Efecto de la oxitocina en los niveles de malondialdehído, óxido nítrico y proteína s100b en el recién nacido / Effect of oxytocin on the levels of malondialdehyde, nitric oxide, and s100b protein in newborns

RESUMEN Objetivos. Evaluar los efectos de la administración de oxitocina en la conducción del parto en los niveles de malondialdehído (MDA), óxido nítrico (ON) y proteína S100B en el recién nacido. Material y Métodos. Se seleccionó a 80 gestantes a término sin patología obstétrica y fetal, formando dos grupos: Gestantes con parto normal y conducidas con oxitocina. Se extrajo sangre inmediatamente después del parto de la vena de cordón umbilical para medir MDA, ON y de la arteria para la proteína S100B. Se cuantificó la concentración de MDA y ON por métodos espectroscópicos y la proteína S100B por ELISA. Resultados. Se tuvo valores de 3,4 uMol/L y 3,6 uMol/L de MDA y 1,4 uMol/Ly 1,8 uMol/L de ON en el grupo conducido con oxitocina y control respectivamente sin diferencia significativa, los niveles de S100B fueron mayores en el grupo conducido con oxitocina, con una mediana de 1,36 μg/L comparado con el grupo de parto normal 1,11 μg/L (p=0,03). No hubo relación entre la dosis de oxitocina administrada y los niveles de MDA, ON y S100B. Conclusiones. No hay diferencia entre los niveles de MDA y ON entre las gestantes con parto normal y conducidas. Hay diferencia significativa en los niveles de proteína S100B en recién nacidos de parto con oxitocina. No hay relación entre la dosis de oxitocina y los niveles de estrés oxidativo y proteína S100B.

ABSTRACT Objectives. To assess the effects of the administration of oxytocin during labor management on the levels of malondialdehyde (MDA), nitric oxide (NO), and S100B protein in newborns. Materials and Methods. We selected 80 term pregnant women without obstetric and fetal pathology, forming two groups: pregnant women with normal delivery and pregnant women conducted with oxytocin. Blood was collected immediately after delivery from the umbilical cord vein to measure MDA, ON and from the artery for protein S100B. The concentration of MDA and ON was quantified by spectroscopic methods and the protein S100B by ELISA. Results. Values of 3.4 uMol/L and 3.6 uMol/L of MDA and 1.4 uMol/L and 1.8 uMol/L of NO were obtained in the oxytocin and control group, respectively, without significant difference; S100B levels were higher in the oxytocin managed group, with a median of 1.36 μg/L compared to the normal delivery group 1.11 μg/L (p=0.03). There was no relationship between the dose of oxytocin administered and the levels of MDA, ON, and S100B. Conclusions. There is no difference between MDA and NO levels between pregnant women undergoing a normal or managed birth. There is a significant difference in S100B protein levels in newborns born via an oxytocin-managed delivery. There is no relationship between oxytocin dose and levels of oxidative stress and S100B protein

Vía de finalización en pacientes con segunda inducción al trabajo de parto en el Hospital Nacional prof. A. Posadas / Postterm pregnancy in patients with second labour induction - Author's experience

The labour induction is an intervention to initiate artificially the uterine contractions to produce the effacement and dilatation of the uterine cervix until the child-birth is achieved. It is indicated when the benefit of the termination of the pregnancy for the mother and the child is greater than its continuation. It is perfored in more or less the 20 % of the women. In our institution the rate oscillates in around the 9 % of the cases. It is understand as an successful induction the termination of the labour through the vaginal delivery. The methods for labour induction more commonly used at present are mechanical and pharmacological. Between the first group we can find the Hamilton maneuver and the amniotomy. And between the pharmacologicals we find the oxytocine. These elements are considered in the article

Labor stimulation with oxytocin: effects on obstetrical and neonatal outcomes / Estimulação do parto com oxitocina: efeitos nos resultados obstétricos e neonatais / Estimulación del parto con oxitocina: efectos en los resultados obstétricos y neonatales

