Oxytocin and cancer: An emerging link

The neuropeptide hormone oxytocin, which is released from the posterior pituitary gland, is involved in a number of physiological processes. Understanding of its effects is gradually increasing due to new research in this area. While mostly recognized as a reproductive system hormone, oxytocin also regulates other organ systems such as the brain and cardiovascular system. Recently, research has focused on unraveling its involvement in cancer, and emerging evidence suggests a potential role for oxytocin as a cancer biomarker. This review summarizes observations linking oxytocin and cancer, with a special emphasis on prostate cancer, where it may promote cell proliferation. Research suggests that oxytocin effects may depend on cell type, concentration of the hormone, its interactions with other hormones in the microenvironment, and the precise localization of its receptor on the cell membrane. Future research is needed to further elucidate the involvement of oxytocin in cancer, and whether it could be a clinical cancer biomarker or therapeutic target.

Oxytocin decreases colonic motility of cold water stressed rats via oxytocin receptors

AIM: To investigate whether cold water intake into the stomach affects colonic motility and the involvement of the oxytocin-oxytocin receptor pathway in rats. METHODS: Female Sprague Dawley rats were used and some of them were ovariectomized. The rats were subjected to gastric instillation with cold (0-4 degrees C, cold group) or room temperature (20-25 degrees C, control group) saline for 14 consecutive days. Colon transit was determined with a bead inserted into the colon. Colonic longitudinal muscle strips were prepared to investigate the response to oxytocin in vitro. Plasma concentration of oxytocin was detected by ELISA. Oxytocin receptor expression was investigated by Western blot analysis. Immunohistochemistry was used to locate oxytocin receptors. RESULTS: Colon transit was slower in the cold group than in the control group (P < 0.05). Colonic smooth muscle contractile response to oxytocin decreased, and the inhibitory effect of oxytocin on muscle contractility was enhanced by cold water intake (0.69 +/- 0.08 vs 0.88 +/- 0.16, P < 0.05). Atosiban and tetrodotoxin inhibited the effect of oxytocin on colonic motility. Oxytocin receptors were located in the myenteric plexus, and their expression was up-regulated in the cold group (P < 0.05). Cold water intake increased blood concentration of oxytocin, but this effect was attenuated in ovariectomized rats (286.99 +/- 83.72 pg/mL vs 100.56 +/- 92.71 pg/mL, P < 0.05). However, in ovariectomized rats, estradiol treatment increased blood oxytocin, and the response of colonic muscle strips to oxytocin was attenuated. CONCLUSION: Cold water intake inhibits colonic motility partially through oxytocin-oxytocin receptor signaling in the myenteric nervous system pathway, which is estrogen dependent. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

Umbilical Vein Oxytocin Injection versus Umbilical Cord Drainage in Management of Third Stage of Normal Vaginal Delivery: A Randomized Controlled Trial

Objectives: Postpartum hemorrhage is an important cause of maternal morbidity and mortality worldwide. Different preventive strategies were tried to determine the best approach for the management of the 3rd stage of labour. We aim to determine the effect of umbilical vein oxytocin injection and umbilical cord drainage in the management of third stage of labour in normal vaginal delivery. Patients and Methods: One hundred twenty three (123) females were enrolled into this randomized controlled trial. They were aligned into three groups: 1st group (I) (cord drainage group), 2nd group (II) (oxytocin group) and 3rd group (III) (control cord traction group). The primary outcomes were duration of 3rd stage and blood loss. Results: Both group I and II had statistically significant shorter third stage duration than patients of group III (p < 0.001). Mean ± SD (7.3 ± 3.45, 4.6 ± 1.74, 9.4 ± 3.67) respectively for groups I, II, III. Also, both group I and II had statistically significant less blood loss than patients of group III (p < 0.001). Conclusion: The current study demonstrated that umbilical vein oxytocin injection and umbilical cord drainage significantly reduce the duration and amount of blood loss in the 3rd stage of labour, thus, reducing the risk of post partum hemorrhage.

