oxytocin and Puerperal-Disorders

Topics: Cesarean Section; Delivery, Obstetric; Dystocia; Female; Humans; Oxytocin; Pregnancy; Puerperal Disorders; Reoperation; Vaginal Birth after Cesarean

Topics: Cervix Uteri; Embolism, Amniotic Fluid; Episiotomy; Ergot Alkaloids; Female; Hematoma; Humans; Labor Stage, Third; Oxytocin; Placenta Accreta; Postpartum Hemorrhage; Pregnancy; Puerperal Disorders; Uterine Inertia; Uterine Rupture; Vagina

Topics: Animals; Cesarean Section; Female; Horse Diseases; Horses; Injections, Intramuscular; Injections, Intravenous; Oxytocin; Placenta; Pregnancy; Puerperal Disorders; Uterus

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 effectiveness and tolerability of carbetocin versus syntometrine in prevention of postpartum hemorrhage (PPH) after cesarean section (CS).. A double-blind randomized study conducted on 300 pregnant subjected randomly either to single 100 μg IV dose of carbetocin (150 women) or combination of 5 IU oxytocin and 0.2 mg ergometrine (150 women) after fetal extraction and before placental removal. Primary outcome parameter was the occurrence of PPH. Other parameters were hemoglobin and hematocrit changes, the need of additional oxytocic, hemodynamic changes and occurrence of side effects.. There was no significant difference between the two study groups regarding hemoglobin and hematocrit at start of CS and after 2 days of surgery and mean blood loss during the operation (p > 0.05). There was a highly significant difference between the two study groups regarding incidence of primary PPH (2.7% versus10%) and the need of additional oxytocic (3.3% versus17.3%). Women in oxytocin group showed a statistically significant lower systolic and diastolic blood pressure at 1, 5 and 30 min than women in carbetocin group. Women in carbetocin group experienced more metallic taste, flushing, headache, dizziness, dyspnea and itching, while women in oxytocin methergine group experienced more palpitations.. Carbetocin is a reasonable effective alternative to syntometrine in prevention of PPH after cesarean delivery.

Topics: Adult; Cesarean Section; Double-Blind Method; Ergonovine; Female; Humans; Infant, Newborn; Oxytocics; Oxytocin; Postoperative Hemorrhage; Postpartum Hemorrhage; Pregnancy; Puerperal Disorders; Young Adult

The objective of this study was to compare outcomes of induced labour with intravenous oxytocin with a start in the evening versus in the morning.. Randomised controlled trial.. Labour wards of three hospitals in Amsterdam, the Netherlands.. Women with an indication for induction of labour with intravenous oxytocin.. Included women were randomized to either the evening group with a start of induction of labour at 21:00 hours, or the morning group with a start at 07:00 hours.. Primary outcome was duration of labour. Secondary outcomes were instrumental delivery rate, adverse neonatal outcome defined as an Apgar score below 7 after 5 minutes, number and indications of paediatric consults and neonatal admissions, duration of second stage, number of intrapartum infections and necessity of pain relief.. We randomised 371 women. Mean duration of labour was not significantly different (primiparae: morning 12 hours and 8 minutes versus evening 11 hours and 22 minutes, P value 0.29; multiparae: morning 7 hours and 34 minutes versus evening 7 hours and 46 minutes, P value 0.70). There were no significant differences in instrumental deliveries rates, number of infections or patient satisfaction. Unexpectedly, neonatal outcome was better in women induced in the evening.. Induction of labour with intravenous oxytocin in the evening is equally effective as induction in the morning.

Topics: Adult; Drug Administration Schedule; Female; Humans; Infusions, Intravenous; Labor Pain; Labor, Induced; Obstetric Labor Complications; Oxytocics; Oxytocin; Parity; Pregnancy; Pregnancy Outcome; Puerperal Disorders; Young Adult

