is required to categorically reach a conclusion.

Efecto contráctil del extracto acuoso de Artemisia absinthium (ajenjo) frente a oxitocina en útero aislado de ratas / Contractile effect of aqueous extract of Artemisia absinthium (ajenjo) against oxytocin in isolated uterus of rats

RESUMEN Introducción. El uso de Artemisia absinthium (ajenjo) en el trabajo de parto es ampliamente empleado en países de la región; sin embargo, no hay evidencia científica suficiente de su eficacia y seguridad, lo que representa un alto riesgo maternofetal. Objetivo. El propósito fue evaluar el efecto contractil de la Artemisia absinthium (ajenjo) en comparación a la oxitocina en útero aislado de ratas. Métodos. Se separaron 8 ratas Holtzman en i) Grupo experimental: Artemisia dosis 5, 10, 20, 30, 40 y 50 mg y ii) Grupo control: oxitocina 10-6 M. Se montaron los úteros en un baño de órganos aislados y se registraron contracciones por 5 minutos. Resultados. La frecuencia de contracciones con ajenjo 40 y 50 mg fueron comparables con oxitocina (p>0,05). Asimismo, dosis de 20 y 30 mg de Artemisia provocaron contracciones significativamente más duraderas que la oxitocina. La intensidad resultó ser comparable con oxitocina con dosis de 20, 40 y 50 mg de Artemisia. Conclusión. El extracto acuoso de Artemisia absinthium presentó efecto contráctil similar a la oxitocina y dependiente de la dosis en útero aislado de ratas.

ABSTRACT Introduction. The use of Artemisia absinthium (wormwood) in labour is widely used in countries in the region; however, there is no enough scientific evidence of its efficacy and safety, which represents a high maternalfetal risk. Objective. The purpose was to assess the contractile effect of Artemisia absinthium (wormwood) compared to oxytocin in utero isolated from rats. Methods. Eight Holtzman rats were separated into i) Experimental group: Artemisia dose 5, 10, 20, 30, 40, and 50 mg and ii) Control group: oxytocin 10-6 M. The uteruses were mounted in an isolated organ bath, and contractions were recorded for 5 minutes. Results. The frequency of contractions with wormwood 40 and 50 mg were comparable with oxytocin (p>0.05). Likewise, doses of 20 and 30 mg of Artemisia caused significantly longer-lasting contractions than oxytocin. The intensity was found to be comparable with oxytocin at doses of 20, 40, and 50 mg of Artemisia. Conclusion. The aqueous extract of Artemisia absinthium has a contractile effect similar to oxytocin and is dose dependent in utero isolated from rats.

A multicenter, double-blind, randomized controlled clinical trial comparing ergometrine with oxytocin and oxytocin alone for prevention of postpartum hemorrhage at cesarean section / 中华妇产科杂志

Objective:To compare oxytocin combined with ergometrine with oxytocin alone in terms of primary prophylaxis for postpartum hemorrhage (PPH) at the time of cesarean section (CS).Methods:This was a multicenter double-blind randomized controlled interventional study comparing ergometrine combined with oxytocin and oxytocin alone administered at CS. From December 2018 to November 2019, a total of 298 parturients were enrolled in 16 hospitals nationwide. They were randomly divided into experimental group (ergometrine intra-myometrial injection following oxytocin intravenously; 148 cases) and control group (oxytocin intra-myometrial injection following oxytocin intravenously; 150 cases) according to 1∶1 random allocation. The following indexes were compared between the two groups: (1) main index: blood loss 2 hours (h) after delivery; (2) secondary indicators: postpartum blood loss at 6 h and 24 h, placental retention time, incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution; (3) safety indicators: nausea, vomiting, dizziness and other adverse reactions, and blood pressure at each time point of administration.Results:(1) The blood loss at 2 h after delivery in the experimental group [(402±18) ml] was less than that in the control group [(505±18) ml], and the difference was statistically significant ( P<0.05). (2) The blood loss at 6 h and 24 h after delivery in the experimental group were less than those in the control group, and the differences were statistically significant (all P<0.05). There were no significant differences between the two groups in the incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution (all P>0.05). (3) Adverse reactions occurred in 2 cases (1.4%, 2/148) in the experimental group and 1 case (0.7%, 1/150) in the control group. There was no significant difference between the two groups ( P>0.05). The systolic blood pressure within 2.0 h and diastolic blood pressure within 1.5 h of drug administration in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05), but the blood pressure of the two groups were in the normal range. Conclusion:The use of ergometrine injection in CS could reduce the amount of PPH, which is safe and feasible.

