Oxytocin morbidity

Preterm labour is the major cause of perinatal morbidity and mortality. Oxytocin antagonists offer an attractive approach to prevention. Chapter 7 reviews three decades of medicinal chemistry in this field. The peptide approach has resulted in valuable injectable products. Selectivity over the related vasopressin receptors and improvement in pharmacokinetic profile have been the key challenges for more recent non-peptide programmes, and these seem likely to yield orally available medicines. 

Uterine contractions and fetal heart rate should be monitored during oxytocin administration (SEDA-13, 1310) (1,2). There is no significant increase in uterine complications or in fetal morbidity or mortality in women with a previous cesarean section, although oxytocin-treated patients had a higher rate of failed trial of labor for reasons that are unclear (3). Oxytocin is structurally similar to vasopressin, and like the latter has water-retaining properties when used in pharmacological doses. 

Lovold A, Stanton C, Armbruster D. How to avoid iatrogenic morbidity and mortality while increasing availability of oxytocin and misoprostol for PPH prevention Int J Gynecol Obstet 2008 103 276-82. 

Buchanan SL, Patterson JA, Roberts CL, Morris JM, Ford JB. Trends and morbidity associated with oxytocin use in labour in nuUiparas at term. Aust N Z J Obstet Gynaecol 2012 52(2) 173-8. 

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