oxytocin and Nausea

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

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

To compare the impact of 5 IU (international units) of oxytocin administered during surgical termination of first-trimester pregnancy compared to no oxytocin, on postoperative bleeding, pain and nausea.. A randomized controlled single-blinded study.. A Norwegian community hospital with 1,064 consecutive legal abortions in the 20 months of study period.. A total of 378 women undergoing surgical termination of first-trimester pregnancy and willing to participate in the study.. Women were randomized into two groups: Group 1, receiving a standard procedure of 5 IU of oxytocin during the surgical procedure, or Group 2, receiving no oxytocic agent. All women had preoperative misoprostol.. Vaginal bleeding, pain and nausea recorded by weighing pads immediately after the surgical procedure and counting pads during the three following days.. No significant differences between the two groups could be demonstrated with regard to the recorded postoperative blood loss, pain and nausea.. The standard routine of administering oxytocin during surgical termination of first-trimester pregnancy should be revised.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Induced; Adult; Female; Follow-Up Studies; Humans; Nausea; Norway; Oxytocics; Oxytocin; Pain, Postoperative; Postoperative Hemorrhage; Pregnancy; Pregnancy Trimester, First; Single-Blind Method; Treatment Outcome

To compare the impact of a dinoprostone vaginal insert and intravenous oxytocin in reducing blood loss of women undergoing vaginal or cesarean delivery.. This study was conducted among term singleton pregnancies delivered vaginally or by elective cesarean section. In the vaginally delivered cases, active management of the third stage of labor was conducted. During cesarean delivery, 20 IU of intravenous oxytocin was administered. Women, who either delivered via the vaginal or abdominal route, were then randomly allocated to receive 10 mg vaginal dinoprostone insert for 12 hours (group I, n: 100) or intravenous oxytocin (group II, n: 100), respectively.. Mean blood loss and need for additional uterotonics and postpartum hemoglobin and hematocrit levels at 24 and 36 hours after delivery did not differ between the two groups. Women allocated to the dinoprostone vaginal insert arm experienced more nausea and vomiting.. Dinoprostone vaginal insert was as effective as intravenous oxytocin in the prevention of postpartum blood loss.

Topics: Administration, Intravaginal; Adult; Delayed-Action Preparations; Delivery, Obstetric; Diarrhea; Dinoprostone; Female; Fever; Humans; Infusions, Intravenous; Nausea; Oxytocics; Oxytocin; Postpartum Hemorrhage; Pregnancy; Prospective Studies; Shivering; Vomiting

Although the third stage of labour is usually uneventful, several significant complications may be encountered that may lead to maternal morbidity and mortality, especially primary postpartum haemorrhage. The objective of this study was to compare 400 ug oral misoprostol with 10 IU intramuscular oxytocin in the active management of the third stage of labour.. This was a prospective randomised controlled clinical trial in which 200 parturients at term who had vaginal delivery were randomly assigned into two groups: oral misoprostol and intramuscular oxytocin, after the delivery of the baby and the clamping of the umbilical cord. The primary outcome was the incidence of primary postpartum haemorrhage. Secondary outcomes included a drop in haemoglobin concentration 48 hours after delivery, the need for extra oxytocics, duration of the third stage of labour and side effects of the oxytocics. These results were subjected to statistical analysis using chi-square test or student's t-test.. No occurrence of primary postpartum haemorrhage or significant difference in the drop in haemoglobin concentration levels was reported after delivery (p-value is 0.49), and no significant differences were observed in other secondary outcome measures with the exception of nausea, which occurred solely in the misoprostol group (4 percent, p-value is 0.04).. Oral misoprostol appeared to be as effective and as safe as intramuscular oxytocin in the active management of the third stage of labour.

Topics: Administration, Oral; Adult; Female; Hemoglobins; Humans; Incidence; Infusions, Intravenous; Labor Stage, Third; Misoprostol; Nausea; Oxytocics; Oxytocin; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications; Risk Factors

