A Risk-Benefit Assessment of Oxytocics in Obstetric Practice

Substances that stimulate contractions of the myometrium have found wide applications in present day obstetrics. Above all, fully synthetic, uterus-selective Prostaglandin analogues are used for preoperative priming of the cervix for termination of pregnancies in the first trimester as well as for the induction of abortions in the second trimester and have proved to have a much higher efficacy than Oxytocin. Because of the pharmacological synergism of their cervix ripening and myometrium stimulating activities, the local use of natural Prostaglandin E2 preparations (used intracervically as a gel or vaginally as a gel or as a tablet) is unequivocally superior to use of Oxytocin with its almost exclusive contraction stimulating activity for induction of labour, especially for women with an unripe cervix. In women with a ripe cervix, Oxytocin and Prostaglandins are equally effective with Oxytocin having the major advantage of its better controllability on continuous intravenous infusion (plasma elimination half-life of 10 minutes).