Abstract
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Highlights
Oxytocin, a neuropeptide produced in the hypothalamus in a pulsatile manner and secreted through the posterior pituitary, is a powerful uterotonic which stimulates contractions of myometrial cells in the uterus and the myoepithelial cells around the mammary alveoli
induction of labour (IOL) with oxytocin alone could be used in women with ruptured membranes, IOL with oxytocin alone is not recommended in women with intact membranes[13]
The oxytocin protocol used in the Academic Obstetric Unit (AOU) at the Teaching Hospital Mahamodera, Galle (THMG), Sri Lanka, from 2006 up to date, has a high starting dose of 5mU/min, irrespective of parity and stepwise increments at 40 minute intervals, until adequate uterine contractions are achieved, and continued at that dose until delivery
Summary
A neuropeptide produced in the hypothalamus in a pulsatile manner and secreted through the posterior pituitary, is a powerful uterotonic which stimulates contractions of myometrial cells in the uterus and the myoepithelial cells around the mammary alveoli. The onset of labour is a complex process which involves several processes such as structural remodeling (‘ripening’) of cervix, mediated by the interaction of nitric oxide with numerous cytokines and free radicals, followed by interlinked, harmonized changes in the levels of oestrogen, progesterone, prostaglandins, cortisol as well as their receptors. The use of “Pitocin”, an extract from the posterior pituitary, was first described for IOL by Bell in 1909 but it was soon abandoned because of serious adverse effects including fetal death and ruptured uteri[5]. It was only in 1954 that the synthesis of oxytocin was first described by Vincent du Vigneaud, and he won a Nobel Prize for his efforts[6]. Like in the case of any medication given to a human being, when using oxytocin, the principle of “primum, non nocere” – first do no harm enunciated by Hippocrates, must be kept in mind
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