In Vitro Optimization of Oxytocin-induced Myometrial Contractility by Propranolol
Status:
Recruiting
Trial end date:
2021-12-01
Target enrollment:
Participant gender:
Summary
The rates of cesarean deliveries (CD) and postpartum hemorrhage (PPH) are on the rise, with
failed induction and augmentation of labor as major contributing factors. Oxytocin is
commonly used for labor induction, as well as during the third stage of labor to minimize the
risk of primary PPH. At delivery, it is imperative that the uterus responds effectively to
parenteral oxytocin. Poor response to oxytocin following delivery is commonly due to
prolonged labor with oxytocin augmentation that is known to "desensitize" the myometrium.
Despite the option of several second line uterotonic agents, none of them are as effective as
oxytocin in controlling PPH. Given that poor uterine muscle contraction is the root cause of
both failed induction or augmentation (leading to a CD in labor) and uterine atony (leading
to PPH), there is an urgent and clinically important need to investigate novel methods to
enhance oxytocin-induced myometrial contractions.
Propranolol, a beta adrenergic receptor agonist, has the potential to improve myometrial
contractions by virtue of its ability to inhibit catecholamine production. The investigators
plan to investigate the effects of propranolol in both naive and desensitized myometrium, in
order to better understand its potential role in improving labor induction and reducing the
risk of PPH following oxytocin exposure during labor.
The investigators hypothesize that propranolol is likely to potentiate the action of oxytocin
upon human myometrium, to ultimately help improve the success of labor induction/augmentation
and treatment of PPH.
Phase:
N/A
Details
Lead Sponsor:
Samuel Lunenfeld Research Institute, Mount Sinai Hospital