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Current Opinion in Anaesthesiology
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Best Practice & Research in Clinical Obstetrics & Gynaecology
Myometrial contractility is integral to the delivery of the placenta and the arrest of potential subsequent haemorrhage. The details of this physiological process are patchy but it is clear that there is an important hormonal contribution. Oxytocin, with or without ergometrine, has thus been widely used with a recognized beneficial treatment effect. This practice, however, was never universal. The injectable nature of these agents restricted their wider use, even in societies with average medical services.The availability of the prostaglandin analogue misoprostol has renewed interest in the third stage of labour, has taken its pharmacological management to new frontiers, and has expanded the therapeutic options for the management of postpartum haemorrhage.
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Seminars in Perinatology
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International journal of obstetric anesthesia
The administration of oxytocic drugs during caesarean section is an important intervention to prevent uterine atony or treat established postpartum haemorrhage. Considerable past and current research has shown that these agents have a narrow therapeutic range. A detailed knowledge by anaesthetists of optimal doses and side effects is therefore required. Oxytocin remains the first line agent. In view of receptor desensitisation, second line agents may be required, namely ergot alkaloids and prostaglandins. This review examines the adverse haemodynamic and side effects, and methods for their limitation. An approach to dosing and choices of agent for the limitation of postpartum haemorrhage is suggested.
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European Journal of Obstetrics & Gynecology and Reproductive Biology
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The present study aimed to compare the effectiveness of the studyOxytocin with misoprostol in the induction of labor to abortion in a sample of pregnant women in Baghdad Hospital. The study was divided Women who Need an abortion because of fetal death inthe sample consisted of (100) women who needed to have an abortion at the end of pregnancy due to fetal death, and 20 women needing abortion at the beginning of pregnancy too,they were divided into two groups (50) women receive misoprostol, and (50) women receive a drug OxytocinComparisons were made between women.The study also consisted of 20 women with early pregnancy who were divided into two groups each receiving a drug similar to the previous oneMisoprostol was found to be more effective than women in both early and delayed pregnancies.
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Aims: the aim of this work is to evaluate the effect of combining dinoprostone and misoprostol as a method of medical termination of pregnancy in patients with late 2nd trimester IUFD. Methods: this is a randomized clinical trial. 150 participants with past history of one transverse Lscs and late 2nd trimester IUFD were admitted for medical termination of pregnancy.they were divided into 3 groups, the first one received intra-vaginal misoprostol 50 μgm (4 doses with 6 hours interval), the second one received intra-vaginal dinoprostone 3 mg (4 doses with 6 hours interval) and the third one received a combination of both drugs intra-vaginally (2 doses of dinoprostone 3 mg followed by 2 doses of misoprostol 50μgm with 6 hours interval) and the clinical response to the three regimens was evaluated. results: Dinoprostone followed by misoprostol showed statistically significant difference when compared to misoprostol and dinoprostone as regard response to induction, induction-contraction interval, induction-expulsion interval and the final outcome of termination of pregnancy. conclusion: Using dinoprostone followed by misoprostol is more effective than using any of the two drugs separately as a method of pregnancy termination in patients with late 2nd trimester IUFD and past history of one Lscs.
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