oxytocin and Hypertension

The automatism of cardiac pacemaker cells, which is tuned, is regulated by the autonomic nervous system (ANS) and multiple endocrine and paracrine factors, including cardiovascular peptides. The cardiovascular peptides (CPs) form a group of essential paracrine factors affecting the function of the heart and vessels. They may also be produced in other organs and penetrate to the heart via systemic circulation. The present review draws attention to the role of vasopressin (AVP) and some other cardiovascular peptides (angiotensins, oxytocin, cytokines) in the regulation of the cardiovascular system in health and cardiovascular diseases, especially in post-infarct heart failure, hypertension and cerebrovascular strokes. Vasopressin is synthesized mostly by the neuroendocrine cells of the hypothalamus. There is also evidence that it may be produced in the heart and lungs. The secretion of AVP and other CPs is markedly influenced by changes in blood volume and pressure, as well as by other disturbances, frequently occurring in cardiovascular diseases (hypoxia, pain, stress, inflammation). Myocardial infarction, hypertension and cardiovascular shock are associated with an increased secretion of AVP and altered responsiveness of the cardiovascular system to its action. The majority of experimental studies show that the administration of vasopressin during ventricular fibrillation and cardiac arrest improves resuscitation, however, the clinical studies do not present consisting results. Vasopressin cooperates with the autonomic nervous system (ANS), angiotensins, oxytocin and cytokines in the regulation of the cardiovascular system and its interaction with these regulators is altered during heart failure and hypertension. It is likely that the differences in interactions of AVP with ANS and other CPs have a significant impact on the responsiveness of the cardiovascular system to vasopressin in specific cardiovascular disorders.

Topics: Angiotensins; Arginine Vasopressin; Cardiovascular Diseases; Cardiovascular System; Cytokines; Heart Failure; Humans; Hypertension; Lung; Oxytocin; Vasopressins

The neurons secreting oxytocin (OXY) and vasopressin (AVP) are located mainly in the supraoptic, paraventricular, and suprachiasmatic nucleus of the brain. Oxytocinergic and vasopressinergic projections reach several regions of the brain and the spinal cord. Both peptides are released from axons, soma, and dendrites and modulate the excitability of other neuroregulatory pathways. The synthesis and action of OXY and AVP in the peripheral organs (eye, heart, gastrointestinal system) is being investigated. The secretion of OXY and AVP is influenced by changes in body fluid osmolality, blood volume, blood pressure, hypoxia, and stress. Vasopressin interacts with three subtypes of receptors: V1aR, V1bR, and V2R whereas oxytocin activates its own OXTR and V1aR receptors. AVP and OXY receptors are present in several regions of the brain (cortex, hypothalamus, pons, medulla, and cerebellum) and in the peripheral organs (heart, lungs, carotid bodies, kidneys, adrenal glands, pancreas, gastrointestinal tract, ovaries, uterus, thymus). Hypertension, myocardial infarction, and coexisting factors, such as pain and stress, have a significant impact on the secretion of oxytocin and vasopressin and on the expression of their receptors. The inappropriate regulation of oxytocin and vasopressin secretion during ischemia, hypoxia/hypercapnia, inflammation, pain, and stress may play a significant role in the pathogenesis of cardiovascular diseases.

Topics: Axons; Brain; Cardiovascular Abnormalities; Cardiovascular System; Humans; Hypertension; Lung; Myocardial Infarction; Neurons; Neurophysins; Oxytocin; Protein Precursors; Receptors, Oxytocin; Vasopressins

Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Prophylactic uterotonic drugs can prevent PPH, and are routinely recommended. There are several uterotonic drugs for preventing PPH but it is still debatable which drug is best.. To identify the most effective uterotonic drug(s) to prevent PPH, and generate a ranking according to their effectiveness and side-effect profile.. We searched Cochrane Pregnancy and Childbirth's Trials Register (1 June 2015), ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) for unpublished trial reports (30 June 2015) and reference lists of retrieved studies.. All randomised controlled comparisons or cluster trials of effectiveness or side-effects of uterotonic drugs for preventing PPH.Quasi-randomised trials and cross-over trials are not eligible for inclusion in this review.. At least three review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We estimated the relative effects and rankings for preventing PPH ≥ 500 mL and PPH ≥ 1000 mL as primary outcomes. We performed pairwise meta-analyses and network meta-analysis to determine the relative effects and rankings of all available drugs. We stratified our primary outcomes according to mode of birth, prior risk of PPH, healthcare setting, dosage, regimen and route of drug administration, to detect subgroup effects.The absolute risks in the oxytocin are based on meta-analyses of proportions from the studies included in this review and the risks in the intervention groups were based on the assumed risk in the oxytocin group and the relative effects of the interventions.. This network meta-analysis included 140 randomised trials with data from 88,947 women. There are two large ongoing studies. The trials were mostly carried out in hospital settings and recruited women who were predominantly more than 37 weeks of gestation having a vaginal birth. The majority of trials were assessed to have uncertain risk of bias due to poor reporting of study design. This primarily impacted on our confidence in comparisons involving carbetocin trials more than other uterotonics.The three most effective drugs for prevention of PPH ≥ 500 mL were ergometrine plus oxytocin combination, carbetocin, and misoprostol plus oxytocin combination. These three options were more effective at preventing PPH ≥ 500 mL compared with oxytocin, the drug currently recommended by the WHO (ergometrine plus oxytocin risk ratio (RR) 0.69 (95% confidence interval (CI) 0.57 to 0.83), moderate-quality evidence; carbetocin RR 0.72 (95% CI 0.52 to 1.00), very low-quality evidence; misoprostol plus oxytocin RR 0.73 (95% CI 0.60 to 0.90), moderate-quality evidence). Based on these results, about 10.5% women given oxytocin would experience a PPH of ≥ 500 mL compared with 7.2% given ergometrine plus oxytocin combination, 7.6% given carbetocin, and 7.7% given misoprostol plus oxytocin. Oxytocin was ranked fourth with close to 0% cumulative probability of being ranked in the top three for PPH ≥ 500 mL.The outcomes and rankings for the outcome of PPH ≥ 1000 mL were similar to those of PPH ≥ 500 mL. with the evidence for ergometrine plus oxytocin combination being more effective than oxytocin (RR 0.77 (95% CI 0.61 to 0.95), high-quality evidence) being more certain than that for carbetocin (RR 0.70 (95% CI 0.38 to 1.28), low-quality evidence), or misoprostol plus oxytocin combination (RR 0.90 (95% CI 0.72 to 1.14), moderate-quality evidence)There were no meaningful differences between all drugs for maternal deaths or severe morbidity as these outcomes were so rare in the included randomised trials.Two combination regimens had the poorest rankings for side-effects. Specifically, the ergometrine plus oxytocin combination had the higher risk for vomiting (RR 3.10 (95% CI 2.11 to 4.56), high-quality evidence; 1.9% versus 0.6%) and hypertension [RR 1.77 (95% CI 0.55 to 5.66), low-quality evidence; 1.2% versus 0.7%), while the misoprostol plus oxytocin combination had the higher risk for fever (RR 3.18 (95% CI 2.22 to 4.55), moderate-quality evidence; 11.4% versus 3.6%) when compare. Ergometrine plus oxytocin combination, carbetocin, and misoprostol plus oxytocin combination were more effective for preventing PPH ≥ 500 mL than the current standard oxytocin. Ergometrine plus oxytocin combination was more effective for preventing PPH ≥ 1000 mL than oxytocin. Misoprostol plus oxytocin combination evidence is less consistent and may relate to different routes and doses of misoprostol used in the studies. Carbetocin had the most favourable side-effect profile amongst the top three options; however, most carbetocin trials were small and at high risk of bias.Amongst the 11 ongoing studies listed in this review there are two key studies that will inform a future update of this review. The first is a WHO-led multi-centre study comparing the effectiveness of a room temperature stable carbetocin versus oxytocin (administered intramuscularly) for preventing PPH in women having a vaginal birth. The trial includes around 30,000 women from 10 countries. The other is a UK-based trial recruiting more than 6000 women to a three-arm trial comparing carbetocin, oxytocin and ergometrine plus oxytocin combination. Both trials are expected to report in 2018.Consultation with our consumer group demonstrated the need for more research into PPH outcomes identified as priorities for women and their families, such as women's views regarding the drugs used, clinical signs of excessive blood loss, neonatal unit admissions and breastfeeding at discharge. To date, trials have rarely investigated these outcomes. Consumers also considered the side-effects of uterotonic drugs to be important but these were often not reported. A forthcoming set of core outcomes relating to PPH will identify outcomes to prioritise in trial reporting and will inform futures updates of this review. We urge all trialists to consider measuring these outcomes for each drug in all future randomised trials. Lastly, future evidence synthesis research could compare the effects of different dosages and routes of administration for the most effective drugs.

Topics: Drug Therapy, Combination; Ergonovine; Female; Fever; Humans; Hypertension; Misoprostol; Network Meta-Analysis; Oxytocics; Oxytocin; Postpartum Hemorrhage; Vomiting

Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Prophylactic uterotonic agents can prevent PPH, and are routinely recommended. The current World Health Organization (WHO) recommendation for preventing PPH is 10 IU (international units) of intramuscular or intravenous oxytocin. There are several uterotonic agents for preventing PPH but there is still uncertainty about which agent is most effective with the least side effects. This is an update of a Cochrane Review which was first published in April 2018 and was updated to incorporate results from a recent large WHO trial.. To identify the most effective uterotonic agent(s) to prevent PPH with the least side effects, and generate a ranking according to their effectiveness and side-effect profile.. We searched the Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (24 May 2018), and reference lists of retrieved studies.. All randomised controlled trials or cluster-randomised trials comparing the effectiveness and side effects of uterotonic agents with other uterotonic agents, placebo or no treatment for preventing PPH were eligible for inclusion. Quasi-randomised trials were excluded. Randomised trials published only as abstracts were eligible if sufficient information could be retrieved.. At least three review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We estimated the relative effects and rankings for preventing PPH ≥ 500 mL and PPH ≥ 1000 mL as primary outcomes. Secondary outcomes included blood loss and related outcomes, morbidity outcomes, maternal well-being and satisfaction and side effects. Primary outcomes were also reported for pre-specified subgroups, stratifying by mode of birth, prior risk of PPH, healthcare setting, dosage, regimen and route of administration. We performed pairwise meta-analyses and network meta-analysis to determine the relative effects and rankings of all available agents.. The network meta-analysis included 196 trials (135,559 women) involving seven uterotonic agents and placebo or no treatment, conducted across 53 countries (including high-, middle- and low-income countries). Most trials were performed in a hospital setting (187/196, 95.4%) with women undergoing a vaginal birth (71.5%, 140/196).Relative effects from the network meta-analysis suggested that all agents were effective for preventing PPH ≥ 500 mL when compared with placebo or no treatment. The three highest ranked uterotonic agents for prevention of PPH ≥ 500 mL were ergometrine plus oxytocin combination, misoprostol plus oxytocin combination and carbetocin. There is evidence that ergometrine plus oxytocin (RR 0.70, 95% CI 0.59 to 0.84, moderate certainty), carbetocin (RR 0.72, 95% CI 0.56 to 0.93, moderate certainty) and misoprostol plus oxytocin (RR 0.70, 95% CI 0.58 to 0.86, low certainty) may reduce PPH ≥ 500 mL compared with oxytocin. Low-certainty evidence suggests that misoprostol, injectable prostaglandins, and ergometrine may make little or no difference to this outcome compared with oxytocin.All agents except ergometrine and injectable prostaglandins were effective for preventing PPH ≥ 1000 mL when compared with placebo or no treatment. High-certainty evidence suggests that ergometrine plus oxytocin (RR 0.83, 95% CI 0.66 to 1.03) and misoprostol plus oxytocin (RR 0.88, 95% CI 0.70 to 1.11) make little or no difference in the outcome of PPH ≥ 1000 mL compared with oxytocin. Low-certainty evidence suggests that ergometrine may make little or no difference to this outcome compared with oxytocin meanwhile the evidence on carbetocin was of very low certainty. High-certainty evidence suggests that misoprostol is less effective in preventing PPH ≥ 1000 mL when compared with oxytocin (RR 1.19, 95% CI 1.01 to 1.42). Despite the comparable relative treatment effects between all uterotonics (except misoprostol) and oxytocin, ergometrine plus oxytocin, misoprostol plus oxytocin combinations and carbetocin were the highest ranked agents for PPH ≥ 1000 mL.Misoprostol plus oxytocin reduces the use of additional uterotonics (RR 0.56, 95% CI 0.42 to 0.73, high certainty) and probably also reduces the risk of blood transfusion (RR 0.51, 95% CI 0.37 to 0.70, moderate certainty) when compared with oxytocin. Carbetocin, injectable prostaglandins and ergometrine plus oxytocin may also reduce the use of additional uterotonics but the certainty of the evidence is low. No me. All agents were generally effective for preventing PPH when compared with placebo or no treatment. Ergometrine plus oxytocin combination, carbetocin, and misoprostol plus oxytocin combination may have some additional desirable effects compared with the current standard oxytocin. The two combination regimens, however, are associated with significant side effects. Carbetocin may be more effective than oxytocin for some outcomes without an increase in side effects.

Topics: Drug Therapy, Combination; Ergonovine; Female; Fever; Humans; Hypertension; Misoprostol; Network Meta-Analysis; Oxytocics; Oxytocin; Postpartum Hemorrhage; Prostaglandins; Randomized Controlled Trials as Topic; Vomiting

Hypertension is a major risk factor for ischemic heart disease and stroke, leading causes of morbidity and death worldwide. Intrauterine growth restriction (IUGR), caused by an excess of glucocorticoid exposure to the fetus, produces an imbalance in oxidative stress altering many biochemical and epigenetic gene transcription processes exposing the fetus and neonate to the 'thrifty' phenotype and pervasive polymorphisms appearance damaging health, cognitive, and behavioral processes in later life. OT is a major regulator of oxidative stress radicals that plays a major role in neonatal maturation of the central nervous system and many peripheral tissues expressing oxytocin/oxytocin-receptor (OT/OTR) system in the early postnatal period. OT and OTR are damaged by IUGR and early stress. This review highlights the fact that hypertension is likely to be a legacy of preterm birth due to IUGR and failure to meet nutritional needs in early infancy when fed formula instead of breastfeeding or human milk.

Topics: Animals; Base Sequence; Breast Feeding; Epigenesis, Genetic; Humans; Hypertension; Oxytocin; Phenotype; PPAR gamma

The elucidation of the genomes of a large number of mammalian species has produced a huge amount of data on which to base physiological studies. These endeavours have also produced surprises, not least of which has been the revelation that the number of protein coding genes needed to make a mammal is only 22 333 (give or take). However, this small number belies an unanticipated complexity that has only recently been revealed as a result of genomic studies. This complexity is evident at a number of levels: (i) cis-regulatory sequences; (ii) noncoding and antisense mRNAs, most of which have no known function; (iii) alternative splicing that results in the generation of multiple, subtly different mature mRNAs from the precursor transcript encoded by a single gene; and (iv) post-translational processing and modification. In this review, we examine the steps being taken to decipher genome complexity in the context of gene expression, regulation and function in the hypothalamic-neurohypophyseal system (HNS). Five unique stories explain: (i) the use of transcriptomics to identify genes involved in the response to physiological (dehydration) and pathological (hypertension) cues; (ii) the use of mass spectrometry for single-cell level identification of biological active peptides in the HNS, and to measure in vitro release; (iii) the use of transgenic lines that express fusion transgenes enabling (by cross-breeding) the generation of double transgenic lines that can be used to study vasopressin (AVP) and oxytocin (OXT) neurones in the HNS, as well as their neuroanatomy, electrophysiology and activation upon exposure to any given stimulus; (iv) the use of viral vectors to demonstrate that somato-dendritically released AVP plays an important role in cardiovascular homeostasis by binding to V1a receptors on local somata and dendrites; and (v) the use of virally-mediated optogenetics to dissect the role of OXT and AVP in the modulation of a wide variety of behaviours.

