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Montanoa tomentosa is used in traditional Mexican medicine to treat reproductive and mood disorders. Preclinical studies support the idea that acute administration of M. tomentosa induces an antidepressant-like response that may be related to oxytocin activation in hypothalamic cells, however, it is unknown whether this behavioral and neuroendocrine effect is maintained when chronically administered. Here, 39 adults male Wistar rats were subjected to two conditions: without and with the forced swimming test (FST). Each group received for 28 consecutive days p.o., vehicle (1 mL/kg); fluoxetine (1 mg/kg); or M. tomentosa (50 mg/kg). M. tomentosa and fluoxetine treatments significantly decreased the total immobility time compared with that using vehicle without producing any significant change in locomotor activity. No significant between-treatment differences were found in the number of oxytocinergic neurons, indicating that chronic infusion of M. tomentosa exerts antidepressant-like effects, similar to those of Fluoxetine, independently of oxytocinergic activation.
Montanoa tomentosa es utilizada en la medicina tradicional mexicana para tratar trastornos reproductivos y de estado de ánimo. Estudios preclínicos, reportan que la administración aguda de M. tomentosa produce efectos tipo antidepresivo asociados con la activación de células hipotalámicas oxitocinérgicas, pero se desconoce si estos efectos conductual y neuroendocrino se mantienen después de un tratamiento crónico. Se incluyeron 39 ratas macho adultas Wistar bajo dos condiciones: sin y con inducción de estrés por nado forzado. Cada grupo recibió durante 28 días consecutivos p.o., vehículo (1mL/kg); fluoxetina (1 mg/kg); o M. tomentosa(Mt; 50 mg/kg). Los tratamientos con M. tomentosa y fluoxetina disminuyeron significativamente el tiempo total de inmovilidad comparado con vehículo, sin cambio significativo en la locomoción. No hubo diferencias significativas en el número de neuronas oxitocinérgicas entre tratamientos, lo que indica que la infusión crónica de M. tomentosa ejerce efectos tipo antidepresivos similares a Fluoxetina, independientemente de la activación oxitocinérgica.
Subject(s)
Animals , Rats , Oxytocin/physiology , Montanoa , Depressive Disorder, Major/drug therapy , Neurons/drug effects , Drug Administration Schedule , Oxytocin/metabolism , Rats, WistarABSTRACT
A retained placenta is suspected when there is failure of expulsion of the placenta even after 30 minutes of delivery of the fetus. Retained placenta is a common cause of PPH and, hence, a significant cause of maternal mortality and morbidity in developing countries. Thus, early intervention is necessary to prevent this post-delivery of the baby. We present a case of retained placenta in a young primigravida with oligohydramnios with fetal horse horseshoe-shaped kidney and a foetal echogenic bowel loop. Her clinical findings and investigations were not significant at the time of admission. She was induced with dinoprostone gel intra-cervically and delivered via vaginal route. There was failure of expulsion of the placenta even after 30 minutes of delivery of the baby. Inj. syntocin 5 units were given via the umbilical cord. In the event of this failure, the patient was shifted inside the OT, and manual removal of the placenta was done under general anaesthesia f/b evacuation retained bits of placental membranes with ovum forceps under USG guidance. Retained placenta can lead to severe PPH and its consequences in the postpartum period. Thus, it requires timely intervention to prevent PPH and reduce maternal mortality and morbidity. Cases of retained placenta can occur even in the absence of any known identified risk factors and should be managed in a tertiary care centre with OT facilities.
