oxytocin and Endometritis

Trial and meta-analysis data revealed a reduction in time to delivery for Foley and prostaglandins or Foley and oxytocin vs Foley alone. However, there are limited data for the comparison of the 2 combination methods against each other.. This study aimed to determine whether Foley and prostaglandins or Foley and oxytocin decrease the time to vaginal delivery using a network meta-analysis.. A network meta-analysis (PROSPERO CRD42018081948) was performed comparing Foley and prostaglandins (prostaglandin E1 or prostaglandin E2) vs Foley and oxytocin for cervical ripening. Foley alone and prostaglandins alone were used as nodes for indirect comparison. Database searches were performed from inception to March 2020 with data abstracted from published manuscripts. Eligibility criteria included randomized trials comparing Foley and oxytocin with Foley and prostaglandins (misoprostol or dinoprostone). Trials that compared Foley catheter or prostaglandins with a combination of Foley and prostaglandins or Foley and concurrent oxytocin were also included. Nulliparous and multiparous women were analyzed together. Foley catheters of any catheter material or size and >24 weeks' gestational age with a live fetus were included. Quasi-randomized, cohorts, and other combination methods for cervical ripening were not included. Prostaglandin E1 and prostaglandin E2 combined methods were analyzed separately in a planned subanalysis. The primary outcome was the mean time from induction to vaginal delivery in hours. Secondary outcomes included time from induction to delivery, delivery within 24 hours, cesarean delivery, chorioamnionitis, endometritis, epidural use, tachysystole, postpartum hemorrhage, meconium, neonatal intensive care unit admission, and 5-minute appearance, pulse, grimace, activity, and respiration score of <7. Data were analyzed as a network meta-analysis using multivariate meta-regression.. A total of 30 randomized controlled trials with a total of 6465 women were considered eligible for inclusion in this network meta-analysis. When compared with Foley alone, the use of Foley-oxytocin reduced the time to vaginal delivery by 4.2 hours (mean duration, -4.2 hours; 95% confidence interval, -6.5 to -1.9). Foley-prostaglandins reduced the time to vaginal delivery compared with Foley but did not meet statistical significance (mean duration, -2.9 hours; 95% confidence interval, -5.7 to 0.0; P=.05). When compared head-to-head, there was no difference in the time to vaginal delivery between Foley-prostaglandins and Foley-oxytocin (mean duration, 1.3 hours; 95% confidence interval, -2.0 to 4.7). There was no difference in the rate of cesarean delivery, chorioamnionitis, epidural, tachysystole, postpartum hemorrhage, meconium, neonatal intensive care unit admissions, or 5-minute appearance, pulse, grimace, activity, and respiration score of <7 for Foley-prostaglandins vs Foley-oxytocin, although the rate of endometritis was high for Foley-prostaglandins. In the subanalysis by prostaglandin type, there was no difference in the time to vaginal delivery for Foley-misoprostol vs Foley-dinoprostone vs Foley-oxytocin. However, Foley-dinoprostone had a definite trend toward longer time to all deliveries compared with that of both Foley-misoprostol and Foley-oxytocin (P=.05).. Time to vaginal delivery was similar when comparing Foley with combined misoprostol, combined dinoprostone, and combined oxytocin. Dinoprostone comparisons are limited by small sample size but suggest longer time to delivery compared with Foley and misoprostol or oxytocin. No significant differences were observed in maternal or neonatal adverse events except for endometritis, but this was limited by the sample size, varied reporting of studies used in the indirect comparisons, and definitions of infectious morbidity use in the studies.

Topics: Anesthesia, Epidural; Apgar Score; Catheters; Cervical Ripening; Cervix Uteri; Cesarean Section; Chorioamnionitis; Delivery, Obstetric; Dinoprostone; Endometritis; Female; Humans; Intensive Care Units, Neonatal; Labor, Induced; Misoprostol; Network Meta-Analysis; Oxytocics; Oxytocin; Postpartum Hemorrhage; Pregnancy; Time Factors

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

Postpartum uterine disease due to poor uterine involution continues to be a significant factor that contributes to poor reproductive efficiency in dairy cattle. Therapy that increases the frequency, duration and strength of uterine contractions in the postpartum period might enhance uterine involution, resulting in improved reproductive performance. The objective of this clinical trial was to study the effect of two uterine ecbolic therapies, oxytocin and prostaglandinF2α on uterine involution, postpartum endometritis, and reproductive performance. A randomized double-blinded clinical trial was conducted in 118 dairy cows from two research herds that had normal parturition and expulsion of the fetal membranes. Within 24 hr after calving, cows were randomly assigned to receive intramuscular injections twice a day of 50 IU of oxytocin, or 25 mg of dinoprost (PGF2α) or saline (control) for 7 days. Cows were monitored from day 3 to day 63 ± 3 days postpartum by transrectal palpation of the uterus, vaginoscopy, Metricheck® examination and by endometrial cytology. Blood samples were collected for measurement of progesterone in weeks 3 (21 ± 3 days), 5 (35 ± 3 days), 7 (49 ± 3 days), and 9 (63 ± 3 days) postpartum. Herd breeding records were obtained to determine reproductive performance in all cows. Neither oxytocin nor prostaglandin F2α therapy during the first week postpartum had any significant effect on the rate of uterine involution, prevalence of endometritis or reproductive performance, compared to untreated controls. Ecbolic drugs, as used here, are not recommended for use in clinical practice to improve involution or reproductive tract health in normal cows.