Summary of best evidence for management of labor course induced by oxytocin drip in term pregnancy / 中国实用护理杂志

Objective:To search, evaluate and summarize the best evidences related to induction of labor by oxytocin infusion in pregnant women with full-term pregnancy, and to provide reference for clinical practice in order to reduce the complications during labor, such as the proportion of instrument delivery, prolonged labor duration, uterine rupture, postpartum hemorrhage, etc. Standardize the management process of induction of labor with oxytocin, improve the satisfaction of pregnant women to participate in the decision of induction of labor, and improve the outcome of the newborn.Methods:Take the evidence-based nursing method, in view of the full-term pregnancy pregnant women oxytocin drip induced labor evidence-based labor management problems, nearly 10 years related literature retrieval from January 1st 2011 to April 9th, 2021, the Australian JBI evidence-based health care center of literature quality evaluation criteria and evidence classification system, all kinds of research evaluation and classification of retrieval.Results:Early detection to 340 articles, and eventually into 9 articles, including 1 clinical decision, 6 guides, 2 pieces of system evaluation. Totally 45 pieces evidences related to induction of labor by oxytocin infusion in pregnant women with full-term pregnancy were sumarized, including induced labor time, oxytocin side effects, induced labor before evaluation, induced labor of guardianship, infusion solution, such as health education, and other seven aspects.Conclusions:The present study summarized 45 pieces of best evidence on the management of labor induced by oxytocin infusion during term pregnancy, which provided some evidence-based basis for midwives, obstetric nurses and managers. Through the application of the best evidence, it is beneficial to improve the outcome of pregnant women in the neonatal perinatal period, standardize the process of inducing labor with oxytocin, and improve the quality of obstetric care.

Effects of oxytocin on neonatal lactation behavior expression and breastfeeding / 中国实用护理杂志

Objective:To investigate the effect of oxytocin on neonatal instinctive behavior expression and breast-feeding.Methods:A total of 71 pairs of parturient women and their newborns who delivered in the delivery room of the Affiliated Hospital of Weifang Medical College from February to May 2021 were selected. According to whether oxytocin induced labor, they were divided into the oxytocin group and the control group. Widstr?m nine stages was used to observe and record neonatal behavior. Breastfeeding was followed up 3 days and 3 months after delivery.Results:Totally 35 pairs in each group were included. In the oxytocin group, the occurrence time of neonatal head or head turning, hand in mouth, body moving to nipple, lips touching areola, licking nipple, nipple and effective sucking were (18.2 ± 5.4), (27.8 ± 8.3), (31.0 ± 10.1), (44.3 ± 14.5), (47.2 ± 15.6), (49.4 ± 16.3), (48.3 ± 13.6) min, which were significantly later than those in the control group (15.3 ± 5.3), (21.0 ± 8.1), (24.3 ± 9.0), (34.0 ± 11.4), (37.2 ± 11.9), (38.6 ± 11.8), (39.6 ± 8.7) min. The difference was statistically significant ( t values ranged from -3.10 to -2.17, P<0.05). The duration of neonatal awakening, activity, crawling and familiarity in the oxytocin group were (6.9 ± 3.2), (18.9 ± 9.3), (13.6 ± 7.9), (9.2 ± 5.1) min, which were significantly longer than those in the control group (5.1 ± 2.8), (12.3 ± 7.1), (10.3 ± 5.3), (6.7 ± 4.3) min; sucking stage duration in the oxytocin group was (35.1 ± 7.2) min, which was significantly shorter than that in the control group (39.6 ± 7.1) min; all the differences were statistically significant ( t values ranged from -3.25 to 2.28, P<0.05). The times of exclusive breast-feeding in the oxytocin group were (2.8 ± 3.1), (4.5 ± 3.3), (6.9 ± 3.0) at 24, 48 and 72 h postnatal, and the exclusive breastfeeding rate at 3 months after birth was 77.1%(27/35), which were significantly lower than those (7.6 ± 3.6), (8.9 ± 2.7), (10.3 ± 2.0) and 82.9%(29/35) in the control group, the differences were statistically significant ( t=6.05, 6.11, 5.48, χ2=0.36, P<0.05). Conclusions:The use of oxytocin during labor may affect the expression of neonatal lactation behavior and negatively affect the breastfeeding.