To determine the efficacy and safety of intradural-epidural analgesia in comparison with continuous epidural analgesia during labor and childbirth.. Forty-two women whose labor began spontaneously were enrolled and distributed randomly in two groups. The intradural-epidural analgesia group (IEA, n = 21) received 25 microgram of intradural fentanyl with 2.5 mg of isobaric bupivacaine with adrenalin, after which analgesia was maintained with epidural administration of one 8 mL bolus of 0.125% bupivacaine, followed by perfusion of a balanced concentration at a rate of 8 ml/h. Patients in the continuous epidural analgesia group (CEA, n = 21) were given 8 ml of 0.25% bupivacaine with adrenalin; the epidural perfusion of 0.125% bupivacaine and 1 microgram/ml of fentanyl was started at the same rate as in the IEA group. We recorded pain as assessed on a visual analog scale, extension of sensory and motor block, maternal hemodynamic constants, number of boluses of bupivacaine used, total doses of bupivacaine and oxytocin, instruments needed for childbirth, and side effects (pruritus, nausea and vomiting).. Analgesic efficacy during the first 30 minutes was greater in the IEA group. The total dose of bupivacaine, required top-up boluses, and the extension of sensory block at 30 minutes, one hour and two hours were also significantly less in the IEA group. The incidence of pruritus was higher in the IEA group. No significant differences were observed for other variables.. Intradural-epidural analgesia provides effective analgesia for labor, with rapid onset, reduced extension of sensory block, lower total doses of local anesthetics and few side effects.

Topics: Adult; Analgesia, Epidural; Analgesia, Obstetrical; Anesthesia Recovery Period; Bupivacaine; Cesarean Section; Epinephrine; Female; Fentanyl; Humans; Hypotension; Infant, Newborn; Labor, Obstetric; Nausea; Oxytocin; Patient Acceptance of Health Care; Pregnancy; Prospective Studies; Pruritus; Safety; Single-Blind Method; Vomiting

In a prospective, open-label, assessor-blind, randomised parallel group study the efficacy and safety of Hemabate (Pharmacia-Upjohn Pharmaceuticals, Milton Keynes, Buckinghamshire) an analogue of 15-methyl-prostaglandin (PGF2alpha) analogue was compared with Syntometrine (Alliance Pharmaceuticals, Chippenham, Wilts) the standard combination of ergometrine and syntocinon used for the active management of the third stage of labour and the prevention of primary postpartum haemorrhage (PPH). The study was set in a district general hospital with approximately 4,000 deliveries annually. The study was discontinued at the time of the interim analysis because of unacceptable gastrointestinal side effects. At the time of the interim analysis, a total of 529 women had completed the study with 263 randomised to receive PGF2alpha and 266 to receive ergometrine and syntocinon. In a pre-specified subgroup analysis, women delivered vaginally were further subdivided into those considered to be at high or low risk of primary PPH. The measured blood loss and incidence of PPH was similar in both treatment groups whether delivered by caesarean section or vaginally independent of whether women were considered to be at high or low risk. Adverse gastrointestinal events were recorded more often in the Hemabate group. The most common symptom was diarrhoea which occurred in 21% of women who received Hemabate compared to only 0.8% of Syntometrine users. PGF2alpha is as effective as Syntometrine in the prophylaxis of primary PPH in all groups studied but there was a statistically significantly increased risk of diarrhoea among users of PGF2alpha.

Topics: Adult; Blood Pressure; Body Height; Body Weight; Carboprost; Cesarean Section; Dinoprost; Disease Susceptibility; Drug Combinations; Ergonovine; Female; Gastrointestinal Diseases; Humans; Nausea; Oxytocin; Parity; Postpartum Hemorrhage; Pregnancy; Random Allocation; Single-Blind Method; Tromethamine

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

Intrathecal injection of morphine was used to provide obstetric analgesia in 20 primiparous women in labor. When the cervix was at least 3 cm dilated, morphine, 1 or 2 mg, was injected intrathecally. In all parturients, labor pains were completely relieved after 15-60 min and analgesia lasted as long as eight to 11 hours. The analgesia was not associated with any alteration of pin-prick sensation or motor power, and there was no change in the arterial blood pressure or heart rate. All infants were delivered vaginally by use of episiotomy annd a low forceps, except two infants of mothers in the 2 mg of morphine group who needed cesarean section. During the second stage of labor, analgesia was supplemented by lidocaine, 2 per cent, using local perineal infiltration in 14 parturients and pudendal block in two parturients, and by epidural block in four parturients. Nineteen of the 20 newborns cried immediately at birth, and had Apgar scores o 7-9 at 1 min and 8-10 at 5 min. During the first 24 hours of life, the neurobehavioral responses of all newborns were scored as normal. Systemic maternal side effects such as somnolence, nausea, vomiting, and itching occurred in a high proportion of the parturients. However, in the majority of cases, these side effects were mild. Only two parturients of the 2 mg morphine group complained of marked somnolence, itching, and vomiting, which persisted post partum; these were effectively reversed by the specific antagonist naloxone. The analgesic effect of intrathecal morphine can be attributed to its action on the opiate receptors in the substantia gelatinosa of the dorsal horn of the spinal cord. However, supraspinal effects of morphine cannot be excluded. The low lipid solubility of morphine can explain its slow onset and prolonged duration of action. Also, this will result in minimal systemic absorption of morphine, which protects the fetus and results in selective maternal analgesia.

