oxytocin and Headache

Retained placenta affects 0.5% to 3% of women following delivery, with considerable morbidity if left untreated. Use of nitroglycerin (NTG), either alone or in combination with uterotonics, may be of value to minimise the need for manual removal of the placenta in theatre under anaesthesia.. To evaluate the benefits and harms of NTG as a tocolytic, either alone or in addition to uterotonics, in the management of retained placenta.. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (14 January 2015), reference lists of retrieved studies and contacted experts in the field.. Any adequately randomised controlled trial (RCT) comparing the use of NTG, either alone or in combination with uterotonics, with no intervention or with other interventions in the management of retained placenta. All women having a vaginal delivery with a retained placenta, regardless of the management of the third stage of labour (expectant or active). We included all trials with haemodynamically stable women in whom the placenta was not delivered at least within 15 minutes after delivery of the baby.. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy.. We included three randomised controlled trials (RCTs) with 175 women. The three published RCTs compared NTG alone versus placebo. The detachment status of retained placenta was unknown in all three RCTs. Collectively, among the three included trials, two were judged to be at low risk of bias and the third trial was judged to be at high risk of bias for two domains: incomplete outcome data and selective reporting. The three trials reported seven out of 23 of the review's pre-specified outcomes.The primary outcome "manual removal of the placenta" was reported in all three studies. No differences were seen between NTG and placebo for manual removal of the placenta (average risk ratio (RR) 0.83, 95% confidence interval (CI) 0.47 to 1.46; women = 175; I² = 81%). A random-effects model was used because of evidence of substantial heterogeneity in the analysis. There were also no differences between groups for risk of severe postpartum haemorrhage (RR 0.93, 95% CI 0.62 to 1.39; women = 150; studies = two; I² = 0%). Blood transfusion was only reported in one study (40 women) and again there was no difference between groups (RR 1.00, 95% CI 0.07 to 14.90; women = 40; I² = 0%). Mean blood loss (mL) was reported in the three studies and no differences were observed (mean difference (MD) -115.31, 95% CI -306.25 to 75.63; women = 169; I² = 83%). Nitroglycerin administration was not associated with an increase in headaches (RR 1.09, 95% CI 0.80 to 1.47; women = 174; studies = three; I² = 0%). However, nitroglycerin administration was associated with a significant, though mild, decrease in systolic and diastolic blood pressure and a significant increase in pulse rate (MD -3.75, 95% CI -7.47 to -0.03) for systolic blood pressure, and (MD 6.00, 95% CI 3.07 to 8.93) for pulse rate (beats per minute) respectively (reported by only one study including 24 participants). Maternal mortality and addition of therapeutic uterotonics were not reported in any study.. In cases of retained placenta, currently available data showed that the use of NTG alone did not reduce the need for manual removal of placenta. This intervention did not increase the incidence of severe postpartum haemorrhage nor the need for blood transfusion. Haemodynamically, NTG had a significant though mild effect on both pulse rate and blood pressure.

Topics: Administration, Sublingual; Female; Headache; Humans; Nitroglycerin; Oxytocics; Oxytocin; Placenta, Retained; Postpartum Hemorrhage; Pregnancy; Randomized Controlled Trials as Topic

The objective of this study is to compare the effectiveness and safety of carbetocin vs. oxytocin in the management of atonic post partum haemorrhage (PPH) after vaginal delivery.. A prospective randomised study was conducted in which 100 pregnant women were randomised into 2 equal groups: group 1 received Carbetocin 100 µgm (Pabal(®) Ferring, UK) and group 2 received oxytocin 5 IU (Syntocinon(®), Novartis, Switzerland).. The amount of blood loss and the need for other uterotonics were significantly lower in the carbetocin group (811 ± 389.17 vs. 1010 ± 525.66 and 10/50 vs. 21/50). There was no significant difference between the carbetocin and oxytocin groups regarding occurrence of major PPH (6 vs. 11), the need for blood transfusion (6 vs. 9), the difference between blood haemoglobin levels before delivery and 24 h after delivery (0.6 ± 0.28 vs. 0.56 ± 0.25), respectively. There was no significant difference between the 2 study groups regarding both systolic and diastolic blood pressure measured immediately after the drug administration and at 30 and 60 min later. Regarding the drugs side effects, there was no significant difference between the 2 groups in the occurrence of nausea, vomiting, tachycardia, flushing, dizziness, headache, shivering, metallic taste, dyspnea, palpitations and itching.. Carbetocin is a better alternative to oxytocin in management of atonic PPH with non-significant hemodynamic changes or side effects .

