SummaryPlasma oxytocin levels were measured serially in 22 women receiving prostaglandin E, or F2,: intravenously for the induction of labour. Oxytocin was detected in the plasma of 19 of the 22 women; positive levels were found in 60 (43/0o) of 139 plasma samples, an incidence similar to that in the late first stage of spontaneous labour. Oxytocin was found in the maternal plasma even when the fetus was dead, and in the plasma of two men receiving prostaglandin infusions. This indicates that prostaglandins stimulate the pituitary directly and suggests that this mechanism may play a part in the oxytocic action of infused prostaglandins.
IntroductionThe prostaglandins produce many diverse actions indirectly by stimulating the hormone system specific to the organ concerned (Flack et al., 1969;Kaneko et al., 1969;Aldridge et al., 1970;Kuehl et al., 1970;Speroff and Ramwell, 1970;Marsh, 1971). We have investigated the possibility that the prostaglandins produce their effect on the uterus by releasing oxytocin from the maternal pituitary.
SUMMARY
The levels of prostaglandins E, A, and 19 hydroxy A in samples of seminal fluid collected from men attending a fertility clinic have been estimated spectrophotometrically and compared with levels found in samples from fertile men undergoing sterilization by vasectomy. Semen taken from oligo or aspermic men and that from men whose wives proved infertile did not contain significantly different amounts of prostaglandin from samples taken from fertile men. However, a smaller scatter of values for PGE content was found in the group where infertility was unexplained. This was significant (P<0.025). It was also found that considerable deterioration of samples occurred on storage.
Summary
Prostaglandin E2 was used to induce labour in 40 patients, between 29 and 42 weeks gestation. Vaginal delivery occurred in 37 patients; 3 other patients required Caesarean section. No fetal complications attributable to PGE2 were observed, nor any maternal cardiovascular or alimentary effects. One patient demonstrated transient uterine hypertonus when infused with 40 ng./kg./min.
It is suggested that as the uterine threshold for PGE2 is variable a slow rate of PGE2 infusion should be used initially, but increased steadily until an effective infusion rate is obtained.
We would like to thank Professor Sheila Sherlock and her colleagues for their advice and help in carrying out this study, and we are also grateful to Ciba Laboratories for generous supplies of rifampicin. We would also like to thank the nursing staff of the chest unit for their precise recording of the results.References Cannetti, G., Le Lirzin, M., Proven, G., Rist, N., and Grumbach, F. (1968 ARNOLD GILLESPIE British Medical Journal, 1972, 1, 150-152 Summary The pharmacological phenomena of enhancement and potentiation of uterine response occur respectively when combinations of some prostaglandins and oxytocin are given serially and simultaneously to a patient. Employing these phenomena allows small doses of the drugs to achieve the same effects as a large dose given alone. In a pilot study of the use of the combination of prostaglandin and oxytocin for the induction of mid-trimester abortion seven of nine women were aborted within 48 hours. Side effects attributable to prostaglandin were eliminated or reduced in severity.
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