Topics: Adolescent; Adult; Anesthesia, Obstetrical; Clinical Trials as Topic; Dose-Response Relationship, Drug; Female; Humans; Injections, Spinal; Morphine; Nausea; Oxytocin; Parity; Pregnancy; Pruritus; Uterine Contraction; Vomiting

This study was undertaken to determine a method of amino infusion that would 1) produce abortion within 12 hours; 2) be relatively free from risks of coagulapathy and electrolyte imbalance; 3) not result in delivery of liveborns; and 4) incur minimal gastrointestinal side effects from prostaglandin. Patients were randomly assigned to 1 of 3 groups unless history and examination revealed a contraindication to the use of prostaglandin. Three infusions were used: prostaglandin alone, urea alone, and a combination of urea and prostaglandin. All patients had pre-infusion laminaria inserted and all received oxytocin following infusion. There was a significant difference in instillation to abortion time when comparing the three groups and a marked reduction in gastrointestinal side effects using a lower dosage of prostaglandin. The synergistic effect of urea and prostaglandin F2alpha, previously demonstrated was further enhanced by the use of oxytocin and laminaria. This produced a mean instillation to abortion time significantly shorter than previous studies have shown and, indeed, offers a means of second trimester abortion suitable for use in ambulatory surgery facilities, precluding the high cost of inpatient care.. The purpose of this study was to determine a method of amnioinfusion which would 1) keep the instillation to abortion time (IAT) within 12 hours; 2) eliminate, as far as possible, the risk of coagulaopathy and electrolyte imbalance; 3) avoid delivery of liveborn fetuses; 4) reduce gastrointestinal side effects from prostaglandin. 89 midtrimester abortion applicants, divided into 3 groups, had laminaria inserted the afternoon prior to admission. 3 types of infusion were given: 40 mg PGF2 alpha, urea, and a combination of urea solution and 20 mg PGF2 alpha. Upon completion of the infusion the laminaria was removed. 1 hour later oxytocin was administered to all patients; the purpose of the delay was to allow time for prostaglandin impact. 21.4% of cases given urea, 47.8 of those given PGF2 alpha, and 77% of those given urea and PGF2 alpha had aborted 12 hours after infusion. 63.7% of those receiving the combination had aborted 9 hours after infusion. Gastrointestinal side effects were observed in 35% of cases given the higher prostaglandin dosage, compared to only 10% of cases given the lower dosage. The findings indicate that the synergistic effect of urea and prostaglandin was enhanced by the concurrent use of laminaria and oxytocin; the urea dosage was only half of that used in previous studies of synergism, the prostaglandin dosage half of that of prostaglandin only infusions. It seems clear that the initial prostaglandin impact is reinforced by simultaneous administration of urea. Future tests will determine whether the rate of progesterone withdrawal is increased by the synergistic activity of urea and PGF2 alpha in combination.

Topics: Abortion, Induced; Amnion; Diarrhea; Drug Synergism; Female; Humans; Infusions, Parenteral; Nausea; Oxytocin; Pregnancy; Pregnancy Trimester, Second; Prostaglandins F; Seaweed; Time Factors; Urea; Vomiting

Stimulation of uterine activity after amniotomy has been carried out with prostaglandin E2 (PGE2) tablets in two dosage regimens and with intravenous oxytocin. Oxytocin stimulation was the most successful. The difference in success rate was most marked in nulliparous patients and those with low Bishop score.

Topics: Apgar Score; Female; Humans; Injections, Intravenous; Labor, Induced; Nausea; Oxytocin; Parity; Pregnancy; Prostaglandins; Tablets; Uterus; Vomiting

Topics: Age Factors; Body Weight; Bradycardia; Cesarean Section; Clinical Trials as Topic; Delivery, Obstetric; Diarrhea; Female; Fetal Diseases; Humans; Infant, Newborn; Labor, Induced; Muscle Tonus; Nausea; Oxytocin; Parity; Phlebitis; Pregnancy; Prostaglandins; Vomiting

Topics: Apgar Score; Body Weight; Bradycardia; Cervix Uteri; Cesarean Section; Clinical Trials as Topic; Diarrhea; Evaluation Studies as Topic; Female; Fetal Heart; Humans; Infant, Newborn; Labor, Induced; Nausea; Obstetric Labor Complications; Oxytocin; Parity; Pregnancy; Prostaglandins; Vomiting