Topics: Adult; Blood Pressure; Delivery, Obstetric; Dizziness; Double-Blind Method; Female; Headache; Humans; Nausea; Oxytocics; Oxytocin; Postpartum Hemorrhage; Pregnancy; Prospective Studies; Switzerland; Treatment Outcome; Vertigo; Vomiting

Oxytocin (OXT), a nonapeptide hormone of posterior pituitary, reaches the central nervous system from systemic blood circulation with a difficulty because of the blood-brain barrier (BBB). The interest has been expressed in the use of the nasal route for delivery of OXT to the brain directly, exploiting the olfactory pathway. Our previous study has demonstrated that OXT in the central nervous system rather than the blood circulation plays an important role in rat pain modulation. The communication tried to investigate the interaction between the OXT and pain modulation in Chinese patients with headache to understand the OXT effect on human pain modulation. The results showed that (1) intranasal OXT could relieve the human headache in a dose-dependent manner; (2) OXT concentration in both plasma and cerebrospinal fluid (CSF) increased significantly in headache patients in relation with the pain level; and (3) there was a positive relationship between plasma and CSF OXT concentration in headache patients. The data suggested that intranasal OXT, which was delivered to the central nervous system through olfactory region, could treat human headache and OXT might be a potential drug of headache relief by intranasal administration.

Topics: Administration, Intranasal; Adult; Asian People; Dose-Response Relationship, Drug; Female; Headache; Humans; Male; Middle Aged; Oxytocin; Pain; Pain Measurement; Young Adult

Topics: Analgesia, Epidural; Analgesia, Obstetrical; Female; Headache; Humans; Hypertension; Oxytocin; Pregnancy; Puerperal Disorders

There are few references to lactational cephalalgia (headache) in the literature, and these few such headaches are attributed to oxytocin surges associated with the milk-ejection reflex. The case described here differs, in that the apparent trigger was overfulness, rather than an oxytocin surge, that occurred when the infant began sleeping through the night or after a missed, delayed, or partial feed. Headaches were relieved by putting the baby to the breast and the resultant milk-ejection reflex. This case study describes maternal coping strategies from 5 months postpartum until weaning was completed at 12 months.

Topics: Adaptation, Psychological; Consultants; Female; Headache; Humans; Lactation Disorders; Oxytocin

Results were kept on 43 spinal anaesthetics performed for caesarean section in the Solomon Islands, a developing tropical country in the Pacific Ocean. A 25-gauge Quincke needle was used and either 2.5 ml of heavy bupivacaine 0.5% or 2.0-2.5 ml of plain bupivacaine 0.5% were injected. Hypotension down to 85 mmHg occurred in four patients and there were no spinal headaches. Five patients had to be given a general anaesthetic. We recommend this technique to other doctors working in the Pacific Islands.

Topics: Anesthesia, General; Anesthesia, Obstetrical; Anesthesia, Spinal; Bupivacaine; Cesarean Section; Female; Headache; Humans; Hypotension; Ketamine; Melanesia; Obstetric Labor Complications; Oxytocin; Pregnancy

Topics: Adolescent; Adult; Drug Evaluation; Headache; Humans; Injections, Intravenous; Male; Oligospermia; Oxytocin; Semen; Sperm Count

Topics: Abortion, Induced; Catheterization; Female; Headache; Humans; Oxytocin; Parity; Pregnancy; Pregnancy Trimester, Second; Saline Solution, Hypertonic; Sodium Chloride; Uterus

Topics: Adult; Age Factors; Animals; Behavior, Animal; Diabetes Insipidus; Female; Headache; Humans; Hypertonic Solutions; Hypopituitarism; Hypothalamo-Hypophyseal System; Kidney; Necrosis; Osmolar Concentration; Oxytocin; Parity; Postpartum Hemorrhage; Pregnancy; Puerperal Disorders; Vasopressins; Water-Electrolyte Balance

Topics: Adult; Edema; Female; Headache; Humans; Injections; Methods; Oxytocin; Postpartum Hemorrhage; Pregnancy