Abstract Objective: to evaluate the effects of labor stimulation with oxytocin on maternal and neonatal outcomes. Method: descriptive and analytical study with 338 women who gave birth at a tertiary hospital. Obstetric and neonatal variables were measured and compared in women submitted and non-submitted to stimulation with oxytocin. Statistics were performed using Chi-square test, Fisher exact test, Student t-test; and crude Odds Ratio with 95% confidence interval were calculated. A p < 0.05 was considered statistically significant. Results: stimulation with oxytocin increases the rates of cesarean sections, epidural anesthesia and intrapartum maternal fever in primiparous and multiparous women. It has also been associated with low pH values of umbilical cord blood and with a shorter duration of the first stage of labor in primiparous women. However, it did not affect the rates of 3rd and 4th degree perineal lacerations, episiotomies, advanced neonatal resuscitation, 5-minute Apgar scores and meconium. Conclusion: stimulation with oxytocin should not be used systematically, but only in specific cases. These findings provide further evidence to health professionals and midwives on the use of oxytocin during labor. Under normal conditions, women should be informed of the possible effects of labor stimulation with oxytocin.

Resumo Objetivo: avaliar os efeitos da estimulação do parto com oxitocina nos resultados maternos e neonatais. Método: estudo descritivo e analítico, com 338 mulheres que deram à luz em um hospital de nível terciário. Variáveis obstétricas e neonatais foram medidas e comparadas em mulheres com e sem estimulação com oxitocina. Estatísticas foram feitas utilizando-se o teste Qui-quadrado, teste exato de Fisher e o teste t-Student; e as Odds Ratio brutas com intervalo de confiança de 95% foram calculadas. Um valor de p < 0,05 foi considerado estatisticamente significativo. Resultados: a estimulação com oxitocina aumentou as taxas de cesarianas, anestesia peridural, febre materna intraparto em primíparas e multíparas. Ela também foi associada com baixos valores de pH do cordão umbilical e com uma menor duração da primeira fase do parto em primíparas. No entanto, ela não afetou as taxas de laceração perineal de terceiro e quarto graus, a episiotomia, a reanimação neonatal avançada, o teste de Apgar de 5 minutos e o mecônio. Conclusão: a estimulação com oxitocina não deveria ser utilizada de maneira sistemática, mas apenas em casos muito específicos. Estes resultados fornecem evidências adicionais aos profissionais de saúde e às parteiras sobre o uso de oxitocina durante o parto. Em condições normais, as mulheres deveriam ser informadas sobre os possíveis efeitos da estimulação com oxitocina.

Resumen Objetivo: valorar los efectos de la estimulación del parto con oxitocina en los resultados maternos y neonatales. Método: estudio descriptivo y analítico con 338 mujeres que parieron en un hospital de tercer nivel. Variables obstétricas y neonatales fueron medidas y comparadas en mujeres con y sin estimulación con oxitocina. Estadísticos Chi-cuadrado, test exacto de Fisher, test t-Student, Odd Ratio cruda y un intervalo de confianza del 95% fueron calculados. Un valor p < 0,05 se consideró estadísticamente significativo. Resultados: la estimulación con oxitocina incrementó el ratio de cesáreas, analgesia epidural, fiebre materna intraparto en primíparas y multíparas; también se relacionó con bajos valores de pH de cordón umbilical, y menor duración de la primera fase del parto en primíparas. Sin embargo no afectó la tasa de desgarros de 3-4 grado, episiotomías, reanimación neonatal avanzada, test de Apgar a los 5 minutos o meconio. Conclusión: la estimulación con oxitocina no debería emplearse de forma sistemática, sino solo en casos muy indicados. Estos hallazgos proporcionan mayor evidencia a los profesionales y matronas a cerca del uso de oxitocina durante el parto. En condiciones normales, las mujeres deberían estar informadas de los posibles efectos de la estimulación con oxitocina.

El uso de la oxitocina en la conducción del trabajo de parto, bloque materno infantil, Hospital Escuela, 2012 / Oxytocin for augmentation of labor