Topics: Animals; Cattle; Cattle Diseases; Cervix Uteri; Dinoprost; Double-Blind Method; Endometritis; Female; Oxytocics; Oxytocin; Parturition; Postpartum Period; Prevalence; Progesterone; Random Allocation; Reproductive Health; Uterus

The objectives of the current study were to investigate the influence of denaverine hydrochloride and carbetocin on softening and dilatation of the birth canal, the need for assistance during parturition, calf mortality, retention of fetal membranes, endometritis, and subsequent fertility. Altogether 200 animals (100 cows and 100 heifers) of the Simmental breed were divided into 2 groups: treatment (n = 100) and control (n = 100). Animals in the treatment group received denaverine hydrochloride and carbetocin (a maximum of twice for each, depending on the progression of labor) during delivery over a maximum of 4 waiting periods (30 min each), whereas control animals experienced the same waiting periods but received no treatment. The treatment protocol had a positive influence on the ease of calving and postpartum reproductive health. The treatment increased the number of animals with the birth canal dilated by more than 25 cm, and halved the need for any assistance at parturition. In addition, treatment decreased the occurrence of difficult calving, the need for episiotomy, the appearance of birth canal lesions, and clinical endometritis. The treatment protocol had an effect throughout the entire puerperal period, as treated animals conceived with fewer artificial inseminations (1.3 vs. 1.6 artificial inseminations/pregnancy) and sooner (67 vs. 78 d open) compared with control animals. Denaverine hydrochloride and carbetocin administered in combination during parturition affected the progression and ease of calving, and thus the welfare of cows in labor and subsequently. However, further studies are needed to confirm the findings and to establish best practices.

Topics: Animals; Benzilates; Cattle; Cattle Diseases; Endometritis; Female; Fertility; Insemination, Artificial; Oxytocin; Parturition; Postpartum Period; Pregnancy; Treatment Outcome

The objective of the present study was to evaluate the beneficial effect of hCG injected immediately after mating in Arabian barren mares treated with uterine lavage and oxytocin. Arabian barren mares (n=36) with PMIE were subjected to detailed clinical examinations including palpation per rectum, vaginoscopy, and cytological examination. After mating the 36 mares were randomly divided into four groups. The mares in group 1 (n=10) were immediately after breeding injected with hCG 3,000 IU IM. Uterine lavage with 1L of N-saline containing 4 million IU of crystalline penicillin and 4 g of streptomycin sulphate was performed 4h after breeding. Then mares received two injections of oxytocin 40 IU IM 2h apart after 6h of mating. Mares in group 2 (n=10) treated with uterine lavage and oxytocin as group 1. While mares in group 3 (n=10) received uterine lavage only. A control group (n=6) as group 4 did not received any treatment. The results of clinical examination indicated that 69.4% of PMIE mares were harboring severe endometritis and 30.6% with a moderate form of endometritis. Significant (P<0.01) increase in lymphocytes were founded in barren mares included in this study. Higher pregnancy rate (P<0.01) was founded in Arabian barren mares 80% injected with hCG immediately after breeding and uterine lavage and oxytocin. No significant difference was found in mares received uterine lavage and oxytocin and uterine lavage only. In a conclusion, administration of hCG immediately after mating and intrauterine lavage containing antibiotics performed 4h and two injections of oxytocin 40 IU IM 2h apart after 6h of mating had improved fertility of Arabian barren mares.

Topics: Animals; Chorionic Gonadotropin; Endometritis; Female; Fertility; Horses; Oxytocin; Pregnancy; Pregnancy Rate; Pregnancy, Animal; Sexual Behavior, Animal; Uterus; Vaginal Douching

To compare the effect of manual removal and spontaneous delivery of placenta on postcesarean bleeding and endometritis.. In this prospective study 400 pregnant women undergoing elective cesarean delivery were randomly assigned to two groups: spontaneous placental delivery (200 women) and manual placental delivery (200). No antibiotic prophylaxis was administered in either group. The significance of blood loss due to cesarean delivery was defined by a drop in hemoglobin concentration of more than 1 g/dl 24 h after delivery in comparison with preoperative hemoglobin concentration. Endometritis was diagnosed in patients who developed clinical signs of fever and suprapubic tenderness 48 h after delivery. We analyzed the data using a t-test.. The overall endometritis rate was 27%, in 40 women in the spontaneous placental delivery group (20%) and 68 women in the manual placental removal group (34%). There was a statistically significant difference between the two groups (P=0.001). Significant blood loss was experienced by 52 women (26%) in the spontaneous placental delivery group vs. 100 women (50%) in the manual placental delivery group. There was a statistically significant difference in blood loss between the two groups (P=0.000; RR=1.92).. Endometritis and blood loss in cesarean delivery is increased by manual removal of the placenta compared with the spontaneous method of placental removal.