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Background: Postpartum haemorrhage (PPH) stands as a prominent global contributor to maternal mortality. Oxytocin's short half-life and heat sensitivity pose challenges in resource-limited areas. Carbetocin, not requiring cold storage, is utilized in third-stage labor management. Consequently, this study aimed to compare the effectiveness of carbetocin with oxytocin in third-stage labor management.Methods: In this prospective study of 200 primigravida patients, group A received heat-stable carbetocin (100 ?g), while group B received oxytocin (10 IU) postpartum. Primary outcome such as mean blood loss in ml and Secondary outcomes such as proportion with blood loss >500 ml, need for uterotonic agents, blood transfusion, surgical PPH management, and drop in haemoglobin after 48 hours were recorded and compared.Results: Groups A and B, comparable in age, blood pressure, and mild anaemia, exhibited significant gestational age differences (p<0.0001). Group B had higher mean blood loss (377.68 ml) than group A (345.34 ml) with a significant p=0.0118*. Side effects showed no differences among groups. Postpartum, group B saw a significant 7% incidence of haemorrhage compared to none in group A (p=0.0071).Conclusions: Carbetocin showed superiority over oxytocin in the active management of third stage of labor, exhibiting a statistically significant reduction in PPH incidence and decreased requirement for additional uterotonic drugs.
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In tradition al Mexican medicine, plants from the Montanoa genus, family Asteraceae ( Montanoa tomentosa , Montanoa grandiflora , and Montanoa frutescens ) have been used to induce labor owing to their uterotonic properties like those produced by oxytocin (OXT). However, w hether infusions of these plants can activate hypothalamic OXT - producing neurons is unknown. To test this possibility, five independent groups of Wistar rats (n=4) were included: intact, vehicle, and three groups that received 50 mg/kg p.o. of M. tomentosa , M. grandiflora , and M. frutescens infusions, respectively. Ninety min after treatment, the brains were obtained and processed using double - labeled immunohistochemistry for Fos protein and oxytocin (Fos/OXT - ir). Rats that received Montanoa infusions had s ignificantly greater number of Fos/OXT - ir cells in the paraventricular (PVN) and supraoptic (SON) nuclei, with respect to intact and vehicle groups. These findings demonstrate that Montanoa infusions activated OXT neurons, an effect that may be related to the reported pharmacological properties.
En la medicina tradicional mexicana, plantas del género Montanoa , familia Asteraceae ( Montanoa tomentosa , Montanoa grandiflora y Montanoa frutescens ), se han utilizado para inducir el parto debido a sus propiedades uterotónicas, aparentemente similares a las producidas por la hormona oxitocina (OXT). Sin embargo, se desconoce si las infusiones de estas plantas pueden activar neuronas hipotalámicas productoras de OXT. Para probar esta posibilidad, se incluyeron cinco grupos independientes (n=4): intacto, vehículo y tres grupos que recibieron 50 mg/kg p.o. de infusiones de M. tomentosa , M. grandiflora , y M. frute scens , respectivamente. Noventa minutos después del tratamiento, los cerebros fueron obtenidos y procesados por doble marcaje de inmunohistoquímica para la proteína Fos y oxitocina (Fos/OXT - ir). Las ratas que recibieron infusiones de Montanoa aumentaron si gnificativamente el número de células Fos/OXT - ir en los núcleos paraventricular (PVN) y supraóptico (SON), respecto a los grupos intacto y vehículo. Estos hallazgos demuestran que las infusiones de Montanoa activan neuronas de OXT, lo que podría estar rela cionado con sus propiedades farmacológicas
Subject(s)
Animals , Rats , Oxytocin , Montanoa/chemistry , Neurons/drug effects , Immunohistochemistry , Plant Extracts/pharmacology , Rats, WistarABSTRACT
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.