Oxytocin and oxytocin receptor alterations,decreased survival,and increased chemoresistance in patients with pancreatic cancer

Background:Oxytocin(OXT)and its receptor(OXTR)is associated with cancer.The present study was to investigate the correlation between the genetic expression alterations of OXT and OXTR and the outcomes in patients with pancreatic cancer(PC).Methods:Information regarding OXT and OXTR genetic alterations and changes in gene expression were retrieved from the Cancer Genome Atlas(TCGA)databases and analyzed using the cBioPortal online tool.We assessed the correlation of overall survival and disease/progression-free months to either OXT or OXTR genetic alterations and changes in gene expression using Kaplan-Meier and Cox regression anal-yses.Quantitative PCR(qPCR)was conducted to assess the mRNA expression levels of OXT and OXTR in human PC cell lines.Results:Five percent of PC cases showed mRNA upregulation in the OXT gene.These PC cases also showed genetic alterations and changes in gene expression of OXTR.The median months of survival and disease-free survival were lower for PC cases with genetic alterations and changes in gene expression in the OXT and OXTR genes as compared to those without such alterations.qPCR data showed that OXT and OXTR mRNA expression were 1-fold and 10-fold higher,respectively in PANC-1 cell lines as compared to L3.6pl cell lines in direct negative correlation with responsiveness to gemcitabine.Conclusions:These data suggest that OXT and OXTR may potentially be important in PC progression,chemoresistance,and patient survival,and potentially could have prognostic and therapeutic implications in a subset of PC patients.

Oxytocin but Not Testosterone Modulates Behavioral Patterns in Autism Spectrum Disorders

Autism spectrum disorder (ASD) is a neurodevelopmental disorder of unknown etiology. Social deficits represent one of the core symptoms of the diagnosis. The aim was to reveal possible correlations among peripheral levels of oxytocin and testosterone with behavioral and symptom characteristics in patients with ASD. 8 children with ASD were recruited and underwent psychological profiling. Blood oxytocin and testosterone levels were analyzed using ELISA method. Oxytocin levels positively correlated with Adaptation to change category of CARS-2 (P = 0.008, R = 0.848) and Vineland-II maladaptive behavior scores (P = 0.004, R = 0.884). No significant correlations were found among testosterone levels and behavioral parameters. Higher oxytocin levels were connected with more severe adaptive behavior in ASD patients. Increased oxytocin levels in children with more severe phenotype could be a result of compensatory mechanism of impaired oxytocin signaling. Oxytocin seems to employ distinct mechanisms in regulating social behavior in autism and healthy population.

Oxytocin and Uterine Atony during Cesarean Section

In our medical practice, in particular obstetrics, it is difficult to change certain consolidated dogmas, but the necessity and the current situation of our obstetrical exercise pushed us to find new technical supports, to make the exercise of our specialty as stripped of pitfalls as possible. Our work is summarized in a prospective comparative study, aimed at evaluating the existence or not of a difference between the administration of oxytocin just before the hysterotomy in a cesarean section and its administration after fetal extraction. We used a set of criteria to include patients in our study. This study took place over a period of one year (2020) in the Mother and Child regional center, in Meknes Imperial city, Morocco, involving a total number of 364 patients. With a group A comprising 176 patients 48% (176/364) who received oxytocin just before the hysterotomy and a group B of 188 patients 52% (188/364) who received it classically after fetal extraction. The difference was very significant as detailed in the article. Conclusion: the very convincing results of our study and the difference between the two groups, allowed us to demonstrate the effectiveness of our process and to endorse its use in our routine practice, with the perspective of conducting a prospective randomized study on a larger series.