Effects of oxytocin versus promestriene on genitourinary syndrome: a pilot, prospective, randomized, double-blind study

Abstract Objectives: In this pilot, prospective, randomized, double-blind study, the authors compared the efficacy of oxytocin with promestriene in improving vaginal atrophy of Genitourinary Syndrome of Menopause (GSM). Methods: A total of 51 postmenopausal women with symptoms of GSM were evaluated. They were randomized into two groups: oxytocin (25 patients) and promestriene (26 patients) and were evaluated before and after 90 days of treatment; the evaluation was based on the domains of the Female Sexual Function Index (FSFI) (lubrication, satisfaction, and pain during sexual intercourse), clinical visual examination, and vaginal wall thickness. Results: After the use of the medications, both groups showed significant improvement in the three evaluated FSFI domains (p < 0.05) and there was no significant difference between the groups (p > 0.05). On clinical examination, the medications improved all the evaluated parameters but without statistical significance (p > 0.05). The evaluation of the thickness of the vaginal epithelium showed that both treatments led to increase in the vaginal epithelium (p < 0.05); however, the efficacy of promestriene was higher than that of oxytocin (p < 0.05). Conclusions: Both medications were effective, however, studies with larger samples and longer follow-ups are needed to confirm the clinical applicability.

Análise das boas práticas de atenção ao parto em maternidade pública de Roraima / Analysis of good practices for child care in Roraima public maternity

Objetivo: Analisar se boas práticas de atenção ao parto estão sendo executadas e quais necessitam ser aperfeiçoadas no Hospital Materno Infantil Nossa Senhora de Nazaré (HMINSN), em Boa Vista-RR. Métodos: Foram registrados os partos normais de setembro de 2019 a março de 2020, pela equipe administrativa do hospital, na base de dados do Apice On. Nove recomendações de boas práticas da Organização Mundial da Saúde (OMS) foram avaliadas e comparadas com outros serviços do País. Resultados: Observou-se que, em comparação com outros serviços do Brasil, entre as nove práticas analisadas, quatro apresentaram melhor resultado no HMINSN, com alta proporção de acompanhantes (90,1%), aplicação de ocitocina no terceiro período (98,7%), amamentação na primeira hora pós-parto (81,5%) e baixo número de episiotomia (8,8%). Além disso, atingiu metas do Apice On em quatro boas práticas, que são a presença de acompanhante (meta: acima de 90%), a aplicação de ocitocina no terceiro período (meta: acima de 90%), o clampeamento tardio do cordão umbilical (meta: acima de 90%) e a episiotomia (meta: abaixo de 10%). Conclusão: Este estudo identificou que é preciso melhorar as taxas de prescrição de dieta livre e o contato pele a pele na primeira hora pós-parto. De modo geral, o HMINSN tem apresentado bons indicadores em relação a outros serviços do País e vem buscando aprimorar a organização da equipe e do serviço para que todas as recomendações da OMS sejam efetivamente praticadas.(AU)

Objective: Analyze whether good practices for child care are being carried out and which need to be improved at the Hospital Materno Infantil Nossa Senhora de Nazaré (HMINSN), in Boa Vista-RR. Methods: Normal deliveries from September 2019 to March 2020 were recorded by the hospital's administrative staff in the Apice On database. Nine recommendations of World Health Organization (WHO) good practices were evaluated and compared with other services in the country. Results: It was observed, in comparison with other services in Brazil, among the nine practices analyzed, four of them had better results at HMINSN, with a high proportion of companions (90.1%), application of oxytocin in the third period (98.7 %), breastfeeding in the first hour postpartum (81.5%) and low number of episiotomy (8.8%). In addition, it reached Apice On targets in four good practices, which are the presence of a companion (target: above 90%), the application of oxytocin in the third period (target: above 90%), the late clamping of the umbilical cord (target: above 90%) and episiotomy (target: below 10%). Conclusion: This study identified that it is necessary to improve the prescription rates of free diet and skin-to-skin contact, in the first postpartum hour. In general, HMINSN has presented good indicators in relation to other services in the country and has been seeking to improve the organization of the team and the service, so that all WHO recommendations are effectively practiced.(AU)

Preparation of oxytocin liposomes modified by cell penetrating peptides and evaluation on brain targeting efficiency via intranasal delivery / 药学学报

