Hemorrhage, Obstetric, Post-Abortion
Conditions
Keywords
Post-abortion hemorrhage, Obstetric hemorrhage, Preterm labor, Abnormal labor, Oxytocin, Oxytocin receptor
Brief summary
This study aims to determine when during gestation oxytocin receptor (OXTR) expression increases in the myometrium, which will contribute new insight to the management of obstetric hemorrhage and our understanding of normal and abnormal labor.
Detailed description
In this descriptive study, we will obtain myometrial tissue samples by core needle biopsy under ultrasound guidance in anesthetized women immediately following surgical abortion and from controls, all of whom are undergoing a separate planned obstetric/gynecologic surgery. Tissue studies will be performed on these biopsy samples to examine oxytocin receptor expression and function.
Interventions
OTHERMyometrial tissue sample collection
Myometrial tissue samples by core needle biopsy under ultrasound guidance
Sponsors
Oregon Health and Science University
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* Women age 18-50 * Gestational age 14-26 weeks; or 6-13 weeks, 37-42 weeks, or non-pregnant (controls) * Undergoing another planned surgical procedure with anesthesia (suction D&C, D&E, gravid hysterectomy, cesarean section, or laparoscopic tubal ligation) * Able to give informed consent in English or Spanish
Exclusion criteria
To optimize biopsy safety, we will exclude patients with anticipated difficult cases, that have additional risks of hemorrhage, or those with features that limit ultrasound visualization. Increased risk of hemorrhage: * Anemia (Hgb \< 9) * Anticoagulation, bleeding disorder, or coagulopathy * Multiple gestation * Infection or sepsis For ultrasound-guided procedures: * Obese, BMI ≥ 40 * History of ≥2 cesarean sections * Large fibroids or uterine anomalies obstructing view * Other poor visualization * Thin myometrium \< 1cm
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Oxytocin receptor expression | 30 minutes | Measure of oxytocin receptor expression. Perform quantitative RT-PCR on mRNA extracted from biopsy samples obtained from subjects at the end of their procedure (within 30 minutes). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Function of myometrial oxytocin receptor | 30 minutes | Assessment of the function of the myometrial oxytocin receptor. Measure intracellular calcium in cultured myometrial cells after activating the receptor with oxytocin from biopsy samples obtained from subjects at the end of their procedure (within 30 minutes). |
Countries
United States
Outcome results
None listed