The Role of Ankaferd Blood Stopper and Oxytocin as Potential Therapeutic Agents in Endometriosis:A Rat Model

To evaluate the potential effect of Ankaferd Blood Stopper(ABS)and oxytocin(OT)in an experimental endometriosis model,18 female Sprague Dawley rats were used in this study.The animals were divided randomly into three groups after surgical induction of endometriosis:group 1:control group(isotonic NaCl,1 mL/kg/day,intramuscular,n=6);group 2:OT group(OT,80 U/kg/day,intramuscular,n=6);group 3:ABS group(ABS,1.5 mL/kg/day,intraperitoneal,n=6).Each group was treated for four weeks(two times per week).Volumes of endometriotic explants were measured in biopsy samples for histopathological analysis.Vascular endothelial growth factor(VEGF),monocyte chemotactic protein-1(MCP-1),and tumour necrosis factor(TNF-α)levels were measured in plasma and peritoneal fluid.Endometriotic explant volumes were significantly decreased after OT administration(P<0.0001).The epithelial score was significantly decreased in both treatment groups compared to the control group(P<0.05).TUNEL immunohistochemistry showed more apoptotic changes in the endometriosis foci(gland epithelium and surrounding tissue)in the OT group than in the control group(P<0.05).The levels of VEGF,MCP-1,and TNF-αwere significantly reduced in the OT group(P<0.05),whereas no significant changes in protein levels were found in the ABS-applied group.The results indicate that OT has greater potential as a therapeutic agent in experimentally induced peritoneal endometriosis,where ABS,which is a VEGF modulator,appears to act through different mechanisms to show its palliative effects on a rat model of peritoneal endometriosis.

Oxytocin in pig seminal plasma is positively related with in vivo fertility of inseminated sows

Background:Identification of relevant in vivo biomarkers for fertility remains a challenge for the livestock industry.Concentrations of the small peptide hormone oxytocin(OXT),involved in male reproductive function and present in the seminal plasma(SP)of several species could be a robust one.This study characterized concentrations of SPOXT in ejaculates from boars used in artificial insemination(AI)programs aiming to evaluate its relationship with sperm quality variables and in vivo fertility of their liquid-stored AI-semen.Seminal OXT concentrations(ng/mL)were measured in 169 ejaculates from 61 boars of the Duroc,Pietrain,Landrace and Large White breeds using a direct competitive immunoassay test based on AlphaLISA®technology.Ejaculate(ejaculate volume,sperm concentration,total sperm count)and sperm parameters(motility,viability,intracellular generation of reactive oxygen species,plasma membrane fluidity)were assessed at 0 h and 72 h in AI-semen samples stored at 17℃.In vivo fertility included only 18 Large White and Landrace boars whose AI-semen was used to inseminated>100 sows and evaluated both farrowing rate and litter size of 3,167 sows.Results:The results showed that SP-OXT differed between boars and between ejaculates within boar(P<0.05)but not between breeds(Duroc,Pietrain,Landrace and Large White).Ejaculates with higher SP-OXT concentration/mL(hierarchically grouped;P<0.001)had larger volume and came from younger boars(P<0.05).Ejaculates of boars showing positive farrowing rate deviation exhibited higher(P<0.05)SP-OXT concentration/mL than those with negative farrowing rate deviation.Conclusion:The SP concentrations of OXT are boar,ejaculate and age dependent,and positively related with ejaculate volume and farrowing rates of liquid-stored semen AI-doses.

