Oxytocin Group Research Articles

The Complex Role of Oxytocin in Major Depressive Disorder

Objective: One proposed mechanism to subclassify depressive illness relates oxytocinergic dysregulation, via its effect on social behavior and Hypothalamic-pituitary-adrenal (HPA) axis inhibition. To further investigate the role of oxytocin in Major Depressive Disorder (MDD), we compared plasma oxytocin levels in patients with MDD to healthy controls. 
 Methods: Plasma samples from 12 healthy controls and 33 MDD patients were collected at baseline, 8 weeks, and 12 weeks of treatment and oxytocin was measured by enzyme-immunoassay. Depression and anxiety scales were administered at screening, baseline, and at weeks 2, 4, 8, and 12 of treatment. Additionally, we investigated possible associations between blood concentrations of inflammatory biomarkers and oxytocin.
 Results: The average baseline oxytocin level was 429 pg/ml in MDD patients and 392 pg/ml in healthy control subjects. A significant negative correlation was found between baseline oxytocin and BMI. Treatment responders had significantly lower baseline oxytocin levels than non-responders. After stratifying patients into low and high oxytocin groups based on a median split, within the high oxytocin group, patients with no prior depressive episodes had significantly higher baseline oxytocin levels. A Chi-square distribution test revealed that African American patients were more likely to belong to the high baseline oxytocin group while Caucasian and Hispanic patients were more likely to belong to the low baseline oxytocin group. We found significant correlations between oxytocin and Von-Willebrand Factor (VWF) and Epidermal Growth Factor (EGF), only within the high oxytocin subgroup. There were no other significant correlations between baseline oxytocin and any other biomarkers.
 Conclusion: Within our limited patient cohort, our data adds to the mixed literature regarding the role of oxytocin in MDD. Oxytocinergic dysregulation and confounding factors may play a role for a subset of depressed patients.

Effect of Carbetocin on Postpartum Hemorrhage after Vaginal Delivery: A Meta-Analysis.

Background The efficacy of oxytocin and carbetocin in preventing postpartum hemorrhage (PPH) in women with vaginal delivery has been controversial. This study is aimed at conducting a meta-analysis that compares the efficacy of carbetocin and oxytocin in the prevention of PPH among women with vaginal delivery. Methods Literature was retrieved from PubMed, Medline, Embase, CENTRAL, and CNKI databases. The randomized controlled trials (RCTs) that compare the efficacy of carbetocin and oxytocin to prevent PPH were searched. Data from the included literatures were extracted by two researchers, including author, title, publication date, study type, study number, the incidence of PPH, number of patients requiring additional uterotonics, and number of patients requiring blood transfusion. Jadad scale was used to evaluate the quality of the included RCTs. The Chi-square test was adopted for the heterogeneity test. A fixed-effect model was used for analysis if heterogeneity did not exist between literatures. If heterogeneity exists between literatures, a random-effect model was used for analysis. The source of heterogeneity was explored by subgroup analysis and sensitivity analysis. Results The incidence of PPH in the carbetocin group was lower than that in the oxytocin group (OR = 0.62, 95% CI (0.46, 0.84), Z = 3.14, P = 0.002). There was no heterogeneity among studies (χ2 = 7.29, P = 0.12, I2 = 45%) and no significant publication bias (P > 0.05). The proportion of women requiring additional uterotonics in the carbetocin group was lower than that in the oxytocin group (OR = 0.41, 95% CI (0.29, 0.56), Z = 5.34, P < 0.00001). There was no heterogeneity among studies (χ2 = 0.82, P = 0.84, I2 = 0%) and no significant publication bias (P > 0.05). There was no significant difference in the proportion of women needing blood transfusion between the carbetocin group and the oxytocin group (OR = 0.92, 95% CI (0.66, 1.29), Z = 0.46, P = 0.64). There was no heterogeneity among studies (χ2 = 3.06, P = 0.55, I2 = 0%) and no significant publication bias (P > 0.05). Conclusion Carbetocin is superior to oxytocin in preventing PPH among women with vaginal delivery and can be widely used in clinical practice.