La Oxitocina es una de las sustancias más utilizadas para estimular las contracciones espontáneas y conducir el trabajo de parto cuando se presentan alteraciones. Objetivo: Determinar las características generales de la conducción del trabajo de parto, estableciendo las complicaciones materno-feto-neonatales de este procedimiento. Materiales y Métodos: Se realizó un estudio descriptivo transversal en la sala de Labor y Parto del bloque Materno Infantil del Hospital Escuela, durante un período de estudio de 78 días. Resultados: 1,014 (31%) pacientes fueron conducidas con Oxitocina, de las cuales 127 (13%)se sometieron a cesáreas; sin embargo de las 2,250 (69%) no conducidas, 873 (39%) terminaron en cesárea, reduciéndose éstas en un 67%, lo que significa que 39 de cada 100 pacientes no conducidas en este hospital terminan en cesárea y 13 de cada 100 pacientes conducidas terminan en cesárea. Las complicaciones neonatales más frecuentes fueron: Sepsis, Síndromede Distrés Respiratorio (SDR) e ictericia.De las gestantes conducidas hubo 21 muertes perinatales. Ninguno de los embarazos conducidos con Oxitocina presentó complicaciones maternas graves (ruptura uterina, shock hipovolémico o muerte materna). Conclusiones: El uso de Oxitocina durante el periodo de estudio está dentro de las normas establecidas internacionalmente y se redujo la incidencia de cesáreas significativamente. Se presentaron complicaciones neonatales y no hubo complicaciones maternas ligadas al uso de 0xitocina...

comparison between sublingual misoprostol and intravenous oxytocin for inducing labor in women with term pregnancy

In this study efficacy of sub lingual Misoprostol was examined in comparison to Oxytocin [I.V.] for inducing of labor in term pregnancy. Seventy patients were allocated by blocked randomization to Groups A [n=35, sub lingual Misoprostol 25 micro g four hourly to maximum of 5 doses] and B [n=35, continuous Oxytocin infusion]. Delivery active phase and total labor phase were shorter with sublingual Misoprostol in comparison to intravenous Oxytocin [p< 0.001] and the rate of cesarean section was lower in Misoprostol group [p<0.04] but delivery latent phase, meconium staining, uterine hypertonisity and apgar score [1 and 5 minute] were similar in two groups. Sublingual Misoprostol is better than intravenous Oxytocin for induction of labor at term

Effect of oxytocin infusion on luteal blood flow and progesterone secretion in dairy cattle

The objective of this study was to investigate the effects of oxytocin infusion on corpus luteum (CL) function during early to mid-diestrus by measuring luteal size (LS) and luteal blood flow (LBF) along with plasma levels of progesterone (P4) and prostaglandin metabolites (13,14-dihydro-15-keto-prostaglandin F2alpha, PGFM). On day (D) 7 of the estrus cycle (D1 = ovulation), seven cows received 100 IU of oxytocin (OXY) or placebo (PL) following a Latin square design. LS and LBF increased in both groups over time and no differences were observed between the groups. PGFM did not differ either within the groups over time or between the groups at any time point. P4 of the OXY group was higher compared to that of the the PL group 360 min after the infusion (p = 0.01) and tended to be higher at the time points 450 min, 48 h, and 72 h (all p = 0.08). Results from this study support the hypothesis that OXY is not directly involved in the mechanism(s) governing blood flow of the CL and has no remarkable effects either on luteal size or P4 and PGFM plasma levels. Further investigation is needed to elucidate the role of OXY in CL blood flow during early and late luteal phases.

Maternal haemodynamic effects of oxytocin bolus or infusion in the third stage of labour

The safety of bolus oxytocin has been questioned due to reports of maternal hemodynamic consequences. This study compared maternal haemodynamic effects of oxytocin bolus or infusion in the third stage of vaginal delivery. This was a randomized double-blind clinical trial in 170 women who received [10IU] intravenous oxytocin bolus or infusion in third stage of labour. Mean arterial pressure [MAP] and heart rate [HR] were measured before delivery and 1, 5, 10, 20 minutes after administration of oxytocin. These serial measurements and postpartum outcome were compared in two groups. Results were analyzed using analysis of variance for repeated measures, t-test, Man U Whitney, Fisher exact test, and chi-square test. Findings showed MAP and HR did not vary between two groups [p= 0.38 and p= 0.65 respectively. Length of the third stage of labour, retained placenta and reduction in haemoglobin concentration for the bolus group was less than infusion group [p=0.000, p=0.042 and P=0.036 respectively]. Other postpartum outcome was similar in two groups. Bolus oxytocin is not associated with adverse maternal hemodynamics and appeared to be as effective and can safely be administered in the third stage of labour

[Comparing the efficacy of intra-amniotic prostaglandin [PG] and oxytocin with rising induction in termination of second trimester pregnancy]