Oxytocin and early parent-infant interactions: A systematic review

Objectives: Social relationships throughout lifespan are critical for health and wellbeing.Oxytocin,often called the'hormone of attachment'has been suggested as playing an important role in early-life nurturing and resulting social bonding.The objective of this paper is to synthesize the associations between oxytocin levels and interactions between infants and parents that may trigger oxytocin release,and in turn facilitate attachments.Methods: A comprehensive cross-disciplinary systematic search was completed using electronic data-bases.The inclusion criteria included studies that focused on mother-infant and father-infant interaction and measured both baseline and post-interaction oxytocin levels.Results: Seventeen studies were included in the final systematic review.The reviewed studies used mother-infant and/or father-infant play and skin-to-skin contact between maternal-infant and paternalinfant dyads to examine the oxytocin role in early life bonding and parenting processes.Studies showed a positive correlation between parent-infant contact and oxytocin levels in infancy period.Increased maternal oxytocin levels were significantly related to more affectionate contact behaviors in mothers following mother-infant contact,synchrony,and engagement.Meanwhile,increased paternal oxytocin levels were found to be related to more stimulatory contact behaviors in fathers following father-infant contact.Oxytocin levels significantly increased in infants,mothers and fathers during skin-to-skin contact and parents with higher oxytocin levels exhibited more synchrony and responsiveness in their infant interactions.Conclusion: The review suggests that oxytocin plays an important role in the development of attachment between infants and parents through early contact and interaction.The complexities of oxytocinergic mechanisms are rooted in neurobiological,genetic,and social factors.

Oxytocin in rat nucleus raphe magnus influences pain modulation

The main function of Nucleus raphe magnus (NRM) is mostly pain mediation. Our previous study has demonstrated that oxytocin (OXT) regulates antinociception through the central nervous system rather than the peripheral organs, and pain stimulation increases OXT concentration in the NRM. The experiment was designed to investigate OXT in the rat NRM effect on pain modulation. The results showed that 1) pain stimulation increased OXT concentration in NRM perfusion liquid;2) Intra-NRM microinjection of OXT increased the pain threshold in a dose-dependent manner, whereas intra-NRM microinjection of OXT receptor antagonist, desGly-NH2, d(CH2)5[D-Tyr2, Thr-sup-4]OVT decreased the pain threshold;3) NRM pre-treatment with OXT receptor antagonist completely attenuated the pain threshold increase induced by intra-NRM administration of OXT. The data suggested that OXT in NRM was involved in antinociception via OXT receptors.

Modulation of Fatty Acid Oxidation and Glucose Uptake by Oxytocin in Adipocytes

Oxytocin (OT) is a hypothalamic neuropeptide synthesized and secreted by OT neurons. In addition to its conventional role in reproductive physiology, central OT also regulates various social behaviors, such as care, trust, and emotions. Central and subcutaneous OT infusions stimulate lipid metabolism in mice and rats when fed standard or high fat diets. Mice lacking the OT receptor (OTR) or OT peptide develop late-onset obesity with greater fat pad weights, larger adipocyte size and elevated plasma levels of leptin. To study the effects of OT on lipid metabolism, we examined the effects of serial OT doses (0, 10, 30, 100, 150, 300 nM) on 3T3L1 adipocytes, together with long (144 hours, 6 days) and short (24 hours, 1 day) term treatments. The short-term treatment with 150 nM OT increased triacylglycerol (TAG) accumulation and decreased mRNA expressions of carnitine palmitoyltransferase 1α (CPT-1α) and fatty acid binding protein 4 (FABP4). After long-term incubation with 150 nM OT, only the CPT-1α mRNA was decreased. In differentiated adipocytes derived from pig adipose tissue stem cells, only hormone sensitive lipase mRNA was decreased after short- or long-term treatment with OT. To obtain further insight into the underlying mechanism of OT induction, we tested the involvement of the AKT/PKB pathway;however, AKT phosphorylation was decreased after treatment with 150 nM OT, suggesting that OT effects may be independent from the AKT/PKB pathway. Taken together, OT effects on adipocyte glucose and lipid metabolism are probably through mechanisms other than the AKT/PKB pathway.

Comparative study of the side effect profiles of oral misoprostol and parenteral oxytocin used in prevention of postpartum haemorrhage in Maiduguri Nigeria

The following work compared adverse effects profile and patients’ acceptability of intra-venous oxytocin 10 iu and oral misoprostol 600 ug used in the prevention of postpartum hemorrhage in the third stage of labour. A total of 1865 pregnant women who have received either oxytocin injection or oral misoprostol in third stage of labour as prophylaxis for postpartum haemorrhage, were enrolled within three health care facilities in Maiduguri, Nigeria. Each patient was observed at parturition and for 24 h after during which oral interviews were conducted and clinical notes studied. The oxytocin medication group exhibited higher abdominal pains (7.1% versus 0.0%;p 0.05) difference in patients acceptability of injectable oxytocin (99.3%) and oral misoprostol (98.3%). Oxytocin usage in the prevention of PPH was associated with abdominal pains and headache while misoprostol was associated with shivering and fever. Patients from this study have demonstrated high level of acceptability of both parenteral oxytocin and oral misopristol prevention of post-partum haemorrhage.