The Effect of Intraoperative Oxytocin Infusion on Irrigation Fluid Absorption During Hysteroscopic Myomectomy: A Randomized Placebo-Controlled Double-Blind Trial

Objectives: One of the most prevalent benign tumors in women is uterine leiomyoma. Large quantities of fluid absorbed during myomectomy may cause serious problems such as volume overload and hyponatremia. The aim was to see how intraoperative oxytocin infusion affected irrigation fluid absorption in individuals having hysteroscopic myomectomy. Materials and Methods: 50 women between 25-45 years who underwent hysteroscopic myomectomy and had an American Society of Anesthesiologists class I or II were evaluated in this randomized, double-blind clinical trial study. A 250 mL ringer solution containing 15 units of oxytocin was administered at a 125 mL/h in the oxytocin group (group S). In contrast, the placebo group (group P) received 1.5 mL of normal saline in the same amount of Ringer solution. Intraoperative hemodynamic alterations, fluid deficit, decreased hemoglobin, hematocrit, sodium, and albumin levels from baseline, complications, and the incidence of toxicity with the administered solutions were assessed intraoperative and 24 hours later. Results: Group S had considerably reduced irrigation fluid volume (P=0.021) and volume deficit (P=0.001). The frequency of hypotension in individuals receiving oxytocin did not differ significantly from the placebo group (P=0.26). In group S, serum hematocrit (P=0.036) and sodium (P=0.026) were decreased significantly. Conclusions: Intraoperative oxytocin infusion during hysteroscopic myomectomy may be associated with reduced irrigation fluid absorption and the problems that come with it. As a result, this approach might decrease the risks associated with high amounts of irrigation fluid being absorbed during hysteroscopic myomectomy.

Intranasal oxytocin studies on dogs might not be double-blind

A single dose of intranasal oxytocin has been shown to affect family dogs’ behaviour across a series of social tasks and situations. These studies have all been conducted using a double-blind placebo controlled design, which is the gold-standard in the field of drug-effect research. However, it has not been investigated whether intranasal oxytocin studies in dogs are truly double-blind, meaning that participants are indeed unaware of the treatment(s) dogs have received. Here we used unpublished data from three already published studies assessing the effects of intranasal oxytocin (compared to placebo) administration on dogs’ behaviour. Owners in these studies were asked in the end to make a guess about the treatment received, which is analysed in the present paper. Results show that in two out of the three datasets owners were above chance with their guesses when dogs had received placebo treatment; and in one out of the three datasets they were also overall significantly above chance when looking at data from both the oxytocin and placebo groups. Owners’ guesses were not related to dogs’ performance in the variables measured in any of the three behavioural tasks. These results clearly indicate that caution should be taken regarding the blindness of intranasal oxytocin experiments in dogs. However, we also conclude that the previously reported oxytocin effects on dogs’ behaviour (at least in these three studies) were not caused by the owners’ beliefs.

Prophylaxis Post-Cesarean Hemorrhage Using Carbetocin versus Oxytocin in High-Risk Women: A Double-Blind Randomized Controlled Trial

Objective: To compare the effectiveness of carbetocin and oxytocin in the prevention of postpartum hemorrhage (PPH) in terms of additional drug use after Cesarean sections in high-risk women. Materials and Methods: A double-blind randomized controlled trial (1:1 ratio) conducted between October 2018 and April 2019 at Rajavithi Hospital in 120 singleton pregnant women that undergone elective or emergency Cesarean sections after 34 weeks of gestation with viable fetuses and presenting at least one of the high-risk factors for PPH. The participants were randomized to receive either intravenous carbetocin 100 μg (60 cases) or oxytocin 20 IU in 1,000 mL of lactate ringer solution as infusion 120 mL/hour (60 cases) after birth of the baby or delivery of the placenta. Results: The mean maternal age, BMI, gestational age at delivery, and risk factors for PPH were not significantly different between the carbetocin and the oxytocin group. A previous Cesarean section was the most common risk factor in both groups. Most of the participants in both groups were multiparity. There was a significant difference between the carbetocin and oxytocin groups in terms of additional uterotonic drug usage at 20.0% versus 36.7% (p=0.04), while the type of uterotonic agents and time from post-delivery until the administration additional drugs were not different. The estimated blood loss, rate of PPH, operative time, or adverse drug effect were comparable between the two groups. Conclusion: The carbetocin group requires less additional uterotonic drugs than the oxytocin group with equal safety profiles. However, its effectiveness in the prevention of PPH is debatable since the incidence of PPH observed was not significantly different. Further studies including the efficacy of the drug in preventing PPH and cost-effectiveness analysis with a larger sample size should be performed. Keywords: Cesarean section; Carbetocin; Oxytocin; Postpartum hemorrhage

Intranasal oxytocin attenuates the effects of monetary feedback on procedural learning

