Uterine motility after post-partum application of sulprostone and other oxytocics

Abstract

With the introduction of prostaglandins to obstetrics another group of substances was known to influence uterine motility also post partum. It was interesting to study the effect of equal doses of synthetic prostaglandin E2 (sulprostone), methergin and synthetic oxytocin on the so-called puerperal model in humans. By transcervically introduced twin-catheters uterine motility was recorded after uncomplicated pregnancy and delivery in 101 volunteers. Uterine motility was recorded and evaluated according to the onset of the effect, its duration, motility pattern and uterine activity. Maternal heart-rate was additionally recorded similarly to the feto-maternal cardiotocogram. All substances were applied by intramuscular injection. The following observations could be made: 1. Onset: sulprostone is effective in the shortest time, followed by oxytocin and methergin. 2.

Duration: the most prolonged effect is noticed with methergin, followed by sulprostone and syntocinon. 3. Motility pattern: the strongest effect can be seen with sulprostone, followed by methergin and syntocinon. 4. Increase of uterine motility was highest with sulprostone, followed by methergin and oxytocin. 5. No side-effects on the maternal heart-rate could be found with any of the tested substances. As a conclusion, sulprostone is recommended in the treatment of severe bleeding post partum when an immediate and long-lasting effect is to be achieved with one single substance.