Topics: Animals; Animals, Genetically Modified; Arginine Vasopressin; Baroreflex; Gene Expression Profiling; Gene Expression Regulation; Genome; Humans; Hypertension; Hypothalamo-Hypophyseal System; Neuropeptides; Oxytocin

Significant scientific advances during the past 3 decades have deepened our understanding of the physiology and pathophysiology of penile erection. A critical evaluation of the current state of knowledge is essential to provide perspective for future research and development of new therapies.. To develop an evidence-based, state-of-the-art consensus report on the anatomy, physiology, and pathophysiology of erectile dysfunction (ED).. Consensus process over a period of 16 months, representing the opinions of 12 experts from seven countries.. Expert opinion was based on the grading of scientific and evidence-based medical literature, internal committee discussion, public presentation, and debate.. ED occurs from multifaceted, complex mechanisms that can involve disruptions in neural, vascular, and hormonal signaling. Research on central neural regulation of penile erection is progressing rapidly with the identification of key neurotransmitters and the association of neural structures with both spinal and supraspinal pathways that regulate sexual function. In parallel to advances in cardiovascular physiology, the most extensive efforts in the physiology of penile erection have focused on elucidating mechanisms that regulate the functions of the endothelium and vascular smooth muscle of the corpus cavernosum. Major health concerns such as atherosclerosis, hyperlipidemia, hypertension, diabetes, and metabolic syndrome (MetS) have become well integrated into the investigation of ED.. Despite the efficacy of current therapies, they remain insufficient to address growing patient populations, such as those with diabetes and MetS. In addition, increasing awareness of the adverse side effects of commonly prescribed medications on sexual function provides a rationale for developing new treatment strategies that minimize the likelihood of causing sexual dysfunction. Many basic questions with regard to erectile function remain unanswered and further laboratory and clinical studies are necessary.

Topics: Adrenocorticotropic Hormone; Diabetes Complications; Erectile Dysfunction; Humans; Hypertension; Male; Muscle, Smooth; N-Methylaspartate; Oxytocin; Penis; Phosphodiesterase Inhibitors

Topics: Adult; Black People; Blood Pressure; Cross-Over Studies; Diet, Sodium-Restricted; Ethnicity; Female; Genetic Predisposition to Disease; Humans; Hypertension; Infant, Newborn; Kidney; Male; Oxytocin; Sodium Chloride, Dietary; Sodium, Dietary; White People

Over the past decade several new routes of neurohypophysial hormone metabolism have been identified. These include nonhepatic splanchnic clearance and renal clearance in addition to filtration that appears to be receptor mediated. The intraluminal degradation of VP in the proximal tubule, and distal tubular secretion, at least in one species, has been identified. The brain has been identified as a site for VP and OT metabolism, and the amniotic sac may be a major site for VP clearance in the guinea pig fetus. There have been generalized findings regarding VP and OT metabolism. First, VP metabolism in the whole body and in the amniotic sac appears to increase with increasing concentrations of hormone; this does not appear to be the case with OT. Also, evidence has been presented that suggests a potential for the formation of biologically active metabolites. There have been several associations of pathophysiological states with altered VP or OT metabolism, sometimes with plasma levels remaining unchanged. Lastly, caution is emphasized when measuring these hormones by RIA, and differences in specificities of antisera toward hormone metabolites must be considered.

Topics: Animals; Female; Humans; Hypertension; Immunologic Techniques; Osmolar Concentration; Oxytocin; Pituitary Hormones, Posterior; Pregnancy; Pregnancy Complications; Vasopressins

Topics: Animals; Arginine Vasopressin; Cardiovascular Physiological Phenomena; Desoxycorticosterone; Diuresis; Female; Gonadal Steroid Hormones; Hypertension; Kidney; Male; Oxytocin; Pituitary Hormones, Posterior; Sex Characteristics; Sodium Chloride; Vasopressins

Topics: Angiotensin II; Angiotensinogen; Animals; Arginine Vasopressin; Blood Pressure; Brain; Brain Mapping; Cardiovascular Physiological Phenomena; Cardiovascular System; Cattle; Desoxycorticosterone; Dogs; Humans; Hypertension; Hypothalamo-Hypophyseal System; Mice; Neurotransmitter Agents; Oxytocin; Rats; Rats, Inbred SHR; Renin-Angiotensin System; Sodium Chloride; Subfornical Organ

Recently, there has been an explosion of knowledge on vasopressin, including its neuro-anatomy, biochemistry and physiology. Recent work demonstrates extensive extra-hypothalamic vasopressinergic projections from the SON and PVN. Of particular importance are projections to the cardiovascular medullary centres. Conversely, the SON and PVN receive reciprocal catecholaminergic innervation from autonomic medullary centres. Vasopressin should now be regarded as a peptide hormone with important peripheral effects, as well as a neuropeptide acting as a neurotransmitter or neuromodulator with important CNS actions. The central and peripheral vasopressin systems are not only anatomically differentiated, but, although integrated, may also function independently. There is an important interaction between the central vasopressin system and the autonomic nervous system. Vasopressin has multiple and diverse actions on the cardiovascular system, including direct vasoconstriction, antidiuresis and hence volume control, central actions on cardiovascular neural centres, modulation of the baroreflex and direct cardiac effects. It also acts in concert with the sympathetic nervous system and the renin-angiotensin system as an integrated neurohormonal system in the control of blood pressure. Vasopressin appears to have an important role as a vasoconstrictor agent whenever volume is threatened, such as in dehydration, haemorrhage, adrenal insufficiency and orthostasis. It seems unlikely that vasopressin acts as a direct vasoconstrictor agent in the pathogenesis of any form of experimental or human hypertension. Although plasma vasopressin levels have been reported to be elevated in most forms of hypertension, this correlates best with the severity of hypertension. Furthermore, the levels are not elevated to the pressor range, so that increased vascular reactivity and sensitivity has to invoked. This does not appear to be specific for vasopressin. However, vasopressin may be indirectly involved through volume maintenance or interactions within the CNS. Indeed, its volume retaining properties have probably been underestimated. Whereas in acute situations the vasoconstrictor properties may be of some importance, it is difficult to sustain long-term hypertension without maintenance of an adequate plasma volume. Vasopressin's central actions on the cardiovascular medullary centres, the baroreflex, the autonomic nervous system and catecholamine metabolism may also be involved in some

Topics: Animals; Blood Pressure; Brain; Cardiovascular Physiological Phenomena; Heart; Humans; Hypertension; Oxytocin; Paraventricular Hypothalamic Nucleus; Rats; Receptors, Angiotensin; Receptors, Vasopressin; Renin-Angiotensin System; Supraoptic Nucleus; Sympathetic Nervous System; Vasoconstriction; Vasopressins

Topics: Adrenergic beta-Agonists; Bed Rest; Cesarean Section; Developing Countries; Female; Fetal Growth Retardation; Fetal Organ Maturity; Humans; Hypertension; Infant Mortality; Infant, Newborn; Infant, Premature; Lung; Obstetric Labor, Premature; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Twins

Topics: Amniotic Fluid; Blood Glucose; Dehydroepiandrosterone; Delivery, Obstetric; Diet, Diabetic; Embryonic and Fetal Development; Estriol; Estrogens; Female; Fetal Death; Fetal Diseases; Humans; Hypertension; Infant, Newborn; Insulin; Length of Stay; Nutritional Physiological Phenomena; Osmolar Concentration; Oxytocin; Pre-Eclampsia; Pregnancy; Pregnancy in Diabetics; Prenatal Care; Smoking

Older adults are increasingly lonely and at risk for hypertension. Endogenous oxytocin levels are associated with lowering blood pressure (BP), suggesting value in increasing oxytocin. Regular practice of Tai Chi improves BP and mood; we explored a single session of Tai Chi Easy (TCE) with older adults and feasibility of measuring oxytocin as a key biomarker.. In a single-arm pre-post design pilot study, 21 older adults (age 55-80) with mild-moderate hypertension practiced a single session (50-min) TCE. BP, psychosocial measures, and saliva samples were collected pre/post to examine feasibility of acute measures of oxytocin and explore effect sizes of outcomes. Participants (N = 21; 19 % Latinx, 76.2 % female, mean age 66.76).. BP systolic: 138.43-134.86; diastolic 78.48-78.00 (p > .05; Cohen's d -0.23; -0.08 respectively). Total Mood Disturbance (TMD) and Connection (CN) improved [TMD mean pre 41.891 (SD=19.60) to post 35.00 (SD=10.21), p = .01; Cohen's d - 0.67); CN mean 7.85 (SD=2.01) to post 9.05 (SD=1.00), p = .01; Cohen's d 0.70]. Baseline oxytocin was positively correlated with baseline loneliness (N = 14, r = .599); pre/post oxytocin changes were negatively correlated with baseline loneliness (N = 14, r = -.585). BP decrease was associated with characteristics of the intervention: "flow" (coef=.=0.58N = 17) and meditative/breath focus (coef=-1.78; N = 17).. Medium to large effect sizes indicating change in mood and connection were found for this single session intervention. Knowing that Tai Chi improves BP when practiced over time, this TCE intervention shows promise for planning a fully powered, randomized controlled study of BP, mood and perceptions of connection in hypertensive older adults. Feasibility of assessing acute salivary oxytocin is less promising. Increase in oxytocin levels occurred for those less lonely, but declined for lonelier participants. With different responses based on baseline loneliness scores, no mean change in oxytocin levels was found. Seemingly unstable levels (possibly related to interaction with study staff) suggests the need for further testing in more controlled study designs. Finally, BP associations with meditative/breath focus and flow could be further explored in future study designs addressing mediation.

Topics: Aged; Aged, 80 and over; Blood Pressure; Female; Humans; Hypertension; Male; Meditation; Middle Aged; Oxytocin; Pilot Projects; Qigong; Tai Ji

To observe the changes in hemodynamic, stress and inflammatory responses during labor and their labor outcomes after continuous spinal anesthesia labor analgesia for hypertensive pregnant women, and to evaluate whether the continuous spinal anesthesia had any advantages compared to continuous epidural analgesia for hypertensive pregnant women and their newborns.. A total of 160 hypertensive pregnant women were selected and randomly divided into continuous spinal anesthesia analgesia group (CSA group) and continuous epidural analgesia group (EA group). Participant age, height, weight and gestational week were recorded; MAP, VAS score, CO and SVR were recorded after the onset of regular uterine contractions (T. The first stage of labor in CSA was longer than EA (P < 0.05); the MAP, VAS and SVR value in CSA were lower than EA group at T. For pregnant women with hypertension during pregnancy, continuous spinal anesthesia labor analgesia has no significant effect on the final mode of delivery, but shows precise analgesic effect and stabilizes circulatory system, it is recommended to perform continuous spinal anesthesia early in labor for hypertensive pregnant women, which can effectively reduce the stress reaction.. ChiCTR-INR-17012659. Date of registration: 13/09/2017.

Topics: Analgesia, Epidural; Analgesics; Anesthesia, Spinal; Female; Humans; Hypertension; Infant, Newborn; Interleukin-6; Labor, Obstetric; Oxytocin; Pregnancy; Pregnant Women; Tumor Necrosis Factor-alpha

To compare intramuscular oxytocin, Syntometrine. Randomised double-blinded clinical trial.. Six hospitals in England.. A total of 5929 normotensive women having a singleton vaginal birth.. Randomisation when birth was imminent.. Primary: use of additional uterotonic agents. Secondary: weighed blood loss, transfusion, manual removal of placenta, adverse effects, quality of life.. Participants receiving additional uterotonics: 368 (19.5%) oxytocin, 298 (15.6%) Syntometrine and 364 (19.1%) carbetocin. When pairwise comparisons were made: women receiving carbetocin were significantly more likely to receive additional uterotonics than those receiving Syntometrine (odds ratio [OR] 1.28, 95% CI 1.08-1.51, P = 0.004); the difference between carbetocin and oxytocin was non-significant (P = 0.78); Participants receiving Syntometrine were significantly less likely to receive additional uterotonics than those receiving oxytocin (OR 0.75, 95% CI 0.65-0.91, P = 0.002). Non-inferiority between carbetocin and Syntometrine was not shown. Use of Syntometrine reduced non-drug PPH treatments compared with oxytocin (OR 0.64, 95% CI 0.42-0.97) but not carbetocin (P = 0.64). Rates of PPH and blood transfusion were not different. Syntometrine was associated with an increase in maternal adverse effects and reduced ability of the mother to bond with her baby.. Non-inferiority of carbetocin to Syntometrine was not shown. Carbetocin is not significantly different to oxytocin for use of additional uterotonics. Use of Syntometrine reduced use of additional uterotonics and need for non-drug PPH treatments compared with oxytocin. Increased maternal adverse effects are a disadvantage of Syntometrine.. IM carbetocin does not reduce additional uterotonic use compared with IM Syntometrine or oxytocin.

Topics: Adult; Blood Transfusion; Delivery, Obstetric; Double-Blind Method; Ergonovine; Female; Humans; Hypertension; Injections, Intramuscular; Oxytocics; Oxytocin; Postpartum Hemorrhage; Pregnancy; Puerperal Disorders; Quality of Life

To compare the efficacy and safety of intravenous oxytocin with intramuscular syntometrine in the management of the third stage of labour.. A prospective randomised trial.. A university teaching hospital.. A total of 991 women having a singleton pregnancy and vaginal delivery were randomised by a computer-generated number to receive either 1 ml syntometrine intramuscularly or 10 units of intravenous Syntocinon after delivery of the anterior shoulder of the fetus.. Blood loss during delivery, rate of postpartum haemorrhage, need for repeated oxytocics, haemoglobin level before and 24 hours after delivery, duration of third stage, need for manual removal of placenta and sides effects including hypertension, nausea, vomiting, headache and chest pain.. The use of intravenous oxytocin was associated with a reduction in postpartum blood loss (P < 0.001) but there was no difference in the risk of postpartum haemorrhage in the need for repeated oxytocic injections and the drop in peripartum haemoglobin level between the two groups. There was also no difference in the risk of prolonged third stage, or in the need for manual removal of placenta. The use of syntometrine was associated with a higher risk of hypertension (RR 2.39, 95% CI 1.00-5.70). Other side effects were mild in nature with no differences between the two groups.. There are no important clinical differences in the effectiveness of intramuscular syntometrine and intravenous oxytocin for the prevention of postpartum blood loss. Intravenous oxytocin is less likely to cause hypertension.

