Oxytocin Pretreatment Attenuates Oxytocin-induced Contractions in Human Myometrium In Vitro

被引:56
|
作者
Balki, Mrinalini [1 ]
Erik-Soussi, Magda
Kingdom, John [2 ]
Carvalho, Jose C. A. [1 ,2 ]
机构
[1] Univ Toronto, Dept Anesthesia & Pain Management, Mt Sinai Hosp, 600 Univ Ave,Room 19-104, Toronto, ON M5G 1X5, Canada
[2] Univ Toronto, Dept Obstet & Gynecol, Mt Sinai Hosp, Toronto, ON M5G 1X5, Canada
关键词
CESAREAN DELIVERY; RECEPTOR; LABOR; DESENSITIZATION; PLASMA; PHARMACOKINETICS; EFFICACY; CELLS;
D O I
10.1097/ALN.0b013e318297d347
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: Oxytocin receptor desensitization has been shown to occur in humans at biomolecular level and in isolated rat myometrium; however, its effect on human myometrial contractility has not been demonstrated. The objective of this in vitro study was to investigate the contractile response of human pregnant myometrium to oxytocin after pretreatment with different concentrations of oxytocin for variable durations. Methods: Myometrial samples were obtained from 62 women undergoing elective cesarean deliveries under regional anesthesia. The strips were pretreated with oxytocin 10(-10), 10(-8), 10(-5) M, or physiological salt solution (control) for 2, 4, 6, or 12h, followed by a dose-response testing with oxytocin 10(-10) to 10(-5) M. Amplitude and frequency of contractions, motility index, and area under the curve during the dose-response period were recorded, analyzed with linear regression models, and compared among groups. Results: Pretreatment with oxytocin 10(-5) and 10(-8) M significantly reduced motility index (estimate [standard error]: -0.771 [0.270] square root units, P = 0.005 and -0.697 [0.293], P = 0.02, respectively) and area under the curve (-3.947 [1.909], P = 0.04 and -4.241 [2.189], P = 0.05, respectively) compared with control group, whereas pretreatment with oxytocin 10(-10) M did not significantly attenuate contractions. Increase in duration of oxytocin pretreatment from 2 to 12h significantly decreased amplitude (type 3 generalized estimating equation analysis: chi-square = 14.0; df = 3; P = 0.003), motility index (chi-square = 9.3; df = 3; P = 0.03), and area under the curve (chi-square = 10.5; df = 3; P = 0.02), but not the frequency of oxytocin-induced contractions. Conclusion: Pretreatment with oxytocin decreases oxytocin-induced myometrial contractions in a concentration and time-dependent manner, likely as a function of the oxytocin receptor desensitization phenomenon.
引用
收藏
页码:552 / 561
页数:10
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