Procedural learning is a vital brain function that allows us to acquire motor skills during development or re-learn them after lesions affecting the motor system. Procedural learning can be improved by feedback of different valence, e.g., monetary or social, mediated by dopaminergic circuits. While processing motivationally relevant stimuli, dopamine interacts closely with oxytocin, whose effects on procedural learning, particularly feedback-based approaches, remain poorly understood. In a randomized, double-blind, placebo-controlled trial, we investigated whether oxytocin modulates the differential effects of monetary and social feedback on procedural learning. Sixty-one healthy male participants were randomized to receive a placebo or oxytocin intranasally. The participants then performed a modified serial reaction time task. Oxytocin plasma concentrations were measured before and after applying the placebo or verum. Groups did not differ regarding general reaction times or measures of procedural learning. For the placebo group, monetary feedback improved procedural learning compared to a neutral control condition. In contrast, the oxytocin group did not show a differential effect of monetary or social feedback despite a significant increase in oxytocin plasma levels after intranasal application. The data suggest that oxytocin does not influence procedural learning per se. Instead, oxytocin seems to attenuate the effects of monetary feedback on procedural learning specifically.

The safety and efficacy of add-on use of oxytocin in uterine leiomyoma patients undergoing high-intensity focused ultrasound and ultrasound-guided intratumoral ethanol injection: a randomized controlled trial.

Uterine leiomyoma is one of the most common benign tumors in females. High-intensity focused ultrasound (HIFU) has been widely used in the therapy of uterine leiomyomas. However, HIFU method has a prolonged duration of operation and poor patient tolerance, which need improvement. This study sought to explore the efficacy and safety of add-on use of oxytocin in uterine leiomyomas patients who received HIFU and ultrasound-guided percutaneous anhydrous ethanol injection. This is a randomized controlled trial. A total of 60 patients with uterine leiomyomas were included and randomly divided into study group and control group. The patients in the control group were treated with HIFU and ultrasound-guided percutaneous anhydrous ethanol injection, while the study group received oxytocin injection in addition to the treatment measures of the control group. The efficacy and safety of the treatments were assessed by using the volume ablation rate of the tumor and the Society of Interventional Radiology (SIR) Practice Guidelines, respectively. Finally, all of the 60 patients (30 in the study group and 30 in the control group) completed the treatments. There were no statistically significant differences between the 2 groups in terms of leiomyoma volume ablation rate (94.48%±2.07% vs. 94.91%±2.53%, P=0.36), crumb gray time (150.70±57.51 vs. 165.77±77.13 s, P=0.37), total treatment energy (556,835.0±202,583 vs. 512,610.0±158,004 J, P=0.19), and total treatment time (116.70±28.61 vs. 107.40±23.22 mins, P=0.14). The pain score of the oxytocin group was significantly greater than that in the control group (4.53±1.55 vs. 3.60±1.19, P=0.008). At 3 months and 1-year post-therapy, no statistically significant differences were observed in the residual necrotic leiomyoma volume between the 2 groups. The add-on use of oxytocin in uterine leiomyomas patients undergoing HIFU and ultrasound-guided intratumoral ethanol injection could not improve treatment effect. Chinese Clinical Trial Registry identifier: ChiCTR2200058584.

Continued versus discontinued oxytocin after the active phase of labor: An updated systematic review and meta-analysis.

To systematically assess the effect of discontinued vs continued oxytocin after active stage of labour is established. Pubmed, Embase, and the Cochrane Library were systematically searched to 18 April 2021. The risk ratio or mean difference with corresponding 95% confidence interval were computed to investigate the effect of intervention or control on maternal and fetus outcomes. This review was registered in the International Prospective Register of Systematic Reviews: CRD42021249635. Discontinuing oxytocin when the active labour was established might decrease the risk of cesarean delivery [RR (95% CI): 0.84 (0.72-0.98), P = 0.02]. However, when we restricted our analysis to women who performed cesarean section after the active phase was reached, the difference was no longer significant [RR (95% CI): 0.82 (0.60-1.10), P = 0.19]. The incidence of uterine tachysystole [RR (95% CI): 0.36 (0.27-0.49)], postpartum hemorrhage [RR (95% CI): 0.78 (0.65-0.93)], and non-reassuring fetal heart rate [RR (95% CI): 0.66 (0.58-0.76)] were significantly lower in the oxytocin discontinuation group. We also found a possible decrease in the risk of chorioamnionitis in discontinued oxytocin group [RR (95% CI): 2.77 (1.02-5.08)]. An increased duration of active [MD (95% CI): 2.28 (2.86-41.71)] and second [MD (95% CI): 5.36 (3.18-7.54)] phase of labour was observed in discontinued oxytocin group, while the total delivery time was not significantly different [MD (95% CI): 20.17 (-24.92-65.26)]. After the active labor is reached, discontinuation of oxytocin could be considered a new recommendation for the improved maternal and fetal outcomes without delaying labour.

