oxytocin and Bacterial-Infections

This article outlines the current modalities of pregnancy termination, as well as their risks and complications, in 3 phases of pregnancy: 1) up to 49 days past the last menstrual period, 2) 8-15 weeks, and 3) 16-24 weeks. Before 8 weeks of pregnancy, suction dilatation and curettage (D and C) is the preferred method. However, a medical approach, possibly self-administered, is viewed as more satisfactory and requires only an improvement in side effects. From 8-15 weeks' gestation, suction D and C and dilatation and evacuation (D and E) are the methods of choice. The use of laminaria tents improves both the facility and safety of these procedures in nulliparous patients and perhaps in multiparous patients. Priming of the cervix with prostaglandin could further decrease the difficulty and risks of these procedures. The use of a hydrogel compound is especially worthy of consideration. There is controversy about the preferred method between 16-20 weeks' gestation. D and E appears to have fewer complications and to be more cost-effective than hypertonic saline injection. Urea-prostaglandin has fewer and less severe complications than saline injection, and seems to be more cost-effective than saline injection in terms of duration of hospitalization. The high frequency of failure and side effects, combined with the possibility of expulsion of a live fetus, make prostaglandin-only injection less desirable. After 20 weeks' gestation, urea-prostaglandin injection is probably the safer method. Given the rapid increase in complications with passing weeks, any delay in providing late abortion services should be avoided. 2nd trimester pregnancy terminations, especially those after 18 weeks' gestation, are associated with increased mortality and morbidity and should be performed at specialized centers where providers are better equipped to manage complications.

Topics: 16,16-Dimethylprostaglandin E2; Abortifacient Agents; Abortion, Induced; Alprostadil; Amnion; Anesthesia; Animals; Arbaprostil; Bacterial Infections; Carboprost; Cervix Uteri; Dilatation and Curettage; Dinoprost; Dinoprostone; Female; Humans; Hypertonic Solutions; Oxytocin; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Progestins; Prostaglandins E; Prostaglandins E, Synthetic; Prostaglandins F; Pulmonary Embolism; Risk; Saline Solution, Hypertonic; Time Factors; Urea; Uterine Hemorrhage; Uterine Perforation

Topics: Animals; Anti-Bacterial Agents; Bacterial Infections; Cattle; Cattle Diseases; Endometritis; Ergonovine; Estrogens; Estrus; Female; Gentamicins; Horse Diseases; Horses; Oxytocin; Penicillins; Pituitary Hormone-Releasing Hormones; Pregnancy; Prostaglandins; Puerperal Infection; Uterine Diseases

Topics: Animals; Bacterial Infections; Female; Ovum; Oxytocin; Snakes

Topics: Anti-Bacterial Agents; Bacterial Infections; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Empyema, Pleural; Humans; Lung Abscess; Microbial Sensitivity Tests; Oxytocin; Treatment Outcome

To compare the obstetric performance, perinatal outcome and risk of neonatal infection in labour following spontaneous (SROM) and artificial (AROM) rupture of membranes.. Prospective, non-randomised, comparative study during a one-month period in 1995. The study was approved by the ethics committee of the Faculty of Medicine, University of Colombo.. University Obstetrics Unit at De Soysa Hospital for Women, Colombo.. 324 women who were in early established labour after 37 weeks of gestation. 151 of these had SROM and 173 AROM. The AROM and SROM groups among primigravidae and multigravidae were considered separately.. Oxytocin use in multigravidae was significantly higher in the AROM group than in the SROM group (p < 0.001). The emergency caesarean section (LSCS) rate in primigravidae was significantly higher in the AROM group than the SROM group (p < 0.001). A significantly larger number of primigravid AROM women had abnormal fetal heart rate changes on auscultation (p < 0.05) and cardiotopographic (CTG) patterns (p < 0.001) when compared with primigravid SROM women. Choreoamnionitis and funisitis were commoner in the AROM group although the difference was not statistically significant.. AROM appears to be associated with a higher chance of fetal distress particularly in primigravidae. Both AROM and SROM are associated with a potential risk of infection at intrauterine sites.. Artificial rupture of the membranes during established labor is believed to augment labor progression, but this practice carries the risk of maternal and neonatal infection. A prospective study conducted at De Soysa Hospital for Women in Colombo, Ceylon, in 1995 compared the obstetric performance, perinatal outcome, and risk of neonatal infection in 151 women with spontaneous rupture of membranes (SROM) and 173 women with artificial rupture of membranes (AROM). The need for oxytocin was higher in both primi- and multigravidae in the AROM group (37.5% and 38.8%, respectively) than the SROM group (24.7% and 18.9%, respectively), but this association reached statistical significance only among multigravidae. Also higher in the AROM group than the SROM group, but not significantly, were the rates of instrumental delivery and emergency cesarean section. Compared with primigravid AROM women, a significantly larger number of primigravid AROM women had abnormal auscultated fetal heart rates and cardiotopographic patterns. The appearance of meconium in liquor and the occurrence of low Apgar scores were similar in both groups. There were no clinical maternal or neonatal infections, but the intrauterine sites showed evidence of inflammation soon after membrane rupture. 36.1% of women in the SROM group and 24.0% of those in the AROM group whose cord and membranes were evaluated had histologic evidence of inflammation. Choreoamnionitis and funisitis were slightly more common in the AROM group. The potential for infection at intrauterine sites had no linear relationship to the mean membrane rupture-delivery interval or the number of vaginal examinations.