To compare the efficacy, side effects, and complications of high-dose vaginal misoprostol with concentrated intravenous oxytocin plus low-dose vaginal prostaglandin (PGE(2)) for second-trimester labor induction.. One hundred twenty-six consenting women with maternal or fetal indications for pregnancy termination and no prior cesarean delivery were randomly assigned to receive either vaginal misoprostol 600 microg 1x, 400 microg every 4 hours 5x (misoprostol group, n = 60) or escalating-dose concentrated oxytocin infusions (277-1,667 mU/min) plus vaginal PGE(2) 10 mg every 6 hours 4x (oxytocin group, n = 66). Both groups received concurrent extra-amniotic saline infusion for cervical ripening. Women who failed their assigned regimen received 20 mg of PGE(2) suppositories every 4 hours until delivery. Analysis was by intent to treat.. Demographic characteristics were similar between study groups. Median induction-to-delivery interval was significantly shorter in the misoprostol group (12 hours) than in the oxytocin group (17 hours; P <.001). There was a higher induction success rate at 24 hours in the misoprostol group (95%) than in the oxytocin group (85%; P =.06), although this difference did not reach statistical significance. The incidence of live birth (25% versus 17%), chorioamnionitis (5% versus 2%), and postpartum hemorrhage greater than 500 mL (3% versus 3%) were similar between the misoprostol and oxytocin groups, respectively. Diarrhea (2% versus 11%; P =.04), nausea/emesis (25% versus 42%; P =.04), and retained placenta requiring curettage (2% versus 15%; P =.008) were significantly less common in the misoprostol group when compared with the oxytocin group, respectively. Isolated intrapartum fever, however, was more frequent in the misoprostol group (67%) than in the oxytocin group (21%; P <.001).. Compared with concentrated oxytocin plus low-dose vaginal PGE(2), high-dose vaginal misoprostol is associated with significantly shorter induction-to-delivery intervals, fewer side effects, a lower incidence of retained placenta, and comparable incidence of live birth.

Topics: Abortifacient Agents, Nonsteroidal; Administration, Intravaginal; Adult; Chorioamnionitis; Dinoprostone; Female; Hemorrhage; Humans; Infusions, Intravenous; Labor, Induced; Misoprostol; Oxytocics; Oxytocin; Pregnancy; Pregnancy Trimester, Second; Puerperal Disorders; Suppositories; Time Factors

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 aim of this prospective study is to asses, the possibility to use Remestyp after the delivery of the head as a prophylaxis of blood lost during the third stage of labor. The material includes 209 cases: 82 with bolus dose of 0.2 mg Methergin, 54 cases with 10 ME Oxytocin, 32 parturition with 200 mg Remestyp, and 41 controls without any uterostonics during the placental period. The blood lost is assessed by gravimetric method. The results show that the total blood lost from the delivery of the neonate to two hours after it is significantly lower in active management of labor than in expectant one. The type of uterostonic is not essential in regard of total blood lost. The prophylactics of blood lost with Remestyp has best results in cases of stimulated with Oxytocin infusion labor. The active management of third stage of labor with Methergin or Remestyp has less complication than are used oxytocin or without uterostonics. The mean time for delivery of placenta is shortest in the group with Remestyp. The three uterostonics in mansion doses do not influenced significantly the artery pressure. Our experience demonstrates that Remestyp can be used for active management of third stage of labor and the results are as those with Methergin. Remestyp is preferable when are expected significant lacerations of the birth canal.

Topics: Female; Humans; Labor Stage, Third; Lypressin; Methylergonovine; Oxytocics; Oxytocin; Pregnancy; Prospective Studies; Puerperal Disorders; Terlipressin; Time Factors; Uterine Hemorrhage; Vasoconstrictor Agents

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 conservative management of pre-labor spontaneous rupture of membranes (SROM) with the use of prostaglandin (PG) E2 in healthy parous women at term (gestational age at least 37 weeks).. An open randomized study was conducted with 100 parous women; 50 were treated conservatively for 24 hours, and 50 were managed actively using PGE2 gel (1 mg), administered at admission and repeated 6 hours later if labor was not established. Both groups received intravenous oxytocin if labor did not start within 24 hours after admission.. The use of PGE2 gel led to a significant reduction in the mean interval (+/- standard error of the mean) from SROM to onset of labor: 17.26 +/- 1.51 hours in the conservative group versus 6.50 +/- 1.23 in the PGE2 group. A significantly smaller proportion of subjects required oxytocin in the PGE2 group (12 versus 38%, P < .02). The two groups were comparable with respect to analgesic requirements. Within 24 hours of SROM, 80% of the women in the PG group and 56% in the conservative group had delivered (P < .02). Most women delivered vaginally, 96% of those managed conservatively and 100% of those managed actively with PGE2.. Active management using PGE2 gel in parous women with pre-labor SROM significantly improves the time to delivery without influencing the cesarean rate or fetal-maternal infective morbidity.

Topics: Administration, Intravaginal; Adult; Anti-Bacterial Agents; Apgar Score; Delivery, Obstetric; Dinoprostone; Female; Fetal Membranes, Premature Rupture; Gels; Humans; Labor Onset; Oxytocin; Parity; Pregnancy; Puerperal Disorders; Time Factors