Topics: Adult; Ergonovine; Female; Hemoglobins; Humans; Hypertension; Injections, Intramuscular; Labor Stage, Third; Oxytocics; Oxytocin; Postpartum Hemorrhage; Pregnancy; Prospective Studies; Puerperal Disorders; Risk Factors; Vomiting

The search for an effective, easily stored, affordable uterotonic agent in preventing postpartum hemorrhage is of importance, especially in the developing world. The objective of this study was to randomly compare the effectiveness of rectal misoprostol with Syntometrine in the management of the third stage of labor.. Four hundred and ninety-one low risk women in labor were randomly allocated to receive either misoprostol 400 microgram rectally or Syntometrine 1 ampuole intramuscularly, and postpartum blood loss was estimated as the principal end point. Comparisons were by the chi-square test or Fisher's test and relative risks with 95% confidence intervals for categorical data, and the Mann-Whitney test for ranked continuous variables.. The baseline characteristics in terms of hemoglobin estimation in antenatal clinic, mean age, parity, and duration of labor in the 250 patients who received Syntometrine and 241 patients who received misoprostol were similar. However, there was a significant difference in the pre-delivery blood pressure of the two groups because of the non-protocol exclusion of women with elevated blood pressure allocated to receive Syntometrine. Duration of third stage of labor, blood loss postpartum and hemoglobin estimation post partum were all similar. Postpartum diastolic hypertension was more common in the Syntometrine group (p= 0.002). No other apparent side effect was noted in either group.. Misoprostol rectally for management of the third stage of labor merits further investigation.

Topics: Administration, Rectal; Adult; Ergonovine; Female; Hemoglobins; Humans; Hypertension; Injections, Intramuscular; Labor Stage, Third; Misoprostol; Oxytocics; Oxytocin; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Puerperal Disorders

To compare intramuscular oxytocin alone and intramuscular oxytocin with ergometrine (Syntometrine) for their effect in reducing the risk of postpartum haemorrhage when both are used as part of the active management of the third stage of labour.. Double blind, randomised controlled trial.. Two metropolitan teaching hospitals in Perth, Western Australia.. All women who expected a vaginal birth during the period of the trial. Informed consent was obtained.. Postpartum haemorrhage, nausea, vomiting, and increased blood pressure.. 3497 women were randomly allocated to receive oxytocin-ergometrine (n = 1730) or oxytocin (n = 1753). Rates of postpartum haemorrhage (> or = 500 ml or > or = 1000 ml) were similar in both arms (odds ratio 0.90 (0.82); 95% confidence interval 0.75 to 1.07 (0.59 to 1.14) at 500 ml (1000 ml) threshold). The use of oxytocin-ergometrine was associated with nausea, vomiting, and increased blood pressure.. There are few advantages but several disadvantages for the routine use of oxytoxinergometrine when prophylactic active management of the third stage of labour is practised. Further investigation of dose-response for oxytocin may be warranted.

Topics: Blood Pressure; Drug Combinations; Ergonovine; Female; Hemoglobins; Humans; Hypertension; Injections, Intramuscular; Labor Stage, Third; Nausea; Oxytocin; Postpartum Hemorrhage; Pregnancy; Risk Factors; Vomiting

A comparison has been made between the effectiveness of infusing prostaglandin E(2) with Syntocinon for the induction of labour in the presence of intact membranes. Rapid titration schedules were used to induce an early uterine response. All 15 subjects receiving prostaglandin E(2) achieved cervical dilatation, whereas this occurred in only 9 out of 15 patients receiving Syntocinon.

Topics: Adult; Apgar Score; Cervix Uteri; Dilatation; Extraembryonic Membranes; Female; Humans; Hypertension; Injections, Intravenous; Labor, Induced; Oxytocin; Pre-Eclampsia; Prediabetic State; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy in Diabetics; Pregnancy, Prolonged; Prostaglandins

Obstructive sleep apnea is a prevalent and poorly treated cardiovascular disease that leads to hypertension and autonomic imbalance. Recent studies that restore cardiac parasympathetic tone using selective activation of hypothalamic oxytocin neurons have shown beneficial cardiovascular outcomes in animal models of cardiovascular disease. This study aimed to determine if chemogenetic activation of hypothalamic oxytocin neurons in animals with existing obstructive sleep apnea-induced hypertension would reverse or blunt the progression of autonomic and cardiovascular dysfunction.. Two groups of rats were exposed to chronic intermittent hypoxia (CIH), a model of obstructive sleep apnea, for 4 weeks to induce hypertension. During an additional 4 weeks of exposure to CIH, 1 group was treated with selective activation of hypothalamic oxytocin neurons while the other group was untreated.. Hypertensive animals exposed to CIH and treated with daily hypothalamic oxytocin neuron activation had lower blood pressure, faster heart rate recovery times after exercise, and improved indices of cardiac function compared with untreated hypertensive animals. Microarray analysis suggested that, compared with treated animals, untreated animals had gene expression profiles associated with cellular stress response activation, hypoxia-inducible factor stabilization, and myocardial extracellular matrix remodeling and fibrosis.. In animals already presenting with CIH-induced hypertension, chronic activation of hypothalamic oxytocin neurons blunted the progression of hypertension and conferred cardioprotection after an additional 4 weeks of CIH exposure. These results have significant clinical translation for the treatment of cardiovascular disease in patients with obstructive sleep apnea.

Topics: Animals; Cardiovascular Diseases; Disease Models, Animal; Heart Diseases; Hypertension; Hypoxia; Neurons; Oxytocin; Rats; Rats, Sprague-Dawley; Sleep Apnea, Obstructive

Oxytocin and its analogue carbetocin are uterotonics whose prophylactic use is recommended to prevent postpartum haemorrhage, which is one of the leading causes of maternal deaths worldwide. However, both drugs can cause specific adverse effects and haemodynamic challenges.. The aim of this work was to exploratively examine reports of adverse drug events of both drugs and to establish a comparative haemodynamic profile.. Using data extracted from the World Health Organization's pharmacovigilance database VigiBase, a descriptive analysis was performed of all reports for oxytocin and carbetocin as a suspected or interacting drug followed by a disproportionality analysis for haemodynamic events. Reporting odds ratios (ROR) of carbetocin for hypertension, hypotension, tachycardia, and bradycardia were calculated, with oxytocin-related reports serving as comparators.. Oxytocin and carbetocin were mentioned as suspected or interacting drugs in 11,258 and 374 reports, respectively. Resulting RORs for carbetocin were 3.45 (95%CI: 1.72-6.92) for hypertension, 2.65 (1.64-4.28) for hypotension, 2.84 (1.79-4.49) for tachycardia, and 2.00 (0.87-4.60) for bradycardia, when compared to oxytocin. Of 231 patients for whom oxytocin-related tachycardia was reported, 2.6% died, and of 91 patients for whom bradycardia was reported, 2.2% died. No deaths were reported with carbetocin for any of the haemodynamic adverse events.. Compared to oxytocin, carbetocin showed an elevated reporting for adverse hypertension, hypotension, and tachycardia in pharmacovigilance data. Clinicians should be aware of their patients' individual susceptibility and the possibility of haemodynamic deterioration until causal inferences are possible.

Topics: Bradycardia; Drug-Related Side Effects and Adverse Reactions; Female; Hemodynamics; Humans; Hypertension; Hypotension; Oxytocics; Oxytocin; Pharmacovigilance

BACKGROUND Although there have been some recent clinical trials on the effects of augmentation of labor with oxytocin, or augmentation of labor, there are no clinical guidelines to explain the variations in obstetric practice between countries and within countries. This retrospective case-control study from a single center in Warsaw, Poland aimed to evaluate the use and effects of augmentation of labor with oxytocin in 4350 women between 2015 and 2020. MATERIAL AND METHODS This was a single-center, retrospective, case-control study in which 29 455 cases were qualified for analysis. The study included the analysis of 2 groups: the study group consisted of 4382 patients who underwent stimulation of childbirth, and the control group consisted of 25 073 patients who did not undergo this obstetric procedure. RESULTS Multivariate logistic regression analysis showed that the factors increasing the frequency of augmentation of labor were higher BMI (P<0.05), preinduction (P<0.05), epidural anesthesia (P<0.05), and family present at birth (P<0.05). Factors influencing reduction in the frequency of augmentation of labor were higher number of deliveries (P<0.05), vaginal birth after cesarean (P<0.05), and pre-pregnancy hypertension (P<0.05). CONCLUSIONS This study from a single center in Poland showed that BMI, preinduction, epidural anesthesia, and family present at birth significantly increased the frequency of labor stimulation with oxytocin. However, a history of previous pregnancies, previous cesarean sections, and pre-pregnancy hypertension significantly reduced the frequency of augmentation of labor with oxytocin.

Topics: Case-Control Studies; Cesarean Section; Female; Humans; Hypertension; Infant, Newborn; Labor, Obstetric; Oxytocin; Poland; Pregnancy; Retrospective Studies

Obstetricians routinely use biochemical parameters from non-pregnant women to assess the condition of the laboring mother. However, it is well known that pregnancy leads to significant physiological changes in most organ systems. The aim of this study was to determine normal values for maternal arterial blood gases during vaginal deliveries as compared with control values from planned cesarean sections. We also wanted to elucidate the effect of various maternal characteristics, mode of delivery and obstetric interventions on blood gas values.. We carried out a randomly selected, prospective-observational cohort study of 250 women undergoing vaginal delivery and 58 women undergoing planned cesarean section at the Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden.. We found significant differences for gestational age, parity, umbilical venous blood pH, pCO. Maternal arterial blood gas parameters varied significantly according to mode of delivery, the use of epidural anesthesia and synthetic oxytocin.

Topics: Adult; Anesthesia, Epidural; Blood Gas Analysis; Cesarean Section; Correlation of Data; Delivery, Obstetric; Female; Fetal Blood; Humans; Hydrogen-Ion Concentration; Hypertension; Lactic Acid; Monitoring, Intraoperative; Oxytocics; Oxytocin; Pregnancy; Smoking; Sweden

Hypertension is a common outcome associated with obstructive sleep apnea (OSA), a prevalent yet poorly treated cardiovascular disease. Recent studies showed oxytocin (OXT), released from hypothalamic paraventricular nucleus (PVN) neurons, activates cardiac vagal neurons in the dorsal motor nucleus of the vagus (DMNX) and may blunt cardiovascular responses to stress. This study tests whether the release of OXT from PVN fibers in the DMNX is diminished with chronic intermittent hypoxia-hypercapnia (CIH/H) exposure, an animal model of OSA, and whether activation of PVN OXT neurons restores OXT release in the DMNX and prevents the hypertension resulting from CIH/H. To assess OXT release from PVN fibers, Chinese hamster ovarian (CHO) cells were engineered to be highly sensitive to OXT by stable expression of the human recombinant OXT receptor and the calcium indicator R-GECO1. PVN fibers in the DMNX were selectively photoactivated in vitro by expression of channelrhodopsin. The release of OXT onto CHO cells in the DMNX was blunted in rats exposed to 21 days of CIH/H. Chronic activation of PVN OXT neurons in vivo, using designer receptors exclusively activated by designer drugs, restored the release of OXT onto CHO cells in the DMNX. Chronic PVN OXT neuron activation in vivo also prevented the hypertension that occurred in conscious unrestrained telemetry-equipped sham rats exposed to 3 wk of CIH/H. These results demonstrate that chronic activation of OXT neurons restores the release of OXT from PVN fibers in the DMNX and prevents the hypertension that occurs with 3 wk of CIH/H exposure.

Topics: Animals; Biosensing Techniques; Blood Pressure; Channelrhodopsins; CHO Cells; Chronic Disease; Cricetulus; Disease Models, Animal; Hypercapnia; Hypertension; Hypoxia; Male; Neurons; Optogenetics; Oxytocin; Paraventricular Hypothalamic Nucleus; Rats, Sprague-Dawley; Receptors, Oxytocin; Signal Transduction; Telemetry; Time Factors; Transfection

Exact cause of the metabolic syndrome [MS], a global epidemic, is still unclear. Man has same fundamental needs to live as animals but modern man's life-style compels him to acquire certainty of resources for all his needs in a complex social network. Today money has become the sole life essential need. Contrarily none of the animals needs to earn money. Brain is also an organ of the human body with a unique thought process to define logical actions to achieve a person's goals. This way life is a flow of desires followed by logical actions. The person struggles to attain desired goals via the allostatic load but a perceived insurmountable threat can make his flow of life stalled to freeze him. Published data from varied branches of medical science indicates role of hormones in overall homeostasis. Particularly multifaceted role of serotonin is well documented. Adrenalin being the primary mediator of Cori cycle is also well known. From the integration of observations from published data with reference to common human's modern lifestyle, it is hypothesized that a perceived trapped situation in life creates acute chaos of thoughts in brain, which results in acute excess of stress hormones and concurrent depletion of resting hormones, which in turn triggers MS. In global terms, MS indicates an acute imbalance of a few hormones and implies psychosomatic roots of the disorder. This may pave a better way in deciding a personalized holistic protocol with combination of counter regulatory psychoactive medications.

Topics: Acidosis, Lactic; Allostasis; Animals; Brain; Cardiovascular Diseases; Cholecystokinin; Cholesterol; Diabetes Mellitus, Type 2; Diet; Dopamine; Epinephrine; Exercise; Homeostasis; Hormones; Humans; Hypertension; Life Style; Metabolic Syndrome; Microbiota; Models, Theoretical; Motivation; Obesity; Oxytocin; Psychophysiologic Disorders; Risk Factors; Serotonin

Oxytocin and its receptor are synthesised in the heart and blood vessels but effects of chronic activation of this peripheral oxytocinergic system on cardiovascular function are not known. In acute studies, systemic administration of low dose oxytocin exerted a protective, preconditioning effect in experimental models of myocardial ischemia and infarction. In this study, we investigated the effects of chronic administration of low dose oxytocin following angiotensin II-induced hypertension, cardiac hypertrophy and renal damage. Angiotensin II (40 μg/Kg/h) only, oxytocin only (20 or 100 ng/Kg/h), or angiotensin II combined with oxytocin (20 or 100 ng/Kg/h) were infused subcutaneously in adult male Sprague-Dawley rats for 28 days. At day 7, oxytocin or angiotensin-II only did not change hemodynamic parameters, but animals that received a combination of oxytocin and angiotensin-II had significantly elevated systolic, diastolic and mean arterial pressure compared to controls (P < 0.01). Hemodynamic changes were accompanied by significant left ventricular cardiac hypertrophy and renal damage at day 28 in animals treated with angiotensin II (P < 0.05) or both oxytocin and angiotensin II, compared to controls (P < 0.01). Prolonged oxytocin administration did not affect plasma concentrations of renin and atrial natriuretic peptide, but was associated with the activation of calcium-dependent protein phosphatase calcineurin, a canonical signalling mechanism in pressure overload-induced cardiovascular disease. These data demonstrate that oxytocin accelerated angiotensin-II induced hypertension and end-organ renal damage, suggesting caution should be exercised in the chronic use of oxytocin in individuals with hypertension.

Topics: Angiotensin II; Animals; Atrial Natriuretic Factor; Calcineurin; Cardiomegaly; Hypertension; Injections, Subcutaneous; Kidney; Male; Oxytocin; Rats; Rats, Sprague-Dawley; Renin

To determine whether the use of uterotonics, including oxytocin and prostaglandins, increases the risk of abruptio placentae and eclampsia.. A retrospective analysis was conducted among 260,174 Japanese women at term. Demographic characteristics were studied as possible candidates for risk factors of abruptio placentae and eclampsia using multivariate logistic regression analyses.. A total of 1,058 (0.41 %) and 147 (0.06 %) women developed abruptio placentae and eclampsia, respectively. Abruptio placentae and eclampsia occurred in 177 (0.29 %) and 42 (0.07 %) of the 61,857 women treated with uterotonics, respectively. Multivariate regression analyses indicated that uterotonics did not increase risk of developing either abruptio placentae or eclampsia. Primiparity [odds ratio (95 % confidence interval) 1.41 (1.24-1.60)], age ≥35 years [1.17 (1.03-1.33)], and presence of hypertension [2.42 (1.93-3.03)] were significant independent risk factors for abruptio placentae, while advancing gestation [0.67 (0.63-0.71)] decreased risk of abruptio placentae. Primiparity [odds ratio (95 % confidence interval) 4.06 (2.49-6.63)], age <20 years [2.44 (1.07-5.58)], presence of hypertension [28.7 (20.5-40.1)], and advancing gestation [1.28 (1.11-1.47)] were significant independent risk factors for eclampsia.. The use of uterotonics did not increase the risk of abruptio placentae and eclampsia.