Topics: Adult; Cesarean Section; Endometritis; Female; Hemoglobins; Humans; Incidence; Labor Stage, Third; Oxytocics; Oxytocin; Placenta; Postoperative Hemorrhage; Postpartum Hemorrhage; Pregnancy

Mares resistant (n=7) and susceptible (n=9) to persistent mating-induced endometritis were artificially inseminated (AI) during oestrus with chilled extended semen. Blood samples were collected from 30 min before AI, for 2 h after AI and again between 16 and 18 h after AI. Samples were assayed for oxytocin and the PGF2alpha metabolite 13,14-dihydro-15-keto PGF2alpha (PGFM). AI caused a significant increase in oxytocin concentrations in both the resistant and susceptible mares and there was no significant difference in oxytocin release between the two groups of mares. Mean PGFM concentrations were significantly higher in the resistant group for the first 30 min after AI. In a second experiment, an i.v. injection of oxytocin (1 iu per 20 kg body weight) was administered to both resistant and susceptible oestrous mares. Blood samples were collected at 5min intervals from 10 min before until 60 min after oxytocin administration. Administration of exogenous oxytocin caused significantly greater PGF2alpha release in resistant than in susceptible mares. The observed pattern of decreased PGFM concentrations in the susceptible group of mares after both AI and oxytocin administration indicates a possible defect in PGF2alpha release at the oxytocin receptor or post-receptor level.

Topics: Animals; Dinoprost; Endometritis; Female; Gene Expression Regulation; Horse Diseases; Horses; Insemination, Artificial; Oxytocin; Time Factors

Oxytocin was administered to reduce incidence of retained placenta and uterine infections that could delay subsequent conception. Three hundred and fifty multiparous Friesian cows, each with spontaneous delivery of a single calf were divided randomly into two groups. Some (n = 175) were injected with 30 IU of oxytocin immediately after delivery and again 2-4 h later, while the remainder formed an untreated control group. The placental retention 24 h after parturition was 24.6% and 10.9% in control and treated animals respectively (P < 0.01). Endometritis occurred in 51.6% of the animals following placental retention as compared to 10.4% of those with normal expulsion of the fetal membranes (P < 0.001). A comparison of reproductive indices showed a statistically significant improvement of fertility in treated cows with the average interval from calving to conception being reduced from 124.4 d to 93.7 d (P < 0.0001).

Topics: Animals; Cattle; Cattle Diseases; Endometritis; Female; Fertility; Incidence; Injections, Intramuscular; Oxytocics; Oxytocin; Placenta, Retained; Pregnancy; Prevalence

The effects on pregnancy rate of three different treatments to remove intrauterine fluid were assessed in 1267 mares. The mares were mated and allocated, in strict rotation, to four treatment groups: 1) untreated controls, 2) intrauterine infusion of broad spectrum antibiotics, 3) intravenous injection of oxytocin, 4) intravenous injection of oxytocin followed by intrauterine antibiotics. The pregnancy status of the mares was determined 13 to 15 days and 27 to 30 days after ovulation by transrectal ultrasonography. The pregnancy rate of group 4 (72 per cent) was higher than that of group 2 (64 per cent, P < 0.01) or group 3 (63 per cent, P < 0.01). The pregnancy rates of groups 2 and 3 were higher than that of group 1 (56 per cent, P < 0.01). The treatment with antibiotics and oxytocin appeared to have an additive beneficial effect which suggested two different modes of action of the combination treatment, namely antibacterial activity and fluid drainage. In the untreated mares more fluid accumulated in the uterine lumen after mating, and this was the most likely reason for their lower pregnancy rate.

Topics: Animals; Anti-Bacterial Agents; Drug Therapy, Combination; Endometritis; Female; Horse Diseases; Horses; Infusions, Parenteral; Injections, Intravenous; Oxytocin; Pregnancy; Pregnancy Rate; Ultrasonography; Uterus

To compare the rates of clinical amnionitis and endometritis in patients with premature rupture of membranes (PROM), using endocervical prostaglandin E2 (PGE2) gel for induction of labor versus immediate oxytocin induction of labor.. We randomized 118 patients to receive either endocervical 0.5 mg of PGE2 gel (study group) or immediate oxytocin induction of labor (control group). If labor was not established in the group receiving PGE2 gel in 24 hours, intravenous oxytocin was given in incremental doses. The rates of clinical amnionitis and endometritis in the two groups were analyzed. Also compared were hours of labor, duration of rupture of membranes and number of vaginal examinations. Student t test, chi 2, or Wilcoxon rank-sum test were used for statistical analysis, as appropriate. P < .05 was considered significant.. The rates of clinical amnionitis were 5.3% in the PGE2 group and 8% in the control group. Endometritis developed in 1.7% of PGE2 patients and 3.2% of controls. These differences in maternal infection rates were not statistically significant. The two groups were comparable with respect to age, parity, and antepartum group B streptococcal colonization. No significant differences in hours of labor, duration of ruptured membranes, or vaginal examinations were observed. Neonatal outcome data (mean birth weight, Apgar scores at 1 and 5 minutes, Apgar score less than 7 at 5 minutes) were not statistically significant.. Endocervical placement of 0.5 mg of PGE2 gel does not increase the incidence of clinical amnionitis and endometritis in patients with PROM at term when compared with immediate induction of labor with oxytocin.