To compare two methods of pre-induction cervical ripening in a randomized clinical trial.. A single intracervical prostaglandin E2 (PGE2) gel application was compared with a single insertion of hygroscopic dilators in 441 women at term with unfavorable cervical scores. Induction success was defined as entry into active labor within 6 hours of oxytocin infusion.. There was no statistical difference in pre- or post-ripening cervical scores. In the group receiving hygroscopic dilators, only 28% entered the active phase of labor within 6 hours of oxytocin infusion compared with 45% (P < .001) in the PGE2 group. Thus, in this study, a change in cervical score did not directly predict induction success. There was a higher rate of postpartum endometritis (24 versus 14%; P = .007) and suspected neonatal infection (10 versus 5%; P = .03) in the dilator group.. Pre-induction ripening by hygroscopic dilators and intracervical PGE2 was equivalent as measured by changes in the cervical score. The change in cervical score, however, was not predictive of successful induction, and PGE2 was more frequently associated with induction success. Hygroscopic dilators were associated with a higher incidence of postpartum maternal and neonatal infection because of a longer duration of labor. Hospital charges for intracervical PGE2 gel totaled $522 compared with $91 for the insertion of three dilators.

Topics: Administration, Intravaginal; Adult; Cervix Uteri; Dilatation; Dinoprostone; Female; Gels; Humans; Infant, Newborn; Labor, Induced; Oxytocin; Pregnancy; Pregnancy Outcome; Puerperal Disorders; Regression Analysis; Time Factors; Treatment Outcome; Uterine Contraction

Seventy pregnant Nigerian women requiring oxytocin for the induction or augmentation of labour were randomized into two groups, one administered 5% glucose, and the other 0.9% saline as vehicle for oxytocin. Another group of seventy women who did not receive intravenous fluids in labour were included for comparison. Sodium ion concentration in maternal antepartum and postpartum plasma as well as umbilical cord plasma samples were estimated in all the patients. There was a statistically significant fall in the maternal postpartum plasma sodium concentration relative to the ante-partum values only in patients receiving 9% glucose solution (P less than 0.001). There was also a significant correlation between the sodium levels in maternal postpartum and cord plasma samples, suggesting that these changes were transmitted to the fetus transplacentally. The use of normal saline as a vehicle for oxytocin administration in parturient women can prevent the hyponatraemia associated with the use of 5% glucose for this purpose.

Topics: Adult; Female; Fetal Blood; Glucose; Humans; Hyponatremia; Infant, Newborn; Infusions, Parenteral; Labor, Induced; Oxytocin; Postpartum Period; Pregnancy; Puerperal Disorders; Sodium; Sodium Chloride

A double blind randomised clinical trial was performed to assess the effects of oxytocin on the duration of placental retention following dystocia. If the placenta remained attached to the uterus immediately following assisted delivery of a calf, and was not expelled in the period taken to complete the protocol, an intramuscular injection of either 3 ml (60 USP units) of oxytocin or 3 ml of 0.9 per cent physiological saline was given to the cow. Each farmer was asked to observe the cow to determine the time of placental expulsion. In 55 cases available for analysis there was no significant difference between the treatment and control groups for percentage of placental retention at days 1, 2 or 3 post partum.

Topics: Animals; Cattle; Cattle Diseases; Clinical Trials as Topic; Double-Blind Method; Dystocia; Female; Injections, Intramuscular; Oxytocin; Placenta; Pregnancy; Puerperal Disorders; Random Allocation; Time Factors

Topics: Clinical Trials as Topic; Ergonovine; Female; Humans; Oxytocics; Oxytocin; Placenta; Postpartum Hemorrhage; Pregnancy; Puerperal Disorders

Topics: Clinical Trials as Topic; Female; Humans; Lactation Disorders; Oxytocin; Pregnancy; Puerperal Disorders

Topics: Clinical Trials as Topic; Female; Humans; Lactation; Oxytocin; Parity; Placebos; Postpartum Period; Pregnancy; Puerperal Disorders; Tablets; Uterus

Topics: Adult; Aerosols; Analgesics; Female; Humans; Labor, Obstetric; Lactation; Muscles; Oxytocin; Phytotherapy; Placebos; Plants, Medicinal; Pregnancy; Psychophysiologic Disorders; Puerperal Disorders; Pyrazoles; Thrombophlebitis; Vaginal Diseases

Topics: Adult; Female; Hematoma; Humans; Labor, Induced; Oxytocics; Oxytocin; Postpartum Hemorrhage; Pregnancy; Prostaglandins; Puerperal Disorders; Uterine Rupture

To provide evidence-based guidelines for safe and effective assisted vaginal birth.. Prerequisites, indications, contraindications, along with maternal and neonatal morbidity associated with assisted vaginal birth.. Medline database was searched for articles published from January 1, 1985, to February 28, 2018 using the key words "assisted vaginal birth," "instrumental vaginal birth," "operative vaginal delivery," "forceps delivery," "vacuum delivery," "ventouse delivery." The quality of evidence is described using the Evaluation of Evidence criteria outlined in the Report of the Canadian Task Force on Preventive Health Care.. These guidelines were approved by the Clinical Practice Obstetrics Committee and the Board of the Society of Obstetricians and Gynaecologists of Canada.