The water-soluble polypeptide drug oxytocin was encapsulated in liposomes by reverse-phase evaporation vesicle method to obtain oxytocin loaded liposomes (OT@LPs) which was further modified with cationic cell penetrating peptide—arginine octamer (R8) to get R8 modified oxytocin loaded liposomes (OT@LPs-R8) which showed enhanced mucoadhesive. The brain targeting efficiency was evaluated preliminarily after nasal administration. OT@LPs-R8 showed a round shape with a particle size distribution of 110.2 ± 7.3 nm, a surface potential as high as +18 mV, a drug loading (62.17 ± 1.88) %, an encapsulation rate (5.85 ± 0.72) %, and stood stable in nasal mucus. After nasal administration, it could significantly prolong the retention and enhance the distribution in the brain with no irritation to the nasal mucosa. The animal experiment in line with the regulations of the Department of Laboratory Animal Science of Fudan University on the ethics of animal experiments had been carried out after passing the review of the Animal Ethics Committee of Fudan University. The results showed nasal administration of OT@LPs-R8 could promote oxytocin directly into the brain from the nose which expected to become a new carrier for delivery of oxytocin to the brain.

Relationship between oxytocin receptor (OXTR) gene polymorphism and obsessive compulsive disorder in Chinese Han

ABSTRACT Recent research has shown that genetic variations in the oxytocin receptor (OXTR) may be related to variations in subtypes of obsessive-compulsive disorder (OCD). We aimed to explore the relationship between different subtypes of OCD and the genetic variation between rs1316193 and rs4686301 of the OXTR. In this case-control study, 92 OCD patients and 92 healthy controls were included in the OCD and control groups, respectively. The Y-BOCS scale was used to assess the severity of the OCD symptoms. The fasting peripheral blood samples were collected to extract DNA. rs4686301 and rs13316193 were genotyped using restriction fragment length polymorphism analysis techniques. Whether the gene frequency of the locus and the distribution of allele frequency were related to OCD were further study by TaqMan allele typing. The rs4686301 locus differed significantly between behavior and control groups. The genotype frequency and allele frequency at the rs4686301 locus were statistically significant between behavior and control groups (P<0.05). There was significant difference in the genotype frequency at the rs13316193 locus between behavior and control groups (P<0.05). The rs4686301 polymorphism of the OXTR may affect the clinical subtype of OCD. The rs13316193 polymorphism of the OXTR may be a risk factor for obsessive-compulsive behavior.

Rol de la oxitocina en patología psiquiátrica / Role of oxytocin in psychiatric pathology

Oxytocin is a neuropeptide that in mammals has important functions on different reproductive stages and socialization behaviors. In humans, its importance has been recognized in processes of social regulation such as social memory, affiliation, mentality and empathy. The objective of this work is to perform an updated review of the evidence about the role of oxytocin in psychiatric disorders. A bibliographic search was carried out on this topic through the Medline / PubMed and SciELO databases. The results show evidence on the possible etiopathogenic role of oxytocin in different clinical conditions. In addition, research has sought answers in this hormone to understand the different symptomatic profiles, such as emotional regulation, the recognition of emotions, the capacity for mentalization and the response to stress, which could operate as targets for possible therapeutic uses of oxytocin. Although the data are still incipient and inconclusive, oxytocin has been positioned as an important focus of neurobiological and therapeutic study in psychiatry for future research.

Síndrome de QT largo en la embarazada con el uso de la oxitocina

RESUMEN Introducción: Los síndromes de QT largo adquiridos pueden ser provocados por el uso de fármacos, dentro de los cuales se encuentra la oxitocina. Objetivo: Identificar los cambios electrocardiográficos con el uso de la oxitocina intravenosa en la embarazada. Método: Se realizó un estudio descriptivo-prospectivo con 57 embarazadas a las que se les realizó cesárea electiva y se le administró oxitocina, inmediatamente después de la extracción fetal, en el Hospital Universitario Gineco-Obstétrico Mariana Grajales de Villa Clara, Cuba, durante el período de septiembre de 2019 a enero de 2020. Resultados: El 63,2% de las pacientes tuvo un QT corregido 470 ms; en estas últimas, un 5,3% lo tuvo entre 481-500 ms, e igual porcentaje > 500 ms. Ninguna paciente presentó síntomas sugestivos o demostración electrocardiográfica de taquicardia ventricular u otras arritmias complejas. Conclusiones: La oxitocina, administrada en el período de alumbramiento, produjo prolongación del intervalo QT por encima de los valores normales en algunas pacientes, sin que se produjeran síntomas cardiovasculares, dispersión del QT o arritmias complejas.