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Objective:To explore the feature of FOS expression in oxytocin-and vasopressin-positive neurons in the hypothalamic paraventricular nucleus(PVN)under different status of diabetes mellitus(DM).Methods:Intraperito-neal injection of vehicle or STZ in mice was conducted to establish control or diabetes model.Mechanical sensitivity was evaluated by von Frey filament tests to distinguish diabetic neuropathic pain(DNP)from without-pain group(DWP).The expression of FOS,oxytocin(OXT)-and vasopressin(VP)-positive neurons,as well as their double labeling was detected by immunohistochemical and immunofluorescent staining.Cell counting and comparison were made in groups.Results:FOS expression was easily detected in the PVN in the three groups(Control group,DNP group and DWP group)at 7 days,while that in DWP and DNP groups at 28 days was hardly detectable,with the number being signifi-cantly different from the 7 days group(P＜0.05 or 0.001).Likewise,compared with the control group,immunofluo-rescent signals for VP and OXT staining in the DNP and DWP groups also showed a trend of weakening as the modeling time increased(P＜0.05).The cell counting after double staining for VP or OXT with FOS showed that,in the DWP group at 7 days,the number of VP and FOS double-labeled neurons was 74.33±22.10,accounting for(56.64± 7.52)％of VP-positive cells,whereas the double labeling rate for OXT and FOS was only(10.44±3.14)％.In the DNP group at 7 days,the number of OXT and FOS double-labeled neurons was 51.00±31.80,accounting for(18.50 ±9.51)％of OXT-positive neurons,whereas the double labeling rate for VP and FOS was only(9.34±3.27)％.In contrast to these changes in 7 days group,the expression of FOS decreased sharply in the group of 28 days,thereby al-most no double-labeled neurons.Conclusion:The plasticity changes of oxytocin-and vasopressin-positive neurons in the PVN are different depending on the status of pain and non-pain,and the stage of disease progression.Understanding the changes is of great significance for unravelling the neural mechanism of diabetes and its complications.
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Background: The third stage of labour is most crutial stage begins with expulsion of baby and end with expulsion of placenta and membranes. The present study was conducted to evaluate the scope of using prophylactic intramuscular carboprost tromethamine in comparison with intramuscular oxytocin for active management of third stage of labor.Methods: Patients were divided randomly into 2 groups 39 in each group. Patients assigned to group 1 received 10 units oxytocin IM and group 2 received carboprost 125 礸 IM after delivery of anterior shoulder of baby. The main outcomes measured were duration of third stage of labor, mean amount of blood loss, additional oxytocic requirement, HB changes in group and side effects of drug which were used in each group.Results: Subjects who received carboprost showed a significant reduction in duration of third stage of labor (P= 0.041), amount of blood loss (P=0.046) and requirement of additional oxytocic compared to the subject who received oxytocin 10 units.Conclusions: Carboprost 125礸 is better alternative compared to injection 10 units oxytocin in the prophylactic management of third stage of labor.
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Background: Postpartum Haemorrhage remains one of the leading causes of maternal morbidity and mortality worldwide. It is estimated that about one quarter to one half of preventable maternal deaths are because of haemorrhage. It is defined by the royal college of obstetrician and gynaecologist as blood loss from the genital tract within the first 24 hours after birth of at least 500ml (minor) and at least 1000ml (major) causes of post-partum haemorrhage (PPH) are commonly ascribed to the four Ts (tone, trauma, tissue, 4 thrombin).Methods: This study aimed to assess the clinical practices used by our hospital in managing major PPH. Observational study of the management of PPH over a period of 2 months from March 2023 to April 2023 was carried out. Criteria examined: history of previous PPH causes of PPH, use of oxytocin in the first stage for more than 6 hours. Role of blood transfusion, presence of senior faculty, and type of uterotonics used.Results: There were 50 patients diagnosed with major PPH among which 26 had caesarean delivery. Two major risk factors were analysed, one was Use of oxytocin in first stage for more than 6 hours and history of previous PPH. Uterine atony was commonest cause in 64% of cases.Conclusions: Uterine atony is responsible for most of cases. Early, aggressive, and coordinated intervention by health care professionals is critical in minimizing blood loss to ensure optimal clinical outcomes in management of women with major PPH.
