Oxytocin receptors in the human uterus during pregnancy and parturition

Fuchs, Anna‐Riitta; Fuchs, Fritz; Husslein, Peter; Soloff, Melvyn S.

doi:10.1016/0002-9378(84)90677-x

Cited by 595 publications

(285 citation statements)

References 12 publications

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“…23,24 Just before the onset of labour, the concentration of OTRs and the sensitivity of the uterus to the effects of oxytocin increase significantly while preparing for parturition. 25,26 As a result, low doses of oxytocin and carbetocin are typically effective for nonlabouring women undergoing elective CD. On the other hand, in the subset of labouring women who fail to progress in labour, there is a decrease in OTR messenger RNA expression, density, and OTR binding sites, which results in the desensitization phenomenon.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, in the subset of labouring women who fail to progress in labour, there is a decrease in OTR messenger RNA expression, density, and OTR binding sites, which results in the desensitization phenomenon. [23][24][25][26] Our group has demonstrated the desensitization phenomenon in several in vitro experiments on isolated strips of both rat and human myometrium. 27,28 A study in pregnant rat myometrium demonstrated that pre-exposure to oxytocin leads to a concentration-dependent attenuation of oxytocin-induced contractions as early as one hour after pre-exposure to oxytocin.…”

Section: Discussionmentioning

confidence: 99%

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Carbetocin at Cesarean delivery for labour arrest: a sequential allocation trial to determine the effective dose

Nguyen-Lu

Carvalho

Farine

et al. 2015

Can J Anesth/J Can Anesth

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Purpose The aim of this study was to estimate the effective dose 90% (ED 90 ) of carbetocin to provide adequate uterine tone at Cesarean delivery (CD) for labour arrest. Methods We conducted a double-blind dose-finding study of carbetocin using a biased-coin up-and-down design in women undergoing CD for labour arrest under epidural anesthesia. Forty healthy term pregnant women who had received at least three hours of oxytocin infusion during labour were recruited for the study. Carbetocin was administered intravenously upon delivery of the anterior shoulder of the fetus. The first patient received 20 lg, and the dose for the subsequent patient was determined according to the response of the previous patient as per the biased-coin allocation scheme using increments or decrements of 20 lg (maximum 140 lg). Uterine tone was assessed by the obstetrician and rated as satisfactory or unsatisfactory throughout the intraoperative period. The primary outcome was satisfactory uterine tone with no need for additional uterotonic drugs intraoperatively. Secondary outcomes included use of additional uterotonic drugs postoperatively in the first 24 hr, estimated blood loss, and adverse effects. Results The ED 90 of carbetocin to produce adequate uterine tone was estimated at 121 lg (95% confidence interval [CI]: 111 to 130; 99% CI: 108 to 133) using the truncated Dixon and Mood (DM) method. The isotonic estimator of ED 90 was 140 lg; however, the observed response rate across all doses was \ 90%. Also, the 95% CI of the DM estimator is likely to have lower than expected coverage, while the 99% CI may have about 90% coverage. Therefore, these results should be interpreted with caution. The overall median (range) estimated blood loss was 1,014 (104-2,436) mL. The overall incidence of hypotension and tachycardia were 45% and 57.5%, respectively. At a dose of 140 lg, the incidence of tachycardia and intraoperative arrhythmias was 76% and 14%, respectively. Conclusion The ED 90 of carbetocin at CD for labour arrest, as determined in our study, should be interpreted with caution since it may be underestimated. This dose is higher than the currently recommended dose of 100 lg at elective CD and should not be used routinely given the uncertainty regarding its efficacy and the high incidence of arrhythmias at higher doses. This trial was registered at ClinicalTrials.gov, number: NCT01725243. RésuméObjectif L'objectif de cette étude était d'estimer la dose efficace à 90 % (DE 90 ) de la carbétocine pour atteindre un tonus utérin adapté lors d'un accouchement par césarienne (AC) pour arrêt de la progression du travail. Méthode Nous avons réalisé une étude de détermination de dose de carbétocine à double insu en nous fondant sur une méthodologie biaisée de pile ou face chez des femmes subissant un AC pour arrêt de progression du travail sous anesthésie péridurale. Quarante femmes enceintes en bonne santé et à terme ayant reçu une perfusion d'oxytocine pendant au moins trois heures pendant le travail obstétrical ont été recrutées p...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Carbetocin at Cesarean delivery for labour arrest: a sequential allocation trial to determine the effective dose