Topics: Analgesia, Epidural; Birth Injuries; Brachial Plexus; Canada; Cardiotocography; Clinical Competence; Episiotomy; Extraction, Obstetrical; Facial Injuries; Female; Humans; Labor Presentation; Labor Stage, Second; Lacerations; Obstetrical Forceps; Oxytocics; Oxytocin; Peripheral Nerve Injuries; Pregnancy; Puerperal Disorders; Scalp; Shoulder Dystocia; Soft Tissue Injuries; Stress Disorders, Post-Traumatic; Time Factors; Vacuum Extraction, Obstetrical; Version, Fetal

Nicolau syndrome, also known as embolia cutis medicamentosa, is a well known but very rare complication occuring after intramuscular drug injections and presenting with local intense pain. Immediately after injection the skin blanches and within minutes to hours an erythematous macule develops, which evolves into a livedoid violaceous patch with dendrites. This condition is initially hemorrhagic, then it ulcerates, and eventually heals with an atrophic scar. Many different drugs have been reported to cause Nicolau syndrome . To date there have been no reports of Nicolau syndrome caused by intramuscular oxytocin injection. We would like to report two cases that occured after intramuscular injection of oxytocin.

Topics: Adult; Debridement; Female; Humans; Injections, Intramuscular; Nicolau Syndrome; Oxytocin; Postpartum Hemorrhage; Pregnancy; Puerperal Disorders; Skin Ulcer

Maternal adaptations, such as decreased anxiety and attenuated stress responsiveness, are necessary to enable successful postnatal development of the offspring. However, there is growing evidence that they are also required to protect the mental health of the mother and that exposure to chronic stress during pregnancy may prevent such adaptations. Overcrowding stress (24 h) and restraint stress (2 × 1 h) were employed on alternate days between pregnancy d 4-16 to examine the impact of chronic pregnancy stress on relevant behavioral, neuroendocrine, and neuronal peripartum adaptations. To determine whether the chronic stress-induced alterations were specific to the peripartum period, we included virgins as controls. Validating the stress procedure, we demonstrated decreased body-weight gain and increased adrenal weight in stressed dams, relative to their nonstressed controls. Chronic stress prevented a number of peripartum adaptations, including basal plasma hypercorticosterone levels, increased oxytocin mRNA expression in the hypothalamic paraventricular nucleus, and anxiolysis. However, chronic stress did not prevent the peripartum-associated decrease in CRH mRNA expression or attenuate corticosterone response to an acute stressor, nor did it affect hypothalamic vasopressin mRNA expression. Illustrating the specificity of these stress-induced changes to the peripartum period, none of these parameters were affected in stressed virgins. Although chronic stress did not alter depression-related behavior, it reversed the response to acute imipramine treatment and increased active maternal behavior in lactation. Thus, prevention of the peripartum-associated increases in basal corticosterone and oxytocin system activity by pregnancy stress reveal two alterations that may increase the risk of postpartum psychiatric disorders, particularly anxiety.

Topics: Adaptation, Physiological; Adaptation, Psychological; Adrenocorticotropic Hormone; Animals; Anxiety; Arginine Vasopressin; Corticosterone; Female; Lactation; Mood Disorders; Oxytocin; Pregnancy; Puerperal Disorders; Rats; Rats, Wistar; RNA, Messenger; Stress, Psychological

Pre-eclampsia is a serious obstetric complication associated with a high rate of maternal and fetal morbidity and mortality. We report the case of a woman with a medical history of insulin-dependent diabetes mellitus and seizures possibly related to hypoglycemia who was admitted for an emergency cesarian due to severe pre-eclampsia and macrosomic fetus. In the first hour after delivery she experienced loss of consciousness and seizure, with vaginal bleeding and hypovolemic shock. Maximum vigilance is required for a patient with several concomitant diseases and a high-risk pregnancy. All prophylactic measures to lower the risk to mother and fetus should be undertaken. We analyze preanesthetic assessment, differential diagnosis, and choice of anesthesia in relation to this case.

Topics: Adult; Cesarean Section; Diabetes Mellitus, Type 1; Diagnosis, Differential; Embolism, Amniotic Fluid; Emergencies; Epilepsy; Female; Fetal Macrosomia; Humans; Hypoglycemia; Hysterectomy; Infant, Newborn; Oxytocin; Postoperative Complications; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics; Pregnancy, High-Risk; Puerperal Disorders; Shock; Stroke; Uterine Hemorrhage

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

Between 1995 and 2003 a total of 1 827 women suffering from puerperal mastitis was studied. Etiology of the disease was defined, white cell counts and microbiologic cultures were obtained. According to the results the illness was classified and treated. Since in all cases we found either simple congestion or non-infectious inflammation of the breast treatment consisted of intensified emptying of the breast by breast feeding every 2 hours and in some cases additional manual expression of milk. Antibiotics and bromocriptine were not used. In 1 826 cases fever and flue symptoms had resolved within 25-36 hours. Redness and soreness had resolved within 2-3 days. Relapse did not occur and none of the women developed an abscess. One woman had to be treated with antibiotics because the baby refused to nurse at the diseased breast and emptying had to be done by hand.