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Background: Postpartum Haemorrhage remains one of the leading causes of maternal morbidity and mortality worldwide. It is estimated that about one quarter to one half of preventable maternal deaths are because of haemorrhage. It is defined by the royal college of obstetrician and gynaecologist as blood loss from the genital tract within the first 24 hours after birth of at least 500ml (minor) and at least 1000ml (major) causes of post-partum haemorrhage (PPH) are commonly ascribed to the four Ts (tone, trauma, tissue, 4 thrombin).Methods: This study aimed to assess the clinical practices used by our hospital in managing major PPH. Observational study of the management of PPH over a period of 2 months from March 2023 to April 2023 was carried out. Criteria examined: history of previous PPH causes of PPH, use of oxytocin in the first stage for more than 6 hours. Role of blood transfusion, presence of senior faculty, and type of uterotonics used.Results: There were 50 patients diagnosed with major PPH among which 26 had caesarean delivery. Two major risk factors were analysed, one was Use of oxytocin in first stage for more than 6 hours and history of previous PPH. Uterine atony was commonest cause in 64% of cases.Conclusions: Uterine atony is responsible for most of cases. Early, aggressive, and coordinated intervention by health care professionals is critical in minimizing blood loss to ensure optimal clinical outcomes in management of women with major PPH.
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Background: Carbetocin and oxytocin are indicated for the prevention of postpartum haemorrhage (PPH) due to uterine atony. Carbetocin is a newer analogue of oxytocin with longer half life and more heat stable. PPH can be effectively reduced by the prophylactic use of uterotonics. The aims of the present study were to compare effects of oxytocin and carbetocin in separation of placenta, in controlling the blood loss and the additional uterotonic needed in caesarean section (CS) at high risk of primary PPH. Methods: Women in the carbetocin group (group A) received a bolus of 100 µg IV; women in the control group (group B) received 20 IU of oxytocin in 1000 ml of 0.9% NaCl solution IV (150 mL/ hour). The efficacy of drugs in controlling blood loss was evaluated. Also, the haemodynamic effects and the need for additional uterotonic agents was compared. In addition, we compared the drop in haemoglobin level, the placental separation, the uterine tone. Results: Both drugs produce hypotension but the effect was greater in oxytocin group. Placental separation was seen early in oxytocin group. Uterine tone was attained earlier in oxytocin group however the tone was maintained persistently in carbetocin group. Additional uterotonic agents were needed in the oxytocin group (46% vs 0%, p=0.05).Conclusions: A single injection of carbetocin appears to be more effective than a continuous infusion of oxytocin to maintain sustained and adequate uterine tone and to prevent the PPH. However, there is delayed placental separation and delayed attainment of adequate uterine tone after use of carbetocin.
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Background: There are several strategies for the induction of labor (IOL), and pharmacologic agents, including oxytocin and prostaglandins, are most commonly used in clinical practice. Compared with oxytocin, the prostaglandin E2 agent, dinoprostone, has been regarded as moreeffective for the induction of labor of LTPs with a non-dilated cervix. Objective was to compare the PGE2 gel placed intracervically with that of oxytocin given intravenously for induction of labor in both primipara as well as multipara with the comparison of Bishop’s score at the starting of induction and its improvement with both of these inducing agents in those with indications for induction with gestational age greater than 36 weeks.Methods: Hospital based prospective observational study over a period of one year on patients attending the antenatal and high-riskpregnancy clinic and scheduled for induction of labor with Bishop score <4.Results: The number of successful induction was low in primiparae group with low Bishop’s score (1-2). There were greater number of successful inductions in both primi as well as multiparae with higher Bishop’s score.Conclusions: When a primigravida had a low cervical score or an unfavourable cervix, intracervical PGE2 gel was found to be more effective at ripening the cervix and inducing labour. Both medicines were equally effective at inducing labour in cases of multigavidae with any Bishop's score and primi with a higher Bishop's score.
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Background: This hospital-based, prospective, comparative interventional study aimed to compare the effectiveness of sublingual misoprostol and intracervical dinoprostone gel for induction of labor in primigravida women. Methods: A total of 100 patients were alternately assigned to induction with either Misoprostol 25mcg 6 hourly or dinoprostone Gel 0.5mg 6 hourly. Results: The induction delivery interval was significantly longer in the dinoprostone group compared to the misoprostol group. The incidence of fetal distress was slightly higher in the Dinoprostone group, but the difference was not statistically significant. There were no significant differences between the two groups in the incidence of respiratory distress, birth asphyxia, and APGAR 1 MIN <6. Conclusions: This study suggests that sublingual misoprostol (a type of prostaglandin E1, or PGE1) is more effective than intracervical dinoprostone gel (a type of prostaglandin E2, or PGE2) for cervical ripening and induction of labor.