Topics: Abruptio Placentae; Administration, Intravaginal; Adult; Asian People; Confidence Intervals; Eclampsia; Female; Humans; Hypertension; Japan; Labor, Induced; Logistic Models; Multivariate Analysis; Odds Ratio; Oxytocics; Oxytocin; Parity; Pregnancy; Prostaglandins; Retrospective Studies; Risk Factors; Socioeconomic Factors

Nesfatin-1 is produced in the periphery and in the brain where it has been demonstrated to regulate appetite, stress hormone secretion, and cardiovascular function. The anorexigenic action of central nesfatin-1 requires recruitment of neurons producing the melanocortins and centrally projecting oxytocin (OT) and corticotropin-releasing hormone (CRH) neurons. We previously have shown that two components of this pathway, the central melanocortin and oxytocin systems, contribute to the hypertensive action of nesfatin-1 as well. We hypothesized that the cardiovascular effect of nesfatin-1 also was dependent on activation of neurons expressing CRH receptors, and that the order of activation of the melanocortin-CRH-oxytocin circuit was preserved for both the anorexigenic and hypertensive actions of the peptide. Pretreatment of male rats with the CRH-2 receptor antagonist astressin2B abrogated nesfatin-1-induced increases in mean arterial pressure (MAP). Furthermore, the hypertensive action of CRH was blocked by pretreatment with an oxytocin receptor antagonist ornithine vasotocin (OVT), indicating that the hypertensive effect of nesfatin-1 may require activation of oxytocinergic (OTergic) neurons in addition to recruitment of CRH neurons. Interestingly, we found that the hypertensive effect of α-melanocyte stimulating hormone (α-MSH) itself was not blocked by either astressin2B or OVT. These data suggest that while α-MSH-producing neurons are part of a core melanocortin-CRH-oxytocin circuit regulating food intake, and a subpopulation of melanocortin neurons activated by nesfatin-1 do mediate the hypertensive action of the peptide, α-MSH can signal independently from this circuit to increase MAP.

Topics: alpha-MSH; Animals; Blood Pressure; Calcium-Binding Proteins; Corticotropin-Releasing Hormone; Disease Models, Animal; DNA-Binding Proteins; Hormones; Hypertension; Male; Melanocortins; Melanocyte-Stimulating Hormones; Nerve Net; Nerve Tissue Proteins; Nucleobindins; Oxytocin; Peptide Fragments; Peptides, Cyclic; Rats; Rats, Sprague-Dawley; Receptors, Corticotropin-Releasing Hormone; Receptors, Oxytocin; Vasotocin

We showed previously that sino-aortic denervation prevented training-induced plasticity in pre-autonomic oxytocinergic neurons and blocked the beneficial effects of training. In this study, we investigate the combined effect of training and removal of specific chemoreceptor afferents on both cardiovascular parameters and oxytocin (OT) gene and protein expression within the hypothalamic paraventricular nucleus (PVN). Wistar rats and spontaneously hypertensive rats (SHRs) underwent carotid body denervation or sham surgery and were trained or kept sedentary for 3 months. After haemodynamic measurements at rest, rats were anaesthetized for brain perfusion. Fresh (perfused with PBS) and fixed brains (perfused with 4% paraformaldehyde) were processed for PVN OT mRNA (real-time PCR) and OT immunoreactivity within PVN subnuclei. In sham-operated rats, training improved treadmill performance and reduced resting heart rate (Wistar, -8%; SHRs, -10%), with a reduction in blood pressure only in SHRs (-8%). Training was accompanied by increased PVN OT mRNA expression (twofold increase in sham-operated SHRs) and peptide density in the posterior, ventromedial and dorsal cap PVN subnuclei (on average 70% increase in both strains), with significant correlations between OT content and training-induced resting bradycardia in sham-operated groups. Carotid body denervation did not interfere with the performance gain, abolished chemoreflex activation (without changing baroreflex control) and blocked training-induced cardiovascular adaptations and training-induced changes in PVN OT content in both strains. After carotid body denervation, there was no correlation between OT mRNA or OT immunoractivity and resting heart rate. The chronic absence of chemoreceptor inputs uncovers an unknown role of chemoreceptor signalling in driving the plasticity/activity of PVN oxytocinergic pre-autonomic neurons, thus mediating training-induced cardiovascular adaptive responses.

Topics: Adaptation, Physiological; Animals; Autonomic Denervation; Baroreflex; Blood Pressure; Carotid Body; Disease Models, Animal; Gene Expression Regulation; Heart Rate; Hypertension; Immunohistochemistry; Male; Neuronal Plasticity; Neurons; Oxytocin; Paraventricular Hypothalamic Nucleus; Physical Exertion; Rats; Rats, Inbred SHR; Rats, Wistar; Real-Time Polymerase Chain Reaction; RNA, Messenger; Sedentary Behavior; Signal Transduction; Time Factors

Hypertensive rats with multiple extra copies of the renin gene (TGR) exert an inverted circadian blood pressure (BP) profile. We investigated whether circadian oscillations in the hypothalamic suprachiasmatic nucleus (SCN), a main circadian oscillator, and the paraventricular nucleus (PVN), involved in BP control, are influenced in TGR rats. The expression of the clock gene per1, a marker of circadian timing, was measured in the SCN and PVN. Moreover, the expression of genes encoding vasopressin (AVP), vasoactive intestinal peptide (VIP) in the SCN, and AVP and oxytocin (OXT) in the PVN were studied by in situ hybridization. Expression of the per1 gene showed a distinct circadian rhythm in both the SCN and PVN with no differences observed between the TGR and control Sprague–Dawley (SD) rats. The expression of avp in the SCN was rhythmic in both strains and moderately higher in TGR than in SD rats while no significant changes were found in the PVN. The expression of vip in the SCN and oxt in the PVN did not differ between both strains. Our results may indicate that changes occurring downstream to the SCN are responsible for the development of the inverted BP rhythm in TGR hypertensive rats.

Topics: Animals; Arginine Vasopressin; Autoradiography; Blood Pressure; Circadian Rhythm; Gene Expression Regulation; Heart Rate; Hypertension; Motor Activity; Oxytocin; Paraventricular Hypothalamic Nucleus; Period Circadian Proteins; Rats; Rats, Sprague-Dawley; RNA, Messenger; Signal Transduction; Suprachiasmatic Nucleus; Vasoactive Intestinal Peptide

We showed previously that oxytocinergic (OTergic) projections from the hypothalamic paraventricular nucleus (PVN) to the dorsal brain stem mediate training-induced heart rate (HR) adjustments and that beneficial effects of training are blocked by sinoaortic denervation (SAD; Exp Physiol 94: 630-640; 1103-1113, 2009). We sought now to determine the combined effect of training and SAD on PVN OTergic neurons in spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats. Rats underwent SAD or sham surgery and were trained (55% of maximal capacity) or kept sedentary for 3 mo. After hemodynamic measurements were taken at rest, rats were deeply anesthetized. Fresh brains were frozen and sliced to isolate the PVN; samples were processed for OT expression (real-time PCR) and fixed brains were processed for OT immunofluorescence. In sham rats, training improved treadmill performance and increased the gain of baroreflex control of HR. Training reduced resting HR (-8%) in both groups, with a fall in blood pressure (-10%) only in SHR rats. These changes were accompanied by marked increases in PVN OT mRNA expression (3.9- and 2.2-fold in WKY and SHR rats, respectively) and peptide density in PVN OTergic neurons (2.6-fold in both groups), with significant correlations between OT content and training-induced resting bradycardia. SAD abolished PVN OT mRNA expression and markedly reduced PVN OT density in WKY and SHR. Training had no effect on HR, PVN OT mRNA, or OT content following SAD. The chronic absence of inputs from baroreceptors and chemoreceptors uncovers the pivotal role of afferent signaling in driving both the plasticity and activity of PVN OTergic neurons, as well as the beneficial effects of training on cardiovascular control.

Topics: Animals; Autonomic Pathways; Blood Pressure; Denervation; Disease Models, Animal; Heart Rate; Hypertension; Male; Models, Animal; Neuronal Plasticity; Neurons, Afferent; Oxytocin; Paraventricular Hypothalamic Nucleus; Physical Conditioning, Animal; Rats; Rats, Inbred SHR; Rats, Inbred WKY; Signal Transduction; Sinoatrial Node; Supraoptic Nucleus

Anaphylactoid reaction to Syntocinon is rare, but has been described in the literature. The reactions described include patchy erythema, hypotension, bronchospasm and oxygen desaturation, but pulseless electrical activity following Syntocinon has not been reported. We present the case of a 34-year-old primigravida with essential hypertension, gestational diabetes and hypothyroidism with a twin pregnancy following in vitro fertilization. During elective caesarean delivery she developed a severe anaphylactic reaction to Syntocinon leading to pulseless electrical activity.

Topics: Adult; Anaphylaxis; Anesthesia, Spinal; Electrocardiography; Female; Humans; Hypertension; Hypothyroidism; Oxytocics; Oxytocin; Palpation; Pregnancy; Pregnancy Complications; Pregnancy, Multiple; Twins

Oxytocinergic brainstem projections participate in the autonomic control of the circulation. We investigated the effects of hypertension and training on cardiovascular parameters after oxytocin (OT) receptor blockade within the nucleus tractus solitarii (NTS) and NTS OT and OT receptor expression. Male spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats were trained (55% of maximal exercise capacity) or kept sedentary for 3 months and chronically instrumented (NTS and arterial cannulae). Mean arterial blood pressure (MAP) and heart rate (HR) were measured at rest and during an acute bout of exercise after NTS pretreatment with vehicle or OT antagonist (20 pmol of OT antagonist (200 nl of vehicle)(-1)). Oxytocin and OT receptor were quantified ((35)S-oligonucleotide probes, in situ hybridization) in other groups of rats. The SHR exhibited high MAP and HR (P < 0.05). Exercise training improved treadmill performance and reduced basal HR (on average 11%) in both groups, but did not change basal MAP. Blockade of NTS OT receptor increased exercise tachycardia only in trained groups, with a larger effect on trained WKY rats (+31 +/- 9 versus +12 +/- 3 beats min(1) in the trained SHR). Hypertension specifically reduced NTS OT receptor mRNA density (-46% versus sedentary WKY rats, P < 0.05); training did not change OT receptor density, but significantly increased OT mRNA expression (+2.5-fold in trained WKY rats and +15% in trained SHR). Concurrent hypertension- and training-induced plastic (peptide/receptor changes) and functional adjustments (HR changes) of oxytocinergic control support both the elevated basal HR in the SHR group and the slowing of the heart rate (rest and exercise) observed in trained WKY rats and SHR.

Topics: Animals; Blood Pressure; Brain Stem; Heart Rate; Hypertension; In Situ Hybridization; Male; Oxytocin; Physical Conditioning, Animal; Rats; Rats, Inbred SHR; Rats, Inbred WKY; Receptors, Oxytocin; Rest; RNA, Messenger

Topics: Adrenergic beta-Antagonists; Adult; Anesthesia, Obstetrical; Anesthesia, Spinal; Anesthetics, Local; Blood Pressure; Bupivacaine; Cardiomyopathy, Hypertrophic; Cesarean Section; Ephedrine; Female; Heart Rate; Humans; Hypertension; Hypotension; Metoprolol; Myocardial Infarction; Oxytocics; Oxytocin; Postoperative Complications; Postpartum Period; Tachycardia; Vasoconstrictor Agents

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

To identify defects in the salt-sensitive Dahl rat (Dahl-S), the natriuretic, catecholaminergic and pressor responses to 60-min elevation of the cerebroventricular sodium concentration (CNS-induced natriuresis) were compared between prehypertensive salt-sensitive Dahl-S and salt-resistant Dahl rats (Dahl-R). The plasma concentrations of the rat natriuretic hormone oxytocin, which has implications for the development of hypertension, and vasopressin (AVP) were also measured. Basal sodium and catecholamine excretion and mean arterial blood pressure (MAP) were similar in both strains. Sodium excretion during CNS stimulation increased more than 15-fold in Dahl-R but only 10-fold in Dahl-S. Dopamine excretion increased only transiently and similarly in both strains. Noradrenaline excretion and response to CNS stimulation were similar, suggesting a comparable sympathetic nervous activity between the strains. MAP increased comparably in Dahl-R and Dahl-S. Plasma AVP concentration was similar in both strains while plasma oxytocin concentration after CNS stimulation was more than 2-fold higher in Dahl-S than in Dahl-R. In conclusion, the prehypertensive Dahl-S has an attenuated natriuretic response to elevations of the cerebroventricular fluid sodium concentration and a higher plasma level of the natriuretic hormone oxytocin. Dopamine is not a mediator of CNS-induced natriuresis in neither strain. The attenuated natriuretic response may partly explain the salt-sensitivity in Dahl-S, and the higher plasma oxytocin value may either represent an effort to compensate for the deficient natriuretic response or reflect a primary defect in this system. Due to the known involvement of oxytocin in central MAP regulation in some hypertensive animal models, the findings warrant further investigation.

Topics: 3,4-Dihydroxyphenylacetic Acid; Animals; Cerebrospinal Fluid; Dopamine; Hypertension; Male; Natriuresis; Norepinephrine; Oxytocin; Rats; Rats, Inbred Dahl; Saline Solution, Hypertonic; Sodium; Vasopressins

We have previously shown that exercise training activates nucleus tractus solitarii (NTS) oxytocinergic projections, resulting in blunted exercise tachycardia. The objective of this study was to determine the effects of hypertension and training on oxytocin (OT) and OT receptor expression in the hypothalamic paraventricular nucleus (PVN) and projection areas (dorsal brain stem [DBS]). Male, normotensive, Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats were trained (55% maximal exercise capacity, 3 months) or kept sedentary, and pressure was measured weekly. DBS sections were processed for immunohistochemistry (polyclonal guinea pig anti-OT) or in situ hybridization for OT and OT receptor (35S-oligonucleotide probes). Other groups of rats had brains removed and frozen to isolate the DBS and PVN; samples were processed for OT and OT receptor cDNA reverse transcription-polymerase chain reaction amplification with beta-actin as the housekeeping gene. Training was equally effective in improving running distance in both groups, with pressure reduction only in SHR (-10%, P<0.05). In trained WKY, baseline bradycardia (P<0.05) occurred simultaneously with increased NTS OT immunostaining and mRNA expression (+3.5-fold), without any change in OT receptor mRNA expression. PVN OT mRNA and DBS OT receptor mRNA expressions were significantly lower in SHR versus WKY (-39% and -56%, respectively). Training did not alter DBS OT receptor density in the SHR group but increased OT mRNA in both PVN and DBS areas (+78% and +45%, respectively). Our results show a marked hypertension-induced reduction in OT receptor mRNA expression, not altered by training. In contrast, training increased OT mRNA expression in sedentary and hypertensive rats, which may facilitate training-induced cardiac performance.