Topics: Administration, Topical; Adult; Cervix Uteri; Chorioamnionitis; Dinoprostone; Endometritis; Female; Fetal Membranes, Premature Rupture; Gels; Humans; Infusions, Intravenous; Labor, Induced; Oxytocics; Oxytocin; Pregnancy; Prospective Studies; Risk Factors

To determine whether leaving the membranes intact in active-phase arrest would affect the cesarean delivery rate or the incidence of maternal morbidity secondary to infection.. We conducted a randomized trial of healthy, spontaneously laboring women at term with an intact chorioamnion and active-phase arrest (defined as 1 cm or less of cervical change over 2 hours in the active phase of labor). Patients were assigned to either oxytocin augmentation with intact chorioamnion or oxytocin augmentation with amniotomy and internal monitoring of the fetal heart rate and uterine contractions.. The intact group (n = 58) and the amniotomy group (n = 60) were similar with respect to maternal age, race, parity, labor epidural usage, gestational age, cervical dilatation at randomization, number of vaginal examinations, and infant birth weight. Four patients in the intact group and five in the amniotomy group underwent cesarean delivery (P = 1.0). No patient in the intact group and three in the amniotomy group were diagnosed with chorioamnionitis (P = .24). Endometritis did not occur in the intact group, whereas four cases occurred in the amniotomy group (P = .12). There were no cases of maternal infection in the intact group, versus seven in the amniotomy group (P = .01). The interval between randomization and vaginal delivery was 44 minutes longer in the intact group than in the amniotomy group (P = .11).. In women with active-phase arrest of labor and intact membranes, oxytocin augmentation with elective amniotomy and internal monitoring increases maternal infectious morbidity.

Topics: Adult; Amnion; Cesarean Section; Chorioamnionitis; Endometritis; Female; Fetal Monitoring; Humans; Labor, Induced; Obstetric Labor Complications; Oxytocin; Pregnancy; Pregnancy Outcome; Puerperal Infection

The purpose of this prospective investigation was to evaluate a protocol for management of term patients with premature rupture of membranes (PROM) and a cervix unfavorable for induction of labor (Bishop score 4 or less). Patients initially were observed for 24 to 36 hours for the spontaneous onset of labor. If spontaneous contractions did not commence, labor was induced with oxytocin. Patients subsequently were divided into three groups: 44 who had spontaneous labor, 29 who had spontaneous labor but required oxytocin augmentation, and 39 women who had oxytocin induction. Patients who entered labor spontaneously had a significantly shorter mean latent period between rupture of membranes and onset of labor (16.0 versus 26.8 and 40.7 hours), shorter mean duration of labor (7.6 versus 12.1 and 13.1 hours), and shorter mean duration of rupture of membranes (23.6 versus 39.0 and 53.8 hours). These women also had a significant decrease in the frequency of chorioamnionitis (7 versus 14 and 33%), and their infants had fewer evaluations for sepsis (25.0 versus 34.5 and 53.8%). We conclude that term patients with PROM and an unfavorable cervix who require oxytocin augmentation or induction of labor are at increased risk for intrapartum and neonatal infection compared with those who progress through labor spontaneously.

Topics: Cervix Uteri; Chorioamnionitis; Endometritis; Female; Fetal Membranes, Premature Rupture; Humans; Labor, Induced; Oxytocin; Pregnancy; Pregnancy Outcome; Prospective Studies; Risk Factors; Time Factors

We conducted a prospective randomized study involving 317 patients with term gestations (greater than 36 weeks) and premature rupture of membranes (PROM). Eighty-five percent of the 167 patients managed conservatively began labor within 48 hours. The cesarean section rate in this group was 7% as opposed to 21% in the group managed by oxytocin induction. There were no neonatal infections, and the maternal intrauterine infection rate was lower in the group managed expectantly, 4% vs 12%. There was no difference in the average time of hospitalization for the two groups. Conservative management of patients with PROM at term will significantly reduce the incidence of cesarean section without placing the mother or infant at a higher risk of infection.

Topics: Cesarean Section; Endometritis; Female; Fetal Diseases; Fetal Distress; Fetal Membranes, Premature Rupture; Fetal Monitoring; Humans; Infant, Newborn; Labor, Induced; Labor, Obstetric; Oxytocin; Pregnancy; Prospective Studies; Random Allocation; Streptococcal Infections; Streptococcus agalactiae; Time Factors

