The role of oxytocin and vasopressin in the pathophysiology of heart failure in pregnancy and in fetal and neonatal life

摘要

Application of posterior pituitary extracts, followed by administration of oxytocin (OT), has been introduced into obstetric practice for the acceleration of protracted delivery. Initially, the advantageous role of OT in pregnancy was attributed mainly to the regulation of uterine contractions and lactiferous activity (12, 163). Later studies on the functional anatomy, cytochemistry, and metabolism of the uterine-placental-fetal entity provided evidence for the presence of local independently regulated oxytocin (OTS) and vasopressin (VPS) systems in individual components of this entity (2, 18, 20, 21, 49, 85, 132). Moreover, it has become evident that during pregnancy these local systems cooperate with systemically and centrally released vasopressin (AVP) and OT in the development and function of the uterus, placenta, and fetus and in the regulation of the cardiovascular systems of the pregnant female and the fetus (2, 18, 21, 163). There is also evidence that AVP and OT play an essential role in the psychosomatic adaptation of the pregnant female to the state of pregnancy and motherhood as well as in the adjustment of the newborn child to the new environment (42, 162, 163). These challenges may be greater when the mother or neonate suffers from heart failure and when the psychogenic stress is intensified.