Topics: Animals; Blood Pressure; Brain; Brain Stem; Heart Rate; Hypertension; Male; Motor Activity; Oxytocin; Paraventricular Hypothalamic Nucleus; Physical Conditioning, Animal; Rats; Rats, Inbred SHR; Rats, Inbred WKY; Receptors, Oxytocin; RNA, Messenger; Solitary Nucleus

The study was aimed to identify obstetric risk factors for early postpartum hemorrhage (PPH) in singleton gestations and to evaluate pregnancy outcome.. A comparison between consecutive singleton deliveries with and without early PPH was performed. Deliveries occurred during the years 1988-2002 in a tertiary medical center. A multivariate logistic regression model was constructed in order to define independent risk factors for PPH.. Postpartum hemorrhage complicated 0.4% (n = 666) of all deliveries enrolled in the study (n = 154 311). Significant risk factors for PPH, identified using a multivariable analysis, were: retained placenta (OR 3.5, 95%CI 2.1-5.8), failure to progress during the second stage of labor (OR 3.4, 95%CI 2.4-4.7), placenta accreta (OR 3.3, 95%CI 1.7-6.4), lacerations (OR 2.4, 95%CI 2.0-2.8), instrumental delivery (OR 2.3, 95%CI 1.6-3.4), large for gestational age (LGA) newborn (OR 1.9, 95%CI 1.6-2.4), hypertensive disorders (OR 1.7, 95%CI 1.2-2.1), induction of labor (OR 1.4, 95%CI 1.1-1.7) and augmentation of labor with oxytocin (OR 1.4, 95%CI 1.2-1.7). Women were assigned into three different groups according to the assessed severity of PPH, assuming that the severe cases were handled by revision of the birth canal under anesthesia, and the most severe cases required in addition treatment with blood products. A significant linear association was found between the severity of bleeding and the following factors: vacuum extraction, oxytocin augmentation, hypertensive disorders as well as perinatal mortality, uterine rupture, peripartum hysterectomy and uterine or internal iliac artery ligation (p < 0.001 for all variables).. Hypertensive disorder, failure to progress during the second stage of labor, oxytocin augmentation, vacuum extraction and LGA were found to be major risk factors for severe PPH. Special attention should be given after birth to hypertensive patients, and to patients who underwent induction of labor or instrumental delivery, as well as to those delivering LGA newborns.

Topics: Arteries; Birth Weight; Blood Transfusion; Female; Gestational Age; Humans; Hypertension; Hysterectomy; Iliac Artery; Infant, Newborn; Labor Stage, Second; Labor, Induced; Multivariate Analysis; Obstetric Labor Complications; Oxytocics; Oxytocin; Postpartum Hemorrhage; Pregnancy; Pregnancy Outcome; Risk Factors; Severity of Illness Index; Uterus; Vacuum Extraction, Obstetrical

Dopamine is an important transmitter in the CNS and PNS, critically regulating numerous neuropsychiatric and physiological functions. These actions of dopamine are mediated by five distinct receptor subtypes. Of these receptors, probably the least understood in terms of physiological functions is the D5 receptor subtype. To better understand the role of the D5 dopamine receptor (DAR) in normal physiology and behavior, we have now used gene-targeting technology to create mice that lack this receptor subtype. We find that the D5 receptor-deficient mice are viable and fertile and appear to develop normally. No compensatory alterations in other dopamine receptor subtypes were observed. We find, however, that the mutant mice develop hypertension and exhibit significantly elevated blood pressure (BP) by 3 months of age. This hypertension appears to be caused by increased sympathetic tone, primarily attributable to a CNS defect. Our data further suggest that this defect involves an oxytocin-dependent sensitization of V1 vasopressin and non-NMDA glutamatergic receptor-mediated pathways, potentially within the medulla, leading to increased sympathetic outflow. These results indicate that D5 dopamine receptors modulate neuronal pathways regulating blood pressure responses and may provide new insights into mechanisms for some forms of essential hypertension in humans, a disease that afflicts up to 25% of the aged adult population in industrialized societies.

Topics: Adrenal Glands; Animals; Blood Pressure; Brain; Brain Chemistry; Epinephrine; Gene Targeting; Hypertension; Immunohistochemistry; Mice; Mice, Inbred C57BL; Mice, Knockout; Norepinephrine; Oxytocin; Receptors, Dopamine D1; Receptors, Dopamine D2; Receptors, Dopamine D5; Receptors, Oxytocin; Receptors, Vasopressin; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Sympathetic Nervous System; Vasopressins

To test whether changes in sympathetic nervous system (SNS) activity or insulin sensitivity contribute to the heterogeneous blood pressure response to aerobic exercise training, we used compartmental analysis of [3H]norepinephrine kinetics to determine the extravascular norepinephrine release rate (NE2) as an index of systemic SNS activity and determined the insulin sensitivity index (S(I)) by an intravenous glucose tolerance test, before and after 6 mo of aerobic exercise training, in 30 (63 +/- 7 yr) hypertensive subjects. Maximal O2 consumption increased from 18.4 +/- 0.7 to 20.8 +/- 0.7 ml x kg(-1) x min(-1) (P = 0.02). The average mean arterial blood pressure (MABP) did not change (114 +/- 2 vs. 114 +/- 2 mmHg); however, there was a wide range of responses (-19 to +17 mmHg). The average NE2 did not change significantly (2.11 +/- 0.15 vs. 1.99 +/- 0.13 microg x min(-1) x m(-2)), but there was a significant positive linear relationship between the change in NE2 and the change in MABP (r = 0.38, P = 0.04). S(I) increased from 2.81 +/- 0.37 to 3.71 +/- 0.42 microU x 10(-4) x min(-1) x ml(-1) (P = 0.004). The relationship between the change in S(I) and the change in MABP was not statistically significant (r = -0.03, P = 0.89). When the changes in maximal O2 consumption, percent body fat, NE2, and S(I) were considered as predictors of the change in MABP, only NE2 was a significant independent predictor. Thus suppression of SNS activity may play a role in the reduction in MABP and account for a portion of the heterogeneity of the MABP response to aerobic exercise training in older hypertensive subjects.

Topics: Aged; Aging; Blood Pressure; Body Composition; Exercise; Female; Forearm; Glucose Tolerance Test; Humans; Hypertension; Hypoglycemic Agents; Insulin; Male; Middle Aged; Norepinephrine; Oxygen Consumption; Oxytocin; Regional Blood Flow; Sympathetic Nervous System; Tritium

We sought to determine risk factors for deep vein thrombosis and pulmonary embolism during pregnancy or post partum.. We performed a population-based case-control study. All Olmsted County, Minnesota, residents with a first lifetime deep vein thrombosis or pulmonary embolism during pregnancy or post partum from 1966 to 1990 were identified (N = 90). Where possible, a resident without deep vein thrombosis or pulmonary embolism was matched to each patient by date of the first live birth after the patient's child. The medical records of all remaining patients and all control subjects were reviewed for >25 baseline characteristics, which were tested as risk factors for deep vein thrombosis or pulmonary embolism.. In multivariate analysis smoking (odds ratio, 2.4) and prior superficial vein thrombosis (odds ratio, 9.4) were independent risk factors for deep vein thrombosis or pulmonary thrombosis during pregnancy or post partum.. Venous thromboembolism prophylaxis may be warranted for pregnant women with prior superficial vein thrombosis. Smoking cessation should be recommended, especially during pregnancy and the postpartum period.

Topics: Bed Rest; Body Mass Index; Case-Control Studies; Delivery, Obstetric; Eclampsia; Female; Heart Diseases; Humans; Hypertension; Obstetric Labor, Premature; Odds Ratio; Oxytocin; Parity; Pre-Eclampsia; Pregnancy; Pulmonary Embolism; Risk Factors; Smoking; Venous Thrombosis

Oxytocin and its receptor are potentially important for cardiovascular functions. In the present paper, we report their chromosome locations in the rat and their comparative mapping with the mouse and human. They are located in chromosome regions previously known to contain quantitative trait loci for blood pressure in various genetic crosses. Thus, they have become valid candidate genes for genetic hypertension.

Topics: Animals; Blood Pressure; Chromosomes, Human, Pair 3; Cricetinae; Humans; Hypertension; Internet; Mice; Oxytocin; Physical Chromosome Mapping; Quantitative Trait, Heritable; Radiation Hybrid Mapping; Rats; Receptors, Oxytocin; Vasopressins

Fetal cardiovascular responses to an altered intrauterine environment of increased myometrial contractures induced by oxytocin (OT) pulses to the ewe over the final 50 days of gestation were studied in chronically instrumented sheep. Ewes received saline (Cntl) or long-term OT treatment (LTOT, 600 microU x kg(-1) x min(-1) in 5-min pulses every 20 min) from 96 days gestational age. Fetal baroreflex responses to sodium nitroprusside (SNP) and phenylephrine (PE) were studied at 133 days gestation. OT increased contractures in LTOT ewes. Fetal blood pressure (FBP) was higher, and fetal heart rate (FHR) and slope of daily change in FBP and FHR were lower in LTOT fetuses. Fetal SNP-induced hypotension resulted in a narrow R-R interval variation range in LTOT fetuses; Cntl fetuses showed early breakdown in compensation. Baroreflex response slope during PE-induced fetal hypertension was lower in LTOT than in Cntl fetuses. Although the cortisol-to-ACTH ratio was lower in LTOT fetuses, fetal plasma ACTH and cortisol changes were similar in control and LTOT fetuses. We hypothesize that contracture-induced alterations in the intrauterine environment accelerate fetal cardiovascular development through mild hypoxemia, repetitive fetal pituitary-adrenal stimulation, and/or physical stimulation.

Topics: Animals; Antihypertensive Agents; Baroreflex; Blood Pressure; Cardiovascular System; Embryonic and Fetal Development; Female; Fetus; Heart Rate, Fetal; Hypertension; Hypotension; Myocardial Contraction; Nitroprusside; Oxytocin; Phenylephrine; Pregnancy; Sheep; Vasoconstrictor Agents

The present study was designed to compare the effects of glucagon-like peptide-1 (7-36) amide (GLP-1) injected centrally or systemically in a dose range of 10-10000 ng on the vasopressin and oxytocin release as well as the blood pressure in the rat. The urethane-anaesthetised Wistar male and female rats were fitted with venous as well as arterial catheters and, in the second study, additionally with the intracerebroventricular cannula. The arterial blood pressure was monitored throughout the experiment. The plasma vasopressin/oxytocin concentrations were measured in blood samples taken 15 min before and 5, 15 and 30 min after the intravenous or intracerebroventricular GLP-1 injection. No gender-dependent differences were seen as to the GLP-1 effect on the blood pressure or the hormone release. GLP-1 administered centrally or systemically at low doses (10 or 100 ng) either showed a hypertensive or biphasic (an increase followed by a decrease in the blood pressure) effect. On the other hand, 1000 or 10000 ng GLP-1 caused a clear increase of the blood pressure regarding the way of injection. When injected systemically, GLP-1 increased the release of both neurohypophysial hormones. When injected centrally, however, GLP-1 either enhanced or, at low doses, significantly reduced the plasma vasopressin/oxytocin levels. The effect on the blood pressure seems to be independent of the possible pressor effect of endogenous vasopressin. It is concluded that GLP-1 may modulate the function of the hypothalamo-neurohypophysial system as well as the cardiovascular system through both the central and systemic mechanisms.

Topics: Animals; Blood Pressure; Dose-Response Relationship, Drug; Female; Glucagon; Glucagon-Like Peptide 1; Glucagon-Like Peptides; Hypertension; Injections, Intravenous; Male; Neurotransmitter Agents; Oxytocin; Peptide Fragments; Radioimmunoassay; Rats; Rats, Wistar; Sex Factors; Time Factors; Vasopressins

To evaluate the effect of early amniotomy in term gestation on the mode of delivery and pregnancy outcome in comparison with premature rupture of membranes (PROM) and oxytocin induction.. The study population consisted of 60 consecutive parturients induced by early amniotomy. The two comparison groups were 147 women admitted with term PROM and 65 patients induced by oxytocin. All study participants were evaluated prospectively and had unfavorable cervical scores.. The duration of the first stage of labor was significantly longer in the PROM group (987.8 +/- 572.3 min) as compared with the early amniotomy group (615.0 +/- 389.6 min) and the oxytocin induction group (650.9 +/- 349.5 min, P<0.001). Higher rates of CS were found in the study group (26.7%) as compared to the controls (11.6% in the PROM and 16.9% in the oxytocin groups, p=0.012). Neonatal outcome was similar in all groups. A stratified analysis comparing the risk of CS while controlling for a previous one did not show a significant difference between the early amniotomy and the oxytocin administration groups.. Early amniotomy is associated with a higher rate of CS. While controlling for a previous CS, both ways of induction were comparable. In order to decrease the CS rates, induction should probably start with cervical ripening techniques in order to improve the Bishop scores.

Topics: Adult; Amnion; Cesarean Section; Delivery, Obstetric; Diabetes, Gestational; Female; Fetal Membranes, Premature Rupture; Fetal Monitoring; Fetal Movement; Gestational Age; Heart Rate, Fetal; Humans; Hypertension; Labor, Induced; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Outcome; Prospective Studies

To determine the maximum tolerated dose (MTD) of carbetocin (a long-acting synthetic analogue of oxytocin), when administered immediately after vaginal delivery at term.. Carbetocin was given as an intramuscular injection immediately after the birth of the infant in 45 healthy women with normal singleton pregnancies who delivered vaginally at term. Dosage groups of 15, 30, 50, 75, 100, 125, 150, 175 or 200 microg carbetocin were assigned to blocks of three women according to the continual reassessment method (CRM).. All dosage groups consisted of three women, except those with 100 microg (n=6) and 200 microg (n=18). Recorded were dose-limiting adverse events: hyper- or hypotension (three), severe abdominal pain (0), vomiting (0) and retained placenta (four). Serious adverse events occurred in seven women: six cases with blood loss > or = 1000 ml, four cases of manual placenta removal, five cases of additional oxytocics administration and five cases of blood transfusion. Maximum blood loss was greatest at the upper and lower dose levels, and lowest in the 70-125 microg dose range. Four out of six cases with blood loss > or = 1000 ml occurred in the 200 microg group. The majority of additional administration of oxytocics (4/5) and blood transfusion (3/5) occurred in the dose groups of 200 microg. All retained placentae were found in the group of 200 microg.. The MTD was calculated to be at 200 microg carbetocin.

Topics: Abdominal Pain; Female; Humans; Hypertension; Hypotension; Injections, Intramuscular; Oxytocics; Oxytocin; Placenta, Retained; Postpartum Hemorrhage; Pregnancy; Vomiting

The neuropeptides arginine vasopressin (AVP) and oxytocin (OT) have been implicated in the genesis of hypertension due to deoxycorticosterone acetate (DOCA)-salt treatment of uninephrectomized rats. In this work, we studied if DOCA treatment of intact rats in doses arousing a salt appetite (a prehypertensive state), modulated mRNA for AVP and OT in the hypothalamus. Male Sprague-Dawley rats were offered both tap water and 3% NaCl in separate bottles and received vehicle or subcutaneous injections of 10 mg DOCA on alternate days for 7 days (4 injections) or 17 days (9 injections). They developed a preference for 3% NaCl solutions 24-48 h after treatment. Brain slices from rats killed on the 8th or 18th day were exposed to 35S-labeled probes encoding prepro-AVP mRNA or OT mRNA, respectively. Expression of these mRNAs was measured in the magnocellular and parvocellular divisions of the paraventricular nucleus (PVN) and magnocellular cells of the supraoptic nucleus (SON). No changes were obtained in neuropeptide mRNA levels in the parvocellular division of the PVN between control and the two groups of DOCA-treated rats. However, DOCA-treated animals presented an increased number of grains per cell for AVP mRNA in the magnocellular division of the PVN and in magnocellular cells of the SON, as shown by group mean comparisons and frequency histograms. No changes were detected for OT mRNA. In a second series of studies, control or DOCA-treated rats were offered 3% NaCl or water as the only choice. Animals drinking 3% NaCl showed increased AVP and OT mRNA levels, whether they received DOCA or not. However, AVP mRNA levels in both nuclei were higher in DOCA-treated rats drinking 3% NaCl than in controls drinking salt solution. In comparison, control and DOCA-treated rats drinking water showed lower levels of AVP mRNA. OT mRNA levels in the SON remained unchanged in the same groups. The results suggest that in the magnocellular cells of the PVN and SON, increments in AVP mRNA are obtained following increments in salt intake produced by either mineralocorticoid treatment or exclusive salt drinking. In rats offered salt solution and water to drink, DOCA effects on AVP mRNA developed before changes occurred in serum sodium levels. Because combined DOCA + salt treatment induced a higher response in terms of AVP mRNA expression, we suggest that AVP could be a target of the central effects of the mineralocorticoid.