Disgust has been proposed to have evolved as a means to rid the body and mouth of noxious substances and toxins, as well as to motivate and facilitate avoidance of contact with disease-causing organisms and infectious materials. Nonemetic species, such as the rat, show distinctive facial expressions, including the gaping reaction, indicative of nausea-based disgust. These conditioned disgust responses can be used to model anticipatory nausea in humans, which is a learned response observed following chemotherapy treatment. As social factors play a role in the modulation and expression of conditioned disgust responses in rats, and the nonapeptide, oxytocin (OT), is involved in the modulation of social behavior, the present study examined the effects of an OT antagonist, L-368 899, on the development and expression of socially mediated conditioned disgust in male rats. When administered 10 min before testing in a distinct context (different from the original conditioning context), L-368 899 (5 mg/kg) significantly decreased gaping behavior in rats that were conditioned with a social partner. LiCl-treated rats administered L-368 899 before testing also showed decreased social initiations toward their social partner. These findings suggest that OT may play a role in the modulation and expression of socially mediated conditioned disgust in rats.

Topics: Animals; Avoidance Learning; Behavior, Animal; Camphanes; Conditioning, Psychological; Facial Expression; Lithium Chloride; Male; Nausea; Oxytocin; Piperazines; Rats; Rats, Long-Evans; Social Behavior; Vomiting, Anticipatory

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is one of the most potent known anorexigens with an unestablished mechanism of action. In the present study, the role of nausea in TCDD-induced hypophagia was assessed by a battery of behavioral (conditioned taste aversion [CTA], kaolin consumption, protein selection), biochemical (plasma oxytocin), and antiemetic drug intervention (trimethobenzamine, metoclopramide) approaches. Moreover, both the most TCDD-susceptible (Long-Evans [L-E]; IP LD50 approximately 10 micrograms/kg) and the most TCDD-resistant (Han/Wistar [H/W]; IP LD50 > 3000 micrograms/kg) rat strains were employed in the experiments. L-E rats were exposed to a lethal dose of TCDD (50 micrograms/kg), whereas H/W rats were treated with high but nonlethal doses (50 or 1000 micrograms/kg). TCDD produced a positive CTA response in H/W rats alone. These animals also increased their kaolin consumption more than L-E rats of either gender after TCDD exposure. TCDD decreased the proportional intake of energy from high-protein diet in female L-E rats, but tended to increase it in male L-E and H/W rats. TCDD did not affect plasma oxytocin concentration by itself, but potentiated the elevation caused by the positive control compound, LiCl, in L-E rats on day 8. Neither antiemetic tested had any detectable influence on TCDD-induced wasting. These findings imply that the degree of nausea elicited by TCDD in the rat depends on strain and gender. However, nausea has only a minor, if at all, causal role in the lethal wasting syndrome characteristic of this compound.

Topics: Animals; Antiemetics; Benzamides; Body Weight; Eating; Energy Metabolism; Female; Kaolin; Male; Metoclopramide; Nausea; Oxytocin; Polychlorinated Dibenzodioxins; Rats; Rats, Inbred Strains; Rats, Wistar; Taste

Topics: Ergonovine; Female; Humans; Nausea; Oxytocin; Postpartum Hemorrhage; Pregnancy

Vasopressin and oxytocin are nonapeptides secreted from the neurohypophysis; increases in vasopressin are associated with nausea and vomiting in some, but not all, species. Our aim was to determine whether plasma vasopressin and oxytocin levels were altered in healthy volunteers who did or did not develop nausea during vection, an optokinetic stimulus which produces the illusion of self-motion. Vection was produced by rotating a drum with an inner surface of black and white vertical stripes around the seated stationary subject. Gastric myoelectrical activity was recorded continuously throughout the experiment with electrodes positioned on the abdominal surface. Plasma samples were obtained before vection and after drum rotation stopped when nausea and tachygastria were present. Vasopressin and oxytocin were extracted from plasma and quantified by RIA. During vection six subjects reported nausea and developed gastric dysrhythmias; six other subjects had no nausea and remained in normal 3-cpm myoelectrical rhythms. Vasopressin and oxytocin values before vection were similar in each group of subjects. One minute after vection stopped, plasma vasopressin levels were significantly greater (P less than 0.05) in subjects experiencing nausea and tachygastrias (35.4 +/- 26.7 pmol/L) than in those without symptoms (2.7 +/- 0.47 pmol/L). Oxytocin levels were unchanged by either vection or nausea. It is concluded that 1) vasopressin, not oxytocin, neurons in the magnocellular-neurohypophyseal system are activated during vection-induced nausea and gastric dysrhythmias; and 2) illusory self-motion may be used safely to study the neuroendocrine responses to brain-gut interactions and nausea in man.