Termination of pregnancy in fetus with severe anomaly is legal in Iran. This study was done in order to compare the rate of effectiveness and complications of intra-amniotic PG and oxytocin, with rising induction in patient candidates for second trimester abortion, at Fatemieh Hospital, in Hamadan. In a randomized clinical trial study, 40 pregnant women in their second trimester with fetal CNS anomalies, were divided into two groups [N=20]. In the first group, one PG E2 Amp was injected intra-amniotic at first and then, 20 IU oxytocin was infused in 500 ml serum ringer for each patient. The infusion rate was increased up to induced effective concentrations every 15 to 30 minutes. In the second group, 50 IU oxytocin was infused with 1000 ml serum ringer and thereafter, another infusion of 50 IU oxytocin was added into the remaining 500 ml of serum. The rate of infusion was regulated on the basis of induced effective concentrations. Finally, both groups were compared for labor duration and probable side effects. The rate of success in both groups was 100%. The mean duration of labor was 19.75 +/- 5.9 hours and 30.2 +/- 6.49 hours in the group with intra-amniotic PG with oxytocin and rising induction group, respectively. This difference was statistically significant [P<0.00]. Diarrhea was seen in only one case with intra-amniotic PG injection. Differences between the frequency of side effects in both groups was not statistically significant. This study showed that the mean duration of laboring intra-amniotic PG with oxytocin method, is less than of rising induction method

Núcleo accumbens y el sistema motivacional a cargo del apego / Nucleus accumbens and the motivational system of attachment

The concept of attachment involves the pursuit of proximity of both a figure linked, as a partner. For that to happen there must be a motivational system for innate social interaction in all mammals including humans. This motivational system has its seat on the dopaminergic mesocorticolimbic pathway, known as the reward pathway and is where the Nucleus Accumbens plays a key role. This pathway would be selected and highly conserved by evolution as a mechanism for perpetuating genetics. There is a great influence of prosocial neuropeptides Oxitocin (OT) and Vasopressin (ADH) in this way. These are released into socio-sexual experiences, which can be demonstrated in the paradigms of adult-adult attachment (pair bonding) and mother and child attachment. The path of motivation cast into critical periods of development, leaving it vulnerable to what happens in the environment and its damage or disease, henee, would leave traces more or less stable throughout the Ufe eyele of the individual. This could be a initial factor to psychopathology from "attachment disorder" to "addiction" to drugs. The motivation could also be useful as a endophenotype.

El concepto de apego implica la búsqueda de proximidad tanto de una figura vincular, como de un compañero (partner). Para que ocurra debe existir un sistema motivacional por la interacción social innato en todos los mamíferos incluyendo al humano. Este sistema motivacional tiene su asiento neurobiológico en la vía dopaminérgica mesocorticolímbica, denominada de la recompensa y es donde el Núcleo Accumbens juega un rol clave. Esta vía estaría seleccionada y altamente conservada por la evolución como mecanismo para la perpetuación genética. Existe una gran influencia de los neuropéptidos prosociales Oxitocina (OT) y Vasopresina (ADH) en esta vía. Estos se liberan en experiencias socio-sexuales, hecho que se puede demostrar en los paradigmas de apego adulto- adulto (pair bonding) y apego materno-infantil. La vía de la motivación se moldea en períodos críticos del desarrollo, dejándolo vulnerable a lo que suceda en el ambiente y su daño o enfermedad, por lo tanto, dejaría huellas más o menos estables a lo largo del ciclo vital del individuo. Esto podría ser un factor inicial de psicopatología desde trastornos del vínculo hasta la adicción a drogas de abuso. La motivación también podría ser útil como un endofenotipo.

Randomized comparison of vaginal dinoprostone and high dose oxytocin of labor: safety and efficacy