Topics: Adrenal Glands; Animals; Appetite; Arginine Vasopressin; Desoxycorticosterone; Drinking; Gene Expression; Hypertension; In Situ Hybridization; Male; Osmolar Concentration; Oxytocin; Paraventricular Hypothalamic Nucleus; Rats; Rats, Sprague-Dawley; RNA, Messenger; Sodium Chloride; Supraoptic Nucleus

The aim of the present study was to investigate the effects of repeated injections of oxytocin on blood pressure and heart rate in spontaneously hypertensive rats (SHR). For this purpose subcutaneous (s.c.) injections of oxytocin 1 mg/kg or saline were given for 5 days to male and female SHR. Blood pressure and heart rate were measured daily before, during and after the oxytocin treatment period. In male rats, a significant decrease in blood pressure (systolic; p < 0.01, diastolic; p < 0.05), but no effect on heart rate, was seen the day after the first injection of oxytocin, when compared to saline-treated controls. Blood pressure decreased further in response to each injection and a maximal difference of 21 mmHg (systolic) (p < 0.01), compared to controls, was reached after the last injection. The significant effect was gone 3 days after the last injection, although a tendency to a lower blood pressure in the oxytocin-treated rats persisted. On day 10, the oxytocin-treated SHR males again had a significantly lower systolic blood pressure (p < 0.05). In female SHR, the same treatment with oxytocin affected neither blood pressure nor heart rate. These results show that oxytocin may cause a sustained decrease in blood pressure, without affecting heart rate, in male but not in female SHR.

Topics: Animals; Blood Pressure; Female; Heart Rate; Hypertension; Injections, Subcutaneous; Male; Oxytocin; Rats; Rats, Inbred SHR; Rats, Sprague-Dawley; Sex Characteristics

The aim of this study was to investigate the effect of oxytocin induction and augmentation on neonatal bilirubin levels in newborns of diabetic and hypertensive mothers. All women included in the study were admitted to the obstetrics department at Al Hussein Hospital. They were 18-38 years old, and their gestational ages were 38-41 weeks by date. A total number of 140 newborn infants were divided into 3 groups and studied for bilirubin levels. The first group consisted of 40 infants of diabetic mothers, 20 of whom were given oxytocin for labor induction and 20 of whom received it for labor augmentation. The second group consisted of 40 infants of hypertensive mothers, 20 of whom were given oxytocin for labor induction and 20 of whom received it for labor augmentation. The third group consisted of 60 controls, 20 of whom were given oxytocin for labor induction, 20 of whom received it for labor augmentation, and 20 of whom received no oxytocin. It was found that total and unconjugated bilirubin levels were higher in infants delivered after induction of labor, whether their mothers were diabetic, hypertensive, or neither, than in infants delivered without labor induction. Bilirubin levels were mildly high in infants of diabetic mothers after augmented delivery and then nullified after 24 hours. However, the study suggested that the increased bilirubin levels were related to induced labor rather than the medical problem of the mothers, provided that the newborns were of average weight.

Topics: Africa; Africa, Northern; Biology; Blood; Case-Control Studies; Delivery, Obstetric; Demography; Developing Countries; Diabetes Mellitus; Disease; Egypt; Endocrine System; Hormones; Hyperbilirubinemia; Hypertension; Middle East; Oxytocin; Physiology; Pituitary Hormones; Population; Population Characteristics; Pregnancy; Pregnancy Outcome; Reproduction; Research; Vascular Diseases; Women

To investigate the central nervous system (CNS) changes in the spontaneously hypertensive rat (SHR), a tissue culture model was used to examine the content and release (24 hour) of the peptide hormones, vasopressin (VP) and oxytocin (OT), from brain explants. Nuclear regions consisting of the paraventricular (PVN) or supraoptic (SON) nuclei were microdissected from prehypertensive SHR and Wistar-Kyoto (WKY) rats. Media levels of VP and OT were measured at 1, 3, 4, and 7 days of culture. After three days of culture, the PVN explants from SHR secreted significantly less VP and OT (both reduced 80%) than did those from WKY. Release of both VP and OT in the SON explants was significantly lower (approximately 50% lower) in the SHR only at seven days of culture. Additionally, tissue content of the peptides was measured after 0, 1, 4, and 7 days of culture. Tissue content of VP and OT was decreased (40% or more) in the SHR in both nuclear regions after four and seven days of culture. In addition, nicotine was found to stimulate the release of VP from SON, but not PVN, cultures in both SHR and WKY explants. Immunohistochemical data showed that there was not a preferential loss of VP or OT neurons in explants from the SHR. Therefore, this in vitro model would indicate that there is a difference in the ability of cultured explants of PVN and SON from SHR and WKY (four-week-old) to synthesize and/or release the peptide hormones VP and OT.

Topics: Animals; Culture Techniques; Hypertension; Immunohistochemistry; Male; Nicotine; Oxytocin; Paraventricular Hypothalamic Nucleus; Rats; Rats, Inbred SHR; Rats, Inbred WKY; Supraoptic Nucleus; Vasopressins

To study the regulation of hypothalamic vasopressin (VP) and oxytocin (OT) gene expression in relation to the development of hypertension, levels of VP mRNA and OT mRNA were determined in spontaneously hypertensive rats (SHR). Differences in VP and OT mRNA content of the supraoptic nucleus (SON) and paraventricular nucleus (PVN) of 4- and 10-week-old SHR and Wistar-Kyoto controls (WKY) were quantitated by dot-blot and Northern blot analysis. VP and OT pituitary content and VP plasma levels were measured by radioimmunoassays. VP mRNA levels were approximately 2-fold and 3-fold higher in the SON and PVN of 4-week-old SHR, respectively, as compared to controls. The OT mRNA levels were approximately 35% lower in both nuclei of the SHR. There was no difference in VP and OT pituitary content between 4-week-old SHR and WKY, but VP plasma levels were higher in SHR. In the 10-week-old SHR VP mRNA levels were still approximately 30-40% higher and the OT mRNA levels were approximately 40% lower in both nuclei when compared to age-matched WKY. Pituitary VP and OT contents were respectively 1.5-fold higher and 20% lower in the 10-week-old SHR than in 10-week-old WKY. VP plasma levels were still elevated in the SHR. The data indicate that in the hypothalamo-neurohypophyseal system of the SHR the VP system is in a higher state of activity, while the OT system is lower in activity.

Topics: Aging; Animals; Blood Pressure; Gene Expression Regulation; Genes; Hypertension; Male; Oxytocin; Paraventricular Hypothalamic Nucleus; Pituitary Gland; Rats; Rats, Inbred SHR; Rats, Inbred Strains; Rats, Inbred WKY; RNA, Messenger; Supraoptic Nucleus; Transcription, Genetic; Vasopressins

A possible involvement of oxytocin (OT) has been indicated in regulation of water and electrolyte metabolism, based on findings that the secretion of OT is increased by either water deprivation or sodium loading. However, to date, no informations have yet been obtained about the role of OT in hypertension. The present study was therefore undertaken to elucidate the role of OT for abnormalities of fluid and electrolyte metabolism in essential hypertension (EH) in comparison with normotensive subjects (NT). The major results were as follows. Plasma level of OT was 3.7 +/- 2.1 pg/ml (mean +/- SD) in EH, not significantly higher than that in NT (3.2 +/- 1.7 pg/ml). Plasma OT in low-renin EH (4.8 +/- 2.5 pg/ml) was significantly different from that in high-renin EH (2.9 +/- 1.4 pg/ml, p less than 0.05) and NT (p less than 0.05), but not in normal-renin EH (3.8 +/- 2.0 pg/ml). Plasma OT was inversely correlated with plasma renin activity (PRA) in EH (r = -0.384, p less than 0.01), but not in NT (r = 0.102). No significant correlation was found between plasma OT and plasma aldosterone concentration (PAC), plasma concentration of antidiuretic hormone (ADH), serum sodium and potassium, blood pressure and renal function in either EH or NT. I.m. injection of OT (0.04 IU/kg) increased significantly urinary excretions of sodium and potassium in EH and NT. However, the increment in sodium excretion was greater in low-renin EH than that in normal-renin EH (0.05 less than p less than 0.10), high-renin EH (p less than 0.05) and NT (p less than 0.05). PRA, PAC and ADH were significantly decreased after OT injection, but blood pressure, serum sodium and potassium were not altered in both EH and NT. I.v. administration of OT (0.1 approximately 0.2 IU/min) suppressed angiotensin II-induced increase of PAC and elevation of blood pressure in both EH and NT. The decrease in PAC by the OT administration was the greatest in low-renin EH. The reduction of blood pressure was significantly greater in EH than in NT (p less than 0.05). I.v. administration of hypertonic saline (5%) resulted in a significant increase of plasma OT in EH and NT, and the increment in OT was the greatest in low-renin EH. Serum sodium concentration was increased by the infusion, positively correlated with plasma OT in both EH (r = 0.458, p less than 0.05) and NT (r = 0.830, p less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Adult; Aged; Diet, Sodium-Restricted; Female; Humans; Hypertension; Male; Middle Aged; Oxytocin; Renin-Angiotensin System; Water-Electrolyte Imbalance

Plasma oxytocin-associated neurophysin concentration [( OT-RNP]) was used to evaluate the responsiveness of oxytocinergic neurons to an acute salt load in Long-Evans (LE) rats and Brattleboro homozygous (DI) rats. This responsiveness was compared with that of vasopressinergic neurons in LE rats as indexed by plasma vasopressin-associated neurophysin concentration [( VP-RNP]). Acute salt loading was induced by infusing 18% saline for 60 min into conscious, trained, chronically catheterized animals and plasma osmolality (Posm) and mean arterial pressure (MAP) were monitored. An increase in Posm was associated with a rise in [OT-RNP] and the relationship between delta [OT-RNP] and delta Posm was similar for both LE and DI rats over the first 40 min of infusion (21.6 and 19.7 fmol ml-1 mosm-1 kg-1, respectively). Although Posm continued to rise between 40 and 60 min infusion, [OT-RNP] actually fell slightly during this period in LE rats to a final elevation of 682 +/- 40 fmol/ml above initial values whereas [OT-RNP] in DI rats continued to rise to a final elevation of 1,927 +/- 288 fmol/ml above initial values at 60 min of infusion. The differences between these elevations at 60 min for LE and DI rats were highly significant (p less than 0.001). For LE rats, the increase of [OT-RNP] with Posm for the first 40 min of infusion was much greater than the increase in [VP-RNP] with the slope between delta [VP-RNP] and delta Posm being only 8.3 compared to 21.6 fmol ml-1 mosm-1 kg-1 in the case of delta [OT-RNP].(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Blood Pressure; Hypertension; Male; Neurons; Neurophysins; Osmolar Concentration; Oxytocin; Rats; Rats, Brattleboro; Saline Solution, Hypertonic; Sodium Chloride; Vasopressins

Changes in brain neuropeptide content in spontaneously hypertensive rats may be primarily related to the development of hypertension or may be secondary consequences of it. We have measured brain concentrations of beta-endorphin, Leu-enkephalin, arginine vasopressin (AVP) and oxytocin (OXT) in stroke-prone spontaneously hypertensive rats (SHRSP) and in age-matched normotensive Wistar Kyoto (WKY) controls, as well as in SHRSP with normalized blood pressure by chronic treatment with clonidine. Opioid peptide contents were measured in 12-, 18- and 24-week-old rats. beta-Endorphin was measured in the neuro-intermediate and anterior lobes of the pituitary, the hypothalamus, mid-brain and brain stem; Leu-enkephalin in the neuro-intermediate lobe of the pituitary, hypothalamus, mid-brain, brain stem, as well as in the spinal cord and adrenal glands. AVP and OXT were measured in the neuro-intermediate lobe of the pituitary, hypothalamus, brain stem and spinal cord. beta-Endorphin in the neuro-intermediate lobe of the pituitary was significantly higher in 12- and 18-week-old SHRSP. Adrenal gland Leu-enkephalin was lower in SHRSP as compared with the WKY. OXT and AVP contents were markedly reduced in all brain regions of SHRSP except the neuro-intermediate lobe of the pituitary, where no significant changes were found. In no case did long-term antihypertensive treatment with clonidine reverse the altered peptide content in the SHRSP. We conclude that alterations in brain neuropeptide content in SHRSP are not secondary to hypertension. The blood pressure lowering activity of clonidine appears not to depend on major alterations of peptide concentrations. A genetic defect in the synthesis of adrenal enkephalins and hypothalamic OXT and AVP seems likely from these studies.

Topics: Animals; Arginine Vasopressin; beta-Endorphin; Brain; Clonidine; Endorphins; Enkephalin, Leucine; Hypertension; Male; Nerve Tissue Proteins; Oxytocin; Rats; Rats, Inbred SHR; Rats, Inbred WKY

The hypothalamo-neurohypophysial system is altered in the spontaneously hypertensive rat (SHR). We hypothesized that an aberrant regulation of vasopressin (VP) and oxytocin (OT) release by endogenous opioid peptides alters this neuroendocrine system in the SHR. Concentrations of the neurohypophysial hormones in plasma and the pituitary were measured in 17-week-old SHRs and two strains of normotensive controls. Wistar Kyoto (WKY) and Sprague-Dawley rats. Animals were decapitated 20 min after s.c. injection of saline (1 ml/kg) or naloxone hydrochloride (1 or 10 mg/kg). In addition, neurohypophysial hormones excreted during the day (08.00-17.30 h) and night (17.30-08.00 h) were determined in urine from 16-week-old animals kept in metabolic cages for 5 days. VP at extrahypothalamic sites was also measured as [VP] in acid extracts of the subfornical organ area, hippocampal commissure-fornix and choroid plexus. Hormones were quantified by radioimmunoassay. The pituitary content, plasma concentration, and urinary excretion of OT were reduced (P less than 0.05) in SHRs, whereas VP content was increased (P less than 0.05) in the pituitary and plasma, but unchanged in urine, of hypertensive animals. In extrahypothalamic tissues, [VP] in the hippocampal commissure-fornix was increased in the SHR. Naloxone elevated (P less than 0.05) the plasma concentration of OT in WKY animals and VP in SHRs. Neither [VP] nor [OT] in plasma was changed by naloxone in Sprague-Dawley rats. Pituitary stores of the neurohypophysial hormones were not altered by naloxone in either hypertensive or normotensive rats. In conclusion, endogenous opioid peptides tonically inhibit OT release in WKY rats, whereas VP release is decreased by opioid peptides in SHRs, 16-17 weeks of age. The neuromodulatory role of opioid peptides in the release of neurohypophysial hormones appears to be altered in the SHR such that VP release is suppressed and OT release is augmented.