Comparison of Clinical Efficacy and Safety between Misoprostol and Oxytocin in the Prevention of Postpartum Hemorrhage: A Meta-Analysis.

In order to systematically evaluate the clinical efficacy and safety of misoprostol versus oxytocin in the prevention of postpartum hemorrhage, this paper provides evidence-based reference for clinical medication, computerized retrieval of Chinese biomedical literature database (CBM), PubMed, Embase, Cochrane Library, and clinical trials. The retrieval period is from the establishment of each database to October 1, 2021. Published randomized controlled trials (RCTS) are included in this study. The literature is screened and evaluated according to inclusion and exclusion criteria, and meta-analysis is performed using RevMan 5.3 software. A total of 13 RCTS are included, with a total of 24754 parturients. The meta-analysis shows the average blood loss (SMD = 0.10, 95% CI (−0.11, 0.32), P=0.35), the time of the third stage of labor (SMD = 0, 95% CI (−0.07, 0.08), P=0.95), and blood transfusion rate (RR = 0.80, 95% CI (0.63, 1.02), P=0.07). However, the incidences of shivering (RR = 2.61, 95% CI (1.79, 0.81), P < 0.00001) and vomiting (RR = 2.78, 95% CI (1.85, 4.18), P < 0.00001) are significantly higher than those in oxytocin group. The effect of misoprostol on preventing postpartum hemorrhage is similar to that of oxytocin, but the incidence of adverse reactions is high, and the occurrence of adverse reactions should be closely watched in the use process. Due to the limitations of the included studies, multicenter, large-sample, and high-quality RCTS are still needed in the future to further verify this conclusion.

High- vs low-dose oxytocin in lean and obese women: a double-blinded randomized controlled trial

Women with obesity are likely to experience longer lengths of labor and are at an increased risk of cesarean delivery. We hypothesized that high-dose oxytocin would decrease the time to delivery in a cohort of women with obesity undergoing induction of labor. This study aimed to assess whether women with obesity benefited from higher doses of oxytocin for induction of labor. A double-blinded randomized controlled trial was conducted to evaluate the effect of low-dose and high-dose oxytocin on length of labor. We recruited women who were undergoing induction of labor at ≥37 weeks of gestation. Patients were randomly assigned in a 1:1 ratio to receive low-dose or high-dose oxytocin stratified by obesity level (obese and lean). The primary outcome was length of time (minutes) to vaginal delivery. The secondary outcomes included overall cesarean delivery rate, cesarean delivery for labor arrest, maximum oxytocin infusion rate, oxytocin infusion discontinuation, oxytocin infusion decrease, blood loss, neonatal intensive care unit admission, and neonatal Apgar scores. A total of 140 patients were randomized into receiving low-dose and high-dose oxytocin stratified into obese and lean stratum (35 for all strata). The primary outcome, time to vaginal delivery, was similar between the low-dose and high-dose oxytocin groups in the lean stratum (796 [±411] vs 694 [±466] minutes; P=.363) and the stratum with obesity (715 [±497] vs 762 [±594] minutes; P=.733). Kaplan-Meier curves between the low-dose and high-dose oxytocin groups were not significantly different in the lean stratum (P=.391) and the stratum with obesity (P=.692). There were 5 cesarean deliveries (14.29%) in the low-dose oxytocin lean stratum vs 2 cesarean deliveries (5.71%) in the high-dose oxytocin lean stratum (P=.232). There were 4 cesarean deliveries (11.43%) in the low-dose oxytocin stratum with obesity vs 1 cesarean delivery (2.86%) in the high-dose oxytocin stratum with obesity (P=.164). There was no difference in the incidence of postpartum hemorrhage between the lean stratum (P=0.526) and the stratum with obesity (P=0.212). There was no difference in mean estimated blood loss between the lean stratum (P=.472) and the stratum with obesity (P=.215). There was no difference in time to delivery between the low-dose and high-dose oxytocin protocols in either the lean cohorts or cohorts with obesity undergoing induction of labor. We did observe a trend toward a lower rate of cesarean delivery in both lean women and women with obesity when high-dose oxytocin was used.