Topics: Breast Feeding; Diagnosis, Differential; Female; Humans; Infant, Newborn; Inflammation; Leukocyte Count; Mastitis; Oxytocin; Prolactin; Puerperal Disorders

This study was undertaken to test the hypothesis of an association between pharmacologic agents used for labor induction, in particular dinoprostone, and postpartum disseminated intravascular coagulation (DIC).. A retrospective hospital-based case-control study. Adjusted odds ratios (AOR) were calculated by a conditional logistic regression.. Forty valid cases of postpartum DIC were compared against 197 matched controls. Labor was induced in 17% of controls, and 56% of cases (AOR = 7.2; 95% CI: 2.1-24.6). The association was observed for both dinoprostone (AOR = 6.7; 95% CI: 1.7-26.5) and oxytocin (AOR = 8.4; 95% CI: 1.4-50.9). Other risk factors identified were as follows: a maternal age older than 34 years (AOR = 9.5; 95% CI: 2.4-37.7), complications during pregnancy (AOR = 5.5; 95% CI: 1.3-22.8), and a gestational age of over 40 weeks (AOR = 3.5; 95% CI: 1.1-11.1). Such factors were shown to also have an interaction with the induction of labor. Oxytocin augmentation showed a negative association (AOR = 0.1; 95% CI: 0.02-0.4). The absolute risk attributable to induction was estimated in 5 per 10,000 deliveries.. The pharmacologic induction of labor is associated with an increased risk of postpartum DIC, regardless the substance used. Although the absolute risk seems to be quite low, the obstetricians should not neglect it, in particular for the special risk groups identified.

Topics: Adolescent; Adult; Case-Control Studies; Dinoprostone; Disseminated Intravascular Coagulation; Female; Humans; Labor, Induced; Maternal Age; Medical Records; Middle Aged; Oxytocics; Oxytocin; Pregnancy; Puerperal Disorders; Retrospective Studies; Risk Factors; Spain

Topics: Adult; Angioplasty, Balloon, Coronary; Ergonovine; Female; Humans; Myocardial Infarction; Oxytocics; Oxytocin; Pregnancy; Puerperal Disorders

The aim of the present study was to investigate if personality profiles reflecting anxiety and social interaction of mothers who delivered by Cesarean section (CS) or by the vaginal route (VD) differed in early postpartum and to investigate whether these personality traits were correlated with hormonal data. Seventeen women delivered by emergency CS and 20 by the vaginal route were selected for this study. The amount of milk transferred to the baby was measured. Blood samples were collected during the second breast-feeding on the second day after delivery. The samples were analysed for oxytocin and prolactin. After breastfeeding, the mothers were asked to fill in the personality inventory, Karolinska Scales of Personality (KSP). The scores were compared between the two groups and with a normative group of women. Each scale on the personality inventory was correlated with hormonal parameters. The KSP showed significant differences between the delivered mothers and the normative group in variables related to anxiety and socialization. The VD mothers deviated more than the CS mothers from the normative group. Correlations with hormonal data indicated that anxiety was inversely related with basal levels of oxytocin and prolactin in the CS mothers, whereas the pulsatility of oxytocin was related to social desirability in both groups. Social desirability and oxytocin pulsativity were also correlated with the amount of milk transferred from the mother to the baby. The correlations indicate that central oxytocin, as reflected by basal plasma levels and patterns, may be involved in behavioral adaptations to the maternal role.

Topics: Adult; Anxiety; Cesarean Section; Delivery, Obstetric; Female; Humans; Lactation; Mothers; Oxytocin; Personality; Personality Inventory; Prolactin; Puerperal Disorders; Social Desirability

We analyzed the clinical course and investigated possible pathophysiologic mechanisms of amniotic fluid embolism.. We carried out a retrospective review of medical records. Forty-six charts were analyzed for 121 separate clinical variables.. Amniotic fluid embolism occurred during labor in 70% of the women, after vaginal delivery in 11%, and during cesarean section after delivery of the infant in 19%. No correlation was seen with prolonged labor or oxytocin use. A significant relation was seen between amniotic fluid embolism and male fetal sex. Forty-one percent of patients gave a history of allergy or atopy. Maternal mortality was 61%, with neurologically intact survival seen in 15% of women. Of fetuses in utero at the time of the event, only 39% survived. Clinical and hemodynamic manifestations were similar to those manifest in anaphylaxis and septic shock.. Intact maternal or fetal survival with amniotic fluid embolism is rare. The striking similarities between clinical and hemodynamic findings in amniotic fluid embolism and both anaphylaxis and septic shock suggest a common pathophysiologic mechanism for all these conditions. Thus the term amniotic fluid embolism appears to be a misnomer.