Unripe cervix is the most important factor in failure of labor induction. This study is conducted to compare the efficacy and side effects of Dinoproston and high dose oxytocin as ripening agents in labor induction. In this double blinded randomized clinical trial, 1290 women with unfavorable cervix who underwent labor induction were randomly assigned to vaginal Dinoproston [9 mg] or intravenous high dose Oxytocin [6miu/min] groups. Initial 12 hours Bishop-Score, labor induction to labor duration, delivery type, 1 and 5 minute APGAR, side effects on mother or neonate, hospitalization duration and hospitalization costs were recorded. Data were analysed using t and Chi-square tests by means of Minitab statistical shoftware. The results showed that vaginal Dinoproston was effective in shortening latent phase of labor [P<0.01]. But, mean Bishop-Score over the initial 12 hours, the interval between labor induction to delivery, and side effects for mother or neonate were not different between the two groups. Based on the results, although hospitalization duration was not different between the groups, hospitalization costs for Dinoproston group was significantly higher [P<0.05] It seems that inspite of shortening the latent phase of labor in vaginal Dinoproston group, it is not more effective than high dose Osytocin as an adjuvant to labor induction in women with unfavorable cervix

G-protein coupled receptors & autism -- reflections on a double-edged sword at the example of the oxytocin receptor system.

G-protein coupled receptors (GPCR) tend to desensitize/internalize when exposed to excess agonist.Previously, we have supported the argument that in the case of the oxytocin receptor (OTR), excess agonist (oxytocin, OT) at birth could be implicated with behavioural disorders of the autistic spectrum. In this review, more recent evidence for this hypothesis is summarized, and it is juxtaposed against reports where exogenous OT was found beneficial in alleviating certain undesired behaviours. Facing this dichotomy, we suggest possible in silico drug discovery approaches to mitigate undesired side effect of OT administration/OTR desensitization, especially in the light of potentially emerging agonist therapies. For this, the most important structural features of OTR are reviewed, and we highlight here the need for higher level of theory studies at the easier approachable extracellular receptor side, where loop 3(e3) and the N-terminated strain of OTR appear to offer targets of particular interest for the development of an agent that conditions the action of excess OT. Another approach, based on the development of new agonists with an improved receptor activation to receptor phosphorylation ratio, is also discussed. Finally, the issue of OTR desensitization is put into the broader context of GPCR desensitization and possible implications for behavioural disorders, and the case is made for the usefulness of computational studies in this area.

Muerte fetal intrauterina por nudo real: a propósito de un caso clínico / Intrauterine fetal death by royal knot: a purpose of a case clinical

El cordón umbilical tiene una longitud de 50-60 centímetros en una gestación de término y constituye la comunicación entre placenta y feto. Entre las patologías de cordón están los nudos falsos (debidos a asas vasculares recubiertas por la acumulación de la gelatina de Wharton que se forma porque la longitud de los vasos supera a la del cordón) y reales. Este último es el que con más frecuencia lleva a muerte fetal intrauterina por causa funicular. Inexplicable cuando el producto se encuentra dentro del útero y evidenciable al producirse su posterior salida, como ocurrió en el caso presentado a continuación.

Ocitocina em cesarianas: qual a Melhor Maneira de Utilizá-la? / Oxytocin in cesarean sections: what is the best way to use it?

JUSTIFICATIVA E OBJETIVOS: A ocitocina é uterotônico utilizado em anestesia obstétrica, cuja administração, tanto profilática quanto terapêutica, justifica-se por reduzir a incidência de hemorragia após o parto. No entanto, ainda não está estabelecido o regime ideal de infusão em cesarianas eletivas. Este estudo tem o intuito de revisar as principais características fisiológicas e farmacológicas da ocitocina e discutir o seu uso racional pelos anestesiologistas, tendo em vista os seus efeitos colaterais. CONTEUDO: A ocitocina é produzida pelo hipotálamo e armazenada pela hipófise posterior. No útero ela determina contração da musculatura lisa que é bastante importante para o controle de hemorragia após a dequitação. Ela atua, também, em outros sistemas, sendo relevante a diminuição da resistência vascular periférica com conseqüente hipotensão arterial. As ações extra-uterinas passam a ser importantes quando a ocitocina é feita em altas doses ou em bolus, especialmente em gestantes sob anestesia (seja bloqueio espinal ou anestesia geral) apresentando hipovolemia, ou com alteração prévia no sistema cardiovascular. Diversos regimes de infusão têm sido estudados, variando-se a dose e/ou velocidade de infusão na tentativa de se estabelecer qual a maneira mais adequada de sua utilização. CONCLUSÕES: A ocitocina permanece como fármaco de primeira escolha para a prevenção e tratamento da atonia uterina após cesariana, especialmente por seu amplo espectro terapêutico. Apesar de estar disponível para a prática clínica há quase 50 anos, ainda não está estabelecido qual o regime adequado de sua infusão em cesarianas. A tendência atual é a utilização em infusão contínua de doses reduzidas, devendo ser evitada a administração em bolus.