Comparative Study between Oxytocin and Carbetocin for the prevention of Primary Postpartum Hemorrhage following Caesarean Section

Background &amp; objective: Of the many pharmacological options for the management of postpartum hemorrhage, oxytocin is the first line of treatment. The newer drug carbetocin is getting popularity among obstetricians, although there is as yet not enough evidence about its safety and efficacy. The present study attempted to compare oxytocin with carbetocin for the routine prevention of postpartum hemorrhage (PPH) following caesarean section.&#x0D; Methods: The present comparative clinical trial was conducted in the Department of Obstetrics and Gynaecology in Rajshahi Medical College Hospital (RMCH), Rajshahi over a period of one year between March 2017 to February 2018. Pregnant women undergoing cesarean section under regional anaesthesia and do not have known hypersensitivity to oxytocin and carbetocin and known bleeding disorders were included in the study. A total of 96 such subjects were consecutively included and were randomly assigned to either Oxytocin (n = 48) and Carbetocin (n = 48) Groups. The outcome was evaluated in terms of incidence of PPH (loss of blood &gt; 1000 ml), blood transfusion needed to compensate for lost blood, additional oxytocics needed to manage PPH and adverse effects encountered by the subjects.&#x0D; Result: The mean age of the subjects was around 25 years and the age distribution between the study groups was almost similar. In terms of obstetric characteristics multigravida was predominant in the Oxytocin group than that in the Carbetocin group. The current pregnancy profile like gestational age, ANC received, number of foetus in utero and placental position all were comparable between the groups. Antenatal conditions/diseases deemed to have influence on PPH were no different between the study groups. Past history of caesarean section was higher in Oxytocin group (43.8%) than that in the Carbetocin group (22.9%). There were negligible incidences of past PPH and myomectomy in either group. The mean haemoglobin level in the former and the latter groups were 9.5 and 10 gm/dl respectively with majority of the subjects being mildly anaemic. More than 80% of the subjects in either group underwent emergency caesarean section. The outcome showed that 83% in the Oxytocin group and 90% in the Carbetocin group did not develop PPH, but the difference was not significant. The mean blood lost was somewhat lower in the carbetocin group (630 ml) than that in the Oxytocin group (685 ml). The number of patients needed to be transfused and the mean amount of blood transfused to them in each group was fairly comparable. Oxytocin group received additional oxytocic drugs, such as, Metherspan and Misoprostol more frequently than the Carbetocin group did, but the differences did not turn significant. A few patients in both groups developed adverse effects but they were comparable. The mean 24-hours urine output was &gt; 2000 ml in either group).&#x0D; Conclusion: The study concluded that the incidence of PPH, the amount of blood lost, number of patients transfused, amount of blood transfused and the additional amount of oxytocics required for the prevention and treatment of PPH were broadly comparable between the two study groups.&#x0D; Ibrahim Card Med J 2021; 11 (1): 71-78

Intranasal oxytocin modulates the salience network in aging

Growing evidence supports a role of the neuropeptide oxytocin in promoting social cognition and prosocial behavior, possibly via modulation of the salience of social information. The effect of intranasal oxytocin administration on the salience network, however, is not well understood, including in the aging brain. To address this research gap, 42 young (22.52 ± 3.02 years; 24 in the oxytocin group) and 43 older (71.12 ± 5.25 years; 21 in the oxytocin group) participants were randomized to either self-administer intranasal oxytocin or placebo prior to resting-state functional imaging. The salience network was identified using independent component analysis (ICA). Independent t-tests showed that individuals in the oxytocin compared to the placebo group had lower within-network resting-state functional connectivity, both for left amygdala (MNI coordinates: x = -18, y = 0, z = -15; corrected p < 0.05) within a more ventral salience network and for right insula (MNI coordinates: x = 39, y = 6, z = -6; corrected p < 0.05) within a more dorsal salience network. Age moderation analysis furthermore demonstrated that the oxytocin-reduced functional connectivity between the ventral salience network and the left amygdala was only present in older participants. These findings suggest a modulatory role of exogenous oxytocin on resting-state functional connectivity within the salience network and support age-differential effects of acute intranasal oxytocin administration on this network.

Efficacy and Safety of Misoprostol for Prevention of Post-Partum Haemorrhage: A Comparative Study

Background: Post-partum haemorrhage condition is a serious condition after delivery.&#x0D; Objective: The purpose of the present study was to see the efficacy and safety of misoprostol for the prevention of post-partum haemorrhage.&#x0D; Methodology: This analytic cross-sectional study was carried out in the Department of Gynaecology and Obstetrics at Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from January 2006 to June 2006 for a period of six months. Pregnant women who were admitted in MMCH during the above period and were expected to have vaginal delivery and women at term with singleton pregnancy were included as study population. Women were divided into 2 groups. Women were in the group A who were treated with misoprostol and women who were treated with oxytocin were in group B. Blood loss during delivery was estimated subjectively by the attending obstetrician.&#x0D; Results: A total number of 100 women were recruited for this study of which 50 women were in the group A and the rest of 50 women were in group B. In this study majority of the patients were belonged to age group 20 to 25 years in both the groups. In oxytocin group 2.0% have developed nausea, 4.0% patients have developed shivering. None have developed vomiting, diarrhoea, temperature. In misoprostol group 10.0% patients have developed nausea, 18.0% patients have developed shivering, 4.0% patients have developed rise of temperature, none have developed diarrhoea, vomiting. The differences were statistically significant. In this study 4.0% patients from oxytocin group and 2.0% patient from misoprostol group required blood transfusion.&#x0D; Conclusion: In conclusion less amount of blood loss is found in misoprostol group than oxytocin group.&#x0D; Journal of National Institute of Neurosciences Bangladesh, July 2021, Vol. 7, No. 2, pp. 152-155