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Background: This hospital-based, prospective, comparative interventional study aimed to compare the effectiveness of sublingual misoprostol and intracervical dinoprostone gel for induction of labor in primigravida women. Methods: A total of 100 patients were alternately assigned to induction with either Misoprostol 25mcg 6 hourly or dinoprostone Gel 0.5mg 6 hourly. Results: The induction delivery interval was significantly longer in the dinoprostone group compared to the misoprostol group. The incidence of fetal distress was slightly higher in the Dinoprostone group, but the difference was not statistically significant. There were no significant differences between the two groups in the incidence of respiratory distress, birth asphyxia, and APGAR 1 MIN <6. Conclusions: This study suggests that sublingual misoprostol (a type of prostaglandin E1, or PGE1) is more effective than intracervical dinoprostone gel (a type of prostaglandin E2, or PGE2) for cervical ripening and induction of labor.
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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.
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Background: This study was conducted to compare the efficacy and safety of oral misoprostol against intramuscular oxytocin in the active management of the third stage of labour, so that it can be widely used in the areas of limited resources to contribute in preventing post-partum haemorrhage and thus decreasing maternal mortality ratio.Methods: This was a prospective randomised controlled clinical study. Two hundred patients fulfilling inclusion criteria were randomized to receive either oral misoprostol (600 mcg) or intramuscular oxytocin (10 IU) in the active management of third stage of labour. Primary outcome measured was mean blood loss and incidence of primary PPH.Results: The mean blood loss during third stage of labour in oral misoprostol group and oxytocin group was 239.16�.78 ml and 240.19�.70 ml respectively with p value-0.7331 which was insignificant. Similarly mean fall in haemoglobin was also not significant. There was no significant differences between the two groups with regard to the incidence of PPH (3% vs. 2% respectively; p=0.651). Women experiencing side effects like shivering and fever were significantly higher among misoprostol group than in oxytocin group.Conclusions: In this study, oral misoprostol was found to be comparable to intramuscular oxytocin regimen, in terms of amount of blood loss, occurrence of postpartum hemorrhage, duration of third stage of labour, fall in hemoglobin and fall in blood pressure. However, shivering and fever were more common with misoprostol, but no other serious side effects were noted.
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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.
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Background: Postpartum haemorrhage is a single major and leading cause of maternal morbidity and mortality. PPH is the loss of more than 500 ml blood following vaginal delivery or 1000 ml blood following caesarean section. India has a maternal mortality ratio of 167 per 1 lakh live births. The most common cause of maternal mortality is haemorrhage which accounts for 25-30% of maternal mortality of which PPH is a significant cause.Methods: 200 patients were included in this prospective observational study and divided into two groups, group A, underwent only active management of third stage of labour and group B received intra umbilical oxytocin administration in addition to AMTSL. The maternal and neonatal outcome was observed between the two and the difference was noted.Results: Mean duration of third stage of labour of group A patients was 3.89±0.89 minutes and Mean blood loss was 386±85.30 ml and that of group B patients was 1.96±0.68 minutes and 235±72.99 ml respectively. These were found to be statistically significant among all the other parameters.Conclusions: The duration of third stage of labour and the amount of postpartum blood loss was significantly less when intra umbilical injection of oxytocin was used in addition to AMTSL. So, to conclude intra umbilical vein oxytocin injection should be used routinely in addition to AMTSL in order to prevent PPH.
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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.
Subject(s)
Humans , Female , Pregnancy , Adult , Placental Hormones/metabolism , Delivery, Obstetric , Fetal Blood/chemistry , Thyroid Hormones/analysis , Umbilical Cord/chemistry , Hydrocortisone/analysis , Oxytocin/analysis , Cesarean Section , Cross-Sectional Studies , Placental CirculationABSTRACT
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.