Topics: Animals; Endorphins; Hypertension; Hypothalamo-Hypophyseal System; Male; Naloxone; Oxytocin; Rats; Rats, Inbred SHR; Rats, Inbred Strains; Rats, Inbred WKY; Vasopressins; Water-Electrolyte Balance

Topics: Amnion; Cesarean Section; Female; Humans; Hypertension; Labor, Induced; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Prospective Studies

A group of 89 individuals with essential hypertension was evaluated with several measurements including the neurophysin believed to be the human oxytocin neurophysin (OT-Np), and the human vasopressin neurophysin (VP-Np). The neurophysins are proteins synthesized within cells of the supraoptic and paraventricular nuclei in conjunction with their respective hormones oxytocin and vasopressin as part of a common precursor molecule and so may reflect the simultaneous presence in plasma of their associated hormones. A poor but statistically significant correlation was noted between levels of OT-Np and renin activity in plasma (PRA) either supine (r = 0.248) or erect (r = 0.255). Levels of OT-Np averaged 1.75 ng/ml and were inversely correlated with creatinine (r = -0.252), supine blood pressure (r = -0.450), plasma volume (r = -0.327), and 24-hour urine sodium (r = -0.313). Levels of Ot-Np could be suppressed by infusion of physiologic saline. Levels of OT-Np were lower in the volume expanded state and were positively correlated with the quantity of sodium excreted into a 24-hour urine collected after the infusion (r = 0.426) and inversely correlated with the supine systolic (r = -0.379) and supine diastolic (r = -0.455) blood pressures recorded after the infusion of saline. Oestrogen, a stimulus to the secretion of OT-Np, did not account for the elevation of OT-Np observed in the study, since mean levels of oestradiol (E2) in a subset of the patients with elevated OT-Np (E2 = 36 pg/ml) were not different from levels in subjects with lower values of OT-Np (E2 = 45 pg/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Age Factors; Blood Pressure; Creatinine; Dopamine; Estradiol; Female; Humans; Hypertension; Male; Middle Aged; Neurophysins; Oxytocin; Plasma Volume; Posture; Renin; Sodium; Vasopressins

A number of experiments were performed in order to investigate the possible importance of vasopressin (AVP) in the pathogenesis of high blood pressure in spontaneously hypertensive rats of the stroke prone strain (SHRSP). Radioimmunological studies revealed reduced concentrations of AVP in the plasma and brain of SHRSP as compared to normotensive controls. Intravenous administration of an AVP pressor antagonist had no significant influence on mean arterial blood pressure, cardiac output and total peripheral resistance in SHRSP. Crossbreeding of SHRSP with rats homozygous for hypothalamic diabetes insipidus resulted in the development of a new strain of rats which show high blood pressure despite of a complete lack in AVP. These results argue strongly against a pressor role of AVP in the development or maintenance of hypertension in SHRSP.

Topics: Animals; Arginine Vasopressin; Blood Pressure; Brain Chemistry; Hypertension; Male; Oxytocin; Rats; Rats, Inbred Strains; Vasopressins

Presented is a case of an eclamptic patient whose primary clinical presentation was cortical blindness. The patient was not known to be preeclamptic during her prenatal course, but she was lost to follow up one month prior to her presentation. Computed tomographic scan of the head was consistent with hypertensive encephalopathy. She was treated as an eclamptic patient. Her blood pressure was controlled with hydralazine, and she was given magnesium sulfate intravenously and intramuscularly. Labor was induced with a pitocin infusion. After delivery of a term infant, her vision returned and all other symptoms resolved without sequelae. The etiology and pathophysiology of cortical blindness as a symptom of eclampsia are discussed.

Topics: Adult; Blindness; Eclampsia; Female; Humans; Hydralazine; Hypertension; Labor, Induced; Oxytocin; Pregnancy; Pregnancy Complications; Tomography, X-Ray Computed

The brain stem and neurohypophyseal content of arginine vasopressin and the brain stem content of oxytocin were measured by radioimmunoassay in 3-, 7-, and 22- to 28-week-old spontaneously hypertensive rats of the stroke-prone strain (SHRSP) and the values were compared to those measured in age-matched normotensive Wistar-Kyoto rats (WKY). When compared to WKY, the content of vasopressin in the brain stems of SHRSP was reduced in all three age-groups; in contrast, the neurohypophyseal contents of vasopressin in the two species were not significantly different at 3 and 7 weeks of age and the content was increased slightly in SHRSP at 22-28 weeks. Similar to the findings for vasopressin in the brain stem, the content of oxytocin in this tissue was reduced in SHRSP at 7 and 22-28 weeks of age. The results demonstrate that brain stem arginine vasopressin levels and neurohypophyseal arginine vasopressin levels may change differentially and that the age-related differences in the brain stem levels of arginine vasopressin and oxytocin in SHRSP and WKY are consistent with the possibility that these peptides may play a role in altering cardiovascular reflex activity.

Topics: Age Factors; Animals; Arginine Vasopressin; Brain Stem; Hypertension; Oxytocin; Radioimmunoassay; Rats; Rats, Inbred Strains

Topics: Adrenal Cortex; Adrenocorticotropic Hormone; Animals; Corticosterone; Diabetes Insipidus; Female; Hypertension; Lypressin; Oxytocin; Pituitary Gland; Pituitary Hormones, Posterior; Rats; Rats, Brattleboro; Rats, Inbred Strains; Rats, Mutant Strains; Sound; Stress, Physiological

Topics: Female; Fetal Death; Fetal Heart; Fetal Monitoring; Heart Rate; Humans; Hypertension; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Multi-Institutional Systems; Oxytocin; Pre-Eclampsia; Pregnancy; Pregnancy in Diabetics; Prospective Studies; Risk; Uterine Contraction

This study includes, 1,542 patients who underwent nonstress tests (NSTs) for primary fetal surveillance and 4,626 patients who underwent contraction stress tests (CSTs) for primary fetal surveillance. All pregnancies were at increased risk for uteroplacental insufficiency. The results showed that the two groups were comparable according to maternal diagnostic criteria for testing. Those patients who underwent NSTs as primary surveillance had a 2.9% incidence of intervention because of abnormal test results while the CST group had a 4.5% incidence of intervention because of abnormal test results ( p less than 0.05). The NST group had significantly more respiratory distress syndrome, intrauterine growth retardation, birth weight less than 2,500 gm, and 5-minute Apgar scores less than 7. The antenatal death rate was nearly eight times higher in the NST group (7.8/1,000 versus 1.1/1,000 in the CST group) (p less than 0.05). After correction for congenital anomalies and unrelated causes, the NST group had an antenatal death rate of 3.2/1,000 versus 0.4/1,000 in the CST group (p less than 0.05); there was still an antenatal death ratio of 8:1.

Topics: Apgar Score; Birth Weight; Female; Fetal Death; Fetal Growth Retardation; Fetal Heart; Fetal Monitoring; Heart Rate; Humans; Hypertension; Infant, Newborn; Multi-Institutional Systems; Oxytocin; Pre-Eclampsia; Pregnancy; Pregnancy in Diabetics; Prospective Studies; Respiratory Distress Syndrome, Newborn; Risk; Uterine Contraction

Topics: Animals; Hypertension; Hypothalamus, Anterior; Male; Oxytocin; Paraventricular Hypothalamic Nucleus; Rats; Rats, Inbred Strains; Suprachiasmatic Nucleus; Supraoptic Nucleus; Vasopressins

Hypothalamic and neurophypophyseal levels of catecholamines and peptides were measured in spontaneous and deoxycorticosterone (DOCA)/salt hypertension. Catecholamines, norepinephrine, epinephrine and dopamine were measured by electrochemical detection while the peptides, vasopressin, oxytocin, luteinizing hormone-releasing hormone (LHRH), the enkephalins and somatostatin (SRIF) were measured by radioimmunoassay. Blood pressure was significantly elevated in both groups as compared to their controls. Marked changes in central neural peptides were observed in the SHR, while no differences were seen in DOCA/salt hypertension. Hypothalamic vasopressin, oxytocin, LHRH and SRIF were significantly decreased. In the posterior pituitary, enkephalins were increased twofold in the SHR. With regard to catecholamines, there was no change in hypothalamic content. However, a dramatic decrease in neurohypophyseal dopamine was observed in SHR. Plasma levels of vasopressin were significantly elevated in both types of hypertension while oxytocin was increased only in the DOCA/salt model. These result show that (1) a wide spectrum of neuroendocrine changes are associated with genetic hypertension, (2) there are CNS differences between DOCA/salt and spontaneous hypertension, and (3) central aminergic changes may be involved in th neuroendocrine alterations seen in the SHR.

Topics: Animals; Blood Pressure; Catecholamines; Desoxycorticosterone; Endorphins; Enkephalins; Gonadotropin-Releasing Hormone; Hypertension; Hypothalamo-Hypophyseal System; Male; Oxytocin; Rats; Sodium Chloride; Somatostatin; Vasopressins

In a consecutive series of 1,201 singleton pregnancies with pre-eclampsia, the onset occurred during labour in 290 (24.1%). There was no difference between the primiparous and parous patient in this respect (25.9% v 20.7%; P less than 0.10). The tendency for pre-eclampsia to develop during labour increased with advancing maturity of the pregnancy and seldom occurred before 38 weeks of gestation; this was again equally true of the primiparous and parous patient, as was the incidence of severe hypertension (diastolic pressure greater than 110mm Hg) (36.1% v 34.1%). The high incidences of severe hypertension (35.5%), proteinuria (41.7%), and eclampsia (2.1%), and the 1 maternal death testified to the severity of the disease process and the need for aggressive management. After delivery, the clinical signs tended to subside rapidly, but the early third stage of labour was a time of maternal risk, irrespective of whether ergometrine or Syntocinon was the oxytocic agent administered. Analysis of perinatal results showed that the risk to the fetus was minimal.

Topics: Adult; Ergonovine; Female; Fetal Distress; Humans; Hypertension; Labor Stage, Third; Middle Aged; Obstetric Labor Complications; Oxytocin; Parity; Pre-Eclampsia; Pregnancy; Proteinuria; Risk

Non-stress and oxytocin exposure tests were applied to 321 patients with hypertensive late gestoses for cardiotocographic monitoring of their high-risk pregnancies, over two years. No prenatal and intranatal deaths of newborns were recordable in cases in which non-stress tests were repeated in two-day intervals together with oxytocin exposure tests, where indicated. Thirty-minute recordings of cardiotocography in two-day intervals, with particular attention to foetal movements, are recommended for routine prepartal monitoring of high-risk pregnancies. Oxytocin exposure tests should not be used unless indicated.

Topics: Acidosis; Cesarean Section; Female; Fetal Monitoring; Humans; Hypertension; Infant, Low Birth Weight; Infant, Newborn; Oxytocin; Pre-Eclampsia; Pregnancy

1. Neurosecretion of peptides from superfused neurohypophyses in vitro was inhibited by dopamine. 2. This inhibition was dose-dependent. 3. Intravenous injection of the dopamine agonist, bromocriptine, lowered blood pressure in spontaneously hypertensive rats within 15 min. 4. Saralasin or captopril also lowered blood pressure of spontaneously hypertensive rats, but progressively over a period of 3 h. 5. The results suggest that dopamine and angiotensin have opposite effects on the neurosecretion of vasopressin. 6. Vasopressin appears to be involved in maintenance of blood pressure in the spontaneously hypertensive rat but is apparently not the only factor.

Topics: Angiotensin II; Animals; Bromocriptine; Captopril; Dopamine; Hypertension; In Vitro Techniques; Oxytocin; Pituitary Gland, Posterior; Proline; Rats; Saralasin; Swine; Vasopressins

Labor was induced with oral prostaglandin (PGE2) without amniotomy in 20 patients (10 nulliparae and 10 multiparae) with hypertension, whether or not associated with edema and/or proteinuria. An average dose of 8 mg was required to achieve effective uterine contractility in both nulliparae and multiparae. Multiparae required only a mean dose of 12 mg but nulliparae a dose of 18 mg to achieve delivery. The mean duration of labor was slightly longer in both nulliparae and multiparae than that achieved with fast escalating doses of i.v. oxytocin. The need for analgesia was greater in oxytocin-induced patients than in the prostaglandin-induced patients. Otherwise no differences were found between the two groups.

Topics: Adult; Female; Humans; Hypertension; Labor, Induced; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Prostaglandins E, Synthetic

The oxytocin challenge test (OCT) has been shown in other studies to be valuable in evaluating high-risk pregnancies. The purpose of this study was to show the relationship of various disease states and clinical conditions with OCT results and fetal performance in labor. Of a group of normal patients, 4% had positive OCTs or late decelerations (LDs) in labor. The incidence of positive OCTs or LDs in labor in patients with diabetes mellitus (DM) class B-R was 23.2%; in DM class A, 27.6%; in intrauterine growth retardation (IUGR), 26.2%; in pregnancy-induced hypertension (PIH), 27.6%; in chronic hypertension (CH), 13.6%; and in prolonged gestation, 10.8%. This study shows that DM of all classes, IUGR and PIH are the most likely conditions in which persistent LDs will occur.

Topics: Apgar Score; Female; Fetal Distress; Fetal Growth Retardation; Fetal Heart; Fetus; Heart Rate; Humans; Hypertension; Infant, Newborn; Labor, Obstetric; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy in Diabetics; Pregnancy, Prolonged; Risk

Sixty-six patients with chronic hypertension were cared for during a total of 72 pregnancies. Patients were treated at home primarily by greater than or equal to 4 hours of bed rest daily in the left recumbent position. Only patients whose diastolic blood pressures remained greater than 110 mmHg were treated with hydralazine (Apresoline, Ciba). With this plan of treatment there were only 3 perinatal deaths for an uncorrected perinatal mortality of 4.1% (1.4% corrected). Twenty-nine percent of the patients had babies that were small for gestational age, 13.8% had positive oxytocin challenge tests, and 36.8% developed superimposed preeclampsia. When compared with the outcome of previous pregnancies, the program of bed rest lowered perinatal mortality from 16.8 to 8.8%. Thus, it is suggested that bed rest together with the avoidance of diuretics and the judicious use of hydralazine results in the most favorable fetal outcome.

Topics: Bed Rest; Birth Weight; Chronic Disease; Female; Fetal Death; Humans; Hydralazine; Hypertension; Infant Mortality; Infant, Newborn; Infant, Small for Gestational Age; Meconium; Oxytocin; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular

Topics: Adult; Antihypertensive Agents; Chronic Disease; Female; Fetal Growth Retardation; Fetus; Growth; Humans; Hydralazine; Hydrochlorothiazide; Hypertension; Infant, Newborn; Methyldopa; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Prenatal Diagnosis; Ultrasonography

A prospective study of primiparous English women and their newborns failed to replicate previous findings that greater irritability was related to higher maternal blood pressure during pregnancy and labour. This apparent lack of replication prompted a search for fetal variables capable of mediating the blood pressure--irritability relationships. Relative fetal growth retardation was found in newborns of women whose peak antenatal blood pressure occurred from 20 to 32 wk gestation. Prenatal growth retardation and exposure to either oxytocin-stimulated labour or higher maternal blood pressure during spontaneous labour were associated with lower intrapartum fetal heart rate. Lower heart rate, in turn, was associated with greater crying and more frequent changes of state during behavioural assessments on the first and fifth days. It is suggested that intrapartum hypoxia is an immediate antecedent of newborn irritability. The blood pressure--irritability relationships may therefore reflect the influence of growth retardation, attributable to increased pregnancy blood pressure, and higher labour blood pressure, respectively, on the ability of the fetus to withstand hypoxia and the degree of hypoxia encountered during labour.