Social Stimulation by the Owner Increases Dogs' (Canis familiaris) Social Susceptibility in a Food Choice Task-The Possible Effect of Endogenous Oxytocin Release.

Simple SummaryIntranasal administration of oxytocin has been proposed to be an effective way of improving several socio-cognitive skills in humans. There is evidence that dogs show human-analogue social behaviours and socio-cognitive capacities. Furthermore, recent studies have demonstrated that the oxytocin system is related to human-directed social behaviour in dogs. Some human studies suggest that pre-treatment with social stimuli (eye contact, touch) has similar behavioural effects because these cues stimulate oxytocin release. In the present study, we show that both social stimulation by the owner as well as intranasal oxytocin administration increases dogs’ social susceptibility in a food choice task. This means that dogs after both treatments (as compared to control conditions) were more prone to conforming to a human demonstrator’s counterproductive choice (smaller amount of food), giving up their natural preference. These results highlight important mechanisms of social tuning between dogs and humans.Recent evidence suggests a human-like susceptibility to social influence in dogs. For example, dogs tend to ignore their ‘natural’ preference for the larger amount of food after having seen a human’s explicit preference for a smaller quantity. However, it is still unclear whether this tendency to conform to the partner’s behaviour can be influenced by social stimuli and/or the neurohormone oxytocin as primers to prosocial predispositions. In Experiment I, eighty two dogs were tested using Prato-Previde et al.’s food quantity preference task. In Experiment I, we investigated in a 2 × 2 design how (i) a 10-minute-long social stimulation by the owner versus a socially ignoring pre-treatment as well as (ii) on-line ostensive communications versus no communication during task demonstration affect dogs’ (N = 82) choices in the abovementioned food choice task. Results indicate that the owners’ pre-treatment with social stimuli (eye contact, petting) increased dogs’ susceptibility to the experimenter’s food preference, but the salient ostensive addressing signals accompanying human demonstration masked this social priming effect. In Experiment II, N = 32 dogs from the subjects of Experiment I were retested after oxytocin (OT) or placebo (PL) pre-treatments. This experiment aimed to study whether intranasal administration of oxytocin as compared to placebo treatment would similarly increase dogs’ tendency to re-enact the human demonstrator’s counterproductive choice in the same task. Results showed an increased susceptibility to the human preference in the OT group, suggesting that both socially stimulating pre-treatment and the intranasal administration of oxytocin have similar priming effects on dogs’ social susceptibility.

The effect of intra-vaginal oxytocin on sexual function in breastfeeding mothers: a randomized triple-blind placebo-controlled trial

BackgroundConsidering the importance of sexual function, high prevalence of sexual dysfunction (especially dyspareunia caused by atrophic vaginitis) in breastfeeding women, and lack of effective interventions, the present research aimed to determine the effect of oxytocin (OXT) vaginal gel on sexual function (primary outcome), sexual satisfaction, and depression (secondary outcomes) in the breastfeeding women.MethodsThis randomized triple-blind controlled trial was conducted on 64 breastfeeding women who referred to health centers in the city of Tabriz, Iran, in 2020-21. Participants were equally assigned to intervention/control groups using block randomization. 200 IU of OXT vaginal gel was given to the participants in the intervention group daily for eight week and the same protocol was carried out for the control group with placebo. Standard questionnaires of Female Sexual Function Index (FSFI), Edinburgh Postpartum Depression Scale (EPDS) and Sexual satisfaction scale for women (SSSW) were completed at baseline and 8 weeks after intervention. ANCOVA test was used to compare post-intervention mean score of the groups, adjusted for the baseline values.ResultsAfter intervention, there was no statistically significant difference between groups in terms of mean total score of FSFI (Adjusted Mean Difference (AMD): 1.14; 95% Confidence Interval (95% CI): -1.28 to 9.16; P= 0.349) and sexual satisfaction (AMD: 5.01; 95% CI: -0.53 to 10.56; P= 0.075). However, there was statistically significant difference between the groups in terms of mean scores of sexual contentment (AMD: 1.56; 95% CI: 0.29 to 2.83; P = 0.017) and depression (AMD: -1.90; 95% CI: -1.27 to -2.54; P < 0.001). One participant in the OXT group and one participant in the placebo group reported mild uterine contraction and one person in the placebo group reported vaginal burning sensations.ConclusionsNo evidence was found for the effects of OXT gel in the improvement of FSFI, even though, OXT significantly improved sexual satisfaction in the domain of contentment, and improved the symptoms of depression in comparison to the placebo group. However, a definite conclusion requires more research in this regard.Trial registrationthe Iranian Registry of Clinical Trials (IRCT), code: IRCT20120718010324N55, Date of registration: 27/05/2020, URL: https://en.irct.ir/user/trial/44986/view.