Topics: Adolescent; Adult; Anaphylaxis; Chi-Square Distribution; Embolism, Amniotic Fluid; Female; Fetal Death; Fetus; Heart Rate, Fetal; Humans; Hypersensitivity; Male; Obstetric Labor Complications; Oxytocin; Pregnancy; Prognosis; Puerperal Disorders; Registries; Retrospective Studies; Sex Factors; Shock, Septic; Survival Rate; United States

Topics: Adult; Cardiomyopathy, Hypertrophic; Dinoprostone; Female; Humans; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Puerperal Disorders; Pulmonary Edema

The effects of metaphylactic measures in cattle herds with the aim of diminishing puerperal disturbances and ensurement of high reproductive performance were studied. About 5000 cows in more than 30 groups (experimental and controls) were included into the clinical investigations. Dietary supplementation by sodium propionic acid over a period of 4 weeks, oxytocin or parasympathomimetics administered during the first 3 days post partum had a certain metaphylactic effect, only when the therapeutic principle met the prevalent cause of the given puerperal disturbance. In herds with high incidence of noninfectious retention of fetal membranes the metaphylactic application of Se and Vitamin E (10 days ante partum) can be taken into account. Stimulation of the ovarian activity by GnRH is recommended in animals which fail to have developed follicular activity by the 12th-15th day post partum.

Topics: Animals; Cattle; Cattle Diseases; Female; Oxytocin; Parasympathomimetics; Propionates; Puerperal Disorders; Selenium; Vitamin E

Topics: Adult; Ergonovine; Female; Humans; Oxytocin; Pregnancy; Puerperal Disorders; Uterine Hemorrhage

A retrospective review identified 56 patients with uterine inversion, from July 1977 through June 1986, from weekly obstetric statistics, delivery records and computerized discharge diagnoses. All patients underwent delivery by house officers, midwives or medical students under supervision. An analysis of the data revealed that the risk factors were primiparity, a fundally implanted placenta and delivery of a macrosomic fetus. Also, patients who received oxytocin with or without MgSO4 were at higher risk of puerperal inversion. MgSO4 by itself did not appear to be a risk factor. A placenta attached at the time of inversion appeared to have a protective effect against the development of shock. The use of betamimetics or MgSO4 appeared to be an acceptable alternative to general anesthesia in relaxing the uterus and aiding in its repositioning. Those agents were more likely to be successful in acute cases than in subacute ones and in second-degree inversion than in third-degree.

Topics: Adolescent; Adult; Anesthesia, General; Birth Weight; Blood Transfusion; Female; Humans; Los Angeles; Magnesium Sulfate; Oxytocin; Parity; Placenta Diseases; Pregnancy; Puerperal Disorders; Retrospective Studies; Risk Factors; Shock; Terbutaline; Uterine Diseases

An ascite complicated an acute ileal obstruction in the immediate post-partum period. The basal hormonal condition and a pharmacological treatment with synthetic oxytocin have to be considered as important etiological factors.

Topics: Adult; Ascites; Female; Humans; Ileal Diseases; Intestinal Obstruction; Oxytocin; Pregnancy; Puerperal Disorders; Torsion Abnormality; Uterine Inertia

Six cases of acute puerperal inversion of the uterus are reported. In four of these, tocolytic agents were used to facilitate replacement of the inverted uterus; and in five, Prostin-15M was given after replacement. The use of tocolytics may obviate the need for general anesthesia for uterine replacement in some patients with uterine inversion. Prostin-15M serves to minimize bleeding and to maintain uterine position after replacement.

Topics: Adult; Carboprost; Combined Modality Therapy; Female; Humans; Magnesium Sulfate; Oxytocin; Pregnancy; Puerperal Disorders; Terbutaline; Uterine Contraction; Uterine Diseases

Topics: Animals; Cattle; Cattle Diseases; Dinoprost; Estrogens; Female; Oxytocin; Pregnancy; Prostaglandins F; Puerperal Disorders

Preparation for childbirth (Lamaze classes) is becoming an increasingly popular addition to patient education. This retrospective study investigates its effect on 64 primiparas in comparison with a control group who had not taken classes. The two groups were matched for age, antenatal risk scores, ethnic derivation, and socioeconomic status. No difference was found in the use of analgesia and anesthesia, the length of labor, type of delivery, incidence of fetal distress, infant birth weights, Apgar scores, or maternal and neonatal complications. However, there was a statistically significant increase in the use of oxytocin for augmentation of labor (P less than 0.01) in the prepared group.