Equine endometritis is one of the most common causes of reproduction failure. To achieve better treatment outcomes, different diagnostic methods should be combined. In the current study, 39 repeat breeder mares were subjected to ultrasonography examination to detect excessive accumulation of intrauterine fluids and an abnormal oedema pattern, which revealed that 61.5% of mares were positive. Combined with endometrial cytology by low-volume uterine flush, 47.7% of smears contain neutrophils (more than 2-3 per HPF X100), and microbial culture. 92.3% of mares were infected with different bacterial isolates, such as Escherichia coli, Streptococci, Staphylococcus, Klebsiella pneumoniae, Klebsiella oxytoca, Citrobacter freundii, Providencia alcalifaciens, and Proteus mirabilis. All mares were given saline solution and gravity withdrawal before being given 20 IU of oxytocin (as ecbolic agents). Mares were divided into three groups; Group one (n = 15) received an intrauterine infusion of 20 mL of freshly prepared autologous platelet-rich plasma (PRP) 6 h after breeding, Group two (n = 15) was treated with three doses of systemic Enrofloxacin 5% during the estrus period, and Group three (n = 9) received only uterine lavage and 20 IU of oxytocin. PRP and Enrofloxacin resulted in a significant (p < .05) reduction in endometrial thickness (oedema; 5.05 and 6.74 mm, respectively) and disappearance of intrauterine fluids compared to the control (10.98 mm). Furthermore, PRP (days) and Enrofloxacin (17.89 days) reduced the days to the next oestrus compared to the control (18.58 and 17.89 vs. 21.19 days, respectively). Furthermore, the pregnancy rate improved to reach 70% in the PRP group and 60% in the Enrofloxacin group, while the control remained low at 22%. In conclusion, autologous PRP can be used as a low-cost alternative therapy for modulating the inflammatory process and effectively treating mares' endometritis.

Topics: Animals; Blood Platelets; Endometritis; Endometrium; Enrofloxacin; Female; Horse Diseases; Horses; Oxytocin; Platelet-Rich Plasma; Pregnancy; Reproduction

The aim of this study was to investigate the effects of PGF

Topics: Animals; Cattle; Cattle Diseases; Dinoprost; Endometritis; Female; Myometrium; Oxytocics; Oxytocin; Pregnancy; Uterine Contraction

To compare maternal and neonatal outcomes based on length of the latent phase during induction with rupture of membranes before 6 cm dilation.. This is a retrospective cohort study using data from the Consortium of Safe Labor study, including 9,763 nulliparous and 8,379 multiparous women with singleton, term pregnancies undergoing induction at 2 cm dilation or less with rupture of membranes before 6 cm dilation after which the latent phase ended. Outcomes were evaluated according to duration of oxytocin and rupture of membranes.. At time points from 6 to 18 hours of oxytocin and rupture of membranes, the rates of nulliparous women remaining in the latent phase declined (35.9-1.4%) and the rates of vaginal delivery for those remaining in the latent phase at these time periods decreased (54.1-29.9%) Nulliparous women remaining in the latent phase for 12 hours compared with women who had exited the latent phase had significantly increased rates of chorioamnionitis (12.1% compared with 4.1%) and endometritis (3.6% compared with 1.3%) and increased rates of neonatal intensive care unit admission (8.7% compared with 6.3%). Similar patterns were present for multiparous women at 15 hours.. Based on when neonatal morbidity increased, in an otherwise uncomplicated induction of labor with rupture of membranes, a latent phase after initiation of oxytocin of at least 12 hours for nulliparous women and 15 hours in multiparous women is a reasonable criterion for diagnosing a failed induction.

Topics: Adult; Chorioamnionitis; Endometritis; Extraembryonic Membranes; Female; Humans; Infant, Newborn; Intensive Care, Neonatal; Labor, Induced; Labor, Obstetric; Oxytocics; Oxytocin; Parity; Pregnancy; Retrospective Studies; Time Factors; Treatment Failure; Young Adult

Endometritis after insemination is ubiquitous in the horse and is associated with semen and/or bacteria in the uterus. In up to 40% of horses, inflammation persists causing infertility. An endometrial explant culture was developed to study uterine secretion of prostaglandin F(2alpha) (PGF(2alpha)) in response to physiological and pathological challenge.. Uteri were collected from mares, the endometrium dissected and explants from the uterine body or horn cultured in William's or RPMI medium. The response of explants to oxytocin, semen or bacteria compared to untreated tissue was tested by collecting medium after 24 and 72 hr and measuring PGF(2alpha) by radioimmunoassay.. Explants from the uterine horn and cultured in William's medium secreted the most PGF(2alpha) after challenge with oxytocin. Explants treated with semen produced a PGF(2alpha) response after 72 hr. Explants collected from mares in the transition season treated with killed S. zooepidemicus or E. coli lipopolysaccharide (LPS) secreted increased concentrations of PGF(2alpha) after 24 and 72 hr. The response to LPS was inhibited by polymyxin B. Follicular and luteal phase explants did not respond to treatments.. An endometrial explant culture was developed that measured PGF(2alpha) and may be used to study endometritis.

Topics: Animals; Anti-Bacterial Agents; Dinoprost; Endometritis; Endometrium; Estrous Cycle; Female; Histocytochemistry; Horse Diseases; Horses; Lipopolysaccharides; Oxytocin; Polymyxin B; Progesterone; Streptococcus equi; Tissue Culture Techniques