Topics: Adult; Amnion; Bacterial Infections; Extraembryonic Membranes; Female; Heart Rate, Fetal; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor, Induced; Labor, Obstetric; Obstetrics; Oxytocin; Parity; Perinatal Care; Pregnancy; Pregnancy Outcome; Prospective Studies; Risk Factors; Sri Lanka

To compare conservative versus prostaglandin management of prelabour rupture of the membranes (PROM) in healthy primigravid women at term.. A prospective randomized study.. Labour Ward, Aberdeen Maternity Hospital.. 230 primigravidae at terms with PROM, 115 allocated to be treated conservatively and 115 to be managed with prostaglandin treatment.. In the conservatively managed group the women were observed for up to 24 h after hospital admission with PROM. The actively managed group had PGE2 gel (2 mg) instilled into the posterior fornix and if contractions had not commenced, a further dose of PGE2 gel (1 mg) was instilled 6 h later. In both groups, if labour had not established 24 h after admission, intravenous oxytocin was given in escalating doses.. PROM to delivery interval, oxytocin augmentation, mode of delivery, maternal and neonatal infective morbidity.. There was a significant reduction in the PROM to delivery interval in the women managed actively with PGE2 gel and fewer women in the PGE2 group required oxytocin augmentation (31% vs 51%). The two managements groups were comparable for intrapartum analgesia, antibiotic treatment, babies requiring admission to the special care nursery unit and delivery by caesarean section.. The early use of prostaglandin is associated with a significant reduction in PROM to delivery interval without a significant increase in infective morbidity or caesarean section rate. However, the advantages of the conservative approach should not be overlooked. More work is still needed in the management of those women where uterine activity fails to establish within 24 h after PROM.

Topics: Administration, Intravaginal; Adult; Apgar Score; Bacterial Infections; Cesarean Section; Dinoprostone; Female; Fetal Membranes, Premature Rupture; Fever; Humans; Infant, Newborn; Injections, Intravenous; Labor Stage, Second; Oxytocin; Pregnancy; Prospective Studies; Uterine Contraction

Premature rupture of the membranes (PROM) in otherwise uncomplicated full-term single pregnancies was studied in a prospective randomized study. Ninety-three women were randomized to either induction with oxytocin infusion (n = 43) or expectant management (n = 50). Twenty-four and 26 respectively were nulliparas. In the induction group, all but 3 were delivered within 24 h from PROM. There were 3 vacuum extractions (VE), all in nulliparous women. No cesarean section (CS) was performed. In the expectancy group, 23 of 50 were delivered within 24 h. There were 5 VE and 3 CS in nulliparas and 1 VE and 1 CS in paras. The instrumental actions were mainly due to arrest of 1st or 2nd stage labor. The only clinical infections occurred in nulliparas in the expectancy group. Our conclusion is that parous women with PROM can be treated by either induction or expectancy while in nulliparas, induction after some hours' expectation seems preferable.