Topics: Adult; Anesthesia, Obstetrical; Delivery, Obstetric; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor, Induced; Labor, Obstetric; Natural Childbirth; Obstetric Labor Complications; Oxytocin; Parity; Pregnancy; Pregnancy Complications; Puerperal Disorders; Retrospective Studies

In Europe, one inversion per 25,000 births is expected with present day obstetric management. Faulty management of the third stage of labour may increase the incidence many-fold. North American figures show that the omission of medications during the third stage of labour and traction on the umbilical cord have increased the incidence to 1 in 2,000. Whether cord traction is as free of danger as has been claimed within recent years, needs to be re-evaluated. The classical symptoms and signs of inversion of the uterus are pain, vascular shock and bleeding. If manual reposition of the uterus occurs immediately following the inversion, even without anesthesia, severe complications and post-operative morbidity are low. Following inversion of the uterus, further normal pregnancies can be expected.

Topics: Adult; Female; Humans; Oxytocin; Pregnancy; Prognosis; Puerperal Disorders; Uterine Prolapse

Topics: Animals; Cattle; Cattle Diseases; Drug Combinations; Estradiol; Female; Oxytocin; Postpartum Period; Pregnancy; Puerperal Disorders; Uterus; Vasopressins

Topics: Affective Disorders, Psychotic; Bipolar Disorder; Cystinyl Aminopeptidase; Female; Humans; Neurophysins; Oxytocin; Pregnancy; Puerperal Disorders

Topics: Adolescent; Adult; Anti-Bacterial Agents; California; Female; Humans; Labor, Obstetric; Magnesium Sulfate; Oxytocin; Parity; Pre-Eclampsia; Pregnancy; Puerperal Disorders; Puerperal Infection; Retrospective Studies; Uterine Diseases

Topics: Female; Humans; Mastitis; Oxytocin; Pregnancy; Puerperal Disorders

Acute puerperal inversion of the uterus is considered to be rare. In one institution there were nine cases during an 11-year period, a rate of one for every 2176 vaginal deliveries. Analysis of these cases failed to identify any contributing factors occurring during the first or second stage of labour. Six cases were directly attributable to failure to administer an oxytocic preparation or, particularly, failure to await uterine contraction before attempting to expel the placenta by fundal pressure or cord traction. Although active management of the third stage of labour may reduce the incidence of postpartum hemorrhage, incomplete application of its principles is extremely hazardous. Immediate uterine replacement was efficacious in seven cases, but the inadvisability of removing the placenta prior to replacement was demonstrated.

Topics: Acute Disease; Adolescent; Adult; Delivery, Obstetric; Female; Humans; Labor, Obstetric; Oxytocin; Placenta; Pregnancy; Puerperal Disorders; Uterine Contraction; Uterine Diseases

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

Topics: Animals; Cats; Cattle; Dogs; Female; Goats; Obstetric Labor Complications; Oxytocin; Pregnancy; Pregnancy Complications; Puerperal Disorders; Reproduction; Sheep; Sheep Diseases; Swine; Swine Diseases

Topics: Cardiac Output; Female; Heart Diseases; Humans; Labor, Obstetric; Mitral Valve Stenosis; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Puerperal Disorders; Pulmonary Edema; Sodium Chloride

Topics: Animals; Dexamethasone; Dystocia; Female; Horse Diseases; Horses; Labor, Induced; Obstetric Labor Complications; Oxytocin; Placenta; Pregnancy; Puerperal Disorders

Topics: Delivery, Obstetric; Female; Humans; Oxytocin; Parity; Pregnancy; Puerperal Disorders; Retrospective Studies; Singapore; Uterine Rupture

Topics: Female; Humans; Labor, Obstetric; Methylergonovine; Obstetric Labor Complications; Oxytocin; Postpartum Hemorrhage; Pregnancy; Puerperal Disorders

Topics: Animals; Cattle; Cattle Diseases; Extraembryonic Membranes; Female; Obstetric Labor Complications; Oxytocin; Pregnancy; Puerperal Disorders

Topics: Amnion; Apgar Score; Delivery, Obstetric; Female; Fetal Death; Fever; Gravitation; Humans; Infant Mortality; Infant, Newborn; Injections; Labor, Induced; Methods; Oxytocin; Postpartum Hemorrhage; Pregnancy; Prospective Studies; Puerperal Disorders; Time Factors

Topics: Abortion, Therapeutic; Amnion; Erythroblastosis, Fetal; Female; Fetal Death; Gestational Age; Humans; Labor, Induced; Oxytocin; Pregnancy; Puerperal Disorders

Topics: Adult; Blood Pressure Determination; Female; Humans; Injections, Intravenous; Oxytocin; Parity; Pregnancy; Puerperal Disorders; Uterine Hemorrhage