BACKGROUND AND OBJECTIVES: Oxytocin is the uterotonic used in obstetric anesthesia, and its prophylactic and therapeutic administration is justified because it reduces the incidence of post-partum hemorrhage. However, the ideal infusion regimen in elective cesarean sections has not been determined yet. The objective of this study was to review the main physiological and pharmacological characteristics of oxytocin and to discuss its rational use by anesthesiologists in view of its side effects. CONTENTS: Oxytocin is produced by the hypothalamus and stored in the posterior lobe of the pituitary gland. In the uterus, is causes contraction of the smooth muscle, which is very important to control hemorrhage after uterine emptying. It also affects other systems, and the reduction in peripheral vascular resistance with consequent hypotension is very important. The extra-uterine actions of oxytocin are important when administered in high doses or in bolus, especially in parturients under anesthesia (spinal block or general anesthesia) with hypovolemia or preexistent alterations in the cardiovascular system. Several infusion regimens have been studied, varying the dose and/or the speed of administration, in an attempt to establish the most adequate. CONCLUSIONS: Due to its wide therapeutic spectrum, oxytocin remains the drug of choice to prevent uterine atony after cesarean sections. Although it has been used for almost 50 years, the adequate infusion regimen in cesarean sections has not been determined yet. The current tendency is to use continual infusion of low doses, and bolus administration should be avoided.

JUSTIFICATIVA Y OBJETIVOS: La ocitocina es un uterotónico utilizado en anestesia obstétrica, cuya administración, tanto profiláctica, como terapéutica, se justifica por reducir la incidencia de hemorragia después del alumbramiento. Sin embargo, todavía no se estableció el régimen ideal de infusión en cesáreas electivas. Este estudio tiene la intención de revisar las principales características fisiológicas y farmacológicas de la ocitocina y discutir su uso racional por parte de los anestesiólogos, teniendo en cuenta sus efectos colaterales. CONTENIDO: La ocitocina es producida por el hipotálamo y almacenada por la hipófisis posterior. En el útero, hay una contracción de la musculatura lisa que es bastante importante para el control de la hemorragia después de la expulsión de la placenta. Actúa también en otros sistemas, siendo relevante la reducción de la resistencia vascular periférica con la consecuente hipotensión arterial. Las acciones extra-uterinas pasan a ser importantes cuando la ocitocina se crea en altas dosis o en bolus, especialmente en embarazadas bajo anestesia (sea bloqueo espinal o anestesia general) presentando hipovolemia, o con alteración previa en el sistema cardiovascular. Diversos regímenes de infusión han sido estudiados, variando la dosis y/o la velocidad de infusión en la tentativa de establecer cuál es la manera más adecuada para su utilización. CONCLUSIONES: La ocitocina permanece como fármaco de primera elección para la prevención y el tratamiento de la atonía uterina después de la cesárea, especialmente por su amplio espectro terapéutico. A pesar de estar disponible para la práctica clínica hace casi 50 años, todavía no está establecido cuál es el régimen adecuado de su infusión en cesáreas. La tendencia actual es la utilización en infusión continua de dosis reducidas, debiendo ser evitada la administración en bolus.

Influence of time at which oxytocin is administered during labor on uterine activity and perinatal death in pigs

Oxytocin is extensively used to induce or augment uterine contractions, especially to facilitate the third stage of labor in humans. Administration of oxytocin to parturient sows reduces duration of labor whereas mortality of the offspring may remain unchanged. This study aimed to evaluate whether time of administration of oxytocin during parturition may alter the uterine response and fetal outcomes. Two hundred parturient sows were randomly assigned to intramuscularly receive either saline solution (control group) or oxytocin 0.083 IU/kg immediately after the delivery of the 1st, 4th or 8th piglet (groups O-1, 0-4 and 0-8, respectively). Uterine effects and fetal outcomes were registered in all groups. The duration of labor was 20-40 min shorter (P < 0.0001) and time interval between babies was reduced by 3-5 min (P < 0.0001) in the three groups receiving oxytocin. The duration and intensity of contractions, meconium-stained piglets and intrapartum deaths decreased as time at which oxytocin administered during labor was increased. In group 0-8, we observed approximately 70 percent less meconium-stained piglets and intrapartum deaths than in the control group. In conclusion, oxytocin administered at early phases of parturition to sows may increase duration and intensity of uterine contractions as well as adverse fetal outcomes.