ABSTRACT Introducción: Acquired long QT syndromes may be due to the use of drugs, within which oxytocin is included. Objetivo: To identify electrocardiographic disturbances related to intravenous oxytocin administration in pregnant women. Método: A descriptive-prospective study was conducted with 57 pregnant women who underwent elective caesarean section and were given oxytocin, immediately after fetal extraction, at the Hospital Universitario Gineco-Obstétrico Mariana Grajales in Villa Clara, Cuba, between September 2019 and January 2020. Resultados: The 63.2% of the patients had a corrected QT interval 470 ms; in the latter, 5.3% had it between 481-500 ms, and equal percentage > 500 ms. No patient presented suggestive symptoms or electrocardiographic demonstration of ventricular tachycardia or other complex arrhythmias Conclusiones: Oxytocin, given during the placental removal period, resulted in the prolongation of the QT interval above normal values in some patients, without the appearance of cardiovascular symptoms, QT interval dispersion or complex arrhythmias.

Perineal trauma in nulliparous women and its associated factors / Laceração perineal em nulíparas e seus fatores associados

INTRODUCTION: Perineal trauma is an important complication for women after giving birth. OBJECTIVE: To evaluate the prevalence of perineal trauma and its associated factors in nulliparous. METHODS: A retrospective cohort study was carried out, through the analysis of the medical records of women with singleton pregnancy who achieved vaginal birth of a live infant, in 2017, in a maternity hospital. Data collection involved information about demographic, obstetric, and clinical data from nulliparous women, and infant birthweight. Univariate and multivariate logistic analyses were performed to verify the association of perineal trauma with the variables assessed, with significant variables remaining in the model (p<0.05), through a stepwise strategy. RESULTS: A total of 326 medical records were analyzed. The percentage of perineal trauma was 60%. In the multivariate analysis, the use of oxytocin increased the chance of perineal trauma by 730%. In addition, the adoption of squatting position and hands and knees decreased the chances of perineal trauma by 81% and 97%, respectively, in comparison with those who adopted the lithotomy position, during the second stage labor. CONCLUSION: The rate of perineal laceration was high, but the severity was low. The use of oxytocin is associated with the presence of trauma and the squatting position and hands and knees, especially, have contributed to the protection of the perineum.

INTRODUÇÃO: Laceração perineal é uma complicação importante para mulheres pós-parto. OBJETIVO: Avaliar a prevalência de laceração perineal e seus fatores associados em primíparas. MÉTODOS: Foi realizado um estudo de coorte retrospectivo, através da análise dos prontuários de mulheres que pariram no ano de 2017, em uma maternidade da cidade. Durante a coleta de dados foi utilizada uma lista de checagem e um formulário para retirar informações sobre dados obstétricos, sociodemográficos e clínicos das mulheres e o peso do recém-nascido. Em seguida foram formuladas tabelas para determinação da associação entre as variáveis independentes e a presença de laceração. Logo após, foi feita a análise de regressão logística múltipla para identificar as variáveis mais fortemente associadas à laceração perineal. RESULTADOS: Um total de 326 prontuários foram analisados. O percentual de laceração perineal foi de 60%. Na análise multivariada, o uso de oxitocina aumentou a chance de laceração perineal em 730%. Além disso, a posição de cócoras e de quatro apoios diminuíram a chance de laceração perineal em 80% e 97%, respectivamente, em comparação com as mulheres que adotaram a posição de litotomia, durante o segundo período do parto. CONCLUSÃO: A taxa de laceração perineal encontrada foi alta, mas a gravidade foi baixa. O uso de ocitocina está associado com a presença de laceração perineal e a posição de cócoras e de quatro apoios contribuem para a proteção do períneo.

Structural, Functional, and Molecular Imaging of Autism Spectrum Disorder / 神经科学通报·英文版

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder associated with both genetic and environmental risks. Neuroimaging approaches have been widely employed to parse the neurophysiological mechanisms underlying ASD, and provide critical insights into the anatomical, functional, and neurochemical changes. We reviewed recent advances in neuroimaging studies that focused on ASD by using magnetic resonance imaging (MRI), positron emission tomography (PET), or single-positron emission tomography (SPECT). Longitudinal structural MRI has delineated an abnormal developmental trajectory of ASD that is associated with cascading neurobiological processes, and functional MRI has pointed to disrupted functional neural networks. Meanwhile, PET and SPECT imaging have revealed that metabolic and neurotransmitter abnormalities may contribute to shaping the aberrant neural circuits of ASD. Future large-scale, multi-center, multimodal investigations are essential to elucidate the neurophysiological underpinnings of ASD, and facilitate the development of novel diagnostic biomarkers and better-targeted therapy.