Brief report: Plasma oxytocin is lower in children with Asperger syndrome and associated with autistic trait attention to detail

Aim: Autism spectrum disorders (ASD) are described as a continuum of severity gradient of autistic symptoms diffusing through particular ASD diagnoses, however the biological correlates among individuals with the different ASD diagnoses slightly or considerably differ. Oxytocin (OT) has been implicated to play an important role in autism etiology. Lower OT levels have been previously found in children with infantile autism, however in a group of high-functioning autistic subjects, no differences have been shown compared to controls. Moreover, whereas the opposite patterns of OT associations with social measures have been found in children with infantile autism compared to healthy children, no associations have been found in individuals with high-functioning autism. We aimed to find out the plasma OT differences between separate group of children with Asperger syndrome (AS) and healthy children and the associations of OT with particular autistic traits in a group of children with AS. Methods: We included 9 children (m = 6, f = 3) with AS at the age 9 to 12 years and 9 age- and gender-matched controls. OT levels were analyzed by ELISA method. Autistic traits in children with AS were evaluated by Autism Spectrum Quotient (AQ), child and adolescent versions. Results: Children with AS had significantly lower plasma OT levels compared to healthy children. We found the significant negative correlation of OT level and AQ Attention to detail area score. Conclusion: In spite of the lower OT level in children with AS, which is also previously found in children with infantile autism, the pattern of OT associations with autistic traits more resembles the pattern in non-autistic population. Our preliminary results support the hypothesis of continuum within the ASD particular diagnoses in the terms of biological correlates.

Inhibitory Effects of Chlorpheniramine and Astemizolum on Contraction of Isolated Rat and Rabbit Uteri Induced by Oxytocin and PGF_(2α)

The contraction of isolated rat and rabbit uteri induced by oxytocin and PGF2α was markedly inhibited by chlorpheniramine (Chl) and astemizolum (Ast) , both of which also decreased the resting tension of uteri, and their spontaneous contraction. The inhibitory effects of both drugs were dose-dependent. At high concentrations , Chl 7. 4 × 10-4 mol/L and Ast 10-4 mol/L could counteract the contraction of the uteri induced by Oxy and PGF2α, and their spontaneous contraction as well. They decreased the resting tension to the lower level. The mechanism of their non-special relaxed action on uteri could not be completely explained only by their H1-receptor blocking action. Whether they act by blocking calcium channel or by inhibiting calmodulin (CaM) remains to be further explored.

The Effectiveness of Postpartum Exercise and Oxytocin Massage on Uterus Involution

The process of involution will work well if uterus contraction is strong, so a treatment can be done to improve uterus contraction. Postpartum exercise can make uterus muscles undergo contractions and retractions. In addition to pospartum exercise, being control of bleeding from the placenta attached is maintaining contraction and retraction fiber of strong myometrium through oxytocin massage. Purpose: This study aimed to ascertain influences of postpartum exercise and oxytocin massage on uterus involution. Method: The design used is quasi experimental research using post test only designing two comparison treatments. This research was conducted at PONED (basic emergency obstetric and neonatal care) in Bandung. The sample size was 50 respondents (25 respondents were given treatment for postpartum exercise and 25 respondents were given the oxytocin massage treatment). The sampling technique with non probability sampling techniques was by means of quota sampling. The data use primary data through the process of interview and observation. Deep data collection tool uses observation sheets and questionnaires. Result: The average uterus involution on the postpartum exercise group was 8.68 days, while the oxytocin massage group was 6.72 days. The results of the Mann Whitney Test statistic were at 95% confidence level;there was a significant difference in uterus involution between the postpartum exercise group and the oxytocin massage group with a value of p Conclusion: Oxytocin massage is more influential than pospartum exercise to uterus involution.