Nguyen-Lu

Carvalho

Farine

et al. 2015

Can J Anesth/J Can Anesth

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“…In pregnant mammals including humans, an abrupt increase in oxytocin binding sites in the uterus may occur at approximately 24 h before the onset of labor, reaching the greatest levels during labor and sharply decreasing after parturition to reach baseline levels 2-5 days postpartum (Alexandrova and Soloff, 1980;Fuchs et al, 1984;Soloff, 1990). An increase in myometrial sensitivity to oxytocin and plasma oxytocin levels was observed to occur simultaneously to the increase in the number of oxytocin receptors (Soloff, 1990).…”

Section: Discussionmentioning

confidence: 99%

Influence of time at which oxytocin is administered during labor on uterine activity and perinatal death in pigs

et al. 2007

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Oxytocin is extensively used to induce or augment uterine contractions, especially to facilitate the third stage of labor in humans. Administration of oxytocin to parturient sows reduces duration of labor whereas mortality of the offspring may remain unchanged. This study aimed to evaluate whether time of administration of oxytocin during parturition may alter the uterine response and fetal outcomes. Two hundred parturient sows were randomly assigned to intramuscularly receive either saline solution (control group) or oxytocin 0.083 IU/kg immediately after the delivery of the 1 st , 4 th or 8 th piglet (groups O-1, O-4 and O-8, respectively). Uterine effects and fetal outcomes were registered in all groups. The duration of labor was 20-40 min shorter (P < 0.0001) and time interval between babies was reduced by 3-5 min (P < 0.0001) in the three groups receiving oxytocin. The duration and intensity of contractions, meconium-stained piglets and intrapartum deaths decreased as time at which oxytocin administered during labor was increased. In group O-8, we observed approximately 70% less meconium-stained piglets and intrapartum deaths than in the control group. In conclusion, oxytocin administered at early phases of parturition to sows may increase duration and intensity of uterine contractions as well as adverse fetal outcomes.

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“…However, OT appears not to be an essential participant in labour as oxytocin (-/-) null mice can deliver normally (Nishimori et al, 1996. The oxytocin receptor increases at term in myometrial tissue (Fuchs et al, 1984) and its increased expression leads to direct contractile effects in myometrium .…”

Section: Oxytocinmentioning

confidence: 99%

Endocrine immune interactions in human parturition

Golightly

Jabbour

Norman

2011

Molecular and Cellular Endocrinology

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Human parturition is an inflammatory event, modulated and influenced by a host of other environmental and physiological processes, including the endocrine hormones.Complex bidirectional communication occurs between the two systems to bring about some of the changes that are seen in labour, an event that is not yet fully understood.Preterm birth is a major problem in obstetrics and neonatology, with dysfunctional labour or prolonged pregnancy also making increasingly significant contributions to maternal morbidity. With better understanding of normal and abnormal parturition we may be able to develop novel ways of treating these complications of pregnancy and reduce maternal and neonatal morbidity and mortality. This review discusses the crucial role that endocrine-immune interaction plays in the process of labour and in the processes of abnormal and preterm labour. We propose that amongst these complex interactions it is the immune system that is the driving force behind human parturition. Keywords Parturition Endocrine InflammationImmune

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Oxytocin receptors in the human uterus during pregnancy and parturition

Cited by 595 publications

References 12 publications

Carbetocin at Cesarean delivery for labour arrest: a sequential allocation trial to determine the effective dose

Carbetocin at Cesarean delivery for labour arrest: a sequential allocation trial to determine the effective dose

Influence of time at which oxytocin is administered during labor on uterine activity and perinatal death in pigs

Endocrine immune interactions in human parturition

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