Topics: Adult; Brain; Digestive System Physiological Phenomena; Female; Humans; Male; Motion Sickness; Nausea; Ovum; Oxytocin; Vasopressins

Exogenous administration of cholecystokinin octapeptide (CCK) is known to decrease food intake and slow gastric emptying in humans and animals. Recent studies have shown that CCK stimulates neurohypophyseal secretion of oxytocin (OT) in rats and arginine vasopressin (AVP) in monkeys, and that gastric distention also stimulates OT release in rats. We therefore studied AVP and OT secretion in 14 normal subjects in response to meal-induced gastric distention and administration of CCK, both separately and in combination, to assess whether these stimuli similarly activated central neurohypophyseal pathways in humans. Neither plasma AVP nor OT concentrations increased after gastric distention produced by ingestion of a large meal. However, a dose-related increase in plasma AVP, but not OT levels, occurred after CCK administration, the threshold CCK dose being 0.05 micrograms/kg body weight. The AVP secretion in response to CCK administration was significantly correlated with subjective aversive symptoms quantified by use of a numeric scale (r = 0.61, P less than 0.001). In 12 of the 14 subjects plasma AVP levels increased in association with symptoms of epigastric pressure and discomfort before the onset of overt nausea or emesis. The combination of CCK and meal-induced gastric distention did not stimulate increases in plasma AVP levels in excess of those produced by CCK administration alone. The results demonstrate that AVP secretion resulting from emetic center activation often is a graded response that can begin in association with milder degrees of visceral discomfort before symptoms of overt nausea or emesis. In addition, the stimulation of AVP secretion by CCK administration, but not by meal-induced gastric distention in association with physiological satiety, suggests that some component of the anorectic effects of exogenous CCK in man likely results from activation of brainstem emetic centers.

Topics: Adult; Arginine Vasopressin; Cholecystokinin; Dose-Response Relationship, Drug; Eating; Female; Gastric Emptying; Humans; Male; Nausea; Oxytocin; Pituitary Gland, Posterior

Based on studies in animals and humans, it has been suggested that nausea activates the hypothalamo-neurohypophyseal system with resultant increases in circulating concentrations of oxytocin or vasopressin. The purpose of these studies was to determine in humans whether nausea is associated with increases in circulating concentrations of neurohypophyseal hormones or various enteropancreatic peptides (vasoactive intestinal polypeptide, substance P, or pancreatic polypeptide). Nausea, induced by intravenous infusion of apomorphine, was associated with fivefold to 75-fold increases in plasma vasopressin concentrations in 7 subjects (mean increase, 41-fold), with no change in plasma oxytocin levels. Furthermore, nausea was associated with sevenfold to 16-fold increases in plasma pancreatic polypeptide concentrations (mean increase, ninefold), with no change in plasma levels of vasoactive intestinal polypeptide or substance P. In 1 subject refractory to nausea, there was no increase in plasma vasopressin or pancreatic polypeptide concentrations with apomorphine. These studies indicate that nausea in humans is associated with vasopressin and pancreatic polypeptide release.

Topics: Adult; Apomorphine; Female; Humans; Infusions, Intravenous; Nausea; Oxytocin; Pancreatic Polypeptide; Substance P; Vasoactive Intestinal Peptide; Vasopressins

Apomorphine, a centrally-acting emetic, was administered subcutaneously (50 micrograms/kg) to nine normal subjects (four male, five female; aged 22-36 years) and four patients with idiopathic diabetes insipidus (DI) (one male, three female; aged 24-49 years). In the normal subjects this stimulus caused nausea (and vomiting in seven of nine) with a latency of 9.5 +/- 0.9 min which was followed by a large increase in plasma arginine vasopressin (AVP) concentration (from 0.9 +/- 0.2 pmol/l to 249 +/- 104 pmol/l at 15 min after the onset of symptoms; mean +/- SEM, P less than 0.01). There was a small but significant increase in plasma oxytocin (OXT) concentration (from 1.6 +/- 0.4 pmol/l to 6.2 +/- 3.4 pmol/l; P less than 0.05). Mean arterial pressure (MAP) fell slightly (from 87 +/- 1.9 mm Hg to 71 +/- 4.4 mm Hg; P less than 0.05) 15 min after the onset of nausea; there was no change in blood haematocrit or plasma osmolality and sodium concentration. In the DI patients apomorphine produced nausea (with vomiting in three of four) with a latency of 10.0 +/- 1.4 min but failed to cause an increase in either plasma AVP or OXT. In the DI patients the fall in MAP did not reach statistical significance (83 +/- 4 mm Hg to 71 +/- 11 mm Hg); there was also no change in haematocrit, osmolality or sodium concentration. Ipecacuanha, an emetic with both peripheral and central actions, was administered orally to seven normal subjects (three male, four female; aged 22-36 years) six of whom also underwent apomorphine tests.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Apomorphine; Arginine Vasopressin; Diabetes Insipidus; Female; Humans; Ipecac; Male; Middle Aged; Nausea; Oxytocin; Vomiting