Oxytocin Massage Can Expedite the Time of Colostrum Discharge in the Post Section Caesarian

The production of breast milk is physiologically influenced by prolactin hormone and breast milk is influenced by oxytocin hormone. Oxytocin massage can increase the oxytocin hormone. The increase in the oxytocin hormone can expedite the time of colostrum. The use of drugs in the post section cesarean (SC) will inhibit the formation of breast milk production. Oxytocin massage is one of the efforts to expedite the release of colostrum. Purpose: To analyze the implementation of oxytocin massage in accelerating the release of colostrum in post-SC and the effect of oxytocin massage, breast care and the frequency of breastfeeding simultaneously to accelerate the release of colostrum. Method: The design used quasi-experiment. The population were post-SC with a sample of 60 people (30 post-SC were treated with oxytocin massage and 30 post-SC were not treated). Both groups were interviewed and observed in breast care, the frequency of breastfeeding and the time of first colostrum discharge. Result: Analysis used independent T-test and double linear regression test with α = 0.05. The results showed significantly that expedite time of colostrum in the post SC group with oxytocin massage occurred 23.04 hours faster than the controlled group who were not treated with oxytocin massage and post SC who were given oxytocin massage accompanied by breastfeeding their babies as often as possible to be faster 2.6 hours when the colostrum was released with α value < 0.05. Conclusion: Massage oxytocin speeds up the release of colostrum in the post SC.

Endorphins, oxytocin, sexuality and romantic relationships: An understudied area

Endorphins are the body's natural opioids that are created and released by the central nervous system, hypothalamus and pituitary gland. Endorphins have a reputation for pain reduction, enhancing excitement or satisfaction, boosting confidence, enabling control of emotions and generating feelings of euphoria, and are involved in the natural reward cycle. There is also evidence in the literature suggesting the role of endorphins in sexuality(including sexual function and sexual behaviours), as they may regulate the release of sex hormones, prolactin and growth hormone, which are involved in sexual function and love. Endogenous oxytocin is another intrinsic hormone whose role in inducing labour contractions, the delivery of the baby and stimulating lactation has been well studied. However, the potential impact of endorphins and oxytocin on sexuality and romantic relationships is not well understood. This article reviews the research on endorphins and endogenous oxytocin and how they relate to human sexuality and romantic relationships. Some animal studies report the effect of endorphin and oxytocin on sex hormones and mating behaviours, but these findings have not been supported by research into human behaviour, indicating many gaps in knowledge relating to the association between these hormones and human sexuality.

The Correlation between Synthetic Oxytocin Given during Labor and Women’s Personality Traits According to the SSP (Swedish University Scales of Personality) Survey: A Pilot Study

Background: In modern obstetric care, oxytocin is one of the most frequently used drugs, and the possible mental impact this drug has on women is very little studied. The objective of this study is to investigate whether women augmented with oxytocin during labor will rate their personality profile differently after childbirth than non-stimulated women. Methods: Prospective cohort study was performed at Women’s Clinic, Soder hospital, Stockholm.76 women received the SSP (Swedish University Scales of Personality) questionnaire to fill in during their stay in the post-maternity ward after labor. Information about the use of oxytocin was retrieved from the women’s medical records. Primary outcome: Differences in the SSP scores in the group augmented with synthetic oxytocin during labor compared with the non-augmented group. Results: Women with and without oxytocin estimates on the SSP subscale form differed regarding personality traits described as “lack of assertiveness” (p = 0.04), which means “lack of ability to speak up and to be self-assertive in social situations”. The result also showed that women that had a long time of augmentation with oxytocin (>5 h) scored higher for “social desirability” (p = 0.004), which was defined as being “socially adapted,” “friendly,” and “helpful”. A difference in “psychological anxiety” (p = 0.04) and “social desirability” (p = 0.004) was found among women who had oxytocin in a dose of at least 200 ImU/h for ≥1 hour. This group also had a lower rate of “mental anxiety” than those who received lower oxytocin doses. Conclusion: Synthetic oxytocin given during labor may affect the woman mentally. The total time and volume of given oxytocin seem to be essential factors when discussing augmentation’s maternal psychological response. We conclude that prolonged and extended use of synthetic oxytocin during labor should be avoided if possible.

