Neuroimaging studies suggest that intranasal oxytocin (IN-OXT) may modulate emotional and social processes by altering neural activity patterns. The extent of brain penetration after IN-OXT is... Show moreNeuroimaging studies suggest that intranasal oxytocin (IN-OXT) may modulate emotional and social processes by altering neural activity patterns. The extent of brain penetration after IN-OXT is unclear, and it is currently unknown whether IN-OXT can directly bind central oxytocin receptors (OXTRs). We investigated oxytocin pathway gene expression in regions affected by IN-OXT on task-based fMRI. We found that OXTR is more highly expressed in affected than unaffected subcortical regions; this effect did not vary by task type or sex. Cortical results revealed higher OXTR expression in regions affected by IN-OXT in emotional processing tasks and in male-only data. No significant differences were found in expression of the closely related vasopressin receptors. Our findings suggest that the mechanism by which IN-OXT may alter brain functionality involves direct activation of central OXTRs. Show less
Skvortsova, A.; Veldhuijzen, D.S.; Pacheco-Lopez, G.; Bakermans-Kranenburg, M.; IJzendoorn, M. van; Smeets, M.A.M.; ... ; Evers, A.W.M. 2020
Unnecessary interventions to manage prolonged labor may cause considerable maternal and perinatal ill-health. We explored how prolonged labor was managed in three rural Rwandan hospitals using a... Show moreUnnecessary interventions to manage prolonged labor may cause considerable maternal and perinatal ill-health. We explored how prolonged labor was managed in three rural Rwandan hospitals using a partograph. A retrospective chart review was done to assess whether (A) the action line on the partograph was reached or crossed, (B) artificial rupture of membranes (ARM) performed, (C) oxytocin augmentation instituted, and (D) vacuum extraction (VE) considered when in second stage of labor. Adequate management of prolonged labor was considered if three clinical criteria were fulfilled in the first and four in the second stage. Out of 7605 partographs, 299/7605 women (3.9%) were managed adequately and 1252/7605 women (16.5%) inadequately for prolonged labor. While 6054 women (79.6%) remained at the left of the alert line, still 1651/6054 (27.3%) received oxytocin augmentation unjustifiably. Amongst women whom were managed adequately for prolonged labor until their cervical dilatation plot reached or crossed the action line. In 115/299 women (38.5%), however, second stage of labor was reached but CS performed without a trial of VE. In 1252/7605 women (16.5%) management was inadequate, when their cervical dilatation plot reached between the alert and action lines, 495/1252 women (39.5%) did not reach the second stage of labor and remained left of the action line had their membranes ruptured and labor augmented, and gave birth by CS. CS was, however, also performed in 151/1252 women (12.1%) whose membranes were still intact. We recommend training for more appropriate decision-making during labor to prevent unnecessary CS and proper use of ARM, oxytocin augmentation and VE can be provided safely. Show less