Carbetocin versus oxytocin for the prevention of postpartum hemorrhage after elective caesarean section in high risk women: a prospective, randomized, open-label, controlled trial in China

Background: To evaluate the efficacy and safety of carbetocin compared with oxytocin for prevention of postpartum hemorrhage (PPH) after elective cesarean section in Chinese high risk women. Methods: This was a single-center, prospective, randomized, open-label, controlled trial recruiting 852 pregnant women with one or more PPH risk factors between April 2017 and August 2019. Pregnant woman who was scheduled for an elective cesarean section were randomly assigned to receive carbetocin or oxytocin for prevention of PPH. The primary efficacy endpoint was the proportion of additional uterotonics. Results: A total of 852 pregnant women were randomly assigned to receive carbetocin (n = 442) or oxytocin (n = 410). The baseline characteristics were comparable between the two groups. The carbetocin group had lower proportion of requiring additional uterotonics (18.4% vs. 24.4%, p = 0.03 in full analysis set [FAS] analysis) to the oxytocin group. The amount of blood loss (intrapartum or postpartum) was no statistically significant difference (all p &gt; 0.05). There were no significant differences in the postpartum hemoglobin, rate of hemostatics, blood transfusion, additional surgical interventions or uterine massage between the two groups. The rates of mild asphyxia in carbetocin and oxytocin groups were 2.1% and 1.3%, respectively. No other poor maternal and neonatal outcomes were observed in two groups. Conclusions: Carbetocin required lower rate of additional uterotonics than oxytocin for prevention of PPH after elective cesarean section in Chinese high risk women. Carbetocin was comparable to oxytocin in postpartum blood loss, postpartum hemoglobin, hemostatics, blood transfusion, additional surgical interventions or uterine massage.

Doppler Imaging Assessment of Changes of Blood Flow in Adenomyosis After Higher-Dose Oxytocin: A Randomized Controlled Trial.

To assess the changes of blood flow in adenomyosis (AM) after higher-dose oxytocin (OT) in different doses, and to evaluate the safety for patients. A total of 124 patients with AM were randomly divided into 4 groups with continuous intravenous infusion of OT as 0.06, 0.12, 0.24 and 0.36 U/min, respectively. The changes of arteries of AM before and after intravenous infusion of OT were observed by color Doppler ultrasound. The changes of blood flow volume of the artery of AM before and after intravenous infusion of OT were compared among the 4 groups, and the vital signs and adverse drug reactions were monitored during intravenous drip. During the trial, no severe adverse reactions occurred and the vital signs of all the patients were stable. Among the 4 groups, it was found that there was a significant difference in the change of blood flow volume of blood artery in AM lesions between 0.06 U/min OT group and the other three groups after intravenous drip of OT (P < .05), but there was no significant difference in blood flow volume among the three groups (P > .05), and the difference of adverse drug reactions was statistically significant with the increase of OT dose (P < .05). OT can effectively reduce the blood flow volume of AM lesions, and continuous intravenous infusion of 0.12 U/min OT is an appropriate dose that can not only minimize the blood flow volume but also reduce the incidence of adverse drug reactions.

Influence of Oxytocin Usage and Dose Difference During Delivery on Pregnancy Outcome of VBAC Pregnant Women.