Persistent, postmating endometritis affects approximately 15% of mares and results in reduced fertility and sizable economic losses to the horse-breeding industry. Mares that are susceptible to postmating endometritis have delayed uterine clearance associated with reduced uterine contractility. Unfortunately, the mechanism for reduced uterine contractility remains an enigma. The present study examined the hypothesis that mares with delayed uterine clearance have an intrinsic contractile defect of the myometrium. Myometrial contractility was evaluated in vitro by measuring isometric tension generated by longitudinal and circular uterine muscle strips in response to KCl, oxytocin, and prostaglandin F(2alpha) (PGF(2alpha)) for young nulliparous mares, older reproductively normal mares, and older mares with delayed uterine clearance. In addition, intracellular Ca(2+) regulation was evaluated using laser cytometry to measure oxytocin-stimulated intracellular Ca(2+) transients of myometrial cells loaded with a Ca(2+)-sensitive fluorescent dye, fluo-4. For all contractile agonists, myometrium from mares with delayed uterine clearance failed to generate as much tension as myometrium from older normal mares. Oxytocin-stimulated intracellular Ca(2+) transients were similar for myometrial cells from mares with delayed uterine clearance and from older normal mares, suggesting that the contractile defect did not result from altered regulation of intracellular Ca(2+) concentration. Furthermore, no apparent age-dependent decline was observed in myometrial contractility; KCl-depolarized and oxytocin-stimulated longitudinal myometrium from young normal mares and older normal mares generated similar responses. However, circular myometrium from young normal mares failed to generate as much tension as myometrium from older normal mares when stimulated with oxytocin or PGF(2alpha), suggesting possible age-related alterations in receptor-second messenger signaling mechanisms downstream of intracellular Ca(2+) release. In summary, for mares with delayed uterine clearance, an intrinsic contractile defect of the myometrium may contribute to reduced uterine contractility following breeding.

Topics: Aniline Compounds; Animals; Calcium; Dinoprost; Endometritis; Female; Fluorescent Dyes; Horse Diseases; Horses; In Vitro Techniques; Muscle, Smooth; Myometrium; Oxytocin; Potassium Chloride; Uterine Contraction; Uterus; Xanthenes

To generate contemporary uterine activity and labor progress data for oxytocin-augmented labor, and assess whether 2 hours of active phase labor arrest with at least 200 Montevideo units justifies cesarean delivery.. Five hundred and one consecutive spontaneously laboring term women with abnormally progressive labor were managed by a standardized protocol: oxytocin and intrauterine pressure catheter with an intent to sustain at least 200 Montevideo units for 4 hours or more before cesarean for labor arrest. Uterine activity was measured, and maternal and neonatal outcomes were evaluated. With a sample of this size, the upper 95% confidence interval limit for an event with an observed rate of 1% is below 3%.. During oxytocin augmentation, nulliparas who were delivered vaginally dilated at a median rate of 1.4 cm/hour versus 1.8 cm/hour for parous women. In both groups, the 5th percentile of cervical dilation rate was 0.5 cm/hour. Thirty-eight women experienced labor arrest for over 2 hours despite at least 200 sustained Montevideo units; 23 (61%) achieved a vaginal delivery. Rates of chorioamnionitis and endometritis for the 38 women were 26%. None of their infants sustained a serious complication, including brachial plexus injury, even though three of the 23 vaginal deliveries (13%) were complicated by shoulder dystocia.. These data demonstrate that oxytocin-augmented labor proceeds at substantially slower rates than spontaneous labor, and support our previous contention that the criteria of labor arrest for 2 hours, despite at least 200 sustained Montevideo units, are insufficiently rigorous for the performance of cesarean.

Topics: Adult; Cesarean Section; Chorioamnionitis; Confidence Intervals; Endometritis; Female; Humans; Infant, Newborn; Labor Stage, First; Labor, Induced; Obstetric Labor Complications; Oxytocin; Parity; Pregnancy; Pregnancy Outcome; Prospective Studies; Time Factors; Uterine Contraction; Uterine Monitoring

The effects of oxytocin on the percentage of technetium 99m albumin colloid (99mTc-microAA), cleared from the uterine lumen was measured in 13 mares. Scintigraphy was performed during 4 consecutive oestrous cycles, on Day 3 of oestrus during Cycles one and 3 and 48 h after ovulation during Cycles 2 and 4. Oxytocin (20 iu) was given i.v. after the initial scintigraphy image during Cycles 3 and 4. Seven multiparous mares (Group 1) were classified as 'susceptible' and 6 mares (2 nulliparous and 4 multiparous; Group 2) were classified as 'resistant' to endometritis. All mares cleared > 90% of 99mTc-microAA within 30 min of oxytocin injection. When no drug was given, Group 1 mares cleared negligible amounts of radiocolloid (< 5%) and Group 2 mares cleared 50-80%. No mares showed signs of colic after oxytocin administration. It is concluded that oxytocin enhances uterine clearance of radiocolloid and may be useful for treating mares exhibiting impaired uterine clearance.

Topics: Animals; Colloids; Disease Susceptibility; Endometritis; Female; Horse Diseases; Horses; Ovulation; Oxytocics; Oxytocin; Radionuclide Imaging; Reproduction; Technetium Tc 99m Aggregated Albumin; Uterus

Topics: Animals; Drainage; Drug Administration Schedule; Endometritis; Female; Fertilization; Horse Diseases; Horses; Injections, Intravenous; Injections, Subcutaneous; Oxytocin; Pregnancy; Ultrasonography; Uterine Contraction; Uterus

The disk method with Ericson and Bauer's solid nutrient media were employed to ascertain the drug resistance of a total of 54 strains of Escherichia coli, 25 strains of Staphylococcus aureus, 11 strains of Streptococcus pyogenes, 7 strains of Corynebacterium pyogenes, 7 strains of Streptococcus uberis, 2 strains of Streptococcus agalactiae, and 1 strain of Streptococcus disgalactiae isolated from utero-cervical exudate and milk samples of sows with clinical symptoms of mastitis-metritis-agalactia (MMA). It was found that gentamycin only suppressed 100 per cent of the strains. So far as the other chemotherapeutic agents were concerned the organisms showed a varying extent of resistance. After determining the sensitivity of the strains to drugs two groups of pigs (from which the strains referred to were isolated) were subject to treatment. All 20 sows of the first group were treated with oxytocin only, while the 446 animals of the second group were treated with gentamycin in combination with oxytocin. It was found that effective therapy in the case of MMA was impossible with the application of preparations on the base of the hind lobe of the pituitary only. It is necessary to use chemotherapeutic means tow which the isolated organisms are susceptible.