Efficiency and Tolerance of Misoprostol versus Oxytocin in the Active Management of the Third Period of Delivery at the University Maternity Porto-Novo, Benin

Objective: To assess the efficiency and tolerance of misoprostol versus oxytocin in Active Management of the Third Period of Childbirth. Framework and Method of Study: The study was carried out at the Porto-Novo university maternity in Benin. The hospital is level 3. He acted in a randomized clinical trial with a descriptive and comparative aim referred from 1st January 2017 to 31st December 2017. We included all eligible women in labor in the delivery room during the study period and at that gestational age was greater than or equal to 37 weeks of amenorrhea, delivery was done through vaginal birth and delivered with a live birth and agreed to participate in the study. The cases eligible by order of admission were grouped in blocks of two, “Misoprostol” and “Oxytocin” corresponding to the Active Management of the Third Period of delivery. The data collected were captured and analyzed using the SPSS version 20 software. For the comparison of the results, we used the chi-square statistical test and the difference was assumed to be statistically significant for a p ≤ 0.05. The confidentiality of parturient was respected. Results: we recorded 1234 of which were delivered via vaginal birth. The Active Management of the Third Period of Delivery was carried out in 1202 parturients. According to our inclusion criteria, 892 parturients were retained for the study, of which 446 for each group. The average age of parturients was 26.94 ± 5.65 years. Almost pregnancies were mono-fetal (95.7% vs. 93.5%). The average time to expel the placenta after utero-tonic administration was 4.05 ± 0.27 min in the “Misoprostol” group versus 3.82 ± 0.52 min in the “Oxytocin” group (p > 0.05). We had only 9 cases of placental retention in the group “Misoprostol” versus 5 cases in the “Oxytocin” group. Most of the parturients had blood loss less than 500 ml (96.2% vs. 96.6%). The frequency of delivery hemorrhage was 3.8% in the “Misoprostol” group versus 3.4% in the “Oxytocin” group. The mean blood volume lost was 284.33l ± 13.31 ml in the “Misoprostol” group versus 225.94 ± 21.52 ml in the “oxytocin” group. Maternal prognosis was generally good in both groups. Conclusion: Misoprostol may be an alternative in Active Management of the Third Period of Delivery especially in developing countries where the cold chain is often lacking.

Automatic &Safe Oxytocin Induction of Labor

Aims: To prevent fetal damage by excess oxytocin administration of manually controlled infusion, by automatic and safe increasing infusion setting with monitoring uterine contraction and fetal heart rate. Methods: Starting infusion level was 2 milliU/ml, as oxytocin sensitivity of a pregnant uterus is unknown, to avoid hyper contraction and fetal bradycardia caused by unexpected excess oxytocin sensitivity. The infusion automatically increased with automatic monitoring of uterine contraction curve, then the increasing stopped when contraction reached to normal labor level, where the infusion level maintained, which continued until delivery, if there is no trouble. However, the infusion continued until expiring all fluid in case of insensitive uterus, where the induction was performed in another day. The infusion stopped automatically when contraction was too strong, or fetal heart rate is abnormal. Thus, oxytocin sensitive case is protected from excess contraction and fetal asphyxia. Results: Normal vaginal delivery was achieved in 28/33 cases (85%), which was more than manually controlled infusion. No case was abnormal in successful oxytocin infusion. Conclusion: The automated technique will be applied to oxytocin labor induction.