Topics: Administration, Oral; Drug Tolerance; Evaluation Studies as Topic; Female; Humans; Oxytocin; Pregnancy; Puerperal Disorders

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

Topics: Abruptio Placentae; Adult; Afibrinogenemia; Amnion; Antifibrinolytic Agents; Blood Transfusion; Cesarean Section; Delivery, Obstetric; Diagnosis, Differential; Female; Fetal Death; Hematocrit; Hemorrhage; Humans; Labor, Induced; Maternal Age; Oxytocin; Parity; Pregnancy; Pregnancy Complications; Puerperal Disorders; Time Factors

Topics: Body Temperature; Female; Humans; Injections; Lactation; Oxytocin; Postpartum Period; Powders; Pregnancy; Puerperal Disorders; Puerperal Infection; Uterus

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

Topics: Adult; Delivery, Obstetric; Female; Humans; Methylergonovine; Oxytocin; Pregnancy; Puerperal Disorders; Retinal Detachment

Topics: Adult; Delivery, Obstetric; Ergonovine; Female; Humans; Injections, Intramuscular; Myocardial Infarction; Oxytocin; Pregnancy; Puerperal Disorders

Topics: Abortion, Spontaneous; Female; Humans; Injections, Intravenous; Labor, Induced; Methods; Obstetric Labor Complications; Oxytocin; Pregnancy; Pregnancy Complications; Puerperal Disorders

Topics: Adult; Creatinine; Diabetes Insipidus; Diuresis; Electric Conductivity; Female; Humans; Labor, Obstetric; Lactation; Neurophysiology; Osmolar Concentration; Oxytocin; Parity; Postpartum Period; Pregnancy; Pregnancy Complications; Puerperal Disorders; Sodium; Uterus; Vasopressins

Topics: Adolescent; Adult; Anorexia Nervosa; Female; Humans; Hypothalamus; Oxytocin; Pregnancy; Psychophysiologic Disorders; Puerperal Disorders; Vasopressins

Topics: Adolescent; Adult; Amnion; Body Height; Cesarean Section; Delivery, Obstetric; England; Female; Fetal Death; Gestational Age; Humans; Infant Mortality; Infant, Newborn; Injections, Intravenous; Labor, Induced; Maternal Age; Oxytocin; Pregnancy; Pregnancy, Prolonged; Puerperal Disorders; Time Factors; Uterine Diseases

Topics: Adult; Aerosols; Breast Diseases; Female; Humans; Inflammation; Oxytocin; Pregnancy; Puerperal Disorders

Topics: Drug Synergism; Female; Humans; Methylergonovine; Oxytocin; Pregnancy; Puerperal Disorders

Topics: Female; Fever; Humans; Intestinal Obstruction; Lactation; Methylergonovine; Oxytocin; Pregnancy; Puerperal Disorders; Thrombophlebitis; Uterus

Topics: Female; Humans; Lactation; Oxytocin; Pain; Pregnancy; Puerperal Disorders

Topics: Delivery, Obstetric; Female; Humans; Methylergonovine; Oxytocin; Postpartum Hemorrhage; Pregnancy; Puerperal Disorders

Topics: Dystocia; Female; Humans; Methylergonovine; Oxytocin; Pregnancy; Puerperal Disorders; Uterine Inertia

Topics: Adult; Female; Humans; Lactation Disorders; Mastitis; Oxytocin; Pregnancy; Puerperal Disorders; Thrombophlebitis

Topics: Breast Diseases; Female; Humans; Lactation Disorders; Oxytocin; Pregnancy; Puerperal Disorders

Topics: Biomedical Research; Drug Therapy; Female; Humans; Injections, Intramuscular; Labor, Obstetric; Methylergonovine; Oxytocin; Placenta; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Puerperal Disorders

Topics: Asphyxia Neonatorum; Birth Weight; Female; Fetal Death; Follicle Stimulating Hormone; Humans; Infant, Newborn; Labor, Induced; Labor, Obstetric; Oxytocin; Pharmacology; Pregnancy; Puerperal Disorders; Puerperal Infection; Statistics as Topic

Topics: Aerosols; Breast; Breast Diseases; Dosage Forms; Female; Humans; Lactation Disorders; Nose; Oxytocin; Puerperal Disorders

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: Ergonovine; Female; Humans; Oxytocin; Postpartum Period; Puerperal Disorders

Topics: Asphyxia Neonatorum; Female; Fetal Diseases; Humans; Infant, Newborn; Labor, Induced; Labor, Obstetric; Oxytocin; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Puerperal Disorders; Toxicology

Topics: Biomedical Research; Communicable Diseases; Drug Therapy; Female; Humans; Mastitis; Oxytocin; Pregnancy; Puerperal Disorders