Effects of calcium channel blocker, mibefradil, and potassium channel opener, pinacidil, on the contractile response of mid-pregnant goat myometrium.

The present study was undertaken to investigate the in vitro influence of mibefradil, a calcium channel blocker, and pinacidil, a potassium channel opener, on pregnant goat myometrial spontaneous rhythmic contractility and contractions induced with the agonist, oxytocin. Longitudinal strips from the distal region of uterus, collected from goats at midgestation, were mounted in an organ bath for recording isometric contractions. Mibefradil (10(-8)-10(-4) M) or pinacidil (10(-10)-10(-4) M), added cumulatively to the bath at an increment of 1 log unit, caused concentration-dependent inhibition of the spontaneous rhythmic contractions of isolated uterine strips. The rhythmic contraction was, respectively, abolished at 100 and 10 microM concentrations of mibefradil and pinacidil. In a concentration-dependent manner, mibefradil (1 and 10 microM) antagonized the contractions elicited with oxytocin (10(-5)-10(-2) IU). Pretreatment of uterine strips with glibenclamide (10 microM), a selective KATP channel blocker, caused a rightward shift of the concentration-response curve of pinacidil with a concomitant decrease in its pD2 value. Pinacidil (0.3, 1 and 3 microM), in a concentration-related manner, antagonized the oxytocin (10(-5)-10(-2) IU)-induced contractile response. The inhibition of spontaneous rhythmic contractions and antagonism of oxytocin-induced contraction by mibefradil in the pregnant goat myometrium may be related to the antagonism of voltage-dependent Ca2+ channels, while by pinacidil suggests that KATP channel could be a therapeutic target for tocolysis.

Guía para la prevención y manejo de la hemorragia / It guides for the prevention and handling of the hemorrhage

El presente protocolo de prevención y manejo de la Hemorragia Postparto (HPP) pretende establecer recomendaciones para: (1) prevención de la HPP inmediata, actuando durante el período del alumbramiento (2) orientar sobre el manejo de la HPP, a fin de contribuir a la reducción de la morbi-mortalidad materna por esta causa y (3) identificar a través de una buena historia clínica los factores de riesgo para HPP. Esta guía esta destinada a todo el personal de salud involucrado en la atención del parto como gineco-obstetras; a todos aquellos que están capacitados para atender un parto.

Indicaciones de cesáreas en embarazadas asistidas en el Hospital Padre Justo Arias de Rubio: Estado Táchira enero 2004-abril 2005 / Indications of cesarean in pregnant attended in the Hospital Padre Justo Arias of Rubio: State Táchira january 2004-april 2005

El presente es un trabajo retrospectivo donde se analizaron 138 casos de cesáreas en el lapso comprendido enero 2004-abril 2005, en el Hospital Padre Justo Arias de Rubio, con el propósito de identificar las causas de las mismas, siendo la desproporción cefalo-pélvica (DCP), la cesárea anterior, la hipertención inducida por el embarazo, la inducción fallida del trabajo de parto seguida de la presentación viciosa, las mas importantes. Los resultados señalan que la edad predominante fue de 24,5 años, la mayor frecuencia de operación se presentó en primigestas, el 68,8 por ciento de las intervenciones se realizó de forma electiva, encontrándose que todos los casos se realizaron en gestaciones a término. Se concluye que los factores que proporcionan la indicación de cesárea deben ser objeto de revisión, para evitar una próxima interrupción del embarazo por vía alta.