Administration of lithium chloride and copper sulfate to adult monkeys caused marked elevations in plasma vasopressin (AVP) levels without significant increases in plasma oxytocin (OT) levels. Emesis was produced in five of the seven animals given these agents, in support of nausea as the main stimulus to AVP release. A similar pattern of AVP release without OT release was found after administration of cholecystokinin (CCK). Although most monkeys vomited in response to 10 micrograms/kg of CCK, a significant increase in plasma AVP levels also was produced with a dose of 1 microgram/kg, which did not produce emesis in any animal. These findings are in marked contrast with previous results in rats, which indicated that lithium chloride, copper sulfate, and CCK each stimulated OT rather than AVP release. Despite this interspecies difference, the significant neurohypophysial hormone secretion in response to both nausea-producing agents and CCK suggests that AVP secretion in monkeys, similar to OT secretion in rats, might reflect activation of central pathways mediating nausea and/or inhibition of food intake, even when overt illness is not produced.

Topics: Animals; Arginine Vasopressin; Chlorides; Cholecystokinin; Copper; Copper Sulfate; Haplorhini; Lithium; Lithium Chloride; Nausea; Oxytocin; Rats; Vomiting

Administration of cholecystokinin (CCK) to rats caused a dose-dependent increase in plasma levels of the neurohypophyseal hormone oxytocin (OT). The OT secretion was comparable to that found in response to nausea-producing chemical agents that cause learned taste aversions. The effect of CCK on OT secretion was blunted after gastric vagotomy, as was the inhibition of food intake induced by CCK. Food ingestion also led to elevated plasma OT in rats, but CCK and aversive agents caused even greater OT stimulation. Thus, after administration of large doses of CCK, vagally mediated activation of central nausea pathways seems to be predominantly responsible for the subsequent decrease in food intake. Despite their dissimilar affective states, both nausea and satiety may activate a common hypothalamic oxytocinergic pathway that controls the inhibition of ingestion.

Topics: Animals; Avoidance Learning; Cholecystokinin; Feeding Behavior; Nausea; Oxytocin; Paraventricular Hypothalamic Nucleus; Rats; Satiation; Vagotomy

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

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

Induction of midtrimester abortion using 40 mg intra-amniotic prostaglandin F2alpha was performed on 276 patients. Gestational age and fetal status had no effect on injection-to-abortion time while multiparity and the concomitant use of laminaria appeared to decrease the abortion time. The side effect and complication rates were acceptable and the results compare favorably with those of other midtrimester abortion techniques.

Topics: Abortion, Induced; Adolescent; Adult; Amnion; Female; Humans; Injections; Nausea; Oxytocin; Plants, Medicinal; Pregnancy; Pregnancy Trimester, Second; Prostaglandins F; Vomiting

Topics: Abortion, Induced; Administration, Oral; Drug Synergism; Female; Fetal Heart; Fetus; Humans; Injections, Intravenous; Labor, Induced; Nausea; Oxytocin; Pregnancy; Prostaglandins; Rectum; Uterus; Vomiting

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

Topics: Apgar Score; Cesarean Section; Female; Fetal Heart; Fetus; Humans; Infant, Newborn; Infant, Newborn, Diseases; Injections, Intravenous; Labor, Induced; Methods; Muscle Contraction; Nausea; Oxytocin; Parity; Pregnancy; Prostaglandins; Time Factors; Uterus

PGE2 (prostaglandin E2), 20 mgm vaginal suppositories were administered to 2 groups of women seeking termination of pregnancy. 1 group had the suppository inserted inside a contraceptive diaphragm. Statistical comparisons were carried out for instillation to abortion time, side effects, and intrauterine pressure parameters. The usage of the diaphragm significantly reduced side effects, and resulted in an instillation to abortion time of 12.8 + or - 2.3 hours with no failures. The quantitative analysis of the uterine pressure recordings revealed activity significantly different than that seen with intraamniotic or extraovular PGF2alpha. The development of uterine activity simulates that of normal labor in that elevation of resting pressure does not occur and maximum active pressure evolves slowly.

