جستجوی مقالات مرتبط با کلیدواژه « oxytocin » در نشریات گروه « پزشکی »

The success of labor induction depends on the condition of the cervix at the time of delivery. This study examines the effect of labor induction with an intra-cervical Foley catheter and oxytocin compared to a Foley catheter and misoprostol on cervical preparation and delivery rate in the first 24 hours after induction.

In a randomized clinical study, pregnant women with a singleton pregnancy and a gestational age of more than 40 weeks, with a Bishop score less than 4 and an intact amniotic sac referred to Umm al-Binin Hospital in Mashhad from 2017 to 2018 were included in the study. They were randomly divided into two groups of Foley catheter and oxytocin (1) or Foley catheter and misoprostol (2). In the first group, immediately after placing the Foley catheter; Oxytocin was started with a dose of 2 milliunits per minute, and every 20 minutes, 2 milliunits were added to reach the maximum dose of 30 milliunits per minute (induction method with a low dose). In the second group, after Foley catheter insertion, sublingual misoprostol was prescribed at a dose of 25 micrograms every 4 hours up to a maximum of 6 doses.

74 pregnant women were randomly evaluated in two groups of 37 people. There is no statistically significant difference in the demographic variables in the two groups. There was a significant difference in the labor rate in the first 24 hours, and it was higher in the oxytocin group (P=0.009). Bishop's score after 24 hours of induction was not significantly different in the two groups. Reaching the active phase was significantly shorter in the oxytocin group. (P=0.01). The time of catheter removal in both groups and the rate of cesarean section and the occurrence of complications were the same in both groups.

The use of oxytocin with a Foley catheter inside the cervix can accelerate the preparation of the cervix and increase the chance of labor in the first 24 hours, but it does not affect labor complications.

The present study was performed with aim to compare the safety and efficacy of different forms of phenylephrine to prevent oxytocin-induced hypotension in cesarean section with spinal anesthesia.

In this systematic review and network meta-analysis, databases of PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, ClinicalTrials.gov, and Scopus and Persian language databases of SID and Elmnet were searched with keywords of "Phenylephrine", "Caesarean section", "blood pressure", "Oxytocin" and their Persian synonyms. The occurrence of hypotension in different groups of clinical trial studies was considered as the effect size. The safety and efficacy of study arms based on different pharmaceutical forms of phenylephrine were investigated with network meta-analysis review techniques.

A total of 6 interventions including low dose bolus (50 micrograms) or high dose (75 or 100 micrograms), intramuscular injection of 1, 2 and 3 milligrams of drug and no injection of phenylephrine (injection of normal saline) and totally 4 studies with a total of 9 pairwise comparisons with direct data were available. Also, 6 nonrealistic (indirect) comparisons were synthesized with predictions based on the Baysesian model. Based on the random effect model, injection of bolus of 75/100 μg significantly with a risk ratio of 0.07 (95% confidence interval 0.01 to 0.48) less than low dose bolus (50 μg) was associated with the occurrence of blood pressure drops. Risk of the occurrence of hypotension in the group of bolus injection of a high dose of phenylephrine (75 or 100 micrograms) was 0.04 times (95% confidence interval 0.01 to 0.31) of normal saline injection. There was no significant difference in other comparisons.

Bolus injection with a high dose of phenylephrine is associated with the lowest chance of hypotension; while other methods of drug administration are not different. The synthesis of hypothetical studies based on Baysesian statistics helps researchers predict the results of future clinical trials on these subjects.

