Lack of reactivity of uterine arteries from patients with obstetric hemorrhage

Characterization of arginine vasopressin actions in human uterine artery: lack of role of the vascular endothelium

“…In the present study we confirmed previous findings that, in contrast to some other arteries (Katusic et al, 1984;Seino et al, 1985;Evora et al, 1993), in which relaxant responses to AVP have been observed, AVP induces contraction of uterine arteries (Svane et al, 1990;Nelson & Suresh, 1992;Kostrzewska et al, 1993). Furthermore, the pD2 values for AVP in our study were similar to those values obtained for the majority of vessels studied (Katusic et al, 1984;Katusic & Krstic, 1987).…”

“…It has been shown that arginine vasopressin (AVP) induces contraction of the human uterine artery (Svane et al, 1990;Ekesbo et al, 1991;Nelson & Suresh, 1992;Kostrzewska et al, 1993), as opposed to some other arteries in which AVP evokes relaxation (Katusic et al, 1984;Seino et al, 1985;Evora et al, 1993).…”

Local injection of vasopressin reduces the blood loss during cesarean section in placenta previa

“…However, during cesarean section in patients with placenta previa, hemorrhage from the placental implantation site may continue after placenta delivery because the lower uterine segment has poorer contraction than the uterine body. Once profound uterine hemorrhaging occurs, then the uterine vasculature is less likely to respond to vasoconstrictor agents because of the potential absence of constrictor reactivity of the uterine vasculature as a result of an unknown mechanism . Therefore, resuscitative measures are often required with large‐volume blood transfusion, and aggressive surgical intervention by hysterectomy is sometimes necessary to ensure survival.…”

“…Once profound uterine hemorrhaging occurs, then the uterine vasculature is less likely to respond to vasoconstrictor agents because of the potential absence of constrictor reactivity of the uterine vasculature as a result of an unknown mechanism. 6 Therefore, resuscitative measures are often required with large-volume blood transfusion, and aggressive surgical intervention by hysterectomy is sometimes necessary to ensure survival.…”

Intractable postpartum bleeding due to placenta accreta: local vasopressin may save the uterus

“…We were able to avoid emergency hysterectomy in a primigravida by local infiltration of vasopressin. The other pressor drugs may have failed because of lack of constrictor reactivity of the uterine vasculature 2 . The augmented response to vasopressin might be explained by the fact that both in the pregnant and nonpregnant human uterus the action of vasopressin involves both the oxytocin and the vasopressin VIa receptors 3 .…”