Topics: Abortion, Induced; Adult; Contraceptive Devices; Diarrhea; Female; Fever; Humans; Muscle Contraction; Nausea; Oxytocin; Parity; Placenta; Pregnancy; Pressure; Progesterone; Prostaglandins; Stimulation, Chemical; Suppositories; Time Factors; Uterus; Vomiting

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

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

20 patients underwent intraamniotic administration of PGF2alpha for termination of pregnancies ranging from 14-20 weeks gestation. Success was achieved in 18 patients (90%) with this method. The 2 failures were terminated vaginally with adjunctive use of intracervical laminaria and intravenous pitocin induction. 10 of the patients had intracervical laminaria placed 4-24 hours prior to drug administration. This latter group was noted to have a shorter induction-abortion interval, shorter onset of uterine contractions, and a decreased incidence of vaginal bleeding prior to abortion. No serious side effects occurred in either group of patients. Clinical toxicity in the form of gastrointestinal symptoms such as nausea and vomiting were common but could generally be controlled with antiemetics. No significant changes were recorded in blood counts, platelet counts, liver function tests, and renal function tests from pretreatment values and at 24 and 48 hours posttreatment. There were no instances of hemorrhage, fever, or infection which occur as complications of hypertonic saline abortion.

Topics: Abortion, Induced; Adult; Amniotic Fluid; Cervix Uteri; Female; Humans; Muscle Contraction; Nausea; Oxytocin; Plants, Medicinal; Pregnancy; Progesterone; Prostaglandins; Seaweed; Time Factors; Uterus; Vomiting

This study evaluates the efficacy of prostaglandin E2 (PGE2) as an oxytocic agent for the augmentation of delay in labor in 40 consecutive patients matched with another group of 40 patients (treated with intravenous oxytocin) as to age, parity, maturity, cervical dilation at time of augmentation, and analgesia. Delay in labor was diagnosed clinically when there was arrest in the descent of the presenting part and/or arrest of dilatation of the cervix. All patients were continuously monitored by means of a presenting part electrode and an intrauterine pressure catheter. Both oxytocin and PGE2 were administered via a constant infusion Palmer pump. Standard dosage increments were used until adequate contractions were achieved and no deleterious effect on the fetus was observed. 0.75 ml of 1 mg/ml ampoule of PGE2 in ethanol was diluted in 500 ml normal saline. Initial rate of infusion was 0.285 mcg/minute for a minimum of 30 minutes; the dose was subsequently doubled at intervals of 1 hour until adequate contractions were achieved. Initial rate for infusion for oxytocin was 2mu/minute; the dose was doubled every hour until adequate contractions were noted. Further cervical dilatation and descent of the presenting part occurred in all cases. Mean Apgar scores at 1 and 5 minutes respectively were 7.53 and 9.50 for the PG group, and 6.93 and 9.18 for the oxytocin group. No perinatal deaths occurred. Mean birthweight was 3.34 kg for the PG group and 3.39 kg for the oxytocin group. The oxytocin group exhibited significantly higher augmentation/delivery interval (7.32 hours vs. 5.2 for the PG group, p 0.001), mean basal uterine tone (13.23 vs. 7.38, p 0.001), mean frequency of contraction (4.39 vs. 3.61, p 0.01), and incidence of side effects (nausea, vomiting, and pyrexia). A fetal heart rate of less than 100 beats/minute was seen in 3 patients in the PG group and 7 in the oxytocin group.

Topics: Adult; Cesarean Section; Female; Fever; Gestational Age; Humans; Injections, Intravenous; Ketosis; Labor, Induced; Nausea; Obstetric Labor Complications; Oxytocin; Parity; Pregnancy; Prostaglandins; Statistics as Topic; Time Factors; Vomiting

160 women with uteri at 10-20 weeks gestation were treated with either PG(prostaglandin)F2alpha or saline solution followed by oxytocin to effect an abortion. 80 women were in each treatment group. The distribution of the patients according to age, parity, and gestation duration is tabulated. PGF2alpha was administered extraovularly in a concentration of .1 mg/ml with .7 mg being injected in the operating theater and nurses administering the rest based on response to previous injections. Administration continued for up to 30 hours. Saline was given in a volume in ml dependent on the duration of pregnancy multiplied by a factor of 10. Subcutaneous injections of oxytocin were given on subsequent days to speed the abortion. 85% of the PG patients successfully aborted without surgical dilatation of the cervix. The average dosage of PG required was 7.5 mg in 11 instillations. Side effects and complications in the PG group were minimal. 1 instillation of saline followed by 2 days of oxytocin were required to effect a 79% abortion rate in the saline group. Although the number of patients requiring surgical dilatation was the same for both groups, the procedure was much less time-consuming for the PG group. The complication rate was 26% for the saline group as compared to 14% for the PG group. The PG group required a shorter hospital stay.