Topics: Animals; Bacteria; Cervix Uteri; Drug Resistance, Microbial; Drug Therapy, Combination; Endometritis; Female; Gentamicins; Lactation Disorders; Mastitis; Microbial Sensitivity Tests; Milk; Oxytocin; Pregnancy; Swine; Swine Diseases; Syndrome

A group of 22 postpartum Holstein Friesian cows showing abnormal uterus were divided into two groups and treated with a) PGF(2)alpha or b) diethylstilboestrol and oxytocin. Most blood P(4) values were under 0.5 ng/mL whereas E(2) blood level was higher than in normal cycling cows. The report emphasizes the need for a careful clinical examination in order to apply the proper therapy.

Topics: Animals; Cattle; Cattle Diseases; Corpus Luteum; Diethylstilbestrol; Endometritis; Estradiol; Female; Labor, Obstetric; Ovulation; Oxytocin; Pregnancy; Progesterone; Prostaglandins F

A description is given of a method for the early diagnosis of the postpartal inflammations of the uterus. The method is based on the postpartal sensitivity of the uterus to oxytocin, which is registered via the method of radio telemetry. The sensitivity of the method suggested is recorded in two positive degrees in dependence on the individual features of the animal body, the season, etc. In cows with no predisposition to postpartum metritis there are sporadic, irregular contractions.

Topics: Animals; Cattle; Cattle Diseases; Endometritis; Female; Oxytocin; Pregnancy; Puerperal Infection; Radio; Telemetry; Time Factors; Uterine Contraction

The dose-response and time-response relationships between injected oxytocin and intramammary pressure were investigated in normal lactating sows. In less than 39 s after 20, 40, or 80 U of oxytocin was given (IM injection), there was a rapid initial increase in intramammary pressure (15 to 27 mm of Hg) which lasted 22 to 32 s. After this initial response, there were secondary oscillations in pressure which lasted approximately 40 minutes (20 U) and up to 60 minutes (40 or 80 U). Changes in intramammary pressure during each oscillation varied between 1 and 5 mm of Hg. Mean values for frequency and amplitude of oscillations and total work (area under the trace) were measured. Compared with response obtained after 20 U of oxytocin was given, responses obtained at the 40-U or 80-U dose level had an increased frequency (150.0% and 249.0%, respectively) and total work (36.6% and 104.4%, respectively), but not amplitude. Thus, there may be some clinical advantage in milk let-down effect when sows are given the larger doses of oxytocin (40 or 80 U). These results indicate that newborn pigs should be allowed to nurse at the same time in which oxytocin is injected.

Topics: Animals; Blood Pressure; Endometritis; Female; Lactation Disorders; Mammary Glands, Animal; Mastitis; Oxytocin; Pregnancy; Swine; Swine Diseases; Syndrome

Mammary gland responsiveness to exogenous oxytocin during lactation was assessed by measuring changes in intramammary pressure of healthy sows given (IM injection) synthetic oxytocin (40 U). Response to oxytocin was measured once a week for the first 8 weeks of lactation. Recordings of pressure changes were expressed as mean area (cm2) under the trace at each 10-minute interval over 30 minutes after oxytocin had been given. During the 2nd week of lactation, there was a 55.3% increase (P less than 0.05) in responsiveness to oxytocin (25.1 +/- 4.2 cm2/10 minutes) as compared with the 1st week (13.9 +/- 2.2 cm2/10 minutes). Responsiveness decreased, however, from the 2nd to the 8th week. Since the incidence of mastitis-metritis-agalactia in sows is particularly high during the 1st week of lactation, low responsiveness of the mammary gland to oxytocin may be a contributing factor.

Topics: Animals; Blood Pressure; Endometritis; Female; Lactation; Lactation Disorders; Mammary Glands, Animal; Mastitis; Oxytocin; Pregnancy; Swine; Swine Diseases; Syndrome

Intra-amniotic hyperosmolar urea (59.7 per cent) augmented by intravenous oxytocin (332 millimicron per minute), prostaglandin F2alpha (20 mg.), prostaglandin F2alpha (10 mg.), or prostaglandin F2alpha (5 mg.) was utilized for 1,913 patients requesting elective midtrimester abortion. Injection-abortion intervals ranging from 13.70 to 21.49 hours were achieved with failure rates of 0.7 to 6.7 per cent. Despite frequent pre-existing medical conditions, the complication rate compared favorably with those of other methods for terminating midtrimester pregnancy such as saline amnioinfusion or dilatation and evacuation.

