Incidence of Uterine Tachysystole in Women Induced with Oxytocin

Kunz, Marguerite K.; Loftus, Rebecca J.; Nichols, Amy

doi:10.1111/j.1552-6909.2012.01428.x

Cited by 22 publications

(13 citation statements)

References 15 publications

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“…Our model is more pragmatic in that it avoids complex vascular surgery to reduce uteroplacental perfusion, but more importantly, allows for quick reversibility of the insult to better reflect complications during human labor. 13,14,[27][28][29] Our findings challenge the prevailing assumption that neonatal metabolic status is a good surrogate for the wellbeing of the fetal brain and suggests that even a short duration hypoxic insult could be damaging to the fetal brain. Furthermore, our findings offer mechanistic evidence linking intrapartum hypoxia, oxidative stress, and persistent abnormalities in functional connectivity as the possible drivers of neurodevelopmental disorders observed after acute obstetric complications.…”

Section: Discussioncontrasting

confidence: 49%

“…For example, aberrant uterine contractility (tachysystole and tetanic uterine contraction) can often lead to transient fetal distress which may or may not necessitate emergent delivery. These episodes are more common, occurring in approximately 5-10% of all laboring women, 13,14 especially when oxytocin (OXT) is used for induction and augmentation of labor. It is widely presumed that these episodes are usually benign because the surrogate markers of fetal well-being, such as umbilical arterial lactate and pH, are typically unaffected.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transient uterine hypercontractility causes fetal cerebral oxidative stress and enduring mitochondrial and behavioral abnormalities in adolescent male rat offspring

Palanisamy¹,

Giri²,

Jiang³

et al. 2019

Preprint

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The impact of transient ischemic-hypoxemic insults on the developing fetal brain is poorly understood despite evidence suggesting an association with neurodevelopmental disorders such as schizophrenia and autism. To address this, we designed an aberrant uterine hypercontractility paradigm with oxytocin to better assess the consequences of acute, but transient, placental ischemia-hypoxemia in term pregnant rats. Using MRI imaging, we confirmed that oxytocininduced aberrant uterine hypercontractility significantly compromised uteroplacental perfusion.This was supported by the observation of oxidative stress and increased lactate concentration in the fetal brain. Genes related to oxidative stress pathways were significantly upregulated in male, but not female, offspring 1 h after oxytocin-induced placental ischemia-hypoxemia. Persistent upregulation of select mitochondrial electron transport chain complex proteins in the anterior cingulate cortex of adolescent male offspring suggested that this sex-specific effect was enduring.Functionally, offspring exposed to oxytocin-induced uterine hypercontractility showed malespecific abnormalities in social behavior with associated region-specific changes in gene expression and functional cortical connectivity. Our findings, therefore, indicate that even transient but severe placental ischemia-hypoxemia could be detrimental to the developing brain and point to a possible mitochondrial link between intrauterine asphyxia and neurodevelopmental disorders. 8.2.1; GraphPad Software Inc.), behavioral data with SYSTAT12 (Chicago, IL), and fcOISI data with MATLAB. Study approval:All experiments reported here were approved by the Institutional Animal Care and Use Committee at Washington University in St. Louis (#20170010) and comply with the ARRIVE guidelines. Author contributionsAP conceived the study design, planned the experiments, and wrote the manuscript with help from all co-authors. AP, TG and JJ developed the OXT dosing paradigm and conducted the molecular biology experiments. JDQ and JRG performed the placental imaging experiments, analyzed the data, and helped draft the manuscript. SBC performed the behavioral experiments, and SEM and DFW conducted the analysis and helped with interpretation and drafting of the manuscript. AB and AQB collected, analyzed, and interpreted the fcOISI data, and helped write the manuscript.

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Section: Discussioncontrasting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Transient uterine hypercontractility causes fetal cerebral oxidative stress and enduring mitochondrial and behavioral abnormalities in adolescent male rat offspring

Palanisamy¹,

Giri²,

Jiang³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Diminished relaxation time, not frequency, appears to be a more sensitive metric for the recognition of XSA than does contraction frequency [73,74]. Bakker et al and others have found that uterine rest of at least 60 s between moderate to strong contractions appears necessary to allow sufficient time for reperfusion and adequate oxygen delivery to the fetus [60,72].…”

Section: Excessive Uterine Activitymentioning

confidence: 96%

Litigation related to intrapartum fetal surveillance

Schifrin

Soliman

Koos

2016

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…The policy, called a "hard stop," is considered essential for patient safety. They did support a policy allowing a "high-dose" Pitocin protocol that has been associated with hypoxia and fetal distress (Kunz, Loftus, & Nichols, 2013). The cesarean rate fluctuated slightly but was never less than 30%.…”

Section: Safe Healthy Birth Practices: Assessing the Family Birth Cementioning

confidence: 99%