生理性分娩时母体血浆中催产素的水平——对子宫收缩和催产素中枢作用的影响的系统回顾。
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uvnasas - moberg K, Ekstrom-Bergstrom A, Berg M, Buckley S, Pajalic Z, Hadjigeorgiou E, Kotlowska A, Lengler L, Kielbratowska B, Leon-Larios F, Magistretti CM, Downe S, Lindstrom B, Dencker A
生理性分娩时母体血浆中催产素的水平——对子宫收缩和催产素中枢作用的影响的系统回顾。
BMC妊娠分娩2019年8月9日;19(1):285。doi: 10.1186 / s12884 - 019 - 2365 - 9。
- PubMed ID
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31399062 (PubMed视图］
- 摘要
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背景:催产素是分娩中的一种关键激素，合成催产素被广泛用于诱导或加速分娩。由于缺乏合成知识，我们对生理性分娩期间的母体血浆催产素水平进行了系统的回顾，并对注射合成催产素的反应进行了系统的回顾，如果在纳入的研究中报道。方法:设计一个先验方案，并于2015年10月在PubMed、CINAHL和PsycINFO进行系统检索。去除重复后，对标题和摘要进行搜索命中筛选(n = 4039)，对69篇文章进行全文审查，20篇论文符合纳入标准。由于这些文章在设计和用于分析催产素水平的方法上有所不同，因此创建了一个叙事综合，并根据效果对材料进行分类。结果:怀孕期间催产素的基础水平增加了3-4倍。从怀孕后期到分娩，催产素脉冲的频率、持续时间和振幅都在增加，在分娩结束时达到最大3次/10分钟。婴儿出生时催产素最多增加了3到4倍。催产素脉冲也出现在与胎盘排出相关的第三分娩阶段。分娩时催产素的峰值与个体子宫收缩的时间无关，这表明在控制宫缩方面有额外的机制。 Oxytocin levels were also raised in the cerebrospinal fluid during labour, indicating that oxytocin is released into the brain, as well as into the circulation. Oxytocin released into the brain induces beneficial adaptive effects during birth and postpartum. Oxytocin levels following infusion of synthetic oxytocin up to 10 mU/min were similar to oxytocin levels in physiological labour. Oxytocin levels doubled in response to doubling of the rate of infusion of synthetic oxytocin. CONCLUSIONS: Plasma oxytocin levels increase gradually during pregnancy, and during the first and second stages of labour, with increasing size and frequency of pulses of oxytocin. A large pulse of oxytocin occurs with birth. Oxytocin in the circulation stimulates uterine contractions and oxytocin released within the brain influences maternal physiology and behaviour during birth. Oxytocin given as an infusion does not cross into the mother's brain because of the blood brain barrier and does not influence brain function in the same way as oxytocin during normal labour does.
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