Topics: Adult; Bacterial Infections; Female; Fetal Membranes, Premature Rupture; Humans; Labor, Induced; Middle Aged; Oxytocin; Pregnancy; Pregnancy Outcome; Prospective Studies

One hundred thirty-four indigent patients at term who had premature rupture of membranes and a cervix unfavorable for induction of labor (80% effacement or less, 2 cm dilation or less) were randomized to compare expectant with intervention management. Women with any medical or obstetric condition warranting immediate intervention were excluded from the study. Patients treated expectantly were placed at bed rest and observed for labor or infection. Patients managed by intervention were given oxytocin if labor did not ensue within 12 hours of rupture of the membranes. Patients in the intervention protocol had longer labor (P less than .02) and a higher incidence of both cesarean delivery (P less than .05) and intraamniotic infection (P less than .05). There was only one case of proven neonatal sepsis, and this occurred in a patient managed by induction of labor. There was no statistically significant difference between groups in mean length of maternal hospitalization.

Topics: Adult; Bacterial Infections; Cervix Uteri; Cesarean Section; Female; Fetal Membranes, Premature Rupture; Humans; Labor, Induced; Oxytocin; Pregnancy; Prospective Studies; Random Allocation

In response to a recent hypothesis that the neuropeptide oxytocin might be involved in human pathogen avoidance mechanisms, we report the results of a study in which we investigate the effect of intranasal oxytocin on two behaviors serving as proxies for pathogen detection. Participants received either oxytocin or a placebo and were asked to evaluate (1) the health of Caucasian male computer-generated pictures that varied in facial redness (an indicator of hemoglobin perfusion) and (2) a series of pictures depicting disgusting scenarios. Men, but not women, evaluated all faces, regardless of color, as less healthy when given oxytocin compared to a placebo. Women, on the other hand, expressed decreased disgust when given oxytocin compared to a placebo. These results suggest that intranasal oxytocin administration does not facilitate pathogen detection based on visual cues, but instead reveal clear sex differences in the perception of health and sickness cues.

Topics: Bacteria; Bacterial Infections; Dose-Response Relationship, Drug; Face; Female; Health Status; Humans; Male; Oxytocin; Photic Stimulation; Sex Characteristics; Skin Diseases; Social Perception; Young Adult

The aims of this study were to test the hypothesis that the substrates of xanthine oxidase (XO), xanthine and hypoxanthine, are consumed while the milk is stored in the gland between milkings, and to explore how XO activity responds to bacteria commonly associated with subclinical infections in the mammary gland. Freshly secreted milk was obtained following complete evacuation of the gland and induction of milk ejection with oxytocin. In bacteria-free fresh milk xanthine and hypoxanthine were converted to uric acid within 30 min (T1/2 approximately 10 min), which in turn provides electrons for formation of hydrogen peroxide and endows the alveolar lumen with passive protection against invading bacteria. On the other hand, the longer residence time of milk in the cistern compartment was not associated with oxidative stress as a result of XO idleness caused by exhaustion of its physiological fuels. The specific response of XO to bacteria species and the resulting bacteria-dependent nitrosative stress further demonstrates that it is part of the gland immune system.

Topics: Animals; Bacterial Infections; Cattle; Escherichia coli; Female; Hydrogen Peroxide; Hypoxanthine; Mammary Glands, Animal; Milk; Oxytocics; Oxytocin; Protein Processing, Post-Translational; Staphylococcus aureus; Substrate Specificity; Time Factors; Uric Acid; Xanthine; Xanthine Oxidase

The antimicrobial effect of oxytocin in combination with 39 antibacterial drugs was studied in vitro with the use of 30 strains of different test cultures. It was shown that oxytocin had a capacity for potentiating the antibiotic effect on many microbial species. The potentiation ratio depended on the antibiotic and microbial species used and ranged from 2 to 24 times. The combined therapy with oxytocin and antibiotics was tested on animals with experimental staphylococcal sepsis. The survival rate of more than 50 per cent was observed only in the group of animals treated with the combinations of antibiotics and oxytocin, while in the other groups the death rate amounted to 100 per cent. The most favourable combinations of oxytocin and antibiotics were used in the treatment of 260 patients with pyoinflammatory affections of the soft tissues (mastitis, postinfection suppuration, paraproctitis, etc). In the majority of cases, the surgical treatment was replaced by the paracentetic treatment with local application of the combinations of oxytocin and antibiotics. This markedly decreased (by 3-4 times) the periods of temporary disability, provided better cosmetic results of the treatment and lowered consumption of the dressing material.

Topics: Abscess; Animals; Anti-Bacterial Agents; Bacteria; Bacterial Infections; Cellulitis; Drug Synergism; Female; Humans; Mice; Oxytocin; Species Specificity; Staphylococcal Infections