Author｜Zeng Xiaojing
Source｜Medical World Obstetrics and Gynecology Channel
Oxytocin, also known as oxytocin, as its name suggests, has the function of contracting the uterus and accelerating the labor process. But if you think it only has this one function, you're underestimating it. Oxytocin not only has a place in obstetrics, but it also plays a role in the brain, influencing our emotions, moods, and social behavior.
Oxytocin and the Nobel Prize
In 1906, Sir Henry Hallett Dale, a British pharmacologist, discovered that a pituitary extract could promote uterine contractions[1], which is the oxytocin we know today.
The word “oxytocin” comes from the Greek words “?ξ?? (oxys)” and “τ?κο? (tocos)”, meaning “rapid production”. In 1953, American scientist Vincent du Vigneaud discovered that oxytocin is a polypeptide composed of 9 amino acids and successfully synthesized this hormone in vitro[2], for which he was awarded the Nobel Prize in Chemistry in 1955.
Oxytocin is not only present in women.
Both men and women secrete oxytocin. Oxytocin is produced by neurons in the supraoptic nucleus and paraventricular nucleus of the hypothalamus. Some oxytocin is released from the posterior pituitary gland and reaches various peripheral tissues; the other part acts on the central nervous system, affecting a variety of physiological, psychological and behavioral activities[3].
Oxytocin, the Obstetrician's Partner
Oxytocin can selectively stimulate uterine smooth muscle to induce uterine contractions. It is mainly used for inducing labor, stimulating labor, preventing and treating postpartum hemorrhage.
Induction of labor
Oxytocin makes the mother's uncoordinated uterine contractions regular, increases the intensity of the contractions, and shortens the intervals between them, thereby shortening the labor process.
Induction of labor refers to stimulating uterine contractions to initiate labor and deliver the fetus before natural labor begins. It is suitable for post-term pregnancies, preeclampsia, premature rupture of membranes, and severe pregnancy complications requiring early termination of pregnancy. Oxytocin is a commonly used drug in the process of induction of labor. When induction of labor is indicated, used correctly, and under close monitoring by a physician and midwife, the use of oxytocin is safe.
An article published in New England Journal of Medicine stated that for low-risk primiparous women at 39 weeks of gestation, induction of labor did not increase the incidence of adverse perinatal outcomes and significantly reduced the cesarean section rate.
Prevention and treatment of postpartum hemorrhage
The 2017 American College of Obstetricians and Gynecologists (ACOG) guidelines for the management of postpartum hemorrhage state [4]:
Oxytocin should be routinely administered immediately after childbirth.
The first-line treatment for postpartum hemorrhage caused by uterine atony is the use of oxytocin.
In addition, the guide also offered the following suggestions:
Currently, no drug is found to be more effective than oxytocin for treating postpartum hemorrhage caused by uterine atony. Combining oxytocin with methylergonovine or oxytocin with misoprostol does not increase the drug's effectiveness.
There is insufficient research to support the use of oxytocin after delayed cord ligation, after delivery of the fetal anterior shoulder, or after placental delivery, and there are no studies linking the timing of oxytocin use to postpartum hemorrhage risk factors. Organizations such as the World Health Organization and the American College of Obstetricians and Gynecologists recommend that the use of oxytocin is best done after the complete delivery of the fetus.
lactation
Milk secretion involves two stages: lactation and milk ejection, which are regulated by prolactin and oxytocin, respectively. Oxytocin can be used to assist in the expression of milk secreted by the mammary glands after childbirth.
other
The oxytocin challenge test (OCT) is an important obstetric test for assessing placental reserve. In addition, oxytocin can be used during cesarean sections and curettage to reduce bleeding; it can also be used for medical abortion to promote the expulsion of the fetus or retained products of conception. Oxytocin can also be used to treat postpartum lochia. Oxytocin also has some application value in labor analgesia.
Oxytocin is not just for inducing labor...
When the baby's first cry rings out, when this vibrant life appears in your arms for the first time, the hardships of ten months of pregnancy instantly disappear.
When your child calls you "Dad" in their sweet, baby voice for the first time, even the tallest and strongest person will feel their heart soften instantly.
When you and your loved one snuggle together, enjoying the peaceful years, you wish time could stand still;
When you get home from get off work and open the door, your pet dog happily runs towards you. Looking into its bright eyes, the hardships of the workday seem to halve...
During these ordinary yet happy moments in the course of life, oxytocin may be quietly working within your body. It can increase prosocial behavior, foster parent-child and romantic relationships, make people more altruistic, generous, empathetic, and more willing to trust others, and alleviate emotions that make us avoid social interaction, such as fear, anxiety, and aversion [3, 5, 6]. Some scientists have found that oxytocin can help reduce the severity of some symptoms in patients with autism and schizophrenia [3]. The effects of oxytocin can also transcend species boundaries, making the relationship between owners and their pet dogs closer [7].
It is worth noting that some studies suggest oxytocin also has a "dark side," potentially causing prejudice, anxiety, and aggressive behavior. Its role in biological behavior is more complex than commonly believed, perhaps related to an individual's upbringing and existing social relationships [3, 8, 9]. Given the interaction between genes and environment, oxytocin may be more aptly described as a "love-hate hormone."
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