Topics: Anesthesia, Obstetrical; Behavior; Crying; Female; Fetal Hypoxia; Fetus; Heart Rate; Humans; Hypertension; Infant, Newborn; Infant, Small for Gestational Age; Meperidine; Obstetric Labor Complications; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Prospective Studies

Oral prostaglandin E2 (PGE2) was used alone or synergistically with intravenous oxytocin to induce labor in 84 women whose pregnancies were at high risk. A control group of 84 similar high-risk pregnancies where labor was induced with intravenous oxytocin alone was studied to compare the safety and efficacy of the two regimens. Oral PGE2 administration, combined with the synergistic effect of intravenous oxytocin, is safe for induction of labor in gravid women whose fetuses are at risk. Uterine polysystole, which is potentially dangerous, especially to the high-risk fetus, was not commonly encountered and only once was associated with transient fetal bradycardia. Uterine hypertonus was not encountered with PGE2; however, it did occur with oxytocin stimulation. Nausea and vomiting occurred in one third of the women treated with PGE2 but were well tolerated and required discontinuation of the drug in only one instance. There was no apparent advantage of using the combination PGE2 regimen in patients whose cervices were more favorable for induction of labor (Bishop score, 5 to 9). However, oral PGE2, used either alone or synergistically with oxytocin, appears twice as effective in inducing labor than was oxytocin alone in women in whom labor was considered to be "difficult to induce" (Bishop score, 0 to 4).

Topics: Administration, Oral; Adult; Cesarean Section; Delivery, Obstetric; Female; Humans; Hypertension; Infant, Newborn; Labor, Induced; Obstetric Labor Complications; Oxytocin; Pregnancy; Pregnancy Complications; Prostaglandins E; Risk

The circulating level of ACTH (by radioimmunoassay) and cortisol (by competitive protein binding) were determined at 1- to 2-hour intervals during spontaneous labor (N=8) and induced labor (N=28) and after delivery. There were no differences in ACTH levels between primiparous and multiparous women. The primiparous women displayed a higher level of cortisol throughout labor than the multiparous women, but not after delivery. After spontaneous onset of labor, ACTH levels were always lower than after elective induction of labor, while there were no differences in the levels of cortisol. The hypertensive complications of pregnancy did not affect the secretion of ACTH. In normal pregnancy the rise of cortisol during labor and after delivery was significant, but it was not significant in the group of patients with hypertensive complications.

Topics: Adrenocorticotropic Hormone; Female; Humans; Hydrocortisone; Hypertension; Labor, Induced; Labor, Obstetric; Oxytocin; Parity; Pituitary-Adrenal System; Postpartum Period; Pregnancy; Pregnancy Complications; Pregnancy Complications, Cardiovascular; Radioimmunoassay; Radioligand Assay; Stress, Physiological

Three cases have been observed over the past 3 years at Los Angeles County-USC Medical Center, Women's Hospital, which have shown an unusual fetal heart rate response to induced uterine contractions during the antepartum period. All 3 cases resulted in perinatal death apparently due to asphyxia. This report describes this unusual pattern and presents a discussion of its possible significance.

Topics: Adult; Chronic Disease; Estriol; Female; Fetal Death; Fetal Heart; Fetus; Gestational Age; Growth; Heart Rate; Humans; Hypertension; Infant, Newborn; Oxytocin; Phonocardiography; Placenta Diseases; Placental Insufficiency; Polyhydramnios; Pregnancy; Pregnancy Complications, Cardiovascular

Eighty-nine pregnancies, at risk for placental insufficiency, were monitored with serial oxytocin challenge tests (OCT) and estriol determinations on 24-hour urine collections. Intraamniotic catheters were used to accurately record intrauterine pressure in 63% of the tests; 114 of the 116 tests (98%) were adequate for interpretation. Thirteen positive tests were recorded; however, in only 2 cases did the positive OCT predict a dysmature-postmature infant when estriol determinations were normal. Prompt delivery following a positive OCT can significantly reduce the incidence of fetal wastage.

Topics: Apgar Score; Birth Weight; Delivery, Obstetric; Estriol; Female; Fetal Diseases; Fetal Heart; Gestational Age; Heart Rate; Humans; Hypertension; Infant, Newborn; Oxytocin; Placenta Diseases; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy in Diabetics; Pregnancy, Prolonged; Prenatal Diagnosis

The purpose of this investigation was to determine whether the oxytocin challenge test (OCT) could serve as the primary method for managing pregnancies characterized by possible placental insufficiency. One hundred and five patients underwent 225 oxytocin challenge tests; no perinatal deaths occurred. Eight tests were positive, 21 suspicious, and 196 negative. Because of data obtained in a preliminary study, all 8 fetuses with positive tests were delivered by cesarean section. Four of the 8 had repetitive suspicious tests prior to a positive test, suggesting that utero-placental function may deteriorate gradually. Urinary excretion of estriol did not decrease significantly in any patient, suggesting that the OCT is a more sensitive indicator of placental function than excretion of estriol. Except for patients with preeclampsia who were induced for maternal indications, all pregnancies with a negative OCT were allowed to terminate spontaneously. Five of the 97 fetuses with negative tests developed late-onset deceleration patterns during labor. This indicates that a negative OCT will not necessarily predict fetal tolerance to labor, contrary to assertions made by some other investigators. It is concluded that the OCT can serve as the primary method for assessing the fetal status in pregnancies characterized by placental insufficiency.

Topics: Chronic Disease; Estriol; Female; Fetus; Gestational Age; Growth; Humans; Hypertension; Infant, Newborn; Oxytocin; Phosphatidylcholines; Placenta Diseases; Placental Function Tests; Placental Insufficiency; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Complications, Cardiovascular; Pregnancy in Diabetics; Pregnancy, Prolonged; Risk; Sphingomyelins; Ultrasonography

Topics: Adult; Diagnostic Errors; Female; Fetal Death; Fetal Distress; Humans; Hypertension; Infant, Newborn; Male; Oxytocin; Placental Insufficiency; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Trimester, Third; Prenatal Diagnosis

Topics: Administration, Oral; Adolescent; Adult; Diarrhea; Female; Humans; Hypertension; Infusions, Parenteral; Injections, Intravenous; Labor, Induced; Meperidine; Nausea; Oxytocin; Pregnancy; Prostaglandins; Time Factors; Vomiting

Topics: Cesarean Section; Chromatography, Gas; Creatinine; Estriol; Female; Fetal Death; Gestational Age; Glucose Tolerance Test; Humans; Hypertension; Infant, Newborn; Labor, Induced; Missouri; Oxytocin; Polyhydramnios; Pre-Eclampsia; Pregnancy; Pregnancy in Diabetics; Pregnancy, Prolonged; Retrospective Studies

Topics: Acceleration; Adult; Diagnosis, Differential; Female; Fetal Diseases; Fetal Heart; Growth Disorders; Heart Rate; Humans; Hypertension; Infant, Newborn; Maternal-Fetal Exchange; Methods; Muscle Contraction; Oxytocin; Placenta Diseases; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy in Diabetics; Uterus

Topics: Female; Hypertension; Obstetric Labor Complications; Oxytocin; Pregnancy

Topics: Abortion, Threatened; Aminopeptidases; Birth Weight; Erythroblastosis, Fetal; Female; Gestational Age; Humans; Hydatidiform Mole; Hypertension; Infant, Newborn; Jaundice; Lung Diseases; Male; Obstetric Labor, Premature; Organ Size; Oxytocin; Polyhydramnios; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics; Pregnancy, Multiple; Pregnancy, Prolonged

Topics: Adolescent; Adult; Evaluation Studies as Topic; Female; Fetus; Heart Rate; Humans; Hypertension; Labor, Induced; Oxytocin; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Complications, Cardiovascular; Pregnancy in Diabetics; Prostaglandins; Uterus; Vomiting

Topics: Abortion, Spontaneous; Abortion, Therapeutic; Adolescent; Adult; Blood Vessels; Constriction; Dilatation; Electrocardiography; Ergonovine; Female; Fingers; Forearm; Humans; Hypertension; Hypotension; Oxytocin; Plethysmography; Posture; Pregnancy; Pulmonary Edema; Receptors, Adrenergic

Topics: Adult; Albuminuria; Edema; Female; Furosemide; Humans; Hypertension; Movement Disorders; Obstetric Labor Complications; Oxytocin; Potassium; Pre-Eclampsia; Pregnancy; Uterine Diseases; Uterine Inertia; Water-Electrolyte Balance

Topics: Adolescent; Adult; Electronics, Medical; Female; Humans; Hypertension; Injections, Intravenous; Labor, Induced; Methods; Obstetric Labor Complications; Oxytocin; Pre-Eclampsia; Pregnancy; Time Factors

Topics: Anesthesia, Inhalation; Anesthesia, Obstetrical; Female; Humans; Hypertension; Injections, Intravenous; Labor, Induced; Meperidine; Nalorphine; Obstetric Labor Complications; Oxytocin; Pregnancy; Pregnancy, Prolonged; Protoveratrines; Self Medication; Time Factors

Topics: Adult; Blood; Cesarean Section; Extraction, Obstetrical; Female; Fetal Death; Fetal Diseases; Glucose; Humans; Hydrogen-Ion Concentration; Hypertension; Hypoglycemia; Infant Mortality; Infant, Newborn; Labor, Obstetric; Monitoring, Physiologic; Natural Childbirth; Oxytocin; Pregnancy; Pregnancy Complications; Pregnancy Complications, Cardiovascular; Tachycardia

Topics: Acidosis; Amnion; Anesthesia, Obstetrical; Apgar Score; Cesarean Section; Delivery, Obstetric; Female; Fetal Death; Humans; Hypertension; Infant Mortality; Infant, Newborn; Labor, Induced; Obstetric Labor Complications; Oxytocin; Postpartum Hemorrhage; Pregnancy; Puerperal Infection; Time Factors

Topics: Blood Pressure; Ergonovine; Female; Humans; Hypertension; Hypotension; Injections, Intramuscular; Injections, Intravenous; Male; Methylergonovine; Oxytocin; Postpartum Hemorrhage; Postpartum Period; Pregnancy

Topics: Amnion; Analysis of Variance; Birth Weight; Delivery, Obstetric; Female; Humans; Hypertension; Labor, Induced; Oxytocin; Parity; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy, Prolonged; Time Factors

Topics: Adult; Amniotic Fluid; Female; Fetal Heart; Heart Rate; Humans; Hypertension; Labor, Induced; Monitoring, Physiologic; Oxytocin; Pre-Eclampsia; Pregnancy; Pressure

Topics: Female; Gestational Age; Humans; Hypertension; Kidney Diseases; Muscle Contraction; Obstetric Labor, Premature; Oxytocin; Parity; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics; Uterus

Topics: Adrenocorticotropic Hormone; Animals; Catecholamines; Corticotropin-Releasing Hormone; Epinephrine; Histamine; Hypertension; Hypothalamus; Injections; Norepinephrine; Oxytocin; Pituitary Gland; Pituitary Hormones, Posterior; Rats; Serotonin; Vasopressins

Topics: Aminopeptidases; Angiotensin II; Buffers; Cystine; Electrophoresis; Hydrogen-Ion Concentration; Hypertension; Oxytocin

Topics: Catheterization; Diazoxide; Female; Humans; Hypertension; Injections, Intravenous; Menstruation; Muscle Contraction; Muscle, Smooth; Muscles; Oxytocin; Uterus

Topics: Adolescent; Adult; Female; Fetal Death; Humans; Hypertension; Injections, Spinal; Labor, Induced; Oxytocin; Parity; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy, Prolonged; Uterine Rupture; Uterus

Topics: Angiotensin II; Animals; Atropine; Blood Pressure; Ergotamine; Female; Heart; Hypernatremia; Hypertension; Injections, Intravenous; Male; Oxytocin; Peptides; Rats; Sodium Chloride; Vagotomy; Vasopressins

Topics: Adrenocorticotropic Hormone; Blood Pressure; Cortisone; Endocrinology; Hypertension; Hypophysectomy; Luteinizing Hormone; Oxytocin; Pharmacology; Pituitary Gland; Pituitary Gland, Posterior; Propylthiouracil; Rats; Research; Testosterone; Thyrotropin; Thyroxine; Vasopressins

Topics: Aerosols; Female; Humans; Hypertension; Labor, Induced; Labor, Obstetric; Obstetrics; Oxytocin; Pre-Eclampsia; Pregnancy

Topics: Alcoholism; Blood Pressure Determination; Blood Volume Determination; Heart Function Tests; Hepatic Veins; Humans; Hypertension; Hypertension, Portal; Iodine Isotopes; Liver Circulation; Liver Cirrhosis; Liver Function Tests; Oxytocin; Pharmacology; Pituitary Hormones, Posterior; Rose Bengal; Serum Albumin; Serum Albumin, Radio-Iodinated; Vasopressins

Topics: Amobarbital; Antihypertensive Agents; Cesarean Section; Eclampsia; Female; Humans; Hydralazine; Hypertension; Infant; Infant Mortality; Labor, Induced; Labor, Obstetric; Maternal Mortality; Oxytocin; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Reserpine; Seasons

Topics: Biomedical Research; Blood Pressure; Blood Pressure Determination; Female; Humans; Hypertension; Labor, Obstetric; Methylergonovine; Oxytocics; Oxytocin; Placebos; Postpartum Hemorrhage; Postpartum Period; Pre-Eclampsia; Pregnancy; Statistics as Topic; Toxicology

Topics: Anesthesia; Angiotensins; Electrocardiography; Guinea Pigs; Halothane; Hypertension; Norepinephrine; Oxytocin; Pharmaceutical Preparations; Pharmacology; Pituitary Hormones; Pituitary Hormones, Posterior; Research

Topics: Adrenalectomy; Angiotensins; Arginine Vasopressin; Atropine; Ergotamine; Hypertension; Nephrectomy; Oxytocin; Pharmacology; Rats; Regeneration; Research; Vagotomy; Vasopressins

Topics: Anesthesia, Epidural; Anesthesia, Obstetrical; Anesthesia, Spinal; Antihypertensive Agents; Anuria; Coma; Eclampsia; Female; Hibernation; Humans; Hypertension; Hypothermia, Induced; Labor, Induced; Labor, Obstetric; Oxytocin; Pre-Eclampsia; Pregnancy; Seizures

Topics: Administration, Intranasal; Blood Pressure; Blood Pressure Determination; Eclampsia; Female; Heart Defects, Congenital; Humans; Hypertension; Oxytocin; Pharmacology; Pregnancy; Pregnancy Complications; Preventive Medicine; Puerperal Disorders

Topics: Animals; Cats; Cerebral Ventricles; Diuresis; Hypertension; Lateral Ventricles; Oxytocin; Pituitary Hormones; Pituitary Hormones, Posterior; Vasopressins

Topics: Atropine; Bradykinin; Caffeine; Chlorpromazine; Dibucaine; Ergot Alkaloids; Humans; Hypertension; Lysergic Acid Diethylamide; Morphine; Oxytocin; Peptides; Phenoxybenzamine; Reserpine; Tripelennamine; Vasopressins; Vitamin B 12

Topics: Emetics; Ergot Alkaloids; Female; Humans; Hypertension; Labor, Obstetric; Obstetric Labor Complications; Oxytocics; Oxytocin; Pregnancy; Toxicology; Vomiting

Topics: Acetylcholine; Adrenal Glands; Animals; Arginine Vasopressin; Epinephrine; Hypertension; Norepinephrine; Oxytocin; Rats; Regeneration; Vasopressins

Topics: Hypertension; Oxytocin

Topics: Angiotensin Amide; Female; Humans; Hypertension; Oxytocin; Pregnancy