In order to explore the influence of oxytocin usage and dose difference during delivery on the pregnancy outcome of VBAC pregnant women, the clinical data of 166 VBAC pregnant women from January 2017 to March 2020 are retrospectively analyzed. All women are divided into different groups according to the usage of oxytocin during delivery and the oxytocin dose difference. Binary logistic regression is used to analyze the factors affecting the pregnancy outcome of pregnant women with VBAC. The gestational weeks and the thickness of the lower uterine segment in the oxytocin group are significantly more than those in the nonoxytocin group (P < 0.05). The time of the first stage of labor, second stage of labor, and total stage of labor in the oxytocin group are significantly longer than the nonoxytocin group (P < 0.05). The proportion of entering NICU in the oxytocin group is significantly lower than the nonoxytocin group (P < 0.05). There is no significant difference in labor duration and pregnancy outcome between low-dose and medium-dose oxytocin groups. Binary logistic regression analysis shows that prenatal BMI <30 kg/cm2, gestational age ≤40 weeks, history of vaginal delivery, uterine expansion, and admission to hospital are the influencing factors for pregnancy success of pregnant women with VBAC. The usage of oxytocin in VBAC pregnant women during delivery may increase the duration of labor. For those with poor uterine contraction, oxytocin can be increased to 4∼18 mU/min to speed up the labor process, without increasing the risk of adverse pregnancy outcomes.

The Efficacy of Intra-umbilical Vein Administration of Carboprost Versus Oxytocin in the Management of Retained Placenta: Surgical and Non-Surgical Risk Factors

Background: Retained placenta is one of the major causes of primary and secondary post-partum hemorrhage (PPH) and active management of the third stage of labor reduces the risk of PPH. Objective: The aim of this paper was to compare the efficacy of intra-umbilical vein injection of carboprost versus oxytocin by time and success rates of total expulsion of the placenta. Methods: This prospective clinical study with quasi-experimental design 2x2x2(risk factors by medication by doses) was conducted at Clinic of Obstetrics and Gynecology, Clinical Center of University of Sarajevo in two-year period. Patients were randomized in 4 groups and 8 subgroupsby different medication doses and risk factors. The main outcome variable was expulsion of retained placenta and second outcome variables were: duration of time from intra-umbilical vein administration of drug to expulsion of retained placenta, the number of cases who required blood transfusion and antibiotics, postpartum hemoglobin after 24h. Statistical significance was accepted for p-values &lt; 0.05. Results: The group B2 (UVI oxytocin 20 IU in 20 mL saline, surgical risk factors) and the group D2 (UVI oxytocin 20 IU in 20 mL saline, non-surgical risk factors) had shorter expulsion time (minutes) (Me=5; IQR=4 to 5; Me=5; IQR=4.3 to 6, respectively) compared with other groups (p&lt;0.001). The success rates of total expulsion of the placenta by groups (A,B,C and D) were not statistically significant (70% vs. 82% vs. 72% vs. 78%, respectively; p=0.483). Post-intervention hemoglobin concentrations was statistically significantly greater in the group B(117.3±1.3) vs. the group A (112.1±1.3), (p =0.028). Conclusion: The time for placental expulsion was significantly shorter and postpartum hemoglobin was significantly higher in the intra-umbilical oxytocin groups than in the carboprost groups.

Misoprostol and oxytocin versus oxytocin alone in the active management of the third stage of labour: a randomised, double-blind, placebo-controlled trial

We investigated whether the use of misoprostol plus oxytocin in the active management of the third of stage of labour (AMTSL) would reduce the rate of primary postpartum haemorrhage (PPH) compared with intramuscular oxytocin alone. This was a multicentre, double-blind, placebo-controlled, randomised trial where 1036 pregnant women, in addition to intramuscular oxytocin (10 IU) in the third stage of labour, randomly received either 400 µg sublingual misoprostol (519 women) or a placebo (517 women). The primary outcome measure was the mean blood loss (MBL) within 1 h of delivery. The trial was registered with ClinicalTrials.gov (NCT02424201). The MBL in the oxytocin plus misoprostol group was 229.73 ± 108.12 compared to 274.58 ± 121.09 in the oxytocin plus placebo group (t = 6.289, p < .001). Twenty-eight (5.4%) women in the misoprostol group had a blood loss ≥500 ml versus 39 (7.5%) women in the placebo group (risk-ratio [RR] − 0·72, 95%CI 0.45–1.14; p = .1616). The combination of misoprostol with oxytocin in the AMTSL reduces MBL post-delivery but is not superior to oxytocin alone in the reduction of the rate of PPH. IMPACT STATEMENT What is already known on this subject? The routine use of 10IU of intramuscular oxytocin in the active management of the third stage of labour reduces the rates of postpartum haemorrhage. What do the results of this study add? The addition of 400ug of sublingual misoprostol to the routine use of 10IU of intramuscular oxytocin in the active management of the third stage of labour reduces mean blood loss when compared with intramuscular oxytocin alone, but is not better in reducing the rates of postpartum haemorrhage. What are the implications of these findings for clinical practice and/or further research? Routine use of misoprostol as adjuncts to the active management of the third stage of labour does not reduce the rate of PPH.