Topics: Abortifacient Agents; Abortifacient Agents, Nonsteroidal; Abortion, Induced; Amnion; Endometritis; Female; Humans; Injections; Nausea; Osmolar Concentration; Oxytocin; Postoperative Complications; Pregnancy; Pregnancy Trimester, Second; Prostaglandins F; Time Factors; Urea; Uterine Hemorrhage; Vomiting

Topics: Adult; Endometritis; Female; Humans; Oxytocin; Pregnancy; Puerperal Disorders

The efficacy of intramuscular administration of 15 methyl (15S) prostaglandin F2alpha (PGF2a) in midtrimester pregnancy termination was evaluated in 16 healthy patients (mean age, 23.3; mean parity, 1.4; mean number of menstrual weeks, 16.1) by measuring dose response; oxytocin conversion; abortion time; side effects; intrauterine dynamics and progesterone withdrawal. Labor was monitored using extraovular balloon placed transvaginally; transcervically; and connected to a Physiograph machine. Patients not aborting within 48 hours after the first dose were considered failures. Blood samples were collected at 0, 3, and 6 hours and at abortion time for plasma progesterone measurement. Average dose given was 789 +or- 60 micrograms. Only 9 of 10 patients aborted within the prescribed 48 hours: 7 were complete abortions, and 2 were incomplete and required suction curettage. Mean induction to abortion time was 20.2 +or- 2.7 hours. Nausea, vomiting and diarrhea were the main side effects. The findings suggest that 15 methyl PGF2a in the dosages and routes prescribed is not as efficient as PGF2a. It is also suggested that prostaglandin affects the myometrium at 2 levels: 1) a membrane effect, and 2) a more fundamental intracellular regulatory effect which is necessary to initiate labor.

Topics: Abortion, Induced; Action Potentials; Diarrhea; Endometritis; Female; Humans; Injections, Intramuscular; Muscle Contraction; Nausea; Oxytocin; Pregnancy; Pregnancy Trimester, Second; Pressure; Progesterone; Prostaglandins; Stimulation, Chemical; Uterus; Vomiting

132 physically health patients (aged 12-41 years; 12-21 weeks gestation) were given intraamniotic PGF2alpha (prostaglandin F2alpha) for induction of midtrimester abortion. Analgesic agents and antiemetics were administered intramuscularly as needed. The patients were grouped as follows: 1) Group A (n=48), those who were given an initial dose of 25 mg PGF2a, then as needed; 2) Group B (n=43), initial dose of 30 mg, 25 mg at hour 6-8, and 25 mg at hour 24; 3) Group C (n=17), initial dose of 40 mg, subsequent 40 mg if unaborted at hour 24; and 4) Group D (n=24), initial dose of 40 mg, 10-25 mg at hour 6-8, additional 20 mg if unaborted at hour 24. A 94.7% incidence of abortion was achieved. In Group A, 29 had complete abortion, 16 incomplete, and 3 failures. Group B had 32 complete abortions, 8 incomplete, and 3 failures. Group C had 9 complete, 7 incomplete, and 1 failure. Corresponding figures for Group D were 19, 5 and 0 respectively. Average time to abortion ranged from 13 hours 22 minutes to 25 hours 33 minutes. The primary side effects of PGF2a were gastrointestinal (vomiting, diarrhea). 70% of patients vomited and 13.6% became febrile. Serious complications included sepsis, systemic reaction to prostaglandin, and cervical laceration. Advantages of intraamniotic PGF2a include ease of administration; generally short injection-abortion time; and its ability to induce myometrial contractions regardless of gestational size. However, the safety, convenience, and acceptability of PGF2 are yet to be established. The following guidelines are suggested for minimizing complications: 1) a test dose of 2.5 mg should be administered slowly over at least 1 minute, 2) fever should not be attributed to drug reaction but considered as suggestive evidence of developing infection, 3) patients unaborted at hour 24 should be considered as high risk with respect to potential failure to abort, development of infection, or cervical laceration, and 4) cervical inspection should be performed, especially in the nulliparous patient with a later gestation and a long labor.

Topics: Abortion, Therapeutic; Adolescent; Adult; Amniocentesis; Amnion; Child; Diarrhea; Endometritis; Female; Fever; Humans; Infections; Injections, Intravenous; Oxytocin; Parity; Pregnancy; Prostaglandins; Time Factors; Vomiting

Topics: Acidosis; Actinomycosis; Animals; Chronic Disease; Endometritis; Ergotism; Female; Hypocalcemia; Lactation Disorders; Mammary Glands, Animal; Mastitis; Necrosis; Obstetric Labor Complications; Oxytocin; Pregnancy; Swine; Swine Diseases

Topics: Animals; Cattle; Cattle Diseases; Endometritis; Female; Hexestrol; Oxytocin; Pregnancy; Puerperal Disorders

Topics: Animals; Cattle; Cattle Diseases; Endometritis; Estradiol; Female; Hexestrol; Oxytocin; Uterus

Topics: Acute Kidney Injury; Endometritis; Female; Humans; Oxytocin; Pathology; Pregnancy; Pregnancy Complications; Puerperal Infection; Pulmonary Edema; Thrombophlebitis; Uterus