Role of Prophylactic Oxytocin in the Third Stage of Labor: Physiologic Versus Pharmacologically Influenced Labor and Birth

“…4,20 However, the generalizability of these meta-analyses outcomes to women undergoing a physiologic birth, or one not stimulated by exogenous oxytocin has been questioned in the literature. 21 Data from the current study contribute to knowledge about PPH prevention in lower-risk populations, but alone cannot recommend for practice changes until further randomized trials specifically address this question. Conceptually, a physiologic blood loss should follow a physiologic birth, as introduced by the midwifery consensus statement.…”

“…Some studies on PPH prevention, when defined at 1000 mL or higher, have also found AMTSL or prophylactic oxytocin beneficial when compared with expectant management or placebo . However, other studies have reported no difference between groups at the 1000 mL threshold, particularly among women who have had a physiologic labor or labors not stimulated by exogenous oxytocin …”

“…Two drug molecules used to treat hypotension and type 2 diabetes, midodrine hydrochloride 37 and saxagliptin, 38 were successfully coupled with quinoline quaternary ammonium salt to provide the quinolylated products 8a and 8b in 72% and 46% yields, respectively. Five peptide molecules, methyl tyroserleutide (liver cancer), 39,40 Val-Cit-PAB-OH (a linker for antibody-drug-conjugation), [41][42][43] oxytocin (improvement of uterine contractions), 44 dermorphin (a μ-opioid receptor agonist), 45 and octreotide (functional gastrointestinal pancreatic endocrine tumors), 46 were reacted to give Table 4 Comparison of different quaternary ammonium salts for N-quinolylation Table 5 N-Quinolylation of some complex molecules and oligopeptides a a Used 2.0 equiv. quinoline quaternary ammonium salt and 1.0 equiv.…”

“…For example, Erickson et al found that women who received oxytocin for induction or augmentation benefited most from AMTSL, whereas women who did not receive oxytocin during the first or second stage of labor did not receive the same benefit. 7…”