Effect of Anthum graveolens fruit extract on rat uterus contractions

Dill [Anethum graveolens] from Umbelliferae is used traditionally to treat convulsions and increasing milk production. Also, in Darab [Fars Province] and Yazd dill fruit is used traditionally to prevent abortion. Its antimicrobial, antihyperlipidaemic, anti-hypercholesteroaemic effects and reducing gastric acid secretion have been reported. The aim of the present study was to investigate the effects of dill fruit hydroalcoholic [DFHE] extract on virgin rat uterus contractions induced by KCI [60mM] and oxytocin [10 mU/ml]. Macerated method was used for extract preparation. Virgin Sprague Dawley female rats were pretreated with an injection of estradiol valerate [5mg/kg, s.c.] 24 hours prior to experiment. Rats were killed and uteri were dissected and mounted in an isolated organ bath containing De Jalon solutions [29°C] bubbled by oxygen. Contractile responses were recorded isometrically under 1g initial tension. The DFHE [0.5, 1, 2, 4 and 8 mg/ml] relaxed both KC1- and oxytocin-induced contractions dosedependently [p<0.0001]. However, the spasmolytic effect of extract on oxytocin-induced contractions was more potent. In Ca[2+] -free, rich K+ [120mM] De Jalon solution, cumulative adding of calcium [0.15, 0.3, 0.6, 1.2 and 2.4 mM], increased contractions dose dependently [p<0.0001]. DFHE [4 mg/ml] shifted this dose-response curve to the right [p<0.05]. In Ca[2+] free solution, oxytocin induced strong contractions if calcium [0.3 mM] was added to the bath. However, DFHE [8 mg/ml] reduced calcium-induced contraction [p<0.001]. The spasmolytic effect of DFHE was reversible. The spasmolytic effect of DFHE [4 mg/ml] was affected neither by propranolol [1micro M] nor by L-NAME [100 micro M]. These results suggest that the relaxatory effect of DFHE on KCI and oxytocin-induced uterus contractions is due, at least in part, to blockade voltage dependent calcium channels and partly by disturbing in releasing calcium from intracellular pool indirectly. In addition, the beta-adrenoceptors and NO are not involved in this inhibitory effect of DFHE. Our results may also support the traditionally usage of dill fruit for preventing abortion

effect of oxytocin on hisological structure and mitotic index of spleen in albino mice

The aimed of these research to shed some light on the effects of oxyticin in histological structure for spleer in male albino mice at age of four and five weeke, the animals were injected intra peritonealy at a dose of 0.2 ml. The results showed some histological changes in spleen, the blood vessels demonstrated vasodilation and fractionation which caused hemorrhage. The lymphoid tissue in periarterial lymphatic sheath [PALS] region of splenic nodule and in red pulp was loose and hyperplasia was present represented by blood vessel congestion and increasing in the number of phagocytes, plasma cells and giant cells and also theme was a significant elevation in the value of spleens cells mitotic Index which was seen in red and white pulp

Evaluation of tocolytic efficacy of selective beta2 adrenoceptor agonists on buffalo uterus.

Present study was conducted on prostaglandin F2alpha (PGF2alpha), oxytocin, (OT), potassium chloride (KCI) and barium chloride (BaCl2) pre-contracted perimetrial uterine strips of dioestrus and pregnant buffaloes to evaluate the tocolytic efficacy of selective beta2 adrenoceptor agonists-albuterol (salbutamol) and terbutaline. Cumulative concentration-response curves of both the beta2 adrenoceptor agonists were constructed and the mean effective concentration (EC50) values determined and compared statistically. Based on the comparative EC50 values in relaxing the pre-contracted uterine strips with different spasmogens, the rank order potency of albuterol was found to be--PGF2alpha > BaCl2 > OT > KCl on uterine strips from dioestrus animals, while OT> BaCl2> PGF2alpha >KCl on the uterine strips of pregnant buffaloes. The rank order potency of terbutaline on uterine strips from dioestrus stage animals was- BaCl2 > OT > KCl > PGF2alpha, while BaCl2 > PGF2alpha > KCl > OT on uterine tissues of pregnant animals. Thus, irrespective of the state of uterus, whether gravid or non-gravid, KCl-depolarized uterine tissues required comparatively higher concentrations of albuterol or terbutaline to produce tocolytic effect. High concentrations of K+ in biophase may have interfered with the beta2 adrenoceptor agonists-induced outward K+ current and hyperpolarization. From the results of present study, it was evident that selective beta2 adrenergic agonists had good tocolytic efficacy on the uterus of buffaloes. Further, indirectly the possibility of existence and activation of K(Ca) channels by selective beta2 adrenoceptor agonists in mediating tocolysis of buffalo myometrium can not be ruled out, however, detailed studies using specific K(Ca) channel blockers are required for characterizing the nature of such channels in buffalo uterus.