Topics: Abortion, Induced; Adolescent; Adult; Amnion; Blood Pressure; Bronchial Spasm; Depression, Chemical; Diarrhea; Female; Humans; Injections; Muscle Contraction; Nausea; Oxytocin; Pregnancy; Prostaglandins; Pulse; Sodium Chloride; Time Factors; Uterine Hemorrhage; Uterine Rupture; Uterus

This paper reports on the 1st experiences with extraamniotic administration of prostaglandin F2alpha (PGF2alpha) in induced abortion. It was found that the average dose in 30 primigravidae and 32 multigravidae was approximately equal. The average time of application was 28 hours 30 minutes in the 1st group and 24 hours 40 minutes in the 2nd. In 11 cases, PG application was followed by oxytocin infusion. The method proved successful in 83.5%; partial success was achieved in 15% of the cases. As partial successes, those cases in which the cervical channel was not completely opened, the evacuation of the uterus with instruments was still achievable without difficulty. 1 failure was observed. The highest doses were needed between weeks 13-16 of pregnancy (the small numbers did not allow the computation of statistical significance). Side effects were remarkably low (e.g., nausea, vomiting, profuse perspiration). A temporary rise in temperature above 38 degrees Celsius was noted in 8 women. Compared with reports from the literature, the dose, number, and degree of side effects were lower than those found with intravenous administration. In contrast to other authors, we administered single doses up to 2000 mcg, at which time the application should be diminished. (author's)

Topics: Abortion, Induced; Female; Fever; Gestational Age; Humans; Nausea; Oxytocin; Parity; Pregnancy; Prostaglandins; Sweating; Time Factors; Vomiting

Using Csapo's technique, a single dose of 24.3 +or- 1.1 mg prostaglandin F2alpha (PGF2alpha) had been delivered intraamniotically to 20 sedated pregnant patients (15.9 +or- 0.6 weeks pregnant) in order to provoke a PG impact (PGI), a consequent progesterone (P) withdrawal, and a conversion of the pharmacologically refractory normal pregnant uterus into a reactive organ. The side effects were occasional and acceptable and no further PGF2alpha treatment was needed except in 4 cases (5-10 mg). Only after the Oxytocin test showed that the uterus is becoming reactive, was 50 mU/minute oxytocin infused intravenously to facilitate the evolution of IUP to 93 +or- 3 mmHg and thus promote clinical progress. All the 20 patients aborted both the fetus and the placenta in 16.5 +or- 2.1 hours, but 8 women retained small placental residues to be removed by curettage. The Csapo score was a high 92 +or- 2. As early as 3 hours after PGI, the plasma P levels already decreased significantly. They continued to decline throughout the IAT and reached a 72% withdrawal when the fetus was aborted. 15 patients whose P withdrawal was rapid, aborted before the mean IAT, while those 5 women whose P withdrawal was slow aborted after this time. Thus, the rate of P withdrawal was direct while parity and gestational age indirectly related to the IAT. Studies are in progress to elucidate further the abortifacient action of PGF2alpha and through this knowledge promote predictable therapy.

Topics: Abortion, Induced; Adolescent; Adult; Amniotic Fluid; Body Height; Body Weight; Curettage; Female; Fetus; Gestational Age; Humans; Injections; Muscle Contraction; Nausea; Oxytocin; Parity; Pregnancy; Pressure; Progesterone; Prostaglandins; Time Factors; Uterus; Vomiting

Topics: Anesthesia, Epidural; Blood Pressure; Bupivacaine; Cesarean Section; Epinephrine; Ergonovine; Female; Humans; Lidocaine; Methods; Nausea; Oxytocin; Pregnancy; Vomiting

Topics: Abortion, Induced; Amnion; Catheterization; Female; Gestational Age; Humans; Injections, Intravenous; Nausea; Oxytocin; Pregnancy; Prostaglandins; Vomiting

Topics: Abortion, Spontaneous; Adolescent; Adult; Atropine; Cervix Uteri; Curettage; Cyclopropanes; Dilatation; Ergonovine; Female; Humans; Meperidine; Middle Aged; Morphine; Nausea; Nitrous Oxide; Oxygen; Oxytocin; Postoperative Complications; Preanesthetic Medication; Pregnancy; Thiopental; Uterine Hemorrhage; Uterus; Vomiting

Topics: Anesthetics, Local; Blood Pressure; Epinephrine; Felypressin; Hemostasis; Humans; Ischemia; Nausea; Otorhinolaryngologic Diseases; Oxytocin; Pulse; Tachycardia; Vasoconstrictor Agents; Vasopressins