Mothers experience hormonal changes and mood disorders during pregnancy. Oxytocin plays a central role in the nervous system in both directions of the mother-infant relationship. In the mother's body, this hormone is normally present in the hormonal cycle and is released from the posterior pituitary gland, and also plays an important role during vaginal stimulation and delivery by acting on receptors (3). The onset of depressive symptoms in the first two weeks after delivery is directly related to a decrease in plasma oxytocin levels during pregnancy, which impairs the emotional adjustment of mother and baby (42). Since physical activity leads to stress in the body and improves blood circulation in the heart and blood vessels, which stimulates the posterior pituitary gland to secrete oxytocin; Exercise can increase oxytocin levels in pregnant women (5). There are drug restrictions for mothers in the treatment of depression during pregnancy and postpartum. Postpartum depression is a condition characterized by persistent experiences of sadness or decreased ability to experience pleasure, irritability, low self-esteem, and overt anxiety (2). Depression in pregnant women is a threat not only to the health of the mother, but also to the health of the baby. Depressive disorders may affect the baby from the embryonic stage, and may also affect the delivery process and the mother-baby relationship in later years. It is important to note that even regular walks that are low-intensity exercise during pregnancy can significantly reduce depressive symptoms in pregnant women (17). Physical activity can also have a positive effect on depressive disorders. After exercise, endorphin levels rise, which is responsible for a more positive and happy mind. While depression reduces the levels of neurotransmitters such as serotonin, norepinephrine or dopamine, their concentration increases with physical activity (8). There is a sudden increase in body size and weight during pregnancy, while physical activity prevents overweight or obesity (11). Therefore, today, exercise for women during pregnancy and after is emphasized by experts (6). According to the American Congress of Midwifery, pregnant women can exercise for 30 minutes or more a day with moderate intensity during pregnancy, but not every day of the week, if there is no ban. High-intensity exercise is not recommended during pregnancy due to insufficient studies on the level of intensity (1). However, it should be borne in mind that for the safety of pregnant women and children, all activities should be performed in consultation with a gynecologist. If the type of physical activity is carefully selected and whether it is done under supervision or without supervision (optional exercise), statistically significant results will be achieved in reducing depressive symptoms. The aim of this study was to evaluate the effect of exercise on serum oxytocin levels and depression during pregnancy and postpartum in female mice.

This study is an experimental study that was performed in the laboratory on mice and is applied in terms of purpose. Sixty healthy female NMRI mice with an approximate age of 80-90 days and weighing 22-25 g were prepared from Pasteur Institute of Iran and kept in light conditions for 12 hours of light and 12 hours of darkness at a temperature of 23 ± 1 °C. Adequate food was provided to them. NMRI mice, after two weeks of adaptation,were given one male for each female to mate, and they were placed in a cage several times to obtain the required number of pregnant mice. Then, the next morning, the vaginal plaque was checked as a pregnancy indicator. Thus, 40 female mice became pregnant and these mice, in which vaginal plaque was seen, were considered as the first day of pregnancy and the animals were transferred to separate cages. Inside the cage of each pregnant animal were two rotating wheels for exercise. By the end of the study, the rotating wheels were inside the animal cage. In this study, animals were divided into four groups to measure depression and oxytocin levels during pregnancy and postpartum. There were 10 NMRI mice in each group. Group 1: Active female mice were tested for behavioral and hormonal disorders during pregnancy. Group 2: Active female mice underwent behavioral and hormonal tests in the post-pregnancy period. Group 3: Active female mice were tested for behavioral and hormonal measures during pregnancy. Group 4: Active female mice underwent behavioral and hormonal tests in the post-pregnancy period. Active group exercise was optional. Exercise and non-exercise rats in the pregnant group on the 18th day of gestation and exercise and non-exercise rats in the postpartum group were evaluated on the 7th day postpartum. First, each mouse was exposed to another unfamiliar mouse and gently placed in the opposite corners of a 20 × 80 × 80 cm square box and examined for 7 minutes. The amount of time animals spend interacting with each other is considered an indicator of depressive behavior. After behavioral assessments, deep anesthesia was performed with ketamine (50 mg / kg) and xylazine (5 mg / kg). The animal's breast was then dissected and blood was drawn from the heart. The vials containing blood were placed on an ice pack for 30 minutes, then centrifuged at serum at 2000 RPM for 15 minutes and stored at -20 ° C. Serum oxytocin levels were measured based on the method in the RayBiotech Co. kit using ELISA technique. Shapiro-Wilk test was used to evaluate the normality of data distribution. Levin test was used to evaluate the homogeneity and homogeneity of variance of dependent variable between different samples. One-way analysis of variance with Tukey post hoc test was used to evaluate the differences between the groups. All statistical tests were performed at the significance level of P <0.05 by SPSS software version 22.

The results showed that the mean changes of oxytocin during pregnancy and postpartum were significantly different between active and inactive groups. The results of the depression test showed that the duration of visit of mice between the active and inactive groups during pregnancy was not significantly different, but in the postpartum period in the active group, a significant change was observed .The test was based on social interaction, meaning that the longer the interaction, the better, and shows that depression is improving.

Based on this study, it can be concluded that physical activity reduces the symptoms of depression during pregnancy and can be a safe preventive treatment. Physically active women have a lower risk of depression than inactive women. Physical activity also indirectly stimulates the secretion of oxytocin, which can reduce the symptoms of depression in the postpartum period. On the other hand, oxytocin secretion during pregnancy also has an advantage. It should also be noted that the introduction of physical activity during or before pregnancy does not always protect a pregnant woman from developing depression or does not affect its course during pregnancy. This indicates the existence of multifactorial dependence, where physical activity is only one component. It is difficult to determine the release of central oxytocin in humans, and the exact mechanism of the link between oxytocin and depression has not yet been determined, and these studies are mostly derived from animal studies. Overall, oxytocin is involved in the cause of depressive symptoms in the postpartum period and more research should be done on the neurological and endocrine aspects.

Induction of labor is a common procedure that is performed due to medical indications of mother or infant or social and elective causes. There are several methods for induction of labor, including misoprostol and oxytocin. Therefore, the aim of the present study was to determine and compare the effect of oxytocin and oral misoprostol on induction of pregnancy in term and post-term pregnancies.

This is a descriptive study that was conducted in 2019-2021. The statistical population consisted of 160 patients who were candidates for termination of pregnancy and were divided into two groups of 80 people, one group with misoprostol 50 micrograms which was administered as an oral solution up to a maximum dose of 200 micrograms and the other group with oxytocin ampoules with Initial doses of 10 units were induced. The success rate in each group was considered to achieve appropriate contractions (three contractions in ten minutes, each lasting 40 seconds) and finally the rate of successful normal delivery. The collected data were analyzed using Mann-Whitney, Chi-square and t-test.

According to the statistical test, a significant difference was observed between the two groups in the variables of type of delivery and lack of progress of delivery. The percentage of normal delivery in the misoprostol group was higher than the oxytocin group, which was statistically significant (p = 0.005). The mean age of patients in the misoprostol group compared to the oxytocin group was 28.21 7 7.64 and 25.84 99 5.99, respectively, which was not statistically significant (p = 0.005). Also, the lack of progression of labor was higher in the oxytocin group compared to the other group, which was statistically significant (p <0.001).

According to these cases, the present study displayed a better effect on induction of labor by misoprostol and considering that the two drugs were not different in side effects, it could indicate a better and more appropriate efficacy of misoprostol in induction of labor.

Studies suggest that early-life maternal sepration (MS) could induce cognitive impairments. One of the stress-modulating factors is enriched environment (EE), which provides more opportunities to explore the environment. Moreover, studies have been shown that oxytocin (OT) reduces stress effects on the rat brain. The aim of this study wass to evaluate EE and OT effects on passive avoidance learning and memory in maternally separated rats.

Eight groups were evaluated during this experiments; CTRL, CTRL + EE, MS, MS + EE, CTRL + saline, CTRL + OT, MS + saline, MS + OT. In MS group, rat pups were separated from their dam for 180 min/day from post natal day (PND) 1-21. From PND 22-34 rats experienced EE and/or received intranasal OT )2 µg/µl(. At adolescence, passive avoidance learning and memory of rats were evaluated in the shuttle box.

MS rats received more foot shocks compared to the CTRL rats. Moreover, in comparison to CTRL animals, the latency to enter the dark chamber decreased in MS rats. EE and OT could improve these MS-induced impairments.

 Obtained results showed that EE and OT could improve stress-induced cognitive impairments.‎

The administration of uterotonic agents during cesarean delivery is highly variable. The aim of this study was to investigate the comparison efficacy of “Rule of Threes” algorithm with William’s guideline in uterine tone evaluations as well as side effects of each approach in the low risk women of elective cesarean delivery (ECD).

This prospective and triple-blind study was conducted in 110 American Society of Anesthesiologists (ASA) physical status I–II patients with low risk of ECD. Based on administration of oxytocin the patients were randomly divided into two groups: group 1 was received oxytocin using Rule of Threes approach; group 2 was received oxytocin using William’s guideline. In both groups total oxytocin consumption and hemodynamics changes were recorded and compared.

The mean dose of oxytocin was 3.32±0.94 (IU)in Rule of Threes versus 6.00±0.00 (IU) for William’s group, which showed a significant difference between the two groups by independent t-test (P<0.001). The mean total consumption of methylergonovine was 0.003±0.02 (mg) for Rule of Threes group versus0.2±0.02 (mg) for William’ s group which showed a significant difference between the two groups by independent t-test(P<0.001). Out of 55 patients at 3, 6, 9, 12, and 15 min 89, 98, 98, 100 and 100 percent patients had adequate uterine tonicity in group Rule of Three , while all of the 55 patients in William’s group had no adequate uterine tonicity at 3, 6, and 9 min as well as 96 percent of patients had adequate uterine tonicity at 12 and 15 min. No differences were observed in either groups respected to maternal hemodynamics, side effects, or blood loss.

In both methods, no abnormal changes in hemodynamics were observed, as well as other complications associated with high doses of oxytocin. The advantages of the Rule of Threes method were high efficacy and shorter time in achieving adequate uterine tonicity, and no second-line treatment was required. Complications such as atony and abnormal bleeding were not observed during the one-day followup.

One of the main causes of maternal death in developing countries is postpartum hemorrhage. Cesarean section is one of the most common surgeries all around the world. In comparison with normal vaginal delivery, cesarean section is a greater risk factor for postpartum hemorrhage and need for blood transfusion. The risk of postpartum hemorrhage will increase when other risk factors such as multiple pregnancies, polyhydramnios, severe preeclampsia, peripartum hemorrhage, protracted labor, labor induction, and obesity are present. Oxytocin is conventionally used for the prevention of uterine atony during the cesarean section. The aim of this study was the evaluation of the effect of sublingual misoprostol in combination with oxytocin in reducing blood loss during and after cesarean delivery.

This randomized clinical trial was performed in Ommolbanin hospital; an academic hospital that is affiliated to Mashhad University of medical sciences from September 2016 to January 2018. The subjects were 90 pregnant women with a term pregnancies who were candidates for emergent cesarean delivery under spinal anesthesia and were at high risk for postpartum hemorrhage. All participants received 40 IU oxytocin in 1 liter of normal saline after delivery, and then they were randomly assigned to the intervention group who received 400 μg sublingual misoprostol in combination with oxytocin infusion, and the control group who received only oxytocin infusion without adding misoprostol.

Sublingual misoprostol in combination with oxytocin infusion during cesarean section led to a significant decrease in postoperative blood loss for six hours after the surgery (P<0.001). The decline in the hemoglobin and hematocrit levels and the amount of intraoperative hemorrhage were the same in both groups. Less additional uterotonic agents were needed in the misoprostol group. The frequency of fever and other side effects were similar in the two groups.

It seems that adding sublingual misoprostol to oxytocin infusion among high-risk women for postpartum hemorrhage is more